How It Happens and How It’s Treated

Dr. Kevin Plancher

Most of the time, Achilles tendinosis doesn’t result from trauma or an injury, but a slow spiral of chronic wear and tear.

The Achilles tendon is the largest, strongest tendon in the body. Few pay attention to this tendon and muscle it until it becomes inflamed – causing pain and tightness – in a condition known as Achilles tendinosis, according to orthopaedic surgeon Kevin D. Plancher, MD, founder of Plancher Orthopaedics & Sports Medicine.

Connecting the calf muscle to the heel bone, the Achilles tendon has an important role: It allows us to rise up on our toes and push off whenever we walk or run, Dr. Plancher explains. So, it’s equally important to understand the forces at work in Achilles tendinosis, which occurs when the tendon gets irritated and becomes inflamed.

“Most of the time, Achilles tendinosis doesn’t result from trauma or an injury, but a slow spiral of chronic wear and tear,” he says. “It’s common in runners, tennis players, gymnasts, and other types of athletes who experience calf tightness.” Dr. Plancher adds that the most severe form of Achilles tendinosis can lead to the unfortunate rupture.

Symptoms of Achilles tendinosis

How can you tell if you’ve developed Achilles tendinosis? A constellation of symptoms may arise, Dr. Plancher says, including:

  •     Pain and/or tightness in the area behind the ankle
  •     Difficulty climbing stairs or running
  •     Pain after sleeping or sitting long periods
  •     A bump in the tendon or just behind the heel bone
  •     Irritation from shoes rubbing against the bump
  •     Less pain wearing shoes with a slight heel instead of flat-soled shoes

When Achilles tendinosis is caused by a bone spur in the heel – a sharp, bony protrusion on the bone sometimes triggered by a calcium deposit – the spur can rub against the tendon, causing tiny tears.

“It’s similar to when a rope is rubbed against a sharp rock, gradually gnawing down the rope,” explains Dr. Plancher, who lectures globally on issues related to orthopaedic procedures and sports injury management. “Of course it’s going to hurt.”

Diagnosis and treatment options

Pinpointing Achilles tendinosis involves…

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