Disorders of the Achilles Tendon: Causes and Treatment Methods

Also referred to as the heel cord, the Achilles tendon enables walking and running by helping to lift the heel off the ground. Today Dr. Hubert Lee of CarePlus Foot & Ankle Specialists is sharing some information regarding some of the most common disorders associated with it.

Two disorders that commonly occur in the Achilles tendon are:

  • Achilles tendonitis, which is a temporary swelling of the Achilles tendon;
  • Achilles tendonosis, which occurs when the tendon loses its structure and develops tiny tears.

Causes of Achilles Tendon Disorders

Commonly referred to as “overuse” disorders, these conditions are typically caused by a sudden increase in a repetitive activity that involves the Achilles tendon.

This type of activity places too much stress on the tendon too quickly, injuring the tendon fibers. As a result of this continuing stress on the tendon, the body can’t repair the injured tissue and the structure of the tendon is altered, resulting in ongoing pain.

Treatment for Achilles Tendon Disorders

Treatment methods for Achilles tendonitis or tendonosis are chosen based on how long the condition has been present and the severity of the damage. In the early stages, one or more of the following treatment options may be recommended:

  • Ice: To decrease swelling, apply a bag of ice over a thin towel (never directly on the skin) to the affected area for 20 minutes of each hour that you are awake.
  • Immobilization:This can include the use of a removable walking boot or cast to promote healing.
  • Orthotics: For those with gait abnormalities or over-pronation, custom orthotic devices may be recommended.
  • Physical therapy: This will typically include soft-tissue massage, stretching, ultrasound therapy, and exercises to strengthen the tendons.
  • Oral medications:Anti-inflammatory drugs, such as ibuprofen, can decrease pain and inflammation.
  • Splints:Night splints help to maintain a stretch in the Achilles tendon while sleeping.

If these non-surgical methods aren’t successful in returning the tendon to its regular condition, surgery may be recommended. Your podiatrist will perform the most effective procedure to repair the tendon, based upon the severity of the injury, your activity level, and age, in addition to other factors.

If you are experiencing pain in your Achilles tendon – don’t delay – contact the office of Dr. Hubert Lee at CarePlus Foot & Ankle Specialists to schedule a consultation. Call our office today at (425) 455-0936 to book your visit or schedule an appointment online.

Plantar Fascia Ruptures

What is a Plantar Fascia Rupture?

Plantar Fascia RuptureThe plantar fascia is a thick band of tissue on the bottom of your foot that extends from your heel to your toes.  It provides stability and support to your arch.  A common cause of heel pain known as plantar fasciitis can occur when the fascia becomes inflamed.  The plantar fascia can also traumatically tear or rupture.  This can occur when jumping or falling from a height or during activities like running or basketball.  If you suffer from a plantar fascia rupture, you may hear or feel a “pop” in your arch.  You will also likely experience sharp pain with bruising and swelling in your arch and heel.

A torn plantar fascia is very painful and requires proper treatment.  Diagnosis of a plantar fascia rupture is made by a complete history and exam.  X-rays and occasionally an MRI may also be necessary.

Treatment and Recovery from a Plantar Fascia Rupture

Treatment for a torn plantar fascia begins with a period of immobilization and crutches followed by a walking boot.  Physical therapy will be initiated, and a supportive, custom orthotic will be made to decrease tension on the fascia.  Recovery can take 9-12 weeks.  Surgery is typically not required, because the fascia tends to heal well on its own.  In fact, a surgical treatment for heel pain caused by plantar fasciitis involves cutting and lengthening the tight fascia.

A ruptured plantar fascia can take several months to completely resolve.  In a 2004 study involving 18 patients with a torn plantar fascia, all patients returned to activities within 4-26 weeks with an average of 9 weeks.  The patients in this study were mostly runners, but this condition can occur in any activity with jumping or running.  If you are suffering from either acute or chronic heel pain, proper diagnosis and treatment of a plantar fascia rupture will ensure a timely return to your activities.

Facts About Achilles Tendinitis

What is the Achilles Tendon?

Achilles tendinitisThe Achilles tendon is the thickest and strongest tendon in your body.  It runs along the back of your lower leg and inserts onto the heel bone.  When running, the Achilles tendon may endure up to 8 times your body weight.  Because of this stress, the Achilles tendon can be easily injured.  This condition is known as Achilles tendinitis and is a common cause of leg and heel pain in an active individual.

Causes

While there are many factors which may cause Achilles tendinitis such as the lack of flexibility, it is commonly caused by overuse.  This occurs when there is a sudden change in activity level without proper training or conditioning.  If you just ran up and down the hills of Seattle and the back of your heel hurts, you may have Achilles tendinitis.

Symptoms

Achilles tendinitis often begins with swelling and an ache or stiffness in the back of the leg and heel.  If left untreated, the pain can worsen, and in severe cases, the tendon may even rupture.

Treatments

Most cases of Achilles tendinitis can be treated conservatively.  Initial treatments can include rest, ice, gentle stretching, splints, and oral or topical medications.  Physical therapy can provide additional relief.  In some cases, the Achilles tendon may require temporary immobilization with a walking boot.  Surgery may be necessary if the pain worsens despite conservative treatments.

Once the pain resolves, it is important to gradually return to activities to avoid re-aggravating the Achilles tendon.  Proper shoes, orthotics, stretching, and strengthening exercises can help prevent future injuries.