What Causes Pain

The Achilles Tendon: Injuries & Treatment

The largest tendon is the Achilles tendon. It connects the calcaneous (heel bone) to the muscles in the back of the calf. This tendon must be able to tolerate a lot of force during exercises, sports and pivoting activities.

There are two types of injury to which the Achilles tendon is particularly susceptible:

#1 Achilles tendonitis is inflammation caused by overuse.

#2 The Achilles tendon can be torn during strenuous activity.

Achilles Tendonitis Information

When you suddenly increase the intensity of your training or change to a new kind of training without completely conditioning your body to it, you may be subject to Achilles tendonitis. You may be particularly prone to it if you add sudden vigorous activity like uphill running to your training schedule. Additionally, if you take a long break from training and then start right back up at your peak level, you may cause Achilles tendonitis.

This may manifest as mild pain following exercise that gradually becomes worse. You may experience mild stiffness, swelling, and tenderness upon arising. These symptoms may improve as you move around during the day. You may feel very severe pain in the tendon several hours after you have completed your exercise routines.

In the case of a torn Achilles tendon surgical repair may be indicated. Toughened, fibrous tissue and tears can be removed with surgery. Following surgery, rehabilitation will speed recovery and help avert future ankle weakness.

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More Information About A Torn Achilles Tendon

During strenuous activity, it is quite possible to tear the Achilles tendon. This is especially likely to happen while participating in sports. When the Achilles tendon tears, you may actually hear an audible snapping or cracking sound. You may have a partial or complete tear. This injury usually occurs just above the heel bone.

If this happens, you may find that you are not able to bend your foot into a downward position or even to walk normally. This type of injury is very painful and causes a lot of swelling around the heel.

A complete rupture is usually treated with surgery. After surgery, your doctor will have you wear a walking boot or a cast to stabilize your ankle. You will need to do this for about three months.

Torn ligaments can be treated non-surgically by using a below-knee cast; however, this is not as effective as surgical treatment. It takes longer, and the healing is not as complete. You are more likely to have problems in the future when you allow the tendon to heal naturally.

With surgery, there is a much better chance of recovering fully. This is why athletes prefer to have the surgery. It allows them to return to their former level of activity with confidence after an Achilles tendon injury.

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Treatments of biologic origin are best when treating knee disease or injury. This type of treatment can restore the knee to a near-normal state. Reconstruction of the ACL (anterior cruciate ligament), meniscal repair, and anatomic knee fracture repair are three kinds of biological surgical repairs that have good success with knee injuries.

Orthopedists as well as patients often find managing a full-thickness, symptomatic chondral lesion of the knee to be problematic.

Injury leading to articular cartilage cell death can best be treated by restoring the surface cells of the joint. The surface cells are the articular cartilage. This is the shiny white surface of which all joints in the body are made.

Four separate treatment options are possible: Osteochondral Allograft, Microfracture, Osteoarticular transfer system (OATS), and Autologous Chondrocyte Implantation (ACI).

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If the patient is young, a small lesion can be repaired with Microfracture surgery. When using this method, a pick-like tool will be used to enter the marrow of the knee multiple times under the chondral defect. These entries will stimulate the bone marrow. This causes repair tissue to be created. The repair tissue fills the chondral defect with fibrous cartilage tissue.

In this scenario, the patient will be on crutches for a month to eight weeks. The patient must not participate in sports for a six months to year. Additionally, the patient must realize that it may take up to eighteen months to be completely pain free.

It is possible to restore the knee surface to a near-normal condition with a procedure called autologous chondrocyte implantation (ACI). This procedure is used if the knee defect is large.

Articular cartilage cells can be harvested from the healthy part of the injured knee for utilization in ACI. There are very specific criteria that must be met for this surgery to be used.

The patient must have a full-thickness, weight-bearing, symptomatic chondral injury to the femoral articular surface. Additionally, the patient must be physiologically young. Furthermore, the patient must agree to an 18 month rehabilitation process.

There is no guarantee of successful surgery to the tibia and patella. In fact, insurance companies will often refuse to pay for this type of surgery. It is important to note that ACI is not a workable procedure for the treatment of osteoarthritis. In this condition, two reciprocal joint surfaces experience damage. X-rays will reveal narrowing of the joint space. Additionally, bone spurs will be in evidence. 3T MRI (magnetic resonance imaging) may be used to assess for ACI. By using this procedure, the proper treatment can be determined.

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What Should I Expect With Knee Replacement?

When you have your knee replaced, it will mean that you are having damaged and arthritic parts of your knee taken out and artificial or prosthetic joints put in their place.

Your new, efficient, artificial prosthetic joint will perform just like a young, healthy, undamaged, natural joint. You will be able to enjoy physical activities without fear of pain.

Does my knee joint have to be in really bad shape before I begin thinking about having it replaced?

You are the only person who can make this decision. Once you have an evaluation by an orthopedist, you will just need to consider the procedure and the effect it will make on your life, and decide for yourself.

If you are having knee pain every day, you may respond by resting your knees. When you do this, the muscles around the knee become weaker. That means that you will have more knee pain.

If you have tried other options like physical therapy and medication, without relief, it may be time for you to consider joint replacement.

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MIS – Minimally Invasive Knee Joint Replacement

When you have MIS, specialized techniques will be used. These techniques let the doctor do major surgery without making any large incisions. That is why this procedure is called minimally invasive. There is less trauma to the soft tissues because a much smaller incision is made.

This is a tremendous improvement over traditional knee replacement surgery in many ways. MIS can mean a very short hospital stay, a speedy recovery, and very little, if any scarring. However, MIS is not the answer for everyone.

Your orthopedist is the only one who can really tell you if MIS is the right procedure for you.

What are the risks of MIS?

Of course, MIS is a major operation, and there are always risks involved with any surgery.

Happily, the complications that may arise with MIS are fairly easy to avoid and/or deal with.

As for driving and working, how long must I wait to return to my regular daily activities?

This is an individual decision that you will make with your orthopedist. Follow your physician’s orders and your surgeons advice. The exact time varies from person to person.

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