Inflammation and Achilles Tendon Pain
Are you experiencing Achilles tendon pain? Dr. Julien Lopez offers comprehensive care to alleviate your pain.
He welcomes you to one of his offices in Nice or Cannes Oxford, performs a diagnosis, and initially guides you towards non-surgical solutions. If these solutions are insufficient to relieve your pain, he may propose a percutaneous surgery to address your Achilles tendon inflammation. With minimal and aesthetic scarring, percutaneous surgery reduces pain and the duration of convalescence. The surgeon always opts for non-invasive interventions whenever possible, rather than traditional open surgical solutions.
Achilles Tendon and Pain: Definitions
Sometimes, acute or chronic pain can occur at the Achilles tendon. These pains should not be neglected as they can lead to complications, including tendon rupture.
Specialized in foot and ankle pathologies, you can schedule an appointment with surgeon Julien Lopez directly online on Doctolib or by calling the office at 06 71 00 19 23. He welcomes you to one of his offices located at the Cannes Oxford Private Hospital or in Nice at the medical center.
The Achilles tendon, also known as the calcaneal tendon, is a tendon plate about 12 to 15 centimeters long. Very thick, it is considered the largest tendon in the human body and the one that transmits the greatest power. It consists of tendon cells surrounded by collagen fibers, making up the majority of its composition. Located at the back of your ankle, you can see and feel it upon touch.
What is the purpose of the Achilles tendon? The Achilles tendon is connected proximally to the calf muscles (the two twins and the soleus muscle) and distally to the heel bone called the "calcaneus." During its contraction, it allows:
- Ankle flexion
- Propulsion of the leg and foot
- All movements of the lower limbs
During walking, sports activities, or simply when moving your foot, the Achilles tendon plays a crucial role.
The name "Achilles tendon" refers to the Greek hero who, in mythology, was dipped by Thetis into one of the rivers of the Underworld (the Styx) in order to become invincible. During this immersion, she held him by the heel, leaving only one part of his body out of the water. This part remained mortal while the rest of his body became immortal. The hero is then killed by an arrow shot by Prince Paris in this vulnerable area, which is the only part that remained susceptible.
This myth gave rise to the expression "Achilles' heel," referring to any person's weakness, as well as the name of this essential tendon for the proper functioning of the body and every movement of the lower part of the human body.
Achilles Tendon Pain Upon Waking: Pathology, Symptoms, and Causes
Are you experiencing Achilles tendon pain upon waking? The possibility of Achilles tendonitis is quite likely.
The name of this condition is composed of the term "Achilles tendon" and the suffix "-itis."
The first term refers to the fibrous structure located at the back of the ankle. The second term refers to inflammation. Just as plantar fasciitis is an inflammation of the plantar fascia, Achilles tendonitis is an inflammation of the Achilles tendon.
Also known as "Achilles tendinopathy," it is characterized by inflammation of the fibrous tissues that are normally involved during walking and when bending the leg and foot. This condition can lead to difficulties in lower limb movements and can be the source of pain. These pains can become quite debilitating if appropriate treatment is not promptly initiated.
It is important to distinguish between two main types of Achilles tendon inflammation. The first category concerns inflammation of the body of the tendon, which is called corporal Achilles tendonitis. The second common and classic inflammation concerns the calcaneal insertion, which is often the site of associated calcifications. This is referred to as calcific tendonitis or calcific insertional Achilles tendinopathy.
Distinguishing between clinical forms is important because the treatments, whether non-surgical or surgical, differ.
This inflammation of the tendon is characterized by swelling, pain, and a burning sensation located at the back of the foot.
It most often occurs in athletes in their thirties or forties and can cause:
- Pain during sports activities
- Difficulty in placing the foot due to limping during walking
- Rest or morning pain (morning stiffness)
The causes of Achilles tendon inflammation are diverse:
- Reduced tendon stretching ability (retraction) due to aging
- Overuse of the lower limbs due to high-intensity physical effort, high frequency, and excessive repetitive movements
- Pressing the big toe and tilting the ankle inward during running ("pronation of the foot")
- Wearing shoes that are not suitable for your foot shape or that force you to change your posture
- Pre-existing foot deformities, such as flat feet
The surgeon, specializing in foot and ankle pathologies, investigates the potential causes of your pain in order to treat predisposing factors.
Achilles Tendon Pain After Running?
Achilles tendon pain after running can occur. In such cases, it is necessary to consult an orthopedic surgeon to make a diagnosis and explore various ways to alleviate the pain.
During your consultation, the surgeon will inquire about your symptoms and examine your foot to determine the causes of your pain, its frequency, and its intensity. The surgeon will also identify aggravating factors for your inflammation in order to guide you towards suitable treatments.
Various non-surgical treatments that can be considered by Dr. Julien Lopez include:
- Sports cessation
- Use of oral or topical analgesics and anti-inflammatories
- Application of ice to the painful area
- Wearing shoes with heel lifts or several centimeters of heel height to reduce stress on the Achilles tendon
- Sessions with a physiotherapist to stretch and restore flexibility to the calf muscles and strengthen the previously inflamed tendon
- Shockwave therapy or ultrasound sessions
- Correction of predisposing factors, such as blood acidity
When the pain subsides, the use of orthopedic insoles is recommended to relieve the tendon, which may have suffered damage.
Complications can arise, such as Achilles tendon rupture.
After a 3-month period of persistent pain, your condition is classified as chronic. Additional medical imaging tests are prescribed by the surgeon to determine the possible existence of fibrosis nodules or calcifications.
After 3 months of unsuccessful well-conducted medical treatment, percutaneous Achilles tendon surgery can be discussed.
In the case of corporal Achilles tendonitis, a few-millimeter incision is made to access the tendon in a minimally invasive manner, and then the tendon is longitudinally incised. This is referred to as the combing of the Achilles tendon. An injection of platelet-rich plasma or PRP is often combined with this procedure.
For calcific insertional Achilles tendinopathy, the most frequent intervention is the detachment and reattachment of the tendon. The surgery aims to remove all calcifications and clean the inflamed tendon, known as tenosynovectomy.
To prevent inflammation of the calcaneal tendon, Dr. Julien Lopez outlines actions that should not be overlooked:
- Prepare your joints for physical exertion with a suitable and thorough warm-up
- Perform stretching exercises to relax your muscles and tendon after sports training
- Mobilize and strengthen your joints by repeatedly walking on tiptoe during the day
- Maintain adequate hydration to reduce the risk of Achilles tendonitis
- Avoid tobacco and alcohol
- Maintain a healthy diet
- Avoid overly acidic foods
If you continue to experience pain after Achilles tendon surgery, Dr. Julien Lopez is available to identify the cause of your pain and implement appropriate treatment.