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Achilles Tendon Pain

What is the Achilles tendon?

The Achilles tendon connects the calf muscle to the heel bone. It lets you rise up on your toes and push off when you walk or run.

What are common Achilles tendon problems?

The two main problems found in the Achilles tendon are:

  • Achilles tendinopathy. Achilles tendinopathy includes one of two conditions:
    • Tendinitis. This actually means “inflammation of the tendon,” but inflammation is rarely the cause of tendon pain.
    • Tendinosis. This refers to tiny tears (microtears) in the tissue in and around the tendon caused by overuse. In most cases Achilles tendon pain is the result of tendinosis, not tendinitis. Some experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis to describe a tendon injury.
  • Achilles tendon tear or rupture. An Achilles tendon also can partially tear orcompletely tear (rupture) camera. A partial tear may cause mild or no symptoms. But a complete rupture causes pain and sudden loss of strength and movement.

Problems with the Achilles tendon may seem to happen suddenly. But usually they are the result of many tiny tears to the tendon that have happened over time.

What causes Achilles tendon problems?

Achilles tendon problems are most often caused by overuse or repeated movements. These movements can happen during sports, work, or other activities. For example, if you do a lot of pushing off or stop-and-go motions when you play sports, you can get microtears in the tendon. Microtears can also happen with a change in how long, hard, or often you exercise. Microtears in the tendon may not be able to heal quickly or completely.

Being out of shape or not warming up before exercising may also cause Achilles tendon problems. So can shoes with poor arch supports or rigid heels.

An Achilles rupture is most often caused by a sudden, forceful motion that stresses the calf muscle. This can happen during an intense athletic activity or even during simple running or jumping. Middle-aged adults are especially likely to get this kind of injury.

A rupture most often occurs in sports such as basketball, racquet sports (including tennis), soccer, and softball. A tendon already weakened by overstretching, inflammation, or small tears is more likely to rupture.

What are the symptoms?

Symptoms of Achilles tendon problems include swelling in the ankle area and mild or severe pain. The pain may come on gradually or may only occur when you walk or run. You may have less strength and range of movement in the ankle.

A rupture of the Achilles tendon may cause a sudden, sharp pain. Most people feel or hear a pop at the same time. Swelling and bruising may occur, and you may not be able to point your foot down or stand on your toes.

How are Achilles tendon problems diagnosed?

Your doctor can tell if you have an Achilles tendon problem by asking questions about your past health and checking the back of your leg for pain and swelling. The doctor may ask: How much pain do you have? How did your injury happen? Have you had other injuries in the ankle area?

If your symptoms are severe or do not improve with treatment, your doctor may want you to get an X-ray, ultrasound scan, or MRI.

How are they treated?

Treatment for mild Achilles tendon problems includes rest, over-the-counter pain medicine, and stretching exercises. You may need to wear well-cushioned shoes and change the way you play sports so that you reduce stress on the tendon. Early treatment works best and can prevent more injury.

Even in mild cases, it can take weeks to months of rest for the tendon to repair itself. It’s important to be patient and not return too soon to sports and activities that stress the tendon.

Treatment for severe problems, such as a torn or ruptured tendon, may include surgery or a cast, splint, brace, walking boot, or other device that keeps the lower leg from moving. Exercise, either in physical therapy or in a rehab program, can help the lower leg get strong and flexible again. The tendon will take weeks to months to heal.

Although treatment for Achilles tendon problems takes time, it usually works. Most people can return to sports and other activities.

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Achilles Tendonitis

Achilles tendinitis

Achilles tendinitis is when the tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot. This tendon is called the Achilles tendon. It is used for walking, running, and jumping.

Causes

There are two large muscles in the calf. These muscles are important for walking. They create the power needed to push off with the foot or go up on the toes. The large Achilles tendon connects these muscles to the heel.

Heel pain is most often due to overuse of the foot. Rarely it is caused by an injury.

Tendinitis due to overuse is most common in younger people. It can occur in walkers, runners, or other athletes.

Achilles tendinitis may be more likely to occur if:

  • Suddenly increase the amount or intensity of an activity
  • Your calf muscles are very tight (not stretched out)
  • You run on hard surfaces such as concrete
  • You run too often
  • You jump a lot (such as when playing basketball)
  • You do not have shoes with proper support
  • Your foot suddenly turns in or out

Tendinitis from arthritis is more common in middle-aged and elderly people. A bone spur or growth may form in the back of the heel bone. This may irritate the Achilles tendon and cause pain and swelling.

Symptoms

Symptoms include pain in the heel and along the tendon when walking or running. The area may feel painful and stiff in the morning.

