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What is the treatment for painful Achilles tendon?

How can I tell my Achilles tendon is haveing troubles?

Achilles tendon is composed of two muscle groups, Soleus and Gastrocnemius muscles. The Gastrocsoleus spans the knee, ankle, and subtalar joints, making it common that patients feel pain and tightness from the thigh to the heel and the arch of foot. When the tendon is severely damaged, there may be a painful enlargement involved, commonly at the midsubstance of the tendon 4-6 cm from the heel bone or directly at the insertion site. Patients may find it hard to do daily activities such as walking, running, and especially walking unhill.

What are the conditions affecting achilles tendon?

A large number of patients has tightness in the calf muscles called "the Gastrocnemius". Tightness from this muscle alone can lead to pain in the calf and heel without significant tendon damage. Some medications such as antibiotics in the Fluoroquinilone group may lead to tendon damage. When the tendon has poor healing response from an injury, it will become enlarged and painful, commonly called "Tendinitis" or "Tendinopathy". Theses conditions can affect either at midsubstance or insertion of the Achilles tendon. A complete Achilles rupture can be explored here

How can I keep my Achilles tendon healthy?

Flexibility is the key. The collagen fibers in the tendon will response well to moderate tension force. Stretching exercise such as runner stretch or wall stretch can help maintain flexibility in the muscle and tendon units. Patient should avoid cortisone injection into the Achilles tendon as it may lead to a complete tendon rupture. Consult with your physicians  prior to taking antibiotics as some may affect the tendon substance. 

What is the conservative treatment for Achilles tendon problems?

Patients may start with antiinflammatory medication to help relief pain. Stretching exercise should be performed regularly. Midstubtance tendinopathy particularly responses well to eccentric exercise. In contrast, insertional tendinopathy may benefit more from strengthening exercise more than stretching. A heel lift may give patients some comfort as it help decrease hyperextension force and act like a cushion against heel counter.  Some midsubstance disease may response well to PRP-injections. Shockwave therapy may also considered if available.

What are the surgical options for Achilles tendinopathy?

Each tendinopathy is different. A patient with contracture of the Gastrocnemius muscle may benifit from a minimally invasive release of the tendon. Patients with midsubstance disease can take advantage of a minimally invasive approach using arthrosopic debridement techniques. Patients with insertional disease, in majority, will require more comprehensive reconstruction of the Achilles tendon such as tendon repair, removal of bone spurs, tendon transfers, and a release of contracted gastrocnemius tendon (See picture below).


What is the recovery after Achilles tendon surgery?

Most of Achiles tendon surgeries can be performed on an outpatient basis. Minimally invasive procedures for tendon contractures and midsubstance desease will allow the patient to immediately bear full weight in a boot. The boot can be weaned off at 6 weeks. Tendon reconstruction procedures for insertional tendinopathy will require 6 weeks of non-weightbearing followed by progressive increase in weightbearing and activities until 12 weeks post-op that the patient will be allowed to resume normal light activites using normal shoes. 

Why should I choose Dr. P for a  Achilles tendon surgery?

Dr. P is a pioneer in Minimally Invasive as well as comprehensive reconstruction of the Achilles tendon with peer-reviewed publications and books.

-Dr. P is one of the most experienced surgeons in Midwest who has performed hundreds of Achilles tendon procedures.

-Dr. P is an instructor for the American Orthopaedic Foot and Ankle Society (AOFAS),  Arthroscopy Association of North America (AANA), and the American Academy of Orthopaedic Surgeon (AAOS) who has taught numerous surgeons around the country

-Dr. P is patient-oriented for achieve goals and expectations of successful outcomes 

What do patients say about Dr. P?

Getting to know Dr. P

Dr. P’s Google Reviews

Dr. P's Healthgrades Reviews

Dr. P's Homepage



Phinit Phisitkul, MD

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