Achilles Tenosynovitis
Achilles Tenosynovitis is an inflammatory condition of the sheath (or layer) of the achilles tendon. It is sometimes also known as paratenonitis.
Symptoms of Achilles Tenosynovitis
- Pain in the achilles tendon.
- Tenderness when touching the tendon.
- Pain on contraction of the calf muscles as in a heel raise exercise or resisted plantarflexion.
- Pain on stretching the achilles tendon (dorsiflexion - pulling the foot upwards).
- swelling or thickening of the tendon.
- A creaking sensation in the tendon when moving the ankle.
Causes
Achilles tenosyonvitis is an overuse injury which occurs due to repeated mictrotrauma of the sheath which surrounds the tendon. It is most common in runners and those involved in repetitively pushing up on the toes or marching in heavy boots.
It may suddenly develop for the following reasons:
- Tight calf and achilles complex.
- A sudden increase in training or hill walking/running.
- A change in footwear which is less supportive.
- Going from wearing high heels everyday to flat shoes.
What's the Difference Between Tendonitis and Tenosynovitis?
Achilles tendonitis is a degenerative condition of the tendon itself. Achilles tenosynovitis is a similar condition of the sheath which surrounds the tendon.
In terms of symptoms, they are very very similar and it is practically impossible to differentiate between the two conditions without investigations such as MRI or ultrasound scans. In a large number of cases, both conditions exist together.
As treatment for the two conditions is much the same, exact diagnosis is not usually necessary.
Treatment
What can the Athlete do?
- Rest from the activity (or activities) which aggravate the condition.
- Apply ice or cold therapy products to the tendon for 15 minutes every 3-4 hours to ease pain, swelling and inflammation.
- Providing it is comfortable to do so, gently stretch the calf muscles.
What can a Specialist do?
- Recommend anti-inflammatory medication in tablet or gel form.
- Use electrotherapy treatments such as ultrasound or laser.
- Use sports massage to loosen the calf muscles.
- Specific sports massage called frictions can be applied to the tendon itself to encourage blood flow and break down adhesions.
- Advise on a rehabilitation programme. Eccentric calf exercises such as heel drops are the best exercise for achilles injuries.
- If conservative treatment fails, a corticosteroid injection may be administered.
