Achilles Tendon Problems
The Achilles Tendon is the band of tissue that attaches the calf muscle to the back of the heel bone. It is located behind the ankle and is visible as a tight, cordlike structure. This tendon is extremely important for walking and especially for performing athletic activities as it is responsible for pushing off and standing on toes. Therefore, problems with the Achilles Tendon need to be addressed appropriately.
Achilles Tendon pain (commonly referred to as Achilles heel pain) is usually caused by Achilles Tendonitis. This means inflammation or swelling of the Achilles Tendon, and is usually the result of a strain or overuse. Many times, the calf muscles and/or the Achilles Tendon become too tight which causes a strain of the tendon. This causes pain behind the ankle, in the tendon itself and in the heel bone where the tendon attaches. Therefore, stretching the calf and Achilles tendon is an important part of the treatment for most cases of pain in the back of the heel. Your foot and ankle specialist might also need to immobilize your ankle in a cast or boot, dispense a night splint, prescribe anti-inflammatory medicines, recommend orthotic insoles, or physical therapy.
When Achilles Tendonitis lasts for a long time, it can lead to degeneration of the Achilles Tendon, or Achilles Tendinopathy. This occurs in the same area of the Tendon, behind the ankle in the “Watershed Region” of the Achilles, where there is not much blood flow to the tendon. In this area, micro- tears can occur, which do not heal well as we age and this leads to degeneration or weakening of the tendon. This causes more pain and swelling and usually can be seen and felt as great thickening of the Achilles behind the ankle and at the back of the heel. Diagnosis is based on a MRI to determine the extent of inflammation, tearing or degeneration present in the tendon. Treatment for degeneration of the Achilles is long term immobilization followed by the same treatments mentioned above. Stem cells, PRP or Amniotic Fluid Injections can accelerate healing of this condition substantially and reduce the likelihood of recurrence. Surgery may be necessary as a last resort to remove the degenerated tissue and repair the tendon.
Haglunds Deformity or Heel Spur
In some cases, a bony prominence develops on the back of the heel where the Achilles tendon attaches called a Haglunds Deformity or Heel Spur. This can cause even more pain and often requires surgical treatment to remove the sharp bone, repair and reattach the tendon. Lengthening of the Achilles Tendon and/or the Calf muscle may also be indicated in severe cases in order to prevent the heel pain from coming back.
Ruptured (Broken) Achilles Tendon
Achilles tendon rupture, sometimes referred to as a Broken or Torn Achilles tendon is the worst form of injury causing Achilles heel pain. In this case, the tendon is broken or torn into two pieces, usually in the area ofa weakened or degenerated tendon as mentioned above. This usually occurs during sports but can also occur from stepping the wrong way if the tendon is weak. Treatment of a partially broken or torn Achilles tendons may consist of casting and non-weight bearing, but complete ruptures may require surgery to repair the tendon in order to regain full function of the foot.
Achilles Tendon Pain should not be ignored. Contact the podiatrists at Certified Food & Ankle Specialists for an evaluation if you notice any pain in your heel. If caught early on, these conditions are treatable without surgery.