The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. But it also the most frequently ruptured tendon.
Both professional and weekend athletes can suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon. Obesity is also often part of the problem.
Events that can cause Achilles tendonitis may include:
- Hill running or stair climbing.
- Overuse resulting from the natural lack of flexibility in the calf muscles.
- Rapidly increasing mileage or speed.
- Starting up too quickly after a layoff.
- Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort such as in a final sprint.
Achilles tendonitis often begins with mild pain after exercise or running that gradually worsens It can also occur with jobs that require a lot of standing or walking. Other symptoms include:
- Recurring localized pain, sometimes severe, along the tendon during or a few hours after running.
- Morning tenderness or tightness about an inch and a half above the point where the Achilles tendon is attached to the heel bone.
- Sluggishness in your leg.
- Mild or severe swelling.
- Stiffness that generally diminishes as the tendon warms up with use.
Treatment normally includes:
- Physical Therapy and Cold Laser therapy
- Non-steroidal anti-inflammatory medication along with icing.
- Orthoses, which are devices to help support the muscle and relieve stress on the tendon such as a heel pad or shoe insert.
- Rest and switching to another exercise, such as swimming, that does not stress the tendon.
- Stretching, massage, ultrasound and appropriate exercises to strengthen the weak muscle group in front of the leg and the upward foot flexors.
- Special Night Splint to be worn at night to hold the foot in a flexed position
Surgical Intervention: Is sometimes needed in cases that have been treated conservatively for 6 momths with no relief of pain. Some of the procedures are more invasive than others. The newer Topaz treatment is a relatively non-invasive procedure that can be done. Sometimes if there is a large spur present as well then open resection of the spur and lengthening and repair of the tendon is needed. This is a very successful procedure but has a long recovery starting with 3-4 weeks on crutches followed by rehab in a walking boot.
