Our feet undergo a lot of wear and tear and are constantly at a risk of infections. One such common condition anyone’s feet can experience is Achilles tendinosis.
Image Courtesy: modpodpodiatry.com.au
Achilles tendon is the biggest tendon in our body. It’s situated at the back of your lower leg and runs from your calf muscles towards your heel bone.
It is used whenever you walk, jump, climb stairs, run and stand on your tip toes. So, you can imagine how much stress it has to undergo. But although it can withstand all this stress, it’s also prone to tendinosis.
What is Achilles Tendinosis?
Achilles tendinosis refers to the degeneration of Achilles tendon. Several patients as well as doctors, unfortunately, confuse Achilles tendonitis with Achilles tendinosis.
In fact, Achilles tendinosis is a chronic condition characterised by minute tears of Achilles tendon. Achilles tendonitis on the other hand occurs when the tendon has an acute inflammation.
Distinguishing between these two conditions is important in order to start proper treatment which can be done by expert podiatrists at https://www.modpodpodiatry.com.au/sydney-city/ for example.
Inflammation Vs. Degeneration
The term Achilles tendonitis refers to the inflammation of Achilles tendon.
Inflammation is usually an acute change (resulting from a sudden injury). It is characterised by redness, swelling, pain and warmth.
Crepitus is a common symptom of Achilles tendonitis which is a grinding sensation which can be felt when you place your hand over a moving tendon and is caused by the inflammation and swelling of the tendon.
If observed under a microscope, inflammatory conditions show particular cells that are brought by the body to the affected area to help control the inflammation and heal the injury.
On the other hand, Achilles tendinosis is an altogether different condition which is not characterised by inflammation. Instead, Achilles tendinosis patients have their tendon thickened.
Warmth or redness is usually absent. However, the area can be sore to touch. Achilles tendinosis is a chronic condition which means that it develops slowly and lasts for a long time.
If observed under a microscope, it will show no inflammatory cells, though minute tears and chronic damage of the tendon can be seen.
Symptoms of Achilles Tendinosis
To diagnose the condition, the best source is its symptoms. Often an X-ray of the ankle will look normal. However, small bone spurs or calcific deposits around the tendon may be seen that are signs of chronic inflammation.
Your doctor may also perform an MRI test that can show microscopic degeneration or tearing of the tendon tissue, and also thickening of the damaged part of the tendon.
It’s essential to distinguish between tendinosis and tendonitis because treatments to both the conditions will differ.
Treatment of Achilles Tendinosis
It’s important to understand that since there is no inflammation in Achilles tendinosis, treatment to control inflammation may not be helpful.
Hence, although ice application and anti-inflammatory medications may be used to address symptoms of discomfort related to Achilles tendinosis, they are not actually addressing inflammation in this condition.
Instead therapeutic exercises, shoe inserts and stretching are more effective therapies for Achilles tendinosis.
Exercises focusing more on eccentric contraction of the Achilles tendon have been particularly found to be the most effective to trigger healing of the damaged part of the tendon.
Eccentric contractions are done by contracting the muscle-tendon unit and applying a lengthening force at the same time. E.g. doing toe dips and dipping down slowly is a helpful eccentric exercise for Achilles tendon.
Image Courtesy: modpodpodiatry.com.au
Is Surgery Necessary?
In a few rare circumstances, your doctor may suggest surgical treatment of the affected tendon. Most often, the affected portion of the tendon is removed surgically in most of these cases.
Once it is removed, the defect in the surrounding tendon is repaired.
However, the effectiveness of this treatment is questionable and some surgeons think that this treatment is effective really because of the rehab that is done after the surgery.
Take the opinion of podiatrist Sydney City like ModPod Podiatry to find the best treatment suited to your Achilles tendinosis and you can live a comfortable life.