Tendinitis is a common overuse injury which results in inflammation of the achilles tendon, most frequently causing mild to severe heel pain. The achilles tendon is the largest tendon in the body,
connecting your calf muscle to your heel bone. It?s used with every step - when you walk, run, and jump. Although the Achilles tendon can withstand great stresses, it?s also prone to tendinitis. The
condition is very common in athletes, especially runners who?ve suddenly increased the intensity or duration of their workouts. It?s also common in middle-aged, ?weekend athletes? who play sports
like tennis or basketball only occasionally. The pain from achilles tendinitis may be felt anywhere from the back of the leg to the top of the heel. Most cases are mild and can be treated at home
under a podiatrist?s supervision. Severe cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.
There are hundreds of tendons scattered throughout our body, but it tends to be a small handful of specific tendons that cause problems. These tendons usually have an area of poor blood supply that
leads to tissue damage and poor healing response. This area of a tendon that is prone to injury is called a "watershed zone," an area when the blood supply to the tendon is weakest. In these
watershed zones, they body has a hard time delivering oxygen and nutrients necessary for tendon healing, that's why we see common tendon problems in the same parts of the body. Tendonitis is most
often an overuse injury. Often people begin a new activity or exercise that causes the tendon to become irritated. Tendon problems are most common in the 40-60 year old age range. Tendons are not as
elastic and forgiving as in younger individuals, yet bodies are still exerting with the same force. Occasionally, there is an anatomical cause for tendonitis. If the tendon does not have a smooth
path to glide along, it will be more likely to become irritated and inflamed. In these unusual situations, surgical treatment may be necessary to realign the tendon.
Dull or sharp pain anywhere along the back of the tendon, but usually close to the heel. limited ankle flexibility redness or heat over the painful area a nodule (a lumpy build-up of scar tissue)
that can be felt on the tendon a cracking sound (scar tissue rubbing against tendon) with ankle movement.
During the physical exam, your doctor will gently press on the affected area to determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment, range
of motion and reflexes of your foot and ankle. Your doctor may order one or more of the following tests to assess your condition, X-rays. While X-rays can't visualize soft tissues such as tendons,
they may help rule out other conditions that can cause similar symptoms. Ultrasound. This device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images
of the Achilles tendon in motion. Magnetic resonance imaging (MRI). Using radio waves and a very strong magnet, MRI machines can produce very detailed images of the Achilles tendon.
The aim of the treatment is to reduce strain on the tendon and reduce inflammation. Strain may be reduced by, avoiding or severely limiting activities that may aggravate the condition, such as
running, using shoe inserts (orthoses) to take pressure off the tendon as it heals. In cases of flat or hyperpronated feet, your doctor or podiatrist may recommend long-term use of orthoses.
I8nflammation may be reduced by, applying icepacks for 20 minutes per hour during the acute stage, taking non-steroidal anti-inflammatory drugs, placing the foot in a cast or restrictive ankle-boot
to minimise movement and give the tendon time to heal. This may be recommended in severe cases and used for about eight weeks. Occasionally depot (slowly absorbed) steroid injections may be tried,
particularly for peri-tendinitis, but great care needs to be taken to avoid injecting into the tendon. This should only be done by a specialist doctor. You may also be given specific exercises to
gently stretch the calf muscles once the acute stage of inflammation has settled down. Your doctor or physiotherapist will recommend these exercises when you are on the road to recovery. Recovery is
often slow and will depend on the severity of the condition and how carefully you follow the treatment and care instructions you are given.
Mini-Open Achilles Tendon Repair. During a mini-open Achilles tendon repair surgery, 2 to 8 small stab incisions are made to pull the edges of the tendon tear together and suture the torn edges to
repair the damage. During this procedure the surgeon will make one 3 to 4 cm long incision on the back of your ankle and 2 to 4 smaller vertical incisions around the long incision. These smaller
veritical incisions are made with a pair of surgical scissors and are commonly referred to as "stab incisions". Once the incisions are opened up, the surgeon will place precise sutures with
non-absorbable stitches to strengthen the damaged Achilles tendon tissue. This suturing technique reduces the amount of scar tissue on the tendon after surgery and provides better surface healing of
the skin. Unlike the traditional method of an open surgery, this procedure has less risks and complications involved. To learn about all risks you may face be sure to speak to your doctor.
Maintaining strength and flexibility in the muscles of the calf will help reduce the risk of tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.