Achillodynia: Description, Causes and Risk Factors:The Achilles tendon is a strong tendon that connects the calf muscles to the heel. When the calf muscles contract they pull on the Achilles tendon causing your foot to point down (plantar flexor) allowing you rise up on your toes. This powerful muscle group allowing you to sprint, jump, or climb.Achillodynia is the medical term for chronic pain in the Achilles tendon. The condition is caused by overuse (e.g. competitive sports), foot deformities, injuries, and certain medications. Characteristically, the problem starts as pain occurring during exercise or sports activities, with the pain being localised in the area where the Achilles tendon attaches to the heel bone. As the condition progresses, the pain is felt even during rest and the tendon area become hot and swollen.Chronic achillodynia are mostly due to ether an injury of the tendon itself (tendinosis) or to an inflammatory process occurring inside the surrounding tissues (bursitis or peritendinitis); these lesions are often seen simultaneously. The Achilles tendon plays an important role during gate (mainly during the propulsion phase), which explains its high incidence in runners, particularly those who are used to train and compete on steep slopes. The diagnosis of the condition is essentially based on medical history and examination: search for trigger factors and events, precise location of the complaints.Other factors associated with achillodynia are recent changes in footwear, and changes in exercise training schedules. Often long distance runners will have symptoms of achillodynia after increasing their mileage or increasing the amount of hill training they are doing.As people age, tendons, like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to achillodynia.The true incidence of achillodynia is unknown, although there is a reported incidence of 6.5-18% in runners.Symptoms:Symptoms may include:· Pain in and around the heel and ankle.
· Pain worse on starting activity and for some time after ceasing it.
· A deep ache on using the calf muscles.
· Stiffness in the tendon.
· Tenderness of the tendon.
· A clicking or similar noise on moving the tendon.
· Swelling of the heel and ankle.
Diagnosis:The physical examination generally reveals localized pain and, in some cases, a palpable bump at the site where the Achilles tendon attaches to the heel bone. Diagnostic options consist of ultrasound (sonography), plain radiographs (X-ray) to check for signs of tendon calcification, and magnetic resonance imaging (MRI) for a more precise assessment of anatomic structures.Treatment:As a rule, conservative treatment is attempted first. Conservative treatment measures include shoe modification, ice, heat, physiotherapy (calf muscle stretching exercises), and medications to reduce pain and inflammation. If all conservative measures fail to relieve the symptoms, then surgical treatment is performed. The surgery is performed through a small incision made in the skin directly over the Achilles tendon. The irritated, inflamed and necrotic (dead) tissues are removed. After surgery, early functional mobilisation will be initiated. This means that physiotherapy is started in the early postoperative phase in order to prevent tissue adhesion and to achieve full recovery of the tendon.NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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