Achilles Tendonitis
The Achilles tendon is the largest tendon in the human body and is responsible for connecting the gastrocnemius muscle (calf muscle) to the heel bone (heel bone). Its use is essential for the body to complete various daily human activities such as walking, jumping, running, and standing on tiptoes. Although the Achilles tendon is naturally able to withstand pressure and severe stress, it remains susceptible to injury, rupture, and inflammation due to excessive effort, as occurs in some violent sports, traumatic injuries, or degeneration and aging with age.
Causes and Symptoms
Most of the causes of Achilles tendonitis or Achilles tendon rupture are due to excessive effort and violent exercises. However, there are some other causes that are not related to this, such as the patient suffering from rheumatoid arthritis. There are some other causes such as:
Exercising without doing the necessary warm-up.
Repeated severe pressure on the Achilles tendon in a specific exercise or sport.
Some sports, such as tennis, require stopping and changing the direction of the knee quickly and repeatedly.
Increasing the exercise effort without gradual changes and not giving the body a chance to adapt to the increased effort.
Wearing inappropriate or worn-out sports shoes.
Wearing high heels on a daily basis and for a long time.
The presence of bony protrusions or growths on the back of the heel bone.
Aging and old age.
The main symptoms of Achilles tendonitis are pain and swelling in the back of the heel when walking, running or doing any kind of effort in general. Other symptoms include:
Feeling uncomfortable and uneasy when moving.
Tension in the calf muscle.
Limiting the movement of the foot.
Feeling of heat on the back of the heel.
Diagnosis
There are two types of Achilles tendonitis, the first type affects the lower part of the Achilles tendon attached to the heel bone. The second type affects the middle part of the Achilles tendon, causing inflammation and micro-tears in the tendon, resulting in pain and swelling. This type affects the age group of young athletes. The condition is diagnosed by clinical examination of the patient, and the following images may be taken to confirm that the symptoms are due to damage to the Achilles tendon:
X-rays: provide a clear picture of the bones and whether there is calcification in the lower part of the Achilles tendon attached to the heel bone. In cases of severe inflammation of the second type, the X-ray images may show calcification in the middle part of the Achilles tendon.
MRI: is not necessary to diagnose Achilles tendonitis, but it is necessary to plan the surgical operation if the condition requires it. MRI images show the extent of the damage and rupture in the Achilles tendon and to determine the most appropriate procedure according to the degree of rupture of the Achilles tendon.
Types of Achilles tendonitis
Treatment
Conservative methods: In the early stages of Achilles tendonitis, conservative treatment options may be used. This includes many different methods that your doctor may advise you to use for your condition, including the following:
Reducing activities and resting, or changing to another type of less strenuous sport.
Stretching and strengthening the calf muscle (physical therapy).
Applying ice packs after exertion or feeling pain.
Raising the foot to reduce swelling (lying down and raising the foot on a pillow).
Using a brace to stabilize the ankle joint.
Taking some anti-inflammatory medications.
Wearing some special medical shoes that reduce pressure on the Achilles tendon.
Local injections: including cortisone injections, which were commonly used in the past, but are rarely recommended at the present time due to the risks of causing Achilles tendon rupture, which have been shown by recent scientific studies.
Regenerative therapy: It is one of the latest methods for dealing with Achilles tendonitis and partial Achilles tendon rupture, and is considered an alternative treatment to temporary local injections such as cortisone injections. Platelet-rich plasma injections are an alternative solution that works to relieve pain, improve movement, and stimulate the repair of damaged tissue in the Achilles tendon. This is done by injecting platelet-rich plasma derived from the patient's own blood and injecting it at a high concentration into the tendon locally. The principle of this method is based on stimulating the healing process and self-healing of the damaged tissue in the Achilles tendon, and this principle is radically different from the methods mentioned above. Surgical methods: They are resorted to as a last resort, and the types of operations vary according to the location of the damage in the tendon and the severity of the damage, such as the process of lengthening the calf muscle to reduce pressure on the Achilles tendon, or the process of suturing the damaged part of the Achilles tendon, or the Achilles tendon transplantation process where a tendon is taken from the big toe and used to repair the Achilles tendon. All of these surgeries require a long period of rehabilitation, strengthening, and physical therapy and may lead to complications or cause the patient to refrain from returning to competitive sports as he did before.
Comentários