Achilles Tendinopathy
Anatomy
The muscles forming the calf are attached to the back of the heel bone (calcaneus) by a strong fibrous band of tissue called the achilles tendon. When the calf contracts the achilles tendon pulls on the heel with great force. This force dramatically increases with acceleration, sprinting, jumping and climbing. Because there is such a dramatic amount of force applied through these anatomical structures, there is the potential for various injuries. These may slowly evolve over time due to the repetition of the force on the tissue or with a sudden traumatic incident.
Conditions
Depending on the site or type of injury, a wide range of complaints can be associated with prolonged excessive force through the tendon. Such conditions may be degeneration of the achilles tendon, or it`s partial or full rupture. There may also be inflammation of surrounding structures, such as bursitis, which is inflammation of the bursa which is located between the achilles tendon and the heel bone. The calf muscles may also have different degrees of injury, which may be chronic or due to an acute episode.
Symptoms
Pain may slowly increase over time, be mainly associated with certain exercise or activity, and may be painful when first standing after rest. Pain may be palpated anywhere from the calf along through the tendon, to the bottom of the heel. Swelling may be absent, localised or diffused. Limping is common and walking uphill or up stairs is often difficult.
Treatment
An accurate diagnosis of the type of injury and the anatomy involved will determine the treatment plan. In the early stages treatment is aimed at reducing pain and inflammation.
Besides rest, there may be a range of physical therapies used, as well as anti-inflammatory medication.
The role of the podiatrist is to address any underlying excessive force on the tendon and surrounds, so as to assist with healing and prevent future problems. This may involve stretching programs, footwear alteration and the use of orthotics. The patient is always at risk of a future injury, so addressing faulty mechanics is important.
Besides rest, there may be a range of physical therapies used, as well as anti-inflammatory medication.
The role of the podiatrist is to address any underlying excessive force on the tendon and surrounds, so as to assist with healing and prevent future problems. This may involve stretching programs, footwear alteration and the use of orthotics. The patient is always at risk of a future injury, so addressing faulty mechanics is important.
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