Tag Archives: achilles tendon

Achilles Tendinopathy

Summary

  • Achilles Tendinopathy is a condition where there is pain, swelling, stiffness, and weakness in your Achilles tendon.
  • It is caused by repeated tiny injuries in this area.
  • Pain develops gradually especially in the morning upon waking up but is worse during rest after exercise.

How did I get this?

  • Achilles tendon is important part of your leg which is found behind and above your heel. It joins the heel bone to your calf muscles. This helps to bend your foot downwards at the ankle. Overuse of tendons, wearing inappropriate footwear during exercise, poor flexibility, and increased intensity of exercise can result to injury in your Achilles tendon. Other causes include arthritis and long-term use of some antibiotics (e.g. Ciprofloxacin).

What can I do about it?

  • Rest and avoid strenuous exercise (such as running). As you improve, you can restart exercise gradually.
  • Cold compress (ice pack) will help to decrease swelling and control the pain.
  • Compression using bandage can also minimize pain and aid in reducing the inflammation.
  • Elevate the injured area above the heart while sitting.
  • For prevention, make sure you stretch before and after exercise.
  • Short term use of anti-inflammatory drugs can be helpful to decrease the pain.

What help can I get for this?

  • A podiatrist for special heel pads to wear in the shoes for cushion and support, and a program of special exercises for the strengthening of the injured tendons.
  • Footwear advice or modification and possible orthoses to relieve strain on the Achilles tendon.
  • A surgeon, if symptoms do not improve after 3 to 6 months, might proceed with surgical repair of the tendons.

When will it get better?

  • Symptoms usually clear within 3 to 6 months of starting nonsurgical treatment (as described above). The earlier the diagnosis and treatment, the better the outcome.

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Retrocalcaneal bursitis

Summary

  • Retrocalcaneal bursitis is a condition characterized by tissue damage and inflammation of the retrocalcaneal bursa (a small fluid filled sac located at the back of the heel) causing heel pain. Risk factors include poor foot biomechanics (particularly flat feet), inappropriate footwear (e.g. excessively tight fitting shoes).  Muscle weakness or tightness (particularly the calf, quadriceps and gluteals), joint stiffness (particularly the ankle or foot), and bony anomalies of the heel bone should be considered. External factors where there is overuse or or a change in conditions or activity are often a factor.

How did I get this?

  • Compressive forces and friction may be placed on the retrocalcaneal bursa during certain ankle movements or by wearing excessively tight shoes. When these forces are excessive due to too much repetition or high force, irritation and inflammation of the bursa may occur.

What can I do about it?

  • Rest.
  • Massaging the calf muscles.
  • Stretching.
  • Ice packs.
  • Seek podiatry consultation.

What help can I get for this?

  • Podiatrist may prescribe padding or strapping, appropriate footwear/modification, exercises, or orthotics
  • Orthopaedic surgeon for surgical removal of bone spur (if present), removing the thickened inflamed retrocalcaneal bursa, and debriding the Achilles tendon.

When will it get better?

  • This condition usually gets better in several weeks with the proper treatment.

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Posterior Heel Spur

Summary

  • Posterior heel spur occurs where the achilles tendon inserts into the back of the heel bone. If there is excessive pull at the attachment, the area can become painful. In some instances a bone spur can form at the back of the heel. There is pain directly over the bone at the back of the heel.

How did I get this?

  • Overuse particularly in sport. However, bone spurs can take many years to form without being painful.

What can I do about it?

  • Rest.
  • Ice.
  • Heel raises can help.
  • An Achilles heel protector can be of benefit.
  • See a podiatrist.

What help can I get for this?

  • Podiatrist may advise appropriate shoes, stretching, heel raise , and possible guided injection for symptoms control.
  • Orthopaedic surgeon for surgical removal of bone spur.

When will it get better?

  • This can be a very difficult condition to treat and can take several months to settle. Whilst the treatment options can be of benefit, they will not reduce any bone spur. With surgery, it often involves a long recovery (6-12 months).

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OsTrigonum Syndrome

Summary

  • Ostrigonum syndrome refers to pain in the back of the ankle. The Ostrigonum is an extra (accessory) bone that sometimes develops behind the ankle. The presence of an Ostrigonum in one or both feet is congenital (present at birth). It becomes evident during adolescence. Pain in the back of the ankle is the first indicator of Ostrigonum syndrome. The area in front of the Achilles tendon is sore to touch and the bony prominence may even be palpable. The diagnosis can usually be confirmed by x-ray views of the ankle from the side.

How did I get this?

  • Ostrigonum syndrome is usually triggered by an injury, such as an ankle sprain. The syndrome is also frequently caused by repeated downward pointing of the toes, which is common among ballet dancers, soccer players and other athletes.

What can I do about it?

  • Rest to stay off the injured foot to let the inflammation subside.
  • Applying a bag of ice covered with a thin towel to the affected area decreases inflammation process.
  • Short term nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
  • Seek podiatry consultation.

What help can I get for this?

  • Podiatrist may consider immobilization using a walking boot or splint to restrict ankle motion to allow healing.
  • Your doctor may prescribe cortisone injection into the area to reduce the inflammation and pain.
  • Foot and ankle surgeon for possible removal of Ostrigonum.

When will it get better?

  • Most patients’ symptoms improve quickly with non-surgical treatment. However, in some patients, surgery may be required to relieve the symptoms. There is usually persistent swelling and discomfort after the surgery so limiting activities is required until these symptoms settle.

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