Achilles can be found at his heels. Surely, many of you have heard this phrase, but not everyone fully understands its true meaning. So that’s it. In common people, the Achilles’ heel is the most vulnerable point of any person.
Historically, the Achilles’ heel is a Greek myth that tells how the mother of Achilles, Thetis, wanted to make her son’s body invulnerable. Dipping him into the sacred river Styx, she held him by the heel, which was not touched by the water, so the heel remained the only vulnerable spot of Achilles, where he was mortally wounded by the poisoned arrow of Paris.
This is where the expression “Achilles’ heel” comes from, meaning the weak side of something or the most “painful” and unprotected place of a person.
Today we will talk about such a concept as the calcaneal (Achilles) tendon.
In orthopedics, the calcaneus tendon is the largest tendon and the most powerful part of the human musculoskeletal system and is called the Achilles tendon.
Achilles tendon (Latin: tendon Achillis) is a massive tendon, which is formed by two muscles – the calf and soleus, and is located between the heel and the calf muscle, which, uniting into a single mechanism, transfer the efforts of the muscles of the lower leg to the foot.
It acts as a kind of shock absorber, as it raises the heel, restrains the influence of traumatic factors, and is also responsible for the movement of a person with the whole foot.
MAIN DISEASES OF ACHILLES TENDON
Among the main diseases of the heel tendon, orthopedists distinguish tendonitis and Achillodynia (Achilles bursitis), on a more detailed description of which we will dwell below.
This disease is an inflammatory process that occurs as a result of injury or overloading of the Achilles tendon, located on the back of the lower leg and connecting the head of the calf muscle to the heel bone. In simple terms, tendonitis is a pathological inflammation of the fibers of a human tendon.
It is most often affected by professional runners, tennis players, basketball players and volleyball players who do not control the intensity and fluency of sports training.
Symptoms of tendonitis
This disease is accompanied by the classic symptoms – redness, swelling, pain and stiffness of movements. Typically, the pain occurs in a state of activity and subsides in a state of rest.
During inflammatory processes in the tissues, the excretion of salts and metabolic products is disturbed, which is why the fibers lose their strength and flexibility. If they continue to receive stress, cracks and micro-ruptures form.
After a while, the tendons recover, but lose their elasticity and acquire scars, therefore, in order to prevent chronic consequences, it is necessary to seek professional medical help in time, in particular, to the specialized clinic “Ladisten”.
The only effective way to get rid of pain and reliably cure tendonitis is to undergo a comprehensive treatment, one of the most effective methods of which is shock wave therapy (SWT). Tendon rupture can occur without prompt and proper treatment. This is a much more serious condition and often requires surgery.
If the inflammation of the tendon does not go away after a few weeks or months, the patient may develop tendinosis (a disease of tendons and ligaments of a degenerative-dystrophic nature, in which they become thinner, worn out, fragile).
Achillodynia (achillobursitis): what is it?
Achillodynia is an inflammatory process that affects the tendon bursa resulting from inflammation of the Achilles tendon and its surrounding membranes, which often develops after excessive physical exertion. This disease is often also referred to as achillobursitis.
Who most often suffers from Achilles bursitis?
This disease occurs quite often, along with inflammation of large joints, mainly in middle-aged men. Also, after intense training, physically unprepared people suffer from achillodynia. This applies not only to running disciplines, but also to other sports. Also, overweight people often have problems with the Achilles tendon. It is important to note that rheumatism and foot deformities significantly increase the risk of developing achillodynia, so people suffering from these diseases need to be especially vigilant.
Causes of occurrence
The reason for its development is all sorts of injuries, tight and uncomfortable shoes, arthritis, arthrosis, endocrine system disorders, hereditary malformations in the foot, poorly developed ligamentous apparatus, hypothermia, obesity, excess weight, diseases of the musculoskeletal system, infections obtained after receiving various injuries (staphylococci, streptococci, pyogenic microbes), as well as gout and hormonal problems.
Types of Achilles bursitis
Depending on which side of the tendon its focus has arisen, posterior and anterior bursitis are distinguished.
Symptoms develop quickly if the cause is bruising or gout, and gradually if other disorders are involved. Symptoms include pain, swelling, and red spots spreading to both sides of the heel.
Symptoms of achillodynia
With achillodynia, the patient has a bulge in the heel due to the accumulation of fluid in the joint capsule.
Typical symptoms of inflammation are pain, localized fever, edema, and functional impairment.
Diagnosis of the disease
The diagnosis of achillodynia (achillobursitis) is made to the patient on the basis of the characteristic clinical picture and the presence of fluid in the joint, which is detected by puncture of the joint capsule. For differential diagnosis with other diseases, it is imperative to conduct an x-ray examination.
For treatment, it is necessary, first of all, to provide rest to the joint, for which a pressing and warming bandage is applied to the patient, and the patient’s joint is fixed.
The most effective treatment for achillodynia today is shock wave therapy (SWT), which restores cellular structure, reduces pain, improves metabolism and microcirculation, resolves fibrosis and stimulates collagen production. Also, excellent results in the treatment of achillodynia in a short time are given by such physiotherapeutic measures as high-intensity laser, electrotherapy, TR-therapy, phonophoresis and magnetotherapy. If the disease does not go away on its own for a long time, then the patient is punctured by the joint capsule and the fluid is removed, followed by the introduction of antibiotics and glucocorticoids into the joint cavity.
In the case of the development of purulent bursitis, surgical opening of the joint capsule with the installation of drains and secondary healing without wound closure is indicated.
The main contraindications for Achilles tendon surgery are:
After surgery, the rehabilitation period is on average 1–3 months. Not only the strength of the seams depends on the observance of remedial measures, but also the likelihood of re-injury. These measures include a state of complete rest, lack of physical activity and fixation of the foot in an elevated position.
Traditionally, rehabilitation includes the following stages:
After removing the plaster, a careful development of the joint begins, but without stress on the sore foot. In this case, crutches are used. One to two months later, bandages and orthoses are applied. In addition to physical rehabilitation, physiotherapy is carried out aimed at eliminating postoperative edema, improving trophism and restoring muscle function. Massage, magnetotherapy, UHF, electromyostimulation can be used.
The most important thing in rehabilitation is its gradualness, because any premature measures can lead to rupture of the stitches.
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