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Achilles Tendon

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What Is the Achilles Tendon?

The Achilles is the longest tendon in the body, traveling down the back of the lower leg and connecting the calf muscle to the heel bone. The Achilles tendon enables us to walk by helping lift the heel off the ground.

What Can Go Wrong: Achilles Tendonitis and Achilles Tendonosis

Zone-of-tendonitisTendonitis and tendonosis are two common disorders of the Achilles tendon.

Achilles tendonitis is an inflammation that is most often caused by overuse. It is common in runners, walkers and other athletes. In older people, it may be a result of arthritis, especially if a bone spur or growth forms behind the heel bone.

If left untreated, the condition may progress to Achilles tendonosis, in which case the tendon may develop microscopic tears.

This degeneration occurs where the Achilles tendon attaches to the heel bone. In some cases, chronic degeneration (with or without pain) may result in a ruptured tendon.

Symptoms of Achilles Tendon Problems

Symptoms of Achilles tendonitis and tendonosis include:

  • Pain—aching, stiffness, soreness, or tenderness—in the tendon. Pain may occur anywhere on the tendon, from the narrow area directly above the heel to the area below the calf muscle. Pain can occur first thing in the morning, improve gradually with motion, then be worsened again by activity.
  • Tenderness or intense pain may be felt when the tendon is squeezed. As the condition progresses, the tendon may become enlarged and develop nodules, or lumps, near the damaged tissue.

Various Causes of Achilles Tendonitis

The Achilles may also be injured by a sudden increase in weight-bearing stress. Certain actions— for instance, when a tennis player rushes the net and then must drop back suddenly when his opponent hits a lob— may place a sudden weight or pressure on the tendon and damage the fibers.

If the stress is long-term, and the body doesn’t have time to repair the injured tissue, the injury may become chronic.

Achilles-insertionAthletes are at high risk for Achilles injuries but tendonitis and tendonosis are common as well in individuals such as laborers or waitresses who are on their feet for long hours each day.

The famous “weekend warriors”—patients who are less fit and engage in strenuous activity only on weekends or infrequently— are another high-risk group we treat at our clinics in Sunnyvale, DeSoto and Dallas. In these individuals, a tendon tear occurs most often in a region that’s removed from the area where it inserts into the heel bone, which has the best blood supply. This makes the injury slower to heal.

People with extreme pronation that tends to flatten the arch of the foot also have a tendency to develop Achilles problems.

Treatment and Prevention of Achilles Injuries

Treatment for tendonitis or tendonosis may be conservative, involving a brace and medication. Patients whose Achilles injuries don’t respond to conservative treatment may be candidates for surgery.

Our medical staff can recommend exercises to stretch and strengthen the calf muscles, which help protect the Achilles tendon. Orthotics are available for runners as well as other athletes.