A tendon is a tough band of tissue that connects muscle to bone and is able to withstand tension. The Achilles tendon is located at the back of the lower leg and connects the calf muscle to the heel bone. Otherwise referred to as the “heel cord,” this tendon enables walking by pushing the heel downward and helping to raise the heel off the ground.
Achilles tendonitis and Achilles tendinosis are two disorders that often occur in the heel cord. Achilles tendonitis is normally a temporary inflammation of the Achilles tendon. If not resolved, the inflammation may lead to Achilles tendonosis, a degeneration of the tendon. This tendon degeneration results in loss of organized structure and most likely leads to microscopic tears. At times, the degeneration involves the site where the Achilles tendon attaches to the heel bone. Rare cases result in chronic degeneration with or without pain that may result in tendon rupture.
Achilles tendonitis and tendonosis, sometimes called “overuse” disorders, are normally caused by a sudden increase of a repetitive activity that involves the Achilles tendon. This sudden increase of activity overstresses the tendon in a short time period that leads to micro-injury of the tendon fibers. Prolonged stress of the tendon prevents the body from repairing the injured tissue, disrupting tendon structure and resulting in ongoing pain.
Athletes are commonly affected by disorders of the Achilles tendon. People with jobs that overstress the ankles and feet, such as laborers, are at high risk as well. “Weekend warriors” - individuals who are less conditioned to undertake athletic activities on the weekends or infrequently - may develop these injuries. Lastly, people with foot deformities and excessive pronation place greater demands on the tendon when walking. Coupled with unstable footwear, their over-pronation could aggravate the Achilles tendon and result in inflammation.
Dr. Radovic diagnosis Achilles tendonitis or tendonosis by examining
the foot and ankle, the range of motaion and condition of the tendon.
X-rays and other imaging studies may be ordered to determine the
extent of the condition.
Surgery may be an option to restore normal tendon function in patients who are unresponsive to non-surgical treatments. Dr. Radovic will consider the patient’s age, activity level, extent of injury and other factors when choosing the most suitable procedure for tendon repair.
Dr. Radovic may recommend stretching and strengthening exercises of the calf muscles to prevent Achilles tendonitis or tendonosis from coming back after conservative or surgical treatment. Patients should also be sure to wear appropriate shoes for their foot type and activity level so the condition does not return.