The Achilles tendon is the
largest tendon in the body. It is formed by the merging together of the upper calf muscles and inserts into the back of the heel bone. Its blood supply comes from the muscles above and the bony
attachment below. The blood supply is limited at the ?watershed? zone approximately 1 to 4 inches above the insertion into the heel bone. Paratendonitis and tendinosis develop in the same area.
Achilles tendinitis implies an inflammatory response, but this is very limited because there is little blood supply to the Achilles tendon. More appropriate descriptions are inflammation of the
surrounding sheath (paratenonitis), degeneration within the substance of the tendon (tendinosis) or a combination of the two.
Tendinitis can result from an injury or over-use. Improper stretching prior to exertion or incorrect form during physical activity can also contribute to the development of tendinitis. Some people,
including those with ?flat feet,? tight tendons or arthritis, are particularly prone to tendinitis.
Symptoms include pain in the heel and along the tendon when walking or running. The area may feel painful and stiff in the morning. The tendon may be painful to touch or move. The area may be swollen
and warm. You may have trouble standing up on one toe.
The doctor will perform a physical exam. The doctor will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes. X-rays can help diagnose bone problems.
An MRI scan may be done if your doctor is thinking about surgery or is worried about the tear in the Achilles tendon.
Self-care strategies include the following steps, often known by the acronym R.I.C.E, Rest. You may need to avoid exercise for several days or switch to an activity that doesn't strain the Achilles
tendon, such as swimming. In severe cases, you may need to wear a walking boot and use crutches. Ice. To decrease pain or swelling, apply an ice pack to the tendon for about 15 minutes after
exercising or when you experience pain. Compression. Wraps or compressive elastic bandages can help reduce swelling and reduce movement of the tendon. Elevation. Raise the affected foot above the
level of your heart to reduce swelling. Sleep with your affected foot elevated at night.
When the tendon tears or ruptures the variety of surgical techniques are available to repair the damage and restore the tendons function. Recent research that is done at Emory University Department
of orthopedics have perfected the repair of the Achilles tendon. The procedure is generally involves making an incision in the back of your leg and stitching the torn tendon together using a
technique developed and tested by Dr. Labib. Depending on the condition of the torn tissue the repair may be reinforced with other tendons.
Suggestions to reduce your risk of Achilles tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain an adequate level of fitness for your sport, avoid dramatic
increases in sports training, if you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse, wear good quality supportive shoes
appropriate to your sport. If there is foot deformity or flattening, obtain orthoses, avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf
muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury, maintain a normal healthy weight.