Achilles Tendon Conditions
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What are achilles tendon conditions?
Achilles tendon conditions refer to disorders which affect the Achilles tendon (heel cord); the band of tissue that connects bone to muscle. It connects the heel bone to the calf muscle up the back of the lower leg. The Achilles tendon plays a vital role in walking, by helping the heel to raise off the ground.
The two main forms of Achilles tendon conditions are Achilles tendonitis and Achilles tendinosis:
Achilles tendonitis refers to the short term inflammation of the Achilles tendon. If Achilles tendonitis is not resolved the condition can lead to the degeneration of the tendon, which is Achilles tendinosis. Achilles tendinosis involves tiny tears and the loss of structure in the Achilles tendon. Degeneration can affect the point where the Achilles tendon attaches to the heel.
Chronic degeneration can lead to the rupture of the tendon, although this is rare.
It has been found that athletes, and people with professions such as labouring, can be at more risk of developing Achilles tendon conditions. That's because of the excessive pressure which these activities can place on the ankle and feet. People with an abnormal flattening of their foot arch (pronation) are also understood to be at a higher risk due to placing more stress on the tendon when walking.
What causes achilles tendon conditions?
Achilles tendon conditions are caused by excessive repetitive activities which involve the Achilles tendon. This activity leads to the micro-injury of the tendon's fibres, and because of the ongoing stress, the injured tissue cannot repair itself. The result is the altering of the tendon structure, which causes pain.
Symptoms of achilles tendon conditions
The main symptoms which are associated with Achilles tendonitis and tendinosis are; pain, tenderness, and stiffness of the tendon, which can arise anywhere along the tendon, from the heel to below the calf muscle; intense pain when the tendon is squeezed on either side; enlargement of the tendon and the disorder progresses to Achilles tendinosis, or nodules in the area where the tendon is damaged.
Pain is typically worse in the morning, or after periods of rest.
Treatment options for achilles tendon conditions
The type of treatment which is recommended for Achilles tendon conditions will depend on the nature of the injury and the level of damage already done. In the early stages of Achilles tendonitis, the following treatments may be advised; ice treatment, applied indirectly using a bag in order to reduce swelling; immobilisation, which can require the wearing of a removable walking boot or cast; orthotic devices; night splints, which can stretch the Achilles tendon when sleeping; physiotherapy, focused on strengthening, stretching and improving range of motion; and oral medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, to reduce inflammation and pain.
A technique called extra-corporeal shockwave therapy can be an effective treatment.
Your specialist may discuss options for injection therapies with you, such as platelet rich plasma.
For cases in which non-surgical treatment paths have proven ineffective, surgery may be considered. The type of surgery which is chosen depends on factors such as the extent of the injury and the patient's profile. Procedures which are used to treat Achilles tendon conditions include the repair of the damaged tendon, and decompression of surrounding tight tissues
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