The tendon may be painful to touch or move. The area may be swollen and warm. You may have trouble standing up on one toe.

Exams and Tests

The doctor will perform a physical exam. The doctor will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes.

X-rays can help diagnose bone problems.

An MRI scan may be done if your doctor is thinking about surgery or is worried about the tear in the Achilles tendon.

Treatment

The main treatments for Achilles tendinitis do not involve surgery. It is important to remember that it may take at least 2 to 3 months for the pain to go away.

Try putting ice over the Achilles tendon for 15 to 20 minutes, two to three times per day. Remove the ice if the area gets numb.

Changes in activity may help manage the symptoms:

  • Decrease or stop any activity that causes you pain.
  • Run or walk on smoother and softer surfaces.
  • Switch to biking, swimming, or other activities that put less stress on the Achilles tendon.

Your health care provider or physical therapist can show you stretching exercises for the Achilles tendon.

They may also suggest the following changes in your footwear:

  • A brace or boot or cast to keep the heel and tendon still and allow the swelling to go down
  • Heel lifts placed in the shoe under the heel
  • Shoes that are softer in the areas over and under the heel cushion

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen can help with pain or swelling. Talk with your health care provider.

If these treatments do not improve symptoms, you may need surgery to remove inflamed tissue and abnormal areas of the tendon. Surgery also can be used to remove the bone spur that is irritating the tendon.

Extracorporeal shock wave therapy (ESWT) may be an alternative to surgery for people who have not responded to other treatments. This treatment uses low-dose sound waves.

Outlook (Prognosis)

Lifestyle changes usually help improve symptoms. However, symptoms may return if you do not limit activities that cause pain, or if you do not maintain the strength and flexibility of the tendon.

Possible Complications

Achilles tendinitis may make you more likely to have an Achilles rupture. This condition usually causes a sharp pain, like someone hit you in the back of the heel with a stick. Surgical repair is necessary, but difficult because the tendon is not normal.

When to Contact a Medical Professional

If you have pain in the heel around the Achilles tendon that is worse with activity, contact your health care provider for evaluation and possible treatment for tendinitis.

Prevention

Maintaining strength and flexibility in the muscles of the calf will help reduce the risk of tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.

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Patient Guide to Achilles Tendinitis

Achilles tendinitis is an overuse injury of the Achilles (uh-KIL-eez) tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone.

Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It’s also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends.

Most cases of Achilles tendinitis can be treated with relatively simple, at-home care under your doctor’s supervision. Self-care strategies are usually necessary to prevent recurring episodes. More-serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.

Symptoms for Achilles Tendinitis:

The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity. Episodes of more severe pain may occur after prolonged running, stair climbing or sprinting.

You might also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity.

When to see a doctor
If you experience persistent pain around the Achilles tendon, call your doctor. Seek immediate medical attention if the pain or disability is severe. You may have a torn (ruptured) Achilles tendon.

Causes of Achilles Tendinitis:

Achilles tendinitis is caused by repetitive or intense strain on the Achilles tendon, the band of tissue that connects your calf muscles to your heel bone. This tendon is used when you walk, run, jump or push up on your toes.

The structure of the Achilles tendon weakens with age, which can make it more susceptible to injury — particularly in people who may participate in sports only on the weekends or who have suddenly increased the intensity of their running programs.

Risk Factors of Achilles Tendinitis:

A number of factors may increase your risk of Achilles tendinitis, including:

  • Your sex and age. Achilles tendinitis occurs most commonly in middle-aged men.
  • Physical problems. A naturally flat arch in your foot can put more strain on the Achilles tendon. Obesity and tight calf muscles also can increase tendon strain.
  • Training choices. Running in worn-out shoes can increase your risk of Achilles tendinitis. Tendon pain occurs more frequently in cold weather than in warm weather, and running on hilly terrain also can predispose you to Achilles injury.
  • Medical conditions. People who have diabetes or high blood pressure are at higher risk of developing Achilles tendinitis.
  • Medications. Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis.

Complications of Achilles Tendinitis:

Achilles tendinitis can weaken the tendon, making it more vulnerable to a tear (rupture) — a painful injury that usually requires surgical repair.

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Achilles Tendon Rupture

Having Achilles Tendon Injury? Achilles Rupture? You are at the right place. Treat your Achilles Injury today. Call us +65 64712744 or SMS to +65 92357641 to schedule for an appointment today.

The Achilles tendon is very strong and flexible. It’s found at the back of your ankle and connects your calf muscle to the bone in the heel of your foot (calcaneum). When an Achilles tendon rupture happens you may partially or completely tear the tendon.

