Molly S. Judge DPM, FACFAS

Achilles Tendonitis Basics


Tendonitis is no small matter especially when it comes to the Achilles tendon. What may start as tendonitis may just put you on the bench.

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An Achilles tendon tear or rupture is often the result of Achilles tendonitis that has gone without treatment. Over time, the inflammation of this condition gets worse causing changes within the tendon that weaken it and later result in partial tears.
Achilles tendonitis, inflammation of the strongest tendon of the leg, ankle and foot, can sneak up on you very slowly over time. Often patients fail to identify any injury or accident that may have caused it to develop. This condition results in pain and a loss of motion at the ankle. If you have pain behind your ankle and cannot bend the ankle beyond 90 degrees to the leg it is likely that you have a tight Achilles tendon. To check for this, a patient lies flat on his back with the knee bent.
The foot is positioned with the second toe aligning with the center of the knee. Pushing up on the foot the ankle will flex causing tension along the Achilles tendon. If the Achilles tendon is too tight, the ankle will not flex past a 90 degree angle with the leg. Often this tightness is painful and simple squeezing of the calf muscle can cause a lot of pain.
Over time, if untreated, Achilles inflammation, or swelling, actually causes a wearing of the tendon covering and later begins to weaken the tendon fibers much like a shoe string wears thin and before it breaks.

If we take a look at a painful flat foot condition it is common to find localized tenderness about the navicular tuberosity and or along the inner arch of the foot. If this is truly a structural problem then improving the posture of the foot and ankle via an orthotic device should prove definitive in reducing symptomatology.
When the chronic flat foot pain is recalcitrant despite aggressive orthotic devices then the diagnoses becomes suspect and in fact there may be a more important dynamic component of the condition that has yet to be uncovered. Commonly tendonopathy and fasciosis develop insidiously over time and often simultaneously. Therefore ancillary imaging becomes helpful in determining the nature and extent of the pathology. This added information will help the physician to devise a thoughtful and protective treatment plan.

Do you want to learn more?

Read some articles that Dr. Molly S. Judge wrote about the subject

Picture of female in sportswear stretching in exterior with foot on railing.

Molly S. Judge DPM, FACFAS

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