Providing quality foot and ankle care with two office locations to serve you
Achilles Tendinitis
What is Achilles Tendinitis
Achilles tendinitis is an inflammation of the Achilles tendon. If the condition persists over time, the Achilles tendon can degenerate, causing thickening of the tendon or Achilles tendinosis. This inflammation and degeneration over time can occur at the tendon’s insertion to the heel bone or in the mid substance region, which is the area that is 2-6cm from the attachment to the heel bone.
Causes
Achilles tendinitis is usually a result of overuse or from a sudden increase in activity. Such activity puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibers. Due to this ongoing stress on the tendon, the body is unable to repair the injured tissue. The structure of the tendon is then altered, resulting in continued pain and Achilles tendinosis.
People with excessive pronation (seen in those with flattened arches) have a tendency to develop Achilles tendonitis and tendinosis due to the greater demands placed on the tendon when walking.
Symptoms
- Pain—aching, stiffness, soreness or tenderness—within the tendon
- Limited ankle range of motion
- When the disorder progresses to degeneration, the tendon may become enlarged and may develop nodules in the area where the tissue is damaged
Diagnosis
In diagnosing Achilles tendonitis or tendinosis, the surgeon will examine the patient’s foot and ankle and evaluate the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays or other imaging modalities.
Treatment
Non-surgical
- Immobilization
- Ice
- Oral medications- NSAIDs
- Orthotics
- Night splints
- Physical therapy
Surgical
In cases where non-surgical approaches fail to restore the tendon to its normal condition or resolve the pain, surgery may be necessary. There are numerous surgical approaches, which the Centerock surgeon will discuss with you. The specific approach will be decided based on numerous factors including location of pain and relative condition of the tendon.
- Open surgical approach- involves an open incision to excise the scar tissue within the tendon and repair the tendon
- Minimally invasive approach- involves utilizing the Tenex procedure along with PRP to remove excessive scar tissue and induce healing.
Achilles Tendon Rupture
What is an Achilles Tendon Rupture
Achilles tendon rupture is the complete or partial tear of the tendon. Typically seen in the “weekend warrior”- typically, middle-aged people participating in sports in their spare time.
Causes
The Achilles tendon either stretches beyond its capacity or during sudden forceful jumping, pushing, pivoting or acceleration.
Symptoms
- Sudden pain which feels like stabbing or someone/something hitting you in the back of the calf that subsides to a dull ache over time
- Popping or snapping sensation
- Swelling of the back of the lower leg
- Difficulty walking
- Inability to rise on toes or push with your foot.
Diagnosis
In diagnosing Achilles tendon rupture, the surgeon will examine the patient’s foot and ankle and evaluate the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays or other imaging modalities as needed.
Treatment
Non-surgical
Immobilization- cast or removable walking boot to restrict motion of the tendon and assist in bringing the torn ends together. Non-surgical treatment is associated with higher rates of re-rupture. Utilized in minor tears, elderly patients who are less active and those with medical conditions that prevent them from undergoing surgery
Surgical
Surgical treatment involves direct repair of the torn tendon. This involves either an open approach or minimally invasive approach. The type of surgery will depend on various factors including the gap between the torn ends, location of the tear and existing medical conditions that the patient may have.
Recovery
Following surgery, the foot and ankle are initially immobilized in a cast and then transitioned to a walking boot. During the post operative period, the ankle will be slowly brought back to a neutral or 90° position from a position where the toes are pointed downward. Physical therapy will also be utilized to help regain strength and flexibility