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Achilles
tendon injuries include inflammation of the paratenon and partial
or complete tears.
The calf muscle attaches to the calcaneus via the Achilles tendon. During running, the calf muscles help with the lift-off phase of gait. Repetitive forces from running combined with insufficient recovery time can initially cause inflammation in the paratenon (fatty areolar tissue that separates the Achilles tendon from its sheath). A complete tear of the Achilles tendon is a serious injury, usually resulting from sudden, forceful stress.
Symptoms,
Signs, and Diagnosis
The primary symptom of Achilles tendon inflammation is pain in the back of the heel, which initially increases when exercise is begun and often lessens as exercise continues. A complete tear causes sudden, severe pain and prohibits normal ambulation.
On examination, an inflamed Achilles tendon is tender when squeezed between the fingers. With a complete tear, a defect along the course of the tendon is palpable, and squeezing the calf muscle does not cause the normally expected plantar flexion (a positive Thompson test).
Treatment
Tendon inflammation can be treated by placing a heel lift in the shoes and by instructing the athlete to do stretching exercises for the calf muscles. Ice and NSAIDs should also be used. The patient should avoid uphill and downhill running until the tendon is not painful. A torn tendon requires surgical repair.
Last full review/revision November 2005
Content last modified November 2005
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