The Achilles tendon is the largest tendon in the human body. It goes all the way down from your upper calf muscles to the back of your heel bone. The Achilles tendon helps you to perform several important functions like walking and helping to raise the heel of the ground. Achilles Tendinosis is a diagnosis where the Achilles tendon becomes degenerate. The term Achilles tendonitis is sometimes used as an alternative. With Achilles tendinosis, the tendon can swell and thus become very painful and stiff.
This condition is commoner in individuals who participate in sports and athletics like Footballers, Cricketers, Baseball players, Runners, and so forth. Those who have calf tightness can also be predisposed to this condition. Achilles tendinosis can either occur in the middle of the tendon (known as Non-insertional / Midsubstance Achilles tendinosis), or it can occur at the point where the tendon is connected to your heel bone (known as Insertional Achilles tendinosis).
The patient may observe many changes if he or she is suffering from an inflamed Achilles tendon. Most people have pain and tightness in the tendon behind their ankles. In most cases, this does not develop due to sudden trauma or injury. Instead, it is of gradual onset with the pain increasing progressively over time. People suffering from this condition face difficulty in running and climbing stairs. Some may feel pain after sitting for a very long time or even when rising after sleeping. Again, some may observe a bump either on the tendon or on the right side of the heel bone. This bump is a source of irritation for many people, especially when they wear shoes. People who wear low heel shoes often observe less pain as compared to those who wear flat shoes.
A common cause of Achilles Tendinosis is Achilles and calf muscle tightness. With regards to Insertional Achilles tendinosis, this could be linked to a heel bone spur. The spur often rubs against the tendons and causes small tears. This condition is very similar to a rope when it is rubbed against a sharp rock. This condition is also sometimes referred to as a Haglund’s deformity. Swelling and pain may also occur as a consequence of daily wear and tear of the tendon.
As this condition occurs due to the daily overuse of your tendon, athletes and sportsmen are more prone to it. If they suddenly increase a repetitive activity that involves the use of the Achilles tendon, they may end up developing Achilles Tendinosis. It is because these activities cause too much explosive stress on the Achilles, and as a result, the tissues of the tendon gets damaged. The structure of the tendon is changed, and as a result, the patient experiences pain and swelling.
To diagnose Achilles Tendinosis, it is best to visit an ankle and foot expert orthopedic surgeon. The specialist will take a detailed history and confirm the diagnosis. Pain in the tendon is a very common symptom of this condition. Some people might also have swelling and thickening in their tendons. Different imaging techniques, like X-rays, could be used to check if there are any bone spurs. You may also need to have an ultrasound or MRI scan to check if there are any tears and how extensively your tendon is affected.
Based on the severity of the condition, there are several different treatment options available. The choice of treatment generally depends upon how severe the symptoms are and how much damage has been inflicted onto the tendon. In the early stages, when there is periodic swelling and pain, one can use one of the following methods to treat Achilles Tendinosis :
Immobilization means limiting the movement of your tendon and therefore your ankle. For this purpose, one could use a cast or a removable walking boot. These things will help you to lower the stress on your tendon when you walk or perform any activities. As a result, the forces in your Achilles tendon are reduced, and its healing potential is increased.
Ice can be used to reduce swelling and pain. You can apply a bag of ice covered with a towel on the affected area for 20 minutes several times a day. One thing that you must remember is to avoid applying ice directly onto your skin. It could damage the skin.
To get rid of pain and swelling, one can also take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. These medicines could be very helpful in the early stages of getting rid of pain and inflammation but of course, is not a permanent solution.
You can get help from a physical therapist. He or she will educate you with specific exercises that you can perform daily at your home and they will help your Achilles tendon to heal quickly. They are usually muscle strengthening exercises that increase the mobility of your muscles making them strong at the same time. ( eccentric loading program ) and the use of extracorporeal shockwave therapy.
Some experts suggested keeping your Achilles tendon stretched to make it heal quickly. It is not possible to do this at night when asleep as all muscles of the body are typically relaxed. So what one can do is to use a night splint to keep the Achilles tendon stretched at night, even when you are sleeping.
If all of the above non-surgical methods mentioned above fail to make things better, then you may need to undergo surgery to bring your tendon back to as close as possible to its normal condition. You will need to visit a foot & ankle surgeon. He or she will assess the severity of your injury, and at the end, make a recommendation on the best procedure to help decompress the tight tendon and repair it. With modern techniques, most of these surgeries can be performed through minimally invasive ( key-hole ) approaches. One will need to do regular rehabilitation post-surgery to gain the best recovery after surgery.