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03/19/2018

The Achilles tendon is the largest and strongest ligament in the human body. Its main physical load comes with walking, running, rising and descending, periods of inactivity, and vertical posture while standing. All of these are concentrated on the Achilles tendon.

Achilles Tendonitis (a degenerative process that affects the tendon due to trauma, inflammation, or congenital shortening of the tendon) most often occurs in athletes as a result of the mechanical injury of the ligament system. With increased levels of physical activity, or incorrectly chosen training regimes, the chance of disease increases. Another cause is the occurrence of systemic inflammation among women wearing high-heeled shoes daily. Also, there are congenital problems with the Achilles tendon, such as when babies are born with a shortened ligament. Tendonitis of any etiology is the most common disease of the tendon apparatus of the lower limbs.

Three kinds of Achilles Tendonitis can be identified:

  • Tendonitis - only the tendon itself is involved in the process;
     
  • Peritendinitis - the tissues surrounding the tendon are affected; this is often associated with a degenerative process in the Achilles tendon;
     
  • Enthesopathy - the tendon is affected where it attaches to the bone. This often occurs with the development of a calcaneal spur (plantar fasciitis) or calcification.

The most common symptoms of Achilles Tendonitis

The primary and most frequent symptom is pain and swelling that appears closer to the back side of the heel along the ligament. Initially, it feels weak, then intensifies, either disappearing after supporting a load or becoming permanent.

Often the adjacent tissues swell, and there is skin hyperemia, thickening of the ligament with prolonged inflammation, creaking during movement, or restriction of mobility.

Treatments for the ligamentous apparatus of the foot

Achilles Tendonitis treatment should start with the elimination of the cause. This includes reducing or eliminating physical activity, reducing pressure on the foot, and treating the problem as a chronic disease.
Effective exercises include calm walking, very gentle stretching of the calf muscles and ligaments, massage, and physical therapy (including weak-current pulses or ultrasound). These often show positive results. 
Profound inflammation requires medical therapy.

It is vital to use orthotics or shoes with a built-up heel to take tension off the Achilles tendon and facilitate comfort and recovery. Correctly selected sets reduce the load on the foot as well as pain. They need to be worn for a long time, and it is best to combine them with physiotherapy methods.
Sometimes it is necessary to immobilize the foot fully. In such cases, a plaster bandage for a period of 6 to 12 weeks is recommended.

If an Achilles tendon is ruptured, surgery may be necessary to repair it. The tendon is sewed, a plaster bandage is applied, and a course of physiotherapeutic procedures are mandatory after the cast is removed.  

Achilles Tendonitis treatment is a long and complicated process.

Dr. Alex Yanovsky at Illinois Foot & Ankle Clinic is a highly skilled and an experienced physician who successfully cope with this kind of problems. Complex treatment and individual approach to each patient make it possible to achieve good results, regardless of the duration and complexity of the disease. 

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