If you are the type of person who loves to run, hike or even take long walks, you must have heard of the Achilles tendon.. This powerful tendon plays a key role in our daily movements, but sometimes it becomes inflamed and can cause a lot of trouble.. Achilles tendonitis is a common condition that occurs when the large tendon at the back of the leg becomes irritated and inflamed. is.. Connects the calf muscles to the heel bone and the tendons are used when walking, running, climbing stairs, jumping and running a lot.. Jumping... slow, but prone to tendinitis, a disease related to overuse.... Description of Achilles Tendonitis
Simply put, tendonitis (sometimes spelled "tendonitis") is the acute inflammation of a tendon.. Inflammation is the body's natural response to injury and often causes swelling, pain, or irritation.. You may also come across the term "tendonopathy" used to describe a condition in which a tendon develops as a chronic injury over time.. Tendonosis and tendinopathy are all common terms that refer to basically Same problem....Achilles tendonitis is different from Achilles tendon rupture, a condition in which the tendon separates from the heel bone or completely tears in half....Achilles tendon rupture usually occurs as a result of a sudden injury....This article focuses on Achilles tendonitis, not Achilles tendon rupture....inflammation....the two types can occur separately or at the same time....### Achilles tendonitis without insert
In non-insertion Achilles tendonitis, the fibers of the middle part of the tendon (above where it attaches to the heel) are affected....over time, the fibers may begin to break and create small tears....this can lead to swelling and thickening of the tendon....Non-insertion tendonitis affects mostly young and active people....###
Median Achilles tendonitis involves the lower part of the tendon where it attaches to the heel bone (also known as the heel bone). Tendonitis can occur at any time or level of activity, although it is still more common in runners.. It is often caused by tightening of the calf muscles, which puts more pressure on the adhesion of the Achilles tendon. Causes of Achilles tendonitis
Achilles tendinitis is usually not related to a specific injury. The problem is caused by repeated stress on the tendon. This often happens when we push our bodies to do too much too quickly. Other factors can also make a person susceptible to Achilles tendonitis, including:
- Sudden increase in the amount or intensity of exercise... for example, increasing the daily running distance to several miles without giving the body a chance to adapt to the new distance, may cause irritation and inflammation... - Stiff calf muscles... rub and cause inflammation and pain.... Symptoms of Achilles Tendonitis
Common symptoms of Achilles tendonitis include:
- Pain and stiffness along the Achilles tendon in the morning
Pain along the tendon or behind the heel that worsens with activity
- Severe pain the day after exercise
- Tendon thickening
- formation of bone spurs (inflammation of insertion)
Swelling that is always present and worsens during the day or with activity
- Pain behind the heel when wearing shoes
If you've experienced a sudden pop in the back of your leg or heel, your Achilles tendon may have ruptured. If you think your tendon has ruptured, see your doctor right away. After explaining your symptoms and discussing your concerns, your doctor will examine your foot and ankle. The doctor will look for these symptoms:
- Swelling along the Achilles tendon or the back of the heel
- bone spur or pain near the lower part of the tendon at the back of the heel (insertion inflammation)
- Pain in the middle of the tendon (inflammation without insertion)
- Heel pain when stretching the leg
- Limited range of motion in the ankle - specifically, reduced ability to point the toes down
Experiments
Your doctor may order imaging tests to help determine if your symptoms are caused by Achilles tendonitis. These tests can also help your doctor assess the severity of your Achilles tendonitis. X-rays provide clear images of the bones. They can show bone spurs in the back of the heel, which may be present in patients with Achilles tendonitis.
Although magnetic resonance imaging (MRI) is not necessary for the diagnosis of Achilles tendinitis, if non-surgical treatment can show damage to the Achilles tendon, it is important to plan surgery. than MRI is operator dependent and may provide less consistent results.. ### Non-surgical treatments
In most cases of Achilles tendonitis, non-surgical treatment options can provide adequate pain relief, although it may take several months for symptoms to completely resolve.. Even with early treatment, pain may persist for more than 3 months.. The first step to pain relief is to reduce or even stop activities that make the pain worse. It puts pressure on the tendon Achilles...your doctor may recommend using a wrist brace or immobilization boot to help with this step..applying ice to the painful area of the Achilles tendon is helpful and can be done as often as needed throughout the day....this can be done for up to 20 minutes at a time, but remove the ice sooner if the skin is simply cupped and then numbed....reusable ice pack....after the water in the glass freezes, the rim remove....then apply ice to the Achilles tendon....use repeatedly, a groove will be created to fit the Achilles tendon and a custom ice pack will be created.... #### Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Anti-inflammatory medications such as ibuprofen and naproxen reduce pain and swelling. These medications can reduce pain enough to allow you to do physical therapy exercises. Place forward and bend the knee.... Press your hips into the wall in a controlled manner to stretch your calf muscles and hamstrings....Hold this position for 10 seconds and then rest....Repeat this exercise 20 times for each leg....You should feel a strong stretch in your calf during the stretch.... **Eccentric Strengthening:** Eccentric strengthening means contraction (muscle contraction) (muscle contraction can strengthen muscles, may strengthen muscles Achilles tendon if it is not done correctly... At first these exercises should be done under the supervision of a physiotherapist.
