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Achilles tendon disorders

Causes & Symptoms

Which diseases of the Achilles tendon are there?

The Achilles tendon can be damaged in different ways: When the Achilles tendon ruptures, your tendon is partially or completely torn. Depending on where exactly the crack occurs, one speaks of a near, distant or central crack.
In so-called attachment tendinosis, the junction between your tendon and your bone is inflamed. If the Achilles tendonitis persists, painful calcifications can form within your tendon.
When a bony protrusion on the top of your heel bone causes tendon irritation, it's called Haglund's exostosis. Usually a chronically inflamed bursa is present at the same time. The permanent inflammatory stimulus leads to further bone growth and the formation of scar tissue. As a result, your heel gets thicker and the discomfort increases.
Some Achilles tendon diseases are also caused by wear and tear. The middle tendon is usually affected here.

Causes: How does an achilles tendon disease develop?

Strong forces act on our Achilles tendon every day. Therefore, complaints in this area are also very common. Mostly athletes and people over the age of 40 are affected:
An Achilles tendon tear is a complete or partial tear. Triggers are often sporting activities, jerky tension in the calf muscles, twisting of the foot or excessive bending of the foot in the ankle.
In some cases, chronic irritation, such as spondyloarthropathies or rheumatism, causes your Achilles tendon to thicken and soften before it is attached to the heel bone. A painful bursitis is often an additional factor. Even a relatively small amount of tension can lead to a rupture of the Achilles tendon.
An Achilles tendon rupture usually occurs when sporting activities are restarted after a long break from training. Sports with rapid changes of direction, such as handball, soccer, tennis or squash, bear the greatest risk of injury.
Long-term use of certain antibiotics and cortisone preparations can also cause your tendon structure to change and your Achilles tendon to be weakened as a result.

Symptoms: Signs of achilles tendon disease

Depending on the type of disease, either your Achilles tendon itself is painful or the junction between the tendon and the bone.
When the Achilles tendon ruptures, your tendon usually tears suddenly with a loud noise, similar to the crack of a whip. This can be very painful. The most important foot flexor muscles in your calf no longer have a starting point. It is no longer possible for you to stand on tiptoe.
Wear-related diseases of your Achilles tendon are accompanied by what is known as starting pain. This means that you have more symptoms at the beginning of a sporting activity. Once your tendon has "warmed up", your pain will decrease. On the other hand, your tendon can hurt even more after exercising.
Attachment tendons and Haglund's exostosis almost always lead to conflicts with your footwear due to chronic Achilles tendinitis. The bony protrusion on the heel bone presses on the attachment of your tendons - and this is especially painful when the shoes are closed. With a partial or complete tear, those affected report feeling as if they had been stabbed in the tendon with a knife. You can no longer stand on tiptoe and sport is out of the question.
With chronic changes in the Achilles tendon, there is usually a thickening in the middle part of the tendon. If your tendon is torn, a dent can be felt.

Diagnosis

Precise diagnostics for the right treatment

Since your Achilles tendon can be damaged in different ways, the individual therapy depends on various questions. In our diagnostics, we therefore clarify exactly how your injury came about and what triggered it.

Proven means: ultrasound and magnetic resonance imaging

Only in the case of Haglund's exostosis and attachment tendinosis can one see changes on the X-ray images that indicate a corresponding disease. That is why our specialists usually choose ultrasound to diagnose cracks. We rely on magnetic resonance tomography, especially when there are changes due to wear and tear. Here the changed areas of the tendon can be seen precisely.