Achilles Tendonitis

The achilles tendon is the largest tendon in the body and can withstand forces in excess of 1000 lbs.  It is also one of the most injured tendons and susceptible to rupture.  This is seen not only in the elite athlete, but also in the  weekend warrior.

 The achilles tendon may become injured from rapidly increasing your running speeed or milage or running up hills or steep inclines on the treadmill. It may be the result of a quick burst of speed as in tennis or basketball or a chronic degeneration in the tendon as a result of the aging process or medications(steroids or certain antibiotics such as Cipro or Levaquin)

Symptoms of achilles tendonitis include pain in the back of the heel where the tendon attaches to the heel or in the area approximately 2-3 inches above the attachment in the so called watershed area.  Pain is usually most intense with initial weightbearing from a sitiing or lying position.  There may also be a feeling or weakness and a palpable bulge in the tendon itself.

Treatment is aimed at reducing the inflamation and controlling the excessive stretch to the tendon. This is accomplished with ice and anti-inflamatory medication.  Gentile stretching exercises prior to weightbearing and the use of a nightsplint can also be helpful. Heel cups or gait orthotics may be worn in the shoe to reduce the pull of the achilles and physical therapy may also be helpful.

Recent non surgical advances including ESWT(extracorporeal shockwave) and PRP(platelet rich plasma) have also helped heal this painful and sometimes chronic condition.  In rare instances surgical intervention may be necessary after all conservative measures have been exhausted.

For more information contact:

Dr William A Sachs


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