Your Achilles tendon is incredibly tough, but it's also susceptible to injuries, including tears, ruptures, inflammation, and degenerative changes. At the Naples Community Hospital in Naples, Florida, fellowship-trained orthopedic foot and ankle surgeon Richard J. de Asla, MD, and the team regularly manage Achilles tendon injuries. If your Achilles tendon is negatively impacting your mobility or quality of life, make an appointment by calling the office today.
What is the Achilles tendon?
The Achilles tendon is the largest and strongest tendon in your body. It connects the calf muscle to the back of your heel bone. The Achilles tendon can withstand stresses multiple times your body weight.
As tough and durable as the Achilles tendon is, it is not invincible. There are a number of conditions that can afflict the Achilles tendon, such as tendinitis, tendinosis, partial tears, or even rupture.
What is Achilles tendinitis?
Achilles tendinitis results from inflammation of a tissue sheath that surrounds the tendon called the paratenon. The cause of this inflammation is not always well understood but is more common in people who suddenly increase their level of activity, such as running or jumping workouts. It is also associated with repetitive activities.
Symptoms are more typical in younger people. Symptoms tend to worsen gradually and are exacerbated with activities and exercises that involve the Achilles tendon. The tendon may appear swollen and can be slightly warm 1 to 4 inches above your heel. Squeezing the tendon typically causes pain.
Sometimes the diagnosis of Achilles tendinitis can be difficult to distinguish from Achilles tendinosis.
What is Achilles tendinosis?
Achilles tendinosis is a degenerative change of the Achilles tendon, causing it to thicken and sometimes become painful. Most of the time, people with Achilles tendinosis do not recall starting any new activities or performing repetitive tasks.
Pain and a sense of stiffness often occur when initiating activities such as getting out of bed in the morning or standing after a prolonged period of sitting. Unlike tendinitis symptoms, symptoms of tendinosis often improve with activity.
Achilles tendinosis may occur in the middle of the tendon (known as non-insertional or mid substance Achilles tendinosis) or where the Achilles tendon attaches to the heel bone (known as insertional Achilles tendinosis).
Most cases of Achilles tendinosis can be treated with non-surgical measures such as physical therapy.
What is an Achilles tendon rupture?
An Achilles tendon rupture is a complete tear of the Achilles tendon. When it happens, the calf muscle is no longer able to push the foot down. Achilles tendon ruptures tend to occur spontaneously and without preceding Achilles tendon pain.
Racquet sports and basketball are the most common sports associated with Achilles tendon ruptures. Ruptures can occur from traumatic events as well.
Patients who experience an Achilles tendon rupture feel as if they were "kicked" in the back of the heel or feel like they were "struck by a rock" in the back of the heel. After the acute event, people who suffer an Achilles tendon rupture may not feel significant pain in the back of the heel afterward. This causes some to underestimate their injury delaying treatment.
Achilles tendon ruptures can be treated surgically or non-surgically. Surgical treatment can often be done using newer, minimally invasive techniques.
Mild Achilles tendon pain usually subsides with rest and conservative measures of care like ice and activity modification.
If your pain persists for more than a few days or it gets progressively worse, make an appointment with Richard J. de Asla, MD. You should also seek treatment if your pain is debilitating or interfering with your mobility; these symptoms may point to a more serious condition such as torn or ruptured Achilles tendon.
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