- **Bilateral heel drop:** Stand on the edge of a stair or fixed platform so that only the front half of your foot is on the step....this position allows your heel to go up and down without hitting the step....be careful to maintain your balance to avoid falling and injury....be sure to hold on to a handrail for balance....lift your heels off the floor, then slowly lower this step to the lowest point....this exercise should be done slowly and in one controlled manner....fast movements can risk tendon damage....as pain improves, you can increase the difficulty level of the exercise by holding small weights in each hand....- **Unilateral Heel Lowers:** This exercise is similar to Bilateral Heel Lowers, except that all your weight is on one leg....This exercise should only be done after you have mastered the Bilateral Heel Lowers....cortisone, some kind of The steroid is a powerful anti-inflammatory drug....While cortisone injections can be used in other injuries and conditions, cortisone injections into the Achilles tendon are not recommended because they can cause tendon tears...In fact, research has shown that tendon strength is significantly reduced after steroid injections....Other injectables, such as platelet-rich plasma (PRP), have been studied for Achilles tendonitis. and several studies have shown pain improvement with PRP injection.
But more information is needed to determine the true effectiveness of PRP for this disease.. A night splint can relieve morning pain when getting out of bed.... By keeping your foot in a toe position (similar to leg extension) during sleep, these movable braces help maintain leg flexibility and reduce pressure on the Achilles tendon on the heel... #### Support shoes and orthotics
Achilles tendinitis is often treated with special shoes and orthotic devices.. For example, shoes that are softer or open at the back of the heel can reduce tendon irritation.. Heel lifts are another option and can reduce pressure on the tendon.
This treatment uses low or high shock waves applied to the Achilles tendon to heal the damaged tendon tissue....- **high energy ESWT** can be done in one session but requires local or general anesthesia..combined with other non-surgical treatments such as eccentric exercises....however, more information is needed to make strong recommendations on its low-risk use..low or no side effects, so it may be another option which you should consider before surgery.... ### Surgical treatment
Surgery for Achilles tendonitis should only be considered if the pain does not improve after 6 months of non-surgical treatment.... The specific type of surgery depends on the location of the tendonitis and the extent of damage to the tendon... #### Debridement
Debridement means removing or "cleaning out" the damaged tissue....For Achilles tendonitis, removal of bone spurs from the heel along with the damaged tendon tissue is usually done with good results....After the unhealthy part of the tendon is removed, the remaining tendon can be reattached to the heel tendon. A boot or removable cast can be used to walk, although the timing depends on the extent of the tendon damage.... In cases where more than 50% of the Achilles tendon has to be removed, the remaining tendon is not strong enough to work on its own....another tendon must be transferred to restore strength from the ground (long foot pressure...)..the tendon, which bends the rotation and helps the big toe down, is usually used....this tendon is removed from under the big toe and attached to the heel....after this surgery, the big toe can still move and Most patients do not feel any change in their walking or running.... #### Gastrocnemius removal
This surgery is to lift the leg muscles (gastrocnemius).. Since tight leg muscles put more pressure on the Achilles tendon, this procedure is useful for patients who still have trouble bending their legs despite constant stretching.. Damage... #### Minimally invasive surgery
Minimally invasive surgery has become increasingly popular for the treatment of many musculoskeletal conditions....For Achilles tendonitis, this may involve using a small incision to insert a camera and small instrument through the skin to remove the damaged and inflamed tissue of the Achilles tendon...Other minimally invasive surgery involves using small holes to release parts of the tendon and muscle from the bone..These techniques may become more popular over time, but there is still information There is a limitation regarding their effectiveness.. they have extensive extension to the tendon, they are less effective.... ### RESULTS
The results of Achilles tendinitis surgery are generally very good.... Tendon debridement studies have shown that up to 75% of patients return to their pre-operative activity level and the patient satisfaction rate is up to 90%.... Gastrocnemius removal has also shown good results, with a high rate of pain reduction and functional improvement after surgery.... The main factor in tendon recovery is the extent of surgical damage... The recovery period will be longer and the patient is less likely to return to sports activities. is....Physiotherapy is an important part of recovery....Many patients need 12 months of rehabilitation to achieve maximum recovery....Persistent postoperative pain may be seen in 20-30% of patients and is the most common complication.... In addition, wound infections may occur and may be difficult to treat in this area of the body.
Step with confidence. Achilles tendonitis can disrupt your daily life, but with early diagnosis and proper treatment, you can return to your favorite activities. If you have symptoms such as morning pain or swelling in the heel area, don't wait! Dr. Homan Kokbi, an orthopedic surgeon and specialist in Tehran, with years of experience in treating orthopedic problems, is ready to help you. For consultation or to schedule an appointment, call us or visit the website. The health of your feet is the key to free movement - be careful! If you have any questions or experience about Achilles tendonitis, write in the comments section... We are always ready to answer!..
