What are Chronic Achilles Tendon Disorders?
There are several Chronic Achilles Tendon disorders that can occur when exposed to extreme or explosive forces during activities like walking, running, jumping, and the like. The two major muscles of the calf are connected to the ankle joint via the Achilles tendon, meaning when those muscles are called on for a sudden forceful movement, the quick increase in stress can damage the Achilles tendon. Some of the chronic disorders of the Achilles tendon include:
- Paratenonitis, which is characterized by inflammation in the paratenon, or the loose tissue that connects the tendon to the bones around it.
- Tendinosis, which is a degenerative condition, but is not inflammatory.
- Paratenoitis with tendinosis, which is when both exist together.
- Retrocalcaneal bursitis, which is when the bursa (fluid-filled sac) that lays between the tendon and heel bone causes inflammation.
- Insertional tendinosis, which is a degenerative condition characterized by a calcified attachment between the tendon an bone.
- Chronic rupture, which is when the tendon tears and can be the result of a gradual tear or a tear having happened all at once. Left untreated these tears will not heal and cause further complications, like a chronic rupture.
Causes of a chronic Achilles tendon disorder:
Typically the two distinct patients types that present with chronic Achilles tendon disorders are young athletes with difficulty running and older, less active individuals with trouble walking. Typically pain associated with these disorders presents gradually over time, further causing issues with certain movements.
Symptoms of a Chronic Achilles Tendon Disorder:
Symptoms of a chronic Achilles tendon disorder include:
- Pain, especially in the morning
- Pain that subsides after a period of rest
- Pain that worsens with increased motion and movement
- Tenderness or intense pain of the Achilles tendon, especially when squeezing the tendon
Diagnosis of a Chronic Achilles Tendon Disorder:
In diagnosing a chronic Achilles tendon disorder, your othopaedic surgeon will examine your foot and ankle, carefully evaluating the range of motion and the functionality of the tendon. Further imaging, like x-rays, MRI scans or CT scans may be ordered to assess the extent of the injuries.
When is surgery recommended in Chronic Achilles Tendon Disorders?
Surgery for chronic Achilles tendon disorders is often recommended when conservative treatment efforts (i.e., physical therapy, orthotic devices, rest, ice, compression, etc.) have not been effective in improving the condition or relieving symptoms.
Surgical procedures used for Chronic Achilles Tendon Disorders:
The most used procedures for chronic Achilles tendon disorders include the following:
- Achilles tendon debridement: This procedure involves removing damaged or degenerated tissue from the Achilles tendon. This promotes healing and reduces pain.
- Achilles tendon repair: In instances where the Achilles tendon is partially or completely torn, surgery may be needed to reattach the tendon to the heel bone.
- Achilles tendon lengthening: This procedure is performed to lengthen a tight Achilles tendon, which can help relieve pain and improve flexibility.
- Tendon transfer: In some cases, a tendon transfer may be necessary to repair a severely damaged Achilles tendon, which involves taking a tendon from another part of the body and using it to replace the damaged Achilles tendon.
Your trusted orthopaedic surgeon will be able to best determine an appropriate surgical procedure for your specific condition. Recovery from Achilles tendon surgery can take several months, and physical therapy is often recommended to further restore strength and flexibility in the affected Achilles tendon.