Achilles tendonitis is the inflammation of the Achilles tendon. The Achilles tendon is the longest and strongest tendon in the body and connects your calf muscles to the back of your heel bone. It allows extension of your foot downward, away from your body, which lets your heel lift off the ground as you move forward when walking. Every time you take a step you rely on your Achilles tendon.

Causes

You can be prone to Achilles Tendon injuries while doing a simple household work. The major causes to Achilles Tendon injuries include running and jumping. Muscles and tendons located in the back of the leg are most likely to get injured while playing sports like basketball and tennis because these games involve a lot of foerward motion. This frontal imbalance can weaken the tendon unless stretching exercises are done on a regular basis. The best way to avoid Achilles Tendon injury is regular exercise. It is best to avoid strenuous sprinting or hill running if you are not in shape for it.

Achilles tendon weakness is common in adults and prompt treatment when symptoms occur can prevent more serious injury.

When the tendon becomes inflamed from overuse or too much sudden stress, tendonitis can weaken it over time and cause microscopic tears and without treatment increases risk for further deterioration and possible rupture.

Symptoms

• Pain, stiffness and tenderness in the area are the main symptoms of Achilles tendonitis
• Pain occurs in the morning, improves with motion, but gets worse with increasing stress and activity
• Achilles tendonitis is common for anyone whose work routine puts constant stress on the feet and ankles
• Achilles tendon injuries happen most often to less conditioned people who overdo exercises or motion they are not used to or conditioned with

When pain and other symptoms indicate possible Achilles tendonitis, surgeon will make a thorough diagnosis to determine the extent of the trauma and evaluate the flexibility and range of motion in the tendon. A physical examination can reveal diffuse swelling and bruising and a palpable gap may be felt along the course of the tendon if there is a complete rupture.

Treatment

Treatment options depend on the extent of the injury.

• Casting to immobilize the Achilles tendon and promote healing
• Ice to reduce swelling
• Non-steroidal anti-inflammatory medication to reduce pain and inflammation
• Physical therapy to strengthen the tendon
• Surgery, if other approaches fail to restore the tendon to its normal condition

There are two types of surgery to repair a ruptured Achilles tendon:

• Open surgery, where the surgeon makes a single large incision in the back of the leg
• Percutaneous surgery, where the surgeon makes several small incisions rather than one large incision

This is not an emergency procedure; usually the surgeon waits for a few days before a surgery is done to bring down the inflammation. In both cases the tendon are joined back together by sutures.

After both types of surgery, you usually wear a cast, walking boot, or similar device for 6 to 12 weeks. At first, the cast or boot is positioned to keep the foot pointed downward as the tendon heals. The cast or boot is then adjusted gradually to put the foot in a neutral position (not pointing up or down). Many health professionals recommend starting movement and weight-bearing exercises early, before the cast or boot comes off.

This surgery is done to repair an Achilles tendon that has been torn into two pieces.

A recent study indicates that re-rupture rates are similar. With 1% to 2% for open and 3.5% to 6.5% for percutaneous surgery, the earlier belief that percutaneous surgery has a higher re-rupture rates than open surgery can be brushed aside. It all depends on how soon you start using the Achilles Tendon.

Open surgery is more likely than percutaneous surgery to result in wound healing problems. However, damage to a nerve is more likely with percutaneous surgery. Newer techniques for percutaneous surgery may make nerve damage less likely than when older techniques are used.

Differences in the age and activity of those having a surgery make it difficult to compare them. The success of a surgery purely depends on the surgeon’s experience, the kind of procedure used and the extent of tendon damage. It also depends on how soon the surgery was performed after the rupture happened and how soon you follow your rehabilitation program after the surgery.

This could results from a small stretch injury that causes the tendon to become swollen, painful and less flexible. This injury if untreated may fail to heal, or progress to a chronically painful condition. In certain cases, the tear may progress to a complete rupture of the tendon. If left untreated, the tendon often fails to heal, thereby resulting in a permanent disability.

The best way to prevent an Achilles tendon injury is to stay in overall good shape and to warm-up, stretch and strengthen the Achilles tendons. Treatment for Achilles tendonitis includes: relative rest, muscle strengthening, physical therapies (i.e. ultrasound, laser photo-stimulation, electrical stimulation) and ice.  Treatment for an Achilles rupture includes complete immobilization, or surgery in the most severe cases. The treatment options for a complete rupture of the tendon include surgery followed by casting, or casting alone. The tendon is either reattached to the calcaneal (heel) bone or the two ends are sewn together is the tendon has been torn in two.

After the tendon repair, your leg will be put in a walking boot or cast for about 8-12 weeks. In order to promote the healing process, the foot will be  initially pointed slightly download in the brace and then moved gradually to a neutral position. Exercises and therapy start immediately after the surgery. This therapy is crucialin the recovery phase of the tendon. It has to be understood that without a carefully monitored program full recovery would be difficult to achieve.

The other Orthopedic Procedures are:

• Hip Replacement
  
• Knee Joint Replacement
  
• Disc Hernia
  
• Elbow Replacement … etc

Few Major Hospitals for Achilles Tendon Repair are:

• Wockhardt Hospitals
  
• Apollo Hospitals
  
• Max Healthcare
  
• Piyavate Hospital
  
• Florence Nightingale Hospital
  

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