Achilles Tendon Pain, Ruptures, and Tendonitis

 
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While the feet and ankles aren't the first thing we think of when major injuries come to mind, the truth is that they are one of the most oft-injured parts of the human body, especially in athletes and people who live highly active lifestyles.

When you think of it, it makes sense. The list of activities that we can do without using the feet and ankles is fairly limited, and the physiological makeup of the human foot and ankle is very intricate.

So, it stands to reason that we would have a firm grasp on how to treat injuries and disorders to the human foot and ankle. Unfortunately, that's not always true, because foot and ankle injuries are also some of the most frequently misdiagnosed injuries that we see. 

That's why it's even more important to see a trained specialist when dealing with complex foot and ankle injuries. 

Today, let's talk about one of the most dramatic and well-known injuries to the the lower body, the achilles tendon injury. 

Achilles Tendon Injuries

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In the Homer's timeless epic "The Illiad", Achilles is the unstoppable warrior who leads the Greeks against the Trojans in the Trojan War. His only weakness: a soft spot where the back of the leg meets the heel. The only way to kill Achilles is to shoot an arrow into that exact spot.

You might see where I'm going with this. The myth of Achilles the warrior sheds light on the true nature of the achilles tendon: many great athletes have fallen due to injuries to the achilles tendon. And, in fact, some report the experience of rupturing the achilles to be akin to being "shot" behind the heel. Ouch!

However, the actual "cause" of an achilles tendon rupture or tear is often a quick movement, such jumping off the starting blocks in a race or making a quick cut or jumping motion in a basketball game.

What is the Achilles Tendon?

Technically, the achilles is where the soleus muscles (calf) join the calcaneus (heel bone). 

What does the achilles tendon do?

The achilles makes it possible to push off while running, jumping, changing direction, and even walking.  The achilles is known as the strongest tendon in the human body.

basic treatment Options for Achilles tendon disorders:

If you have inflammation - rest, activities modification.

If you have an acute injury - rest, activities modification, icing and  physical therapy.

If you have chronic inflammation that does not respond to non-surgical treatment - consider surgery.

The Three Grades of Achilles Tendon Strains

The Three Grades of Achilles Tendon Strains

Achilles Tendonitis

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Achilles tendonitis pain and Symptoms

If you have achilles tendonitis, chances are that you will experience some pain when you begin your daily activities. Achilles tendonitis is a condition that will become more pronounced with increased exercise. As the condition worsens, it takes less exercise to cause the pain. 

What exactly is achilles tendonitis?

If you have achilles tendonities, you are experiencing a decreased blood supply at the achilles tendon, resulting in pain.

Achilles Tendon Ruptures

A rupture may occur when the tendon has a decreased blood supply and is subjected to cutting or a sharp change in direction. 

This is the dramatic, debilitating injury that we all associate with the achilles tendon. At the end of this article, I've presented some cases of famous NBA players with achilles ruptures.

A New, Minimally Invasive Technique (Surgery) to Repair Achilles Ruptures

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A new minimally invasive technique to repair Achilles ruptures is now available. The new procedure has been shown to have equivalent outcomes with less risk of wound or infection problems than with older techniques.

We are able to repair most Achilles ruptures with this technique, but a minority of ruptures are not amenable to this technique and are better repaired with other techniques.

The older method of treating Achilles ruptures was to either place the patient’s leg in a cast to immobilize the ruptured tendon, or to repair the tendon using a large incision on the back of the leg.  Unfortunately the cast does not allow motion at the ankle, which can lead to stiffness.  We are looking for patients to get their range of motion back as soon as possible.

The minimally invasive or limited open approach to repairing the tendon requires a small incision, about one inch, on the back of the leg overlying the rupture that is just large enough to put the tendon ends back together and repair it with strong sutures in the tendon.  The patient is placed in a splint for about 10 days, then a removable boot so they can start walking on it and moving the ankle.

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As you can see, an injury to the achilles tendon can be a debilitating injury, but it doesn't have to be something that causes a long-term problem. 

If you've torn your achilles, feel free to reach out to Dr. Elton or the staff at Vail/Summit Orthopaedics for more information on how we can help you.