A tendon is a band of tough tissue that usually connects muscle to bone. The Achilles tendon connects calf muscles to the heel. Achilles tendinopathy includes two conditions: tendinitis and tendinosis. Tendinitis is inflammation (swelling) of this tendon. Tendinosis means there are tiny tears in tissue in and around the tendon caused by overuse.
Causes include sports activities, such as basketball, that put stress on calf muscles and Achilles tendon. Other causes include sudden increase in intensity or frequency of exercise (overuse), poor conditioning, flattened arch, trauma, and infection.
Jumping or trauma can also cause the tendon to rupture (tear) partly or completely.
Symptoms include a dull ache or pain when pushing off the foot during walking or when rising on the toes. Others are tenderness or swelling over the Achilles tendon, stiffness that gets better with walking, and a crackling sound when touching or moving the tendon.
The health care provider uses a history and physical examination for diagnosis. The tendon will be painful on touching and can be made worse with flexing the ankle so tension is put on the tendon. The health care provider will squeeze the calf to check for Achilles tendon rupture (tear).
X-rays and MRI may be done when the diagnosis is unclear.
Self-care methods include rest, ice, compression, and elevation (RICE). Over-the-counter drugs such as nonsteroidal antiinflammatory drugs (NSAIDs) may relieve pain. Improved stretching, night splints (to stretch the tendon), and immobilization for 2 to 4 weeks may help. Other treatments are orthotic devices (shoe inserts to raise the heel) and heel pads or cups for shoes. Severe cases may need walking boots and crutches. Physical therapy and maybe changes in the exercise program may let the tendon heal. The last resort is surgery to remove inflamed tissue around the tendon.
If tendinitis is untreated and the tendon continues to have small tears caused by exercise and repeated movement, the tendon can rupture. Then, surgery is needed
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