Achilles tendon problems

The Achilles tendon is part of a very powerful and important muscle used when walking and running called the calf muscle. If the tendon becomes mechanically stressed or fatigued then it can become inflamed or degenerative and hence painful.

Problems may include tendocalcaneal bursitis, Achilles tendonitis, pain in the back of the calf muscle, and in severe cases, may result in rupture of the Achilles tendon. Rupture occurs when there is forced dorsiflexion against a contracted heel cord or in sudden acceleration, often involving a sporting activity. However, rupture may also occur in the person who has complained of low-grade pain in the area for a long time, causing unnoticed degenerative changes of the tendon before it finally ruptures. Some conditions such as diabetes and inflammatory arthritis can also predispose the tendon to rupture. Rupture of the tendon can be partial or complete.

In some circumstances surgery is carried out on the Achilles tendon area. This may be to remove any inflammatory and degenerative changes which have occurred as a result of pathology. In the case of rupture, surgery may be carried out to re-attach the ruptured ends. This procedure is performed via an incision on the back of the ankle near the affected area. The two ends of the Achilles tendon are sewn together using internal dissolving stitches and the skin is then sewn together using external stitches that will be removed after a healing period.



Often patients will be required to wear some form of cast or brace to protect the repaired area and encourage healing, this may be required for up to 8 weeks after surgery. Following this, adjustments to footwear and orthoses may be required and physiotherapy will be indicated to improve the strength and motion of the ankle and Achilles tendon.