Achilles Tendonitis

Achilles Tendinitis / Tendinosis

The Achilles tendon is the largest tendon in the human body. It is located at the back of the ankle joint and can be felt as a large, cord-like structure attaching to the back of the foot. Since tendons serve to attach muscles to bone, the Achilles tendon also attaches the large calf muscles, the gastrocnemius and soleus, to the back of the heel bone, the calcaneus.

Because of the large amount of stress which the Achilles tendon is subjected to during running and jumping activities, the Achilles tendon is prone to injury.

Achilles tendonitis tends to occur more frequently in older athletes than in younger athletes. As a person ages into their thirties and especially into their forties and fifties, the ligaments and tendons of the body tend to lose some of their stretchiness and are not as strong as before. This predisposes older individuals who are active in running and jumping activities, to tendon injuries such as Achilles tendinitis. However, Achilles tendonitis can also occur in teenagers who are very active in running and jumping sports.

Achilles Tendonitis Diagnosis

Achilles tendonitis is diagnosed by a history and physical examination of the patient who describes pain at the back of the ankle with walking and/or running activities

During the physical examination, the podiatrist will feel and push lightly around the Achilles tendon to see if it is tender or has any irregularities in its surface.

Achilles tendonitis may cause the tendon to be thickened in areas, may cause swelling of the area around the tendon, and can even feel like the tendon has a painful bump on it.

X-rays are not always helpful in diagnosing Achilles tendonitis so an MRI or Ultrasound may be ordered to better evaluate the tendon.

Non-Surgical Treatment For Achilles Tendonitis

Most cases of Achilles Tendonitis can be treated conservatively, although it may take several months for symptoms to completely subside. This involves a number of modalities including:

  • Resting: The first step in reducing pain is to decrease the activities that aggravate one’s symptoms. Switching to low-impact activities until the acute inflammatory phase has passed will put less stress on the Achilles tendon.
  • Cross-training activities such as biking, elliptical exercise, and swimming are low-impact options to help you maintain being active.
    This can be done up to twenty minutes interval through the day as necessary.
  • Stretching exercises
  • Strengthening exercises with eccentric contractions of the Achilles.
  • Supportive shoes and Heel lifts
  • Custom-made orthotic devices
  • Non-steroidal anti-inflammatory medications (NSAIDs): Drugs such as ibuprofen and naproxen reduce pain and swelling.

Minimally-Invasive Achilles Tendonitis Treatments

Two of the latest and most effective surgical management techniques to treat Achilles Tendonitis are Tenex and Platelet Rich Plasma (PRP).

PRP therapy and Tenex are potential treatments for patients who are unable to successfully treat  pain and other symptoms using non-surgical treatment methods.

Platelet Rich Plasma (PRP Therapy) is derived from a patient’s own blood, which has been processed to concentrate the platelets. These concentrated platelets contain powerful growth factors that can jumpstart the healing of injured tendons and ligaments by stimulating tissue repair and regeneration. This procedure is done in conjunction with Tenex to maximize healing and repair of the Achilles Tendon.

Tenex is a minimally invasive procedure that uses high intensity ultrasound waves to identify and remove damaged collagen fibers and scar tissue that generate pain and inflammation in tendons.

A Tenex procedure is done on an outpatient basis using a local anesthetic. The procedure takes approximately 20 minutes to complete and the recovery time is much faster than a traditional surgical procedure.

If the Achilles tendon is severely injured, a traditional surgical procedure may be required to repair the damaged tendon.

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