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Achilles Tendon Injuries
Introduction
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Pain of the Achilles tendon commonly affects both competitive athletes and the sedentary
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The Achilles tendon is the largest tendon in the body
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Injury can occur from overuse, vascular disease, neuropathy (nerve problems), rheumatologic disease, and injuries from activities such as running, jumping and sudden acceleration or deceleration.
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The hallmark of Achilles tendon problems is damaged, weak, inelastic tissue
Terminology
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Terms used to characterize acute or chronic tendon pain include:
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tendonitis​
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tendinosis
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tendinopathy
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paratendonitis
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enthesopathy
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insertional tendonitis
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The term "tendonitis" is confusing because inflammation is often not seen on histopathology (under the microscope)
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Pain where the achilles tendon attaches to the calcaneus (heel bone)
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Occurs in patients with a tight heel cord
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Repetitive trauma leads to infammation followed by cartilagenous then bony changes within the tissue
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X-rays can sometimes show
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Posterior heel pain, burning, and stiffness
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Sometimes a bony "bump" can be seen on the back of the heel
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Usually normal but can show a bone spur and calcification within the tendon
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Can help to evaluate the extent of the damage (degeneration)
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