Achilles tendinosis is a chronic condition in which small tears develop in the Achilles tendon. Over time, these tears occur due to overuse or strain, and are more common in individuals in their 30s and 40s. As the tears accumulate, blood flow to the tendon decreases, making it harder for the tendon to heal. This condition can be quite painful and can worsen without treatment.

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Causes of Achilles Tendinosis

Achilles tendinosis is primarily caused by overuse of the tendon, making sudden or repetitive movements that strain the Achilles tendon, or wearing improper footwear.

  • Sports and Physical Activity: Sports that involve running, jumping, pivoting, or pushing off from the toes (such as basketball, football, or tennis) place constant strain on the Achilles tendon. Over time, these movements can cause the tendon to weaken, making it more prone to small tears.
  • Lack of Stretching: Failing to stretch or warm up properly before physical activity can leave the tendon tight and more vulnerable to injury, increasing the likelihood of developing tendinosis.
  • Footwear: Wearing shoes with high arches or frequently switching between heels and flats can strain the Achilles tendon, contributing to tendinosis by stretching the tendon improperly.

Symptoms of Achilles Tendinosis

The symptoms of Achilles tendinosis may include:

  • Development of scar tissue that may cause a noticeable thickening of the tendon.
  • Pain and soreness around the Achilles tendon, typically located between the heel and calf.
  • Reduced range of motion in the ankle.
  • Stiffness and creaking of the tendon, particularly in the morning.
  • Swelling around the Achilles tendon.
  • Weakness or pain when pushing off from the toes.

Treatment of Achilles Tendinosis

Treatment for Achilles tendinosis focuses on resting the tendon and reducing stress to allow it time to heal. Key treatment options include:

  • Rest and Reduction of Activity: Reducing activities that put strain on the Achilles tendon is important to allow healing. Activities that don’t involve the Achilles, such as swimming or biking, may be recommended.
  • Pain Relief: Over-the-counter pain relievers, such as aspirin or ibuprofen, can help reduce pain and inflammation.
  • Bracing or Immobilization: A boot or brace may be used to keep the foot in place, helping with healing. However, the foot shouldn’t be immobilized for too long, as this can weaken the tendon and make it more susceptible to injury.
  • Physical Therapy and Stretching: Once the acute pain reduces, physical therapy and stretching exercises are essential to regain strength and flexibility in the tendon.

Healing typically takes a few weeks, but it can take longer if circulation to the tendon is poor. In severe cases, when non-surgical treatments haven’t worked after several months, surgery may be required to either remove scar tissue or transfer another tendon to restore function.

If you are suffering from Achilles tendinosis, it’s important to consult with your doctor to discuss the best treatment plan and determine whether surgery might be necessary.