Achilles tendinosis is a chronic condition that is also known as degenerative tendinopathy. The condition, which may start out as tendonitis that is left untreated, can be caused by overuse or improper footwear. While there may not be full recovery from Achilles tendinosis, there are treatment options to help lessen the severity of symptoms. The best bet is to take steps to prevent it condition from occurring, which means paying attention to the body and seeking treatment as soon as any symptoms are evident.
Identification
The Achilles tendon, which is the longest tendon in the body, attaches the calf muscles to the heel bone. This tendon is used to push off the foot when walking, running or raising up onto the toes. The Achilles tendon can become tight and it is prone to injuries such as tendinitis, which is an inflammation of the tendon. According to the The Nicholas Institute of Sports Medicine and Athletic Trauma, tendinitis left untreated can become tendinosis. Achilles tendinosis is diagnosed when the tendon starts to degenerate and develops microtears.
Causes
Tendon injuries tend to happen in cases where the intensity of a workout routine is drastically increased, states the Journal of the American Medical Association. It can happen when a sedentary person suddenly tries a hard workout or when an athlete abruptly changes to a higher level of intensity. Exercising on a different surface than normal or suddenly adding in a stair or uphill workout can also stress the tendon too much. Wearing high heels, pronating the foot (rolling in) and weak calf muscles can all contribute to Achilles tendinitis and eventually tendinosis. Tendinosis typically occurs between the ages of 35 and 45.
Diagnosis
The first step in treatment is to diagnoses the severity of the injury. Diagnosing this condition involves a physical exam, a review of the history of symptoms and, when necessary, an MRI. An MRI can tell a physician the severity and location of the tears. With Achilles tendinopathy the tendon appears swollen and it will be painful to the touch. The Foot and Ankle Clinic at Lindsay Park states that a physician can palpate the area to check for a thickening of the tendon. Pushing off of the foot or rising up onto the toes will make the pain worse, and if the tears are severe, these motions may be limited.
Treatment and Prognosis
The treatment of Achilles tendinosis first involves resting the area and avoiding the activities that cause pain to allow the area to heal. This can take time because there is limited blood supply to the Achilles tendon as compared to other areas of the body. The length of recovery time and the prognosis depends on the severity of the injury. The sooner treatment is started after symptoms appear the better the outcome. If treatment is delayed until the pain is severe, recovery will take longer and may not be complete. A minor injury may require a week or two of treatment and then a gradual return to normal activities. A more severe case can take months, may require immobilization of the area and full use of the ankle may never return. Initially a period of physical therapy, ice and medication may be needed to help control symptoms. A physical therapist can demonstrate safe and effective exercises to help the tendon regain flexibility and strength. If conservative methods fail, surgery may be required to repair the torn tendon. However, surgery is not always successful, and in some cases the tendon can not be repaired. This may lead to chronic pain and limited activities.
Prevention/Solution
The best way to manage Achilles tendinosis is to listen to the body when exercising so you know if the training intensity has become too much. Early signs, such as stiffness after inactivity and soreness in the Achilles tendon area during activity, should be taken seriously and training intensity should be reduced. Pain that continues after exercise stops is an indication that the injury to the tendon is getting worse. Cross training is an important component in the treatment of Achilles tendinosis. This means alternating walking and running or other high impact sports with low to no impact activities. Biking and swimming are good alternatives. Making sure the calf muscles are strong is also essential. This involves participating in a strength training program using weights or bands at least three times a week. Keeping the Achilles tendon flexible with a daily stretching program and by warming up before activities will help to lower the risk of future injuries and tears.
