Achilles tendonitis is very common. The Achilles is the largest tendon in the body. It is used for various physical activities such as walking, running, sprinting and jumping. Achilles tendonitis occurs when the large tendon that runs from the calf to the heel bone becomes irritated and inflamed. The Achilles tendon can withstand great stress; however, it is particularly prone to develop inflammation, resulting in Achilles tendon pain. This pain most often occurs due to overuse and degeneration. Certain athletes, such as long distance runners and sprinters are at increased risk for Achilles tendonitis and even an Achilles rupture.
There are two types of Achilles tendonitis:
Symptoms of Achilles Tendonitis
Common symptoms of Achilles Tendonitis may include:
Causes or Risk Factors for Achilles Tendonitis
Achilles tendonitis is generally not caused by a specific injury. It typically happens from repetitive stress on the Achilles tendon. Repetitive stress happens when a person pushes in an exercise or sport too much within a short amount of time, commonly known as an “overuse injury.” This puts too much stress too fast on the Achilles tendon.
However, there are other risk factors that may cause Achilles tendinitis to develop, including:
Treatment Options for Achilles Tendinitis
The good news is that there are several non-surgical treatment options for Achilles tendonitis:
Surgical Treatment Options for Achilles Tendonitis & Achilles Rupture
If non-surgical treatment options have been exhausted, surgery to repair the tendon may be considered. The operation chosen may depend on the extent of the condition, as well as the person’s age, activity level and overall goals.
Surgery and Immobilization for Achilles Rupture When the Achilles ruptures, often due to overstretching of the Achilles tendon, surgery is typically needed to repair the ruptured tendon. However, immobilization is also a common treatment option, where a cast, splint, brace, walking boot, or other device keeps the lower leg and ankle from moving. This allows for the ends of the Achilles tendon to reattach and heal. While surgery and immobilization are often very successful options for a ruptured Achilles, another rupture is less likely after surgery versus immobilization.
Surgery for Midsubstance or Noninsertional Achilles Tendonitis
For midsubstance or noninsertional Achilles tendonitis, surgery will focus on removing the bad portion of the tendon. If the tendon is damaged, a surgeon will often use the tendon that goes to the big toe to support the Achilles tendon. If the Achilles tendon or calf muscles are too tight, surgery may also focus on lengthening them.
Surgery for Insertional Achilles Tendonitis
In this surgery, diseased tissue is often removed. The tendon is then repaired back down to the heel bone. The surgeon may shave down the bone spur and smooth it out. This prevents the bone spur from rubbing the Achilles tendon and irritating it. Often a fluid- filled sac called a “bursa” is a contributing factor to pain and inflammation. In these cases, the bursa is removed during surgery.