Achilles tendinosis involves degeneration and inflammation of the Achilles tendon. The tendon can become swollen and this results to pain. The condition is common among runners, athletes and individuals suffering from calf stiffness.
Achilles tendinosis can develop in the middle of the tendon. It can also occur at the site where the tendon links to the heel bone. Tightness of the Achilles tendon and calf are the usual causes of Achilles tendinosis.
Indications
Various changes are evident if the Achilles tendon is inflamed such as:
- Pain or achiness and/or tightness in the tendon at the back of the ankle
- Difficulty climbing stairs
- Pain or discomfort after being seated for extended periods or after sleeping
- A protrusion either in the tendon or at the back part of the heel bone
In some individuals, there is irritation from shoes scraping against the bump and settles when wearing shoes that are backless. There is also less pain when using shoes with a slightly elevated heel than flats.
How is it diagnosed?
A thorough history is taken and a physical exam is carried out. The individual usually has pain or discomfort on the tendon or at the back part of the heel. There is also swelling and thickening of the tendon.
An X-ray might also be taken to check if there are any bone spurs. An ultrasound or MRI might also be carried out to further assess the severity of the affected tendon and to check for any tears.
Management of Achilles tendinosis
The treatment is based on the severity and length of the symptoms. In most cases, the condition can improve without requiring surgery.
Adequate rest and oral medications can help in reducing the pain and swelling. Heel cups can be used to improve the pain by relieving some of the stress from the Achilles tendon while walking. In addition, a walking boot or other type of brace might be suggested.
Oftentimes, physical therapy is suggested that involves stretching and improve mobility within the calf muscle. Other treatment options that might be used include:
- Ultrasound
- Massage
- Shockwave therapy
- Topical nitroglycerin patches
In some instances, surgery might be needed. This is based on the site and extent of Achilles tendinosis.