This type of injury occurs most often in athletes or people between the age of 30 and 50, but it can affect anyone. Complete rupture is more common in men.

Achilles Tendon Rupture

Achilles Tendon Rupture

Symptoms of Achilles tendon rupture

If you rupture your Achilles tendon you will feel a sharp pain in the back of your leg and you will be unable to flex your ankle or point your toes. You may:

  • have swelling in your lower leg
  • be unable to put your full weight on your ankle
  • hear a snapping or tearing sound when it happens
  • have a limp, and be unable to stand on tiptoe or climb stairs
  • develop bruising

When the injury occurs, you may feel like you have been kicked or hit in the back of the leg.

Causes of Achilles tendon rupture

Achilles tendon rupture is most likely to happen when your leg is straight and your calf muscle is contracted during activities such as running, jumping or playing sport such as football or tennis.

There is a very small risk of Achilles tendon rupture if you have Achilles tendinopathy. Achilles tendinopathy is pain, thickening and stiffness in your Achilles tendon both during exercise and often following exercise.

Certain medicines taken together may increase the risk of Achilles tendon injuries. These are quinolone antibiotics (eg ciprofloxacin) and corticosteroids. The exact risk of Achilles tendon rupture caused by these medicines isn’t clear.

Diagnosis of Achilles tendon rupture

Our specialist may ask you to do a series of movements or exercises to see how well you can move and how affected your lower leg is. These may include squeezing your calf muscle or asking you to try to stand on tiptoe.

At the hospital, you may have further tests to look at your Achilles tendon. These may include:

  • an ultrasound scan, which uses sound waves to produce an image of the inside of a part of the body
  • an MRI (magnetic resonance imaging) scan, uses magnets and radiowaves to produce images of the inside of the body

Treatment of Achilles tendon rupture

Achilles tendon ruptures are treated using surgery, or by keeping it immobile while it heals. The treatment you have may depend on how much time has passed since the injury, your age and how active you are.

Whether you have an operation or not, you will have a plaster cast on your lower leg and won’t be able to put weight on it for at least four weeks.

You can take painkillers that you would usually take for a headache, for example a non-steroidal anti-inflammatory painkiller such as ibuprofen. Always read the patient information leaflet that comes with your medicine.

Surgery

Surgery is usually recommended for active young people.

There are two types of surgery used to repair a ruptured Achilles tendon:

  • open surgery, which is when one long cut is made to reach the tendon to repair it
  • percutaneous surgery, which is when a number of small cuts are made to reach the tendon to repair it

Both types of surgery involve stitching the tendon together so it can heal. Open surgery is less likely to cause injury to one of the nerves in your leg.

After surgery you will have a series of casts or an adjustable brace on your leg to help the Achilles tendon heal. This will usually be for between four and eight weeks.

About five in 100 people who have surgery for this injury get an infection. This can be treated with antibiotics. There may be a lower risk of infection if you have percutaneous surgery. For between one and three in 100 people the tendon will re-rupture after the operation.

Non-surgical treatment

A cast or brace is put onto your lower leg to help the tendon heal. You will have to wear a cast or brace for at least six to eight weeks. During this time the cast will be changed a number of times to make sure the tendon heals in the right way. It usually takes longer to recover from Achilles tendon rupture using this treatment, compared with surgery.

There is no risk of infection from this type of treatment and it’s suitable for people who may have complications during surgery.

The tendon may re-rupture in about 13 in every 100 people who have this treatment.

If your tendon is partially ruptured you’re more likely to be given a cast or brace, instead of surgery.

After your treatment

Once your cast or brace is removed you will need to gradually increase your activity to strengthen the tendon. Your doctor, or a physiotherapist, will give you a number of exercises to do, which will increase the range of movement and strength in your lower leg. Your physiotherapist may try various techniques to reduce the pain. These may include exercises and soft tissue techniques (deep tissue massage). He or she will also advise you on returning to exercise. You should be able to return to your usual level of activity six months after your injury. However, this may take longer and will also depend on the activity.

Prevention of Achilles tendon rupture

There are ways to reduce the risk of injury to your Achilles tendon. To prevent injury when starting a new exercise regime, gradually increase the intensity and the length of time you spend being active.

Warming up your muscles before you exercise and cooling them down after you have finished may help. Five to 10 minutes of low intensity activity, such as brisk walking, is enough for a warm up and this is also needed for a cool down. You can do a series of muscle stretches to help prevent injuries after your warm up and cool down. This can include a calf muscle stretch, which will lengthen the Achilles tendon before you exercise.

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