Achilles Tendon Injury in Orange County

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What Is the Achilles Tendon?
A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. The Achilles tendon facilitates walking by helping to raise the heel off the ground. Our Podiatrist / Foot and Ankle Surgeon in Orange County can help with your Achilles tendon injury at our Irvine, Huntington Beach, Newport Beach, or Orange, CA offices.

 

Causes
As “overuse” disorders, Achilles tendon injuries in Orange County are usually caused by a sudden increase of a repetitive activity involving the Achilles tendon. Such activity puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibers. Due to this ongoing stress on the tendon, the body is unable to repair the injured tissue. The structure of the tendon is then altered, resulting in continued pain.

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Athletes are at high risk for developing disorders of the Achilles tendon. Achilles tendonitis and tendonosis are also common in individuals whose work puts stress on their ankles and feet, such as laborers, as well as in “weekend warriors”—those who are less conditioned and participate in athletics only on weekends or infrequently.

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In addition, people with excessive pronation (flattening of the arch) have a tendency to develop Achilles tendonitis and tendonosis due to the greater demands placed on the tendon when walking. If these individuals wear shoes without adequate stability, their over-pronation could further aggravate the Achilles tendon.

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Achilles Tendon Rupture in Orange County

An Achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.

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Achilles tendon ruptures are most often seen in "weekend warriors" – typically, middle-aged people participating in sports in their spare time. Less commonly, illness or medications, such as steroids or certain antibiotics, may weaken the tendon and contribute to ruptures.

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A person with a ruptured Achilles tendon in Orange County may experience one or more of the following:

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• Sudden pain (which feels like a kick or a stab) in the back of the ankle or calf – often subsiding into a dull ache

• A popping or snapping sensation

• Swelling on the back of the leg between the heel and the calf

• Difficulty walking (especially upstairs or uphill) and difficulty rising up on the toes

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Achilles Tendonitis and Achilles Tendonosis
Two common Achilles tendon disorders in Orange County are Achilles tendonitis and Achilles tendonosis. Achilles tendonitis is an inflammation of the Achilles tendon. This inflammation is typically short-lived. If not resolved, the condition may progress to a degeneration of the tendon (Achilles tendonosis), in which the tendon loses its organized structure and is likely to develop microscopic tears. Sometimes the degeneration involves the site where the Achilles tendon attaches to the heel bone. In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.

 

The symptoms associated with Achilles tendonitis and tendonosis include:

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• Pain—aching, stiffness, soreness, or tenderness—within the tendon. This may occur anywhere along the tendon’s path, beginning with the tendon’s attachment directly above the heel upward to the region just below the calf muscle. Often pain appears upon arising in the morning or after periods of rest, then improves somewhat with motion but later worsens with increased activity.

• Tenderness, or sometimes intense pain, when the sides of the tendon are squeezed. There is less tenderness, however, when pressing directly on the back of the tendon.

• When the disorder progresses to degeneration, the tendon may become enlarged and may develop nodules in the area where the tissue is damaged.

 

Diagnosis
In diagnosing Achilles injuries, the surgeon will examine the patient’s foot and ankle and evaluate the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays or other imaging modalities.

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Treatment of Achilles Tendon Injury in Orange County
Treatment approaches for Achilles tendon injuries are selected on the basis of how long the injury has been present and the degree of damage to the tendon. Non-surgical treatment, which is generally associated with a higher rate of re-rupture, is selected for minor ruptures, less active patients, and those with medical conditions that prevent them from undergoing surgery. Non-surgical treatment may include:

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• Immobilization. Immobilization may involve the use of a cast or removable walking boot to reduce forces through the Achilles tendon and promote healing.

• Ice. To reduce swelling due to inflammation, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice directly against the skin.

• Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation in the early stage of the condition.

• Orthotics. For those with over-pronation or gait abnormalities, custom orthotic devices may be prescribed.

• Night splints. Night splints help to maintain a stretch in the Achilles tendon during sleep.

• Physical therapy. Physical therapy may include strengthening exercises, soft-tissue massage/mobilization, gait and running re-education, stretching, and ultrasound therapy.

 

When is Surgery Needed?
If non-surgical approaches fail to restore the tendon to its normal condition, surgery may be necessary. Our Orange County Foot and Ankle Surgeon will select the best procedure to repair the tendon, based upon the extent of the injury, the patient’s age and activity level, and other factors.

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For achilles tendon ruptures in Orange County, surgery offers additional, important potential benefits. Besides decreasing the likelihood of re-rupturing the Achilles tendon, surgery often increases the patient’s push-off strength and improves muscle function and movement of the ankle. 

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Various surgical techniques are available to repair the rupture. Our Orange County Podiatrist / Foot and Ankle Surgeon will select the procedure best suited to your individual needs.

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Following surgery, the foot and ankle are initially immobilized in a cast or walking boot. Our surgeon will determine when the patient can begin weightbearing.

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Please contact our office in Irvine, Huntington Beach, Newport Beach, or Orange in Orange County, CA to make an appointment with our foot and ankle surgeon / podiatrist (Dr. Coyer) to have your achilles tendon injury in Orange County fully evaluated.