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Achilles Tendinopathy

Overview

The Achilles tendon is the largest tendon in the body which attaches to the back of the heel. It is part of the calf muscles and primarily helps in push off during running. Achilles tendon integrity is necessary for running, climbing stairs and a lot of other daily activities.

 

Why am I getting heel pain?

The area of Achilles tendon insertion to the heel bone is subject to a lot of stress as it forms the tie beam for the plantar fascia. A stiff plantar fascia transfers stress to the Achilles tendon insertion. Increased stress in this area leads to increased frequency of micro injuries. We often see a bone spur growing over here at the site of insertion. This is due to body depositing calcium there while attempting to heal the micro tears. Hence bone spur is the consequence of the problem and not the reason for the problem.

 

Who gets Achilles Tendinopathy?

 

This is often seen in the age group between 30 and 50. It occurs in both sporting and non-sporting population. In sporting population the reason for Achilles tendinopathy are

  • Poor warm up

  • Restarting playing / running after a long gap

  • Sudden escalation in the intensity of the workouts

  • Over use (Not having gap days or rotation to help heal the stress injuries)

 

 

Symptoms

 

  • Pain when climbing steps or running.  

  • Pain after playing or running.

  • Swelling around the back of the heel

 

When to seek medical help?

 

If the pain is not getting relieved with heat therapy, analgesic gels and sprays and with basic warm up stretches, then it is necessary to see a Sports Orthopedics Surgeon. The diagnosis is based on the symptoms and clinical examination. X-ray may sometimes be asked for, however the x-ray helps to rule out the heel bone (Haglund deformity) abnormality causing the Achilles tendon irritiation.

What happens to Achilles tendinopathy if no treatment is undertaken?

The micro-injuries of the Achilles tendon may persist and are likely to keep stopping you from doing further activities such as running. Natural healing of the tendon can take place over a period of 12 to 24 months, but in majority the pain persists unless the right kind of remedies is undertaken.

 

What happens when I visit the Consultant?

 

You will be asked about your sporting history, symptoms further to that so far. Consultant will examine you and discuss the treatment modalities.

What treatment options do we have?

 

The treatment modalities range from simple exercise based treatments to PRP Injection to surgical treatments such as arthroscopic removal of Haglund deformity and debridement

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