Achilles’ tendonitis typically refers to acute inflammation of the Achilles’ tendon. This can occur either along the middle portion of the tendon or near the insertion at the heel bone. Tendonitis often results from acute injury to the tendon being overloaded. Tears in the tendon can cause pain and swelling to the area. In tendonitis, calcification can also occur along the tendon. This means that the damaged fibers can harden and form hard “bumps”. Common causes of Achilles’ tendonitis include sudden increases in your activity level, repetitive stress to the tendon, inflexibility of the lower leg muscles, or bone spurs on the heel where the tendon attaches1. Typical symptoms of tendonitis are pain and swelling along the tendon or heel, thickening of the tendon, bone spurs. Normally, swelling will increase and worsen with increased activity levels in someone with Achilles’ tendonitis1. The most common treatment for tendonitis is to reduce inflammation through the RICE acronym, taking anti-inflammatory medications, stretching the calf muscle, and eccentric strengthening of the calf muscle1.
Achilles’ tendinosis refers to a chronic degenerative condition to the tendon that is not caused by an inflammatory response. Typically, this is caused by overuse or repetitive trauma resulting in micro tears to the tendon that do not heal properly over time2. Tendons are made up of collagen, a strong fibrous connective tissue; these fibers are broken down leading to loss of strength and increased risk for re-injury3. Anti-inflammatory drugs, NSAIDs, are NOT recommended for tendinosis because they inhibit production and repair of collagen, an important process for rebuilding the tissue that makes up the tendon3.
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