Acute Achilles Inflammation (Paratendinitis)
There is a very thin, flimsy sheath
surrounding the Achilles tendon called the paratenon. In some patients,
particularly runners, the paratenon can get quite inflamed. This is
the result of rapid acceleration and deceleration of the foot leading
to traction on the edge of the Achilles tendon with inflammation.
This is usually present in individuals who hyperpronate (roll the
foot inwards) during running. The tendon begins to get inflamed but
not thickened. This cannot be diagnosed by means of an MRI. The diagnosis
is made by palpating the tendon where it is slightly thickened and
tender along its inner edge, about four-centimeters behind the attachment
to the heal bone.
Treatment of acute inflammation begins with rest, cross training for
the athlete and the runner, physical therapy treatments and, at times,
immobilization. An orthotic support to control pronation is added
to the shoe. If these treatments do not fix the problem, surgery may
required to remove the lining of the tendon (the paratenon). Recovery
is fairly rapid. Patients may be able to run after two to three months
although this can take longer if underlying degeneration of the tendon
is present. |
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