Achilles Tendonitis

Achilles tendonitis

     The Achilles tendon connects the heel and the calf muscles. It is the largest tendon in the body and allows the fingers to do the required actions while walking or running.

     The most common diseases include:

1. Achilles tendonitis includes:
• Achilles tendon inflammation (tendonitis)
• Tendonitis resulted from a series of small cracks (crazing) located inside the tendon edges.

     In most cases the pain is the result of Achilles tendonitis. The Achilles tendonitis is a term no longer used by specialists. Some of them still use the word "tendonitis" to describe lesions of the tendon.

2. Achilles tendon rupture or laceration

     Achilles tendon can be broken partially or completely. While a partial rupture can be completely asymptomatic which can cause mild symptoms, a complete rupture causes pain and a sudden loss of strength and mobility of the affected leg.

Causes for Achilles tendonitis

     Achilles tendonitis is most commonly caused by:

• Overuse or repeated movements during exercise, work or other activities; in sports a change in duration, intensity or type of exercise or the environment (such as switching from a flat surface to climb a slope or on a paved road or a country road) can cause crazing in the tendon that cannot heal so quickly which can lead to pain
• Injuries due to repetitive stop-start or push movements, common in activities such as running, basketball, tennis or dancing.
• Physical condition or inadequate warm up (when starting a new activity or when a previous warm up was not made and subsequent to the physical activity)
• Shoes with little arch or vault with rigid heel side.

     Achilles tendon rupture is due to:

• Strong sudden movements that may overburden the calf muscles, as it happens during intense athletic activity or while running or jumping, especially in middle-aged men (but also sports such as basketball, tennis or football frequently cause of tendon ruptures Achilles)
• Excessive stretching of tendon during activities when it is already damaged by other diseases such as Achilles tendonitis
• Achilles tendonitis can gradually weaken the tendon, increasing the risk of rupture; the tendon that is under frequent stress can get fractured
• Corticosteroid injections (in the past they were commonly used as treatment for tendon injuries) corticosteroids can weaken or break the tendon tissue.

Achilles tendonitis symptoms

     Achilles tendonitis includes symptoms such as:

• Pain in the back of the calf, Achilles tendon area, pain can be mild or severe and may be with or without edema
• A high sensitivity of the Achilles tendon, most pronounced in the morning
• Stiffness in the tendon, which is reduced with movement
• Decreased strength and mobility in the limb.

     The Achilles tendon rupture can cause symptoms such as:

• A sudden and sharp pain, felt as a direct kick to the tendon, a click may occur when the rupture occurs, followed or not by a edema and ecchymosis (bruise)
• Heel pain (may be severe)
• The patient may be unable to set the foot in the ground, to stand or walk comfortably.

     If case of a partial tendon tear it is possible that the limb's strength and mobility to be close to normal and to be less intense compared to the pain of a total rupture of the tendon.

Manifestations of Achilles tendonitis

     Achilles tendonitis can manifest as an inflammation of the tendon (tendonitis) or crazing (tendinosis). Achilles tendonitis begins with repeated small cracks of the tendon without obvious symptoms or with medium to severe pain while walking. Crack progression leads to laxity and tendon pain. There may also occur, in this stage, nodes that lead to its thickening. Recovery and treatment of injury leads often to the relieve pain. Exercise during the physiotherapy or rehabilitation program gives back the patient's flexibility of the foot. Warm up exercises, of the lower part of the calf and the Achilles tendon, heal and prevent its damage in strenuous activities such as sports or stair climbing.

     Without rest and treatment the Achilles tendonitis are chronicized leading to persistent pain and tendon shortening, increasing thus the risk for fracture.