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Achilles tendinopathy is the gradual degeneration of the Achilles tendon caused by overuse or sudden increase in activity. Symptoms include pain, difficulty walking, and enlarged tendon. Treatment ranges from home care to surgery, including immobilization, ice, medication, physical therapy, and surgery.
Achilles tendinopathy, also called degenerative tendinopathy, is the gradual degeneration and deterioration of the Achilles tendon. Achilles tendinosis begins with tiny tears in the connective tissue in and around the Achilles tendon. These tears, if not allowed to heal, eventually cause the tendon to lose its structure and swell up. The paratenon, a covering of the Achilles tendon that provides lubrication and blood flow to the tendon, becomes inflamed and pain ensues.
The longest tendon in the body, the Achilles tendon, connects the calf muscle and the heel bone. Running along the back of the lower leg, the Achilles tendon is sometimes called the “heel cord.” The tendon allows you to lift the heel off the ground when walking.
Most often caused by overuse, Achilles tendinosis usually develops due to repetitive activity or a sudden increase in activity that uses the tendon. The body is unable to repair the small tears that occur because the tendon is under constant stress from use. This makes athletes particularly prone to Achilles tendinosis. Achilles tendinosis can also occur while wearing certain types of shoes if the wearer is genetically prone to problems with the Achilles tendon.
Symptoms of Achilles tendinosis include pain within the tendon, especially after periods of rest, and difficulty walking or climbing stairs. The tendon may become enlarged and sometimes nodules develop in the area where the tissue is damaged. Diagnosis includes evaluating the condition of the tendon and the patient’s range of motion, along with X-rays and other imaging tools.
Treatment for Achilles tendinosis can range from home care to surgery. Immobilization is almost always recommended, and a cast or walking boot might be used to reduce the stress on the tendon while it is healing. Ice and medications such as ibuprofen are used to reduce inflammation and pain. Night splints to keep the tendon stretched are also used in treatment, as is physical therapy. In some cases, orthopedic treatment is used and a wedge of material lifts the heel to reduce pressure on the tendon during walking.
If the condition is unresponsive, surgery to stretch the Achilles tendon might be done. Topaz radiofrequency ablation is a new treatment method that is used to stimulate an inflammatory reaction within the tendon and initiate a natural healing process. Another method of treating Achilles tendinosis is a platelet-rich plasma injection, during which the patient’s plasma is collected and injected into the Achilles tendon to promote healing.
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