The Achilles tendon - What symptoms might I have?What symptoms might I have?
Pain, well localised to the problematic region of tendon, and as a result possibly restriction of activity. In the case of insertional problems it may occur just in shoe wear. Pain may initially occur just during or after activity. It may progress to produce symptoms at rest or even at night (depending upon the nature of the tendon problem). Causes of the problem? (Why does the Achilles tendon degenerate)?
Tendons, like all musculoskeletal tissue, are exposed to multiple episodes of minor trauma during activity. They are slow to repair themselves. Over a period of time if the tendons capacity for repair is continually exceeded structural changes and degeneration can occur. What treatments are available?
As with many conditions both non-operative and operative options exist. Often non-operative management will be advised first. Physiotherapy supervision. In the acute phases ultrasound, restriction of activity and rest. maybe of use. Later deep friction massage of the Achilles tendon and tendon stretches will be used.
Orthotic. The options are limited. A heel raise may be of use. This is a wedge of material which raises the heel relative to the front of the foot, thus removing some tension from the tendon. Cast immobilisation. This rests the Achilles tendon by preventing movement, though weight bearing is still allowed. A lightweight plaster cast, worn for two months, may be advised. As an alternative the Aircast Achilles walking boot may be prescribed. This allows the option of occasional removal during the period of treatment.
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