characterized by inflammation and pain at the Achilles tendon (back of the ankle). This tendon, sometimes called the heel cord, is the tendon attachment of the calf muscles from the leg and knee to
the heel. This structure is important in standing on your toes or in the pushing-off phase of walking, running, or jumping.Achilles-tendinitis is usually a grade 1 or 2 strain of the tendon. A grade
1 strain is a mild strain. There is a slight pull of the tendon without obvious tendon tearing. (There is microscopic tendon tearing.) There is no loss of strength, and the tendon is the correct
length. A grade 2 strain is a moderate strain. There is tearing of tendon fibers within the substance of the tendon or where the tendon attaches to muscle or bone. The length of the tendon or whole
muscle-tendon-bone unit is increased, and there is usually decreased strength. A grade 3 strain is a complete rupture of the tendon.
Tendinitis most often occurs when a tendon is over used. As the foot extends the Achilles tendon engages the calf muscles. The calf muscle generates force, which is transferred to the foot via this
tendon. As this action repeats the tendon will endure large amounts of stress. An under-trained or inexperienced athlete is most likely to be affected by tendinitis since their body is not accustomed
to the stress involved with athletics. Improper foot mechanics is another common cause of Achilles tendinitis. A properly functioning foot will distribute weight evenly across the foot. On the
contrary, if the foot is experiencing improper mechanics, the weight of the body will not be evenly distributed. This can result in tendinitis, plantar fasciitis, calluses, bunions, neuromas and much
Patients with this condition typically experience pain in the region of the heel and back of the ankle. In less severe cases, patients may only experience an ache or stiffness in the Achilles region
that increases with rest (typically at night or first thing in the morning) following activities which place stress on the Achilles tendon. These activities typically include walking or running
excessively (especially uphill or on uneven surfaces), jumping, hopping, performing heel raises or performing calf stretches. The pain associated with this condition may also warm up with activity in
the initial stages of injury. As the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance. Pain may also increase when performing a
calf stretch or heel raise (i.e. rising up onto tip toes). In severe cases, patients may walk with a limp or be unable to weight bear on the affected leg. Patients with Achilles tendonitis may also
experience swelling, tenderness on firmly touching the Achilles tendon, weakness and sometimes palpable thickening of the affected Achilles tendon when compared with the unaffected side.
If you think you might have Achilles tendonitis, check in with your doctor before it gets any worse. Your doc will ask about the activities you've been doing and will examine your leg, foot, ankle,
and knee for range of motion. If your pain is more severe, the doctor may also make sure you haven't ruptured (torn) your Achilles tendon. To check this, the doc might have you lie face down and bend
your knee while he or she presses on your calf muscles to see if your foot flexes. Any flexing of the foot means the tendon is at least partly intact. It's possible that the doctor might also order
an X-ray or MRI scan of your foot and leg to check for fractures, partial tears of the tendon, or signs of a condition that might get worse. Foot and ankle pain also might be a sign of other overuse
injuries that can cause foot and heel pain, like plantar fasciitis and Sever's disease. If you also have any problems like these, they also need to be treated.
Use the R.I.C.E method of treatment when you first notice the pain. Although rest is a key part of treating tendonitis, prolonged inactivity can cause stiffness in your joints. Move the injured ankle
through its full range of motion and perform gentle calf and ankle stretches to maintain flexibility. If self-care doesn't work, it's important to get the injury treated because if the tendon
continues to sustain small tears through movement, it can rupture under excessive stress. Your doctor may suggest a temporary foot insert that elevates your heel and may relieve strain on the tendon.
Other possible treatments include special heel pads or cups to wear in your shoes to cushion and support your heel, or a splint to wear at night. Physical therapy may also help allow the tendon to
heal and repair itself over a period of weeks.
In most surgeries, damaged tissue is cleaned out before surgeons make the necessary repairs. However, a new minimally-invasive surgery to repair a torn Achilles tendon actually uses the damaged
tissue to help repair the tear. The percutaneous Achilles repair system, or PARS technique, enables surgeons to better repair a torn Achilles tendon through a smaller incision. This procedure was
recently performed at Houston Methodist Hospital to treat an NFL cornerback, getting him back on field for this season.
To prevent Achilles tendonitis or tendonosis from recurring after surgical or non-surgical treatment, the foot and ankle surgeon may recommend strengthening and stretching of the calf muscles through
daily exercises. Wearing proper shoes for the foot type and activity is also important in preventing recurrence of the condition.