The Achilles tendon is a strong, fibrous band of tissue that connects the heel with the muscles in your calf, supporting normal heel and ankle flexibility and movement and providing you with a lot of your balance when you walk and run. The “foot end” of the tendon attaches to the back of the heel bone. Sometimes, the tendon can become irritated and inflamed, often as a result of tiny growths of bone called heel spurs that form along the edge of the heel, and at other times due to trauma or as a result of wearing shoes that don’t fit well.
People who have very tight or short Achilles tendons, foot deformities or gait problems also may be more prone to Achilles tendonitis, as can athletes like runners and basketball players whose feet and ankles are subjected to repeated impacts. Achilles tendonitis tends to become more common with age, and it can also be more common in people who are overweight or obese. In Achilles tendonitis, the fibers of the tendon become irritated and inflamed, and tiny tears can form in the tendon. Sometimes, Achilles tendonitis can cause additional inflammation in the heel bursa, small sacs of fluid that promote normal movement in the heel and ankle.
Insertional tendonitis is caused by irritation and inflammation where the tendon attaches to—or inserts into—the heel. Noninsertional tendonitis is associated with inflammation and irritation in the middle of the tendon, and it’s more common among younger, physically active people, including athletes.
Some mild cases of Achilles tendonitis may be treated with stretching exercises to improve flexibility in the tendon. But often, chronic or severe tendonitis requires a more aggressive approach to relieve inflammation and promote healing in the tendon fibers. In those cases, Dr. LaMour may recommend a noninvasive treatment called extracorporeal shockwave therapy (ESWT) or platelet-rich plasma (PRP) injections, both of which work by stimulating circulation and promoting natural healing.
ESWT and PRP can be performed right in the office, and there’s no downtime afterward. Dr. LaMour will perform a careful evaluation of your tendon to determine the best approach. Ideally, you should schedule an office visit at the first sign of tendon, ankle, or heel pain so he can provide treatment as early as possible, before tendon inflammation and damage become more extensive.
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