Achilles tendon disorders and surgery

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Achilles tendinopathy

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Achilles tendinopathy is a type of tendinitis in which the achilles tendon becomes swollen and stiff. Since this tendon connects the heel to the calf muscle, pain usually is felt at the back of the heel, radiating down, and worsening to the point where normal walking is extremely difficult. The area also can be sore to the touch. This overuse injury is common among athletes and those who train excessively, especially if technique is poor. The repetitive stress causes small tears in the achilles tendon, causing stiffness before pain begins.

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Achilles tendinosis

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Characterized by degeneration of the tendon, in which tears become pronounced and the tendon may begin to detach from the heel. In some cases, the tendon ruptures. Pain can be severe and treatment difficult.

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Surgery

Surgery may be considered for an achilles injury that is not responding to treatment, or when a patient is unable to function. Since the achilles tendon is critical for walking, the goal in surgical repair is to repair a tear and/or reconnect the heel bone to the calf muscle so as to regain the ability to push off.

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Surgery is usually done as an outpatient. The ends of the tendon are located and sutured, and the patient is typically in a cast or splint for about two weeks. Physical therapy generally starts about six weeks after surgery.

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Most patients do well with achilles repairs, however, full recovery can take months or even more than a year.