Achilles tendonitis is a condition of irritation and inflammation of the large tendon in the back of the ankle. Achilles tendonitis is a common overuse injury that tends to occur in middle-age recreational athletes. The overuse causes inflammation that can lead to pain and swelling. Furthermore, Achilles tendonitis can lead to small tears within the tendon, and make it susceptible to rupture.
The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. But it is also the most frequently ruptured tendon, and both professional and weekend athletes can suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.
The most common Achilles tendon injuries are Achilles tendinosis (formerly called Achilles tendonitis) and Achilles tendon rupture. Achilles tendinosis is a soreness and stiffness that comes on gradually and continues to worsen until treated. It often starts with stiffness and creaking when first getting out of bed in the morning. Lightly pinching the Achilles tendon with the forefinger and thumb will indicate soreness. Achilles tendinosis is a common injury among middle and long distance runners. Achilles tendon rupture is a partial or complete tear of the Achilles tendon. It comes on suddenly,
The achilles tendon does not have a rich blood supply. The blood supply has been found to be weakest at a point between 2 and 6 cm above its insertion into the calcaneus. (Although Astrom found with Doppler flow measurements the least vascularity at the insertion.) It is not invested within a true tendon sheath. A paratenon composed of other soft tissue surround it. The outer layer is a portion of the deep fascia, the middle layer is called the mesotenon and the inner layer is contiguous with a thin layer surrounding the tendon itself (epitenon). The blood supply to the proximal portion of the tendon comes from the branches of the muscles themselves.
The Achilles tendon (tendo calcaneus) is formed from the tendinous contributions of the gastrocnemius and soleus muscles, coalescing approximately 15 cm proximal to its insertion. Along its course in the posterior aspect of the leg, the tendon spirals 30-150° until inserting into the calcaneal tuberosity. The tendon's ability to glide is facilitated by the presence of a thin paratenon sheath, which is composed of both a visceral layer and parietal layer, rather than simply a true synovial sheath. The tendon's blood supply arises from the osseous insertion, the musculotendinous junction, and multiple infiltrating mesotenon vessels, which cross the layers of the anterior paratenon.
Achilles tendon problems are most often caused by overuse or repeated movements. These movements can happen during sports, work, or other activities. For example, if you do a lot of pushing off or stop-and-go motions when you play sports, you can get microtears in the tendon. Microtears can also happen with a change in how long, hard, or often you exercise. Microtears in the tendon may not be able to heal quickly or completely.
When treated promptly, Achilles tendinitis is often short-lived. Left untreated, Achilles tendinitis could cause persistent pain or cause the tendon to tear (rupture). If so, you may need surgery to correct the damage.
Achilles tendonitis, also sometimes called Achilles tendinitis, is a painful and often debilitating inflammation of the Achilles tendon (heel cord). The Achilles tendon is the largest and strongest tendon in the body.It is located in the back of the lower leg, attaches to the heel bone (calcaneus), and connects the leg muscles to the foot.