All patients are looking for the top or best Achilles tendon surgeons to evaluate their Achilles problem or perform their surgery. We believe that giving different treatment options (non surgical treatment) is a top priority.
At our practice our patients always have three choices:
Each patient is different and conservative treatment vs. surgical correction both differ for the particular type of problem, age and lifestyle. The right treatment must also meet the patient’s expectations in regard to resolution of their problem(s) and future functionality. And if conservative treatment fails, the option to not have surgery is as important as the surgery chosen by your surgeon. Of course, surgical training is very important, and continuing medical education on the latest medical advancements is important as well, but it’s the careful planning before and after surgical treatment that produces the best outcome.
Tendons attach to muscles at one end and a bone at the other. Irritation, partial tears or complete rupture can occur at those attachments or the tendon itself.
These vary in severity from a dull ache to severe pain. They also have a covering or “sheath” that can get irritated, tear or form a “ganglion” (fluid filled sack). Tendonitis can be a simple overuse syndrome, injury, or secondary problem from other foot and ankle conditions. All tendonitis, especially ones where a tear, rupture or associated fracture is suspected need to be evaluated by a physician with standard x-rays taken or other advanced testing.
This condition is associated with other foot and ankle conditions such as:
Tendonitis weight bearing status ranges from total and partial weight bearing to complete non-weight bearing. Keeping pressure off the area is the best way to minimize a more serious situation like a complete tear or rupture. Crutches, walkers, wheel chairs and strollers are helpful.
Crutches and non-weight bearing on the affected foot or ankle for 1 to 3 weeks is the best care for a severe overuse syndrome or injury, but a simple decrease in activities may be enough to relieve symptoms. Depending on tendonitis location, shoe gear modification can also aid recovery. Try to avoid bare feet and shoes without support
Static stretching to the “point of discomfort” and holding those positions for 10 seconds each for 3 sets every day will help speed recovery and reoccurrence.
Anti-inflammatory medication can help with the chronic pain, but are not much help with the acute pain
Casting or a removable Cam Walker is the best “aggressive” conservative care for severe tendonitis or injuries.
Temporary arch supports or supportive athletic shoes will support the foot and ankle in a more neutral position. This will put less strain on the injured area and decrease the incidence of re-injury when returning to activities or exercise. Custom molded orthotics are the best solution for immediate and long term treatment.
Examples of physical therapy include massage, cold therapy, contrast baths, stretching, ultrasound, and electric stimulation.
No surgery is usually required for this condition, but partial tears, “attenuations” or complete ruptures may necessitate reattachment. The procedure is a simple suturing of the tendons ends unless a graft is needed or reattachment to the bone with a “bone anchor” device.
The post-operative period is extended to 6-8 weeks non-weight bearing with physical therapy thereafter.
CAUTION: GRAPHIC CONTENT This surgery shows the repair of an achilles tendon rupture using a tendon graft jacket. This material contains graphic content, minors please obtain parental consent before viewing.
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