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Michigan Sports and Spine

Achilles Tendonitis

Overview
Simply defined, tendinitis is inflammation of a tendon. Inflammation is the body's natural response to injury or disease, and often causes swelling, pain, or irritation. There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed.

Noninsertional Achilles Tendinitis
In noninsertional Achilles tendinitis, fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell, and thicken.  Tendinitis of the middle portion of the tendon more commonly affects younger, active people.

Insertional Achilles Tendinitis
Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone.  In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may also calcify (harden). Bone spurs (extra bone growth) often form with insertional Achilles tendinitis.  Tendinitis that affects the insertion of the tendon can occur at any time, even in patients who are not active.

Causes
Repetitive stress to the tendon
Sudden increase in the amount or intensity of exercise activity
Tight calf muscles
Bone spur

Symptoms
Pain and stiffness along the Achilles tendon in the morning
Pain along the tendon or back of the heel that worsens with activity
Severe pain the day after exercising
Thickening of the tendon
Bone spur
Swelling that is present all the time and gets worse through the day with activity

Diagnosis
Physical examination and medical history consultation
X-rays
MRI

Treatment
Rest
Ice
Non-steroidal anti-inflammatory medications
Exercises
Physical therapy
Cortisone injections
Orthotics
Extracorporeal shockwave therapy
Surgery

Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00147

 

Ligament Sprain

Overview
The ligaments of the ankle hold the ankle bones and joint in position.  They protect the ankle joint from abnormal movements especially twisting, turning, and rolling of the foot.  A ligament is an elastic structure. Ligaments usually stretch within their limits, and then go back to their normal positions. When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers.

Causes
Twisting, rolling, or turning of the foot beyond its normal motions

Symptoms
Loss of balance when the foot is placed unevenly on the ground
Inability to stand on the injured foot
"Popping" sound
Pain and swelling

Diagnosis
Physical examination and medical history consultation
X-rays
MRI

Treatment
RICE (Rest, Ice, Compression, Elevation)
Cast or brace
Physical therapy
Non-steroidal anti-inflammatory medications
Surgery (rare)

Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00150

 

Peroneal Tendonitis

Overview
Problems affecting the two peroneal tendons that  lie behind the outer ankle bone (lateral malleolus) are common in athletes.  These problems mainly occur in the area where the two tendons glide within a fibrous tunnel behind the lateral malleolus.  When these tendons become inflamed, their ability to glide within this tunnel is hampered and pain and irritation results.

Causes
Injury
Repetitive ankle motions
High arch

Symptoms
Pain in the outer part of the ankle or just behind the lateral malleolus
Pain that worsens with activity and eases with rest
Swelling
Pain that worsens when pressure is applied along the tendons

Diagnosis
Physical examination and medical history consultation
X-rays
MRI

Treatment
Rest
Immobilization
Physical therapy
Anti-inflammatory medications
Surgery

Source: http://www.orthogate.org/patient-education/ankle/peroneal-tendon-problems.html

 

Plantar Fasciitis

Overview
Plantar fasciitis (fashee-EYE-tiss) is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year.  Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed.

Causes
Most times unidentifiable
Tight calf muscles
Obesity
Very high arch
Repetitive impact activity
New or increased activity

Symptoms
Pain on the bottom of the foot near the heel
Pain with the first few steps after getting out of bed in the morning or after a long period of rest
Greater pain after (but not during) exercise or activity

Diagnosis
Physical examination and medical history consultation
X-rays
MRI
Ultrasund

Treatment
Rest
Ice
Non-steroidal anti-inflammatory medications
Exercises
Cortisone injections
Orthotics
Night splints
Physical therapy
Extracorporeal shockwave therapy
Surgery

Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00149

 

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