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Achilles Tendon

Achilles Tendon Injuries

Despite the strength that the Achilles tendon holds, it is vulnerable to injuries such as Achilles tendonitis or Achilles tendon rupture.

Achilles Tendon Anatomy and Use

The Achilles tendon is the strongest tendon in the human body! The Achilles tendon is a tough band of tissue that connects the two calf muscles to the heel bone and is located at the lower end of the leg muscle.

The Achilles tendon helps you walk, run, jump and stand on your toes! When the calf muscles are flexed, the Achilles tendon pulls on the heel, pressing the ball of the foot into the ground and pushing you forward.

Dr. Bryant Castelein, DPM – Podiatry Specialist

Foot Doctor in Milford Michigan

Advanced Imaging for the Achilles Tendon

Generally, imaging is needed to diagnose and effectively treat an Achilles tendon injury.
  • X-Ray: An x-ray shows any changes to underlying bone structure, hardening of the soft tissues and guides Dr. Castelein to order further imaging to diagnose tendonitis or ruptures. Brighton Foot and Ankle has an in-office x-ray machine, which allows Dr. Castelein to quickly diagnose and treat the injury.
  • Ultrasound: Ultrasound is an important diagnostic tool that is used to identify lesions on the Achilles tendon, tendinopathy, or full thickness tear of the tendon.
  • MRI: MRI is the most advanced imaging modality to diagnose tendonitis, partial or complete rupture of the Achilles tendon. MRI offers the greatest level of information during the pre-surgical planning process. Dr. Castelein works closely with radiologists and takes time to evaluate each MRI himself. This allows for the availability to evaluate studies quickly and schedule follow up appointments as needed.

Achilles Tendonitis

Injury and Pathology Discussion

Achilles tendonitis occurs when the Achilles tendon becomes inflamed, painful or swollen. Usually, pain begins as a mild ache in the back of the leg or above the heel during activity. Episodes of more severe pain may occur after strenuous exercise. Achilles tendonitis usually results from repetitive or excess stress to the tendon from a sudden increase in activity, tight calf muscles or certain foot deformities. The structure of the tendon itself can weaken with time, which increases the chances of injury. Untreated and/or advanced Achilles tendonitis increases the risk of severe injury such as tendon rupture in the future.

Conservative Treatments

Achilles Tendonitis typically responds well to conservative treatments. Dr. Castelein focuses first on reducing inflammation and pain, then on supporting and reducing stress to the tendon. Inflammation is reduced by prescribing anti-inflammatory medications and mechanical methods such as stretching and massage. Long-term pain relief and support is given to the tendon by a combination of wearing certain shoes, custom orthotics, at-home stretching exercises, and physical therapy.

Surgical Treatments

If the conservative methods of treatment are not aiding the pain of Achilles tendonitis, Dr. Castelein may suggest minimally invasive surgery. One surgical option utilizes a microdebrider, roughly the size of a needle, to remove focal areas of thickened and painful scar tissue within the tendon; which helps to restore the body’s natural healing process. Another potential solution includes lengthening the muscle complex of the Achilles tendon itself which is known as an Endoscopic Gastrocnemius Recession. This procedure utilizes a camera to visualize, inspect and lengthen the muscle-tendon complex. It is a very powerful procedure reducing stress to the Achilles tendon. This is an outpatient procedure allowing patients to walk the same day.

Achilles Rupture or Tear

Injury and Pathology Discussion

An Achilles tendon rupture occurs when the tendon is stretched beyond its normal capacity and results in a partial or complete tear. Sudden accelerations when running, jumping forcefully, or quickly pivoting can cause the tendon to rupture. When a rupture occurs, most people experience a popping or snapping sound at the time of injury, moderate to severe pain or swelling near the heel, an inability to bend the foot downward, or an inability to stand on the toes. Achilles tendon ruptures are most commonly seen in people known as “weekend warriors” who engage in sports in their spare time. Rupture usually occurs in a small section of the tendon, just above where it attaches itself to the heel bone. This area is called the “watershed region” and is at greater risk of injury due to a natural reduction in blood flow.

Conservative Treatments

The course of treatment Dr. Castelein utilizes will depend on your age, activity level, and the severity of your injury. Conservatively, the treatment involves a walking boot to immobilize the ankle and resting the tendon itself by using crutches. However, nonsurgical treatment of a ruptured Achilles tendon is generally associated with a higher likelihood of re-rupture and decreased strength to the area.

Surgical Treatments

In most cases, Dr. Castelein will recommend surgery to repair the ruptured Achilles tendon. Surgical repair of the tendon will lessen the future likelihood of the tendon rupturing, provide greater strength, and improve muscle function. The goal of Achilles tendon repair is a return to pre-injury activity. There are various minimally invasive surgical techniques Dr. Castelein can offer to repair the ruptured tendon. Depending on the severity of the injury and your age, Dr. Castelein will select the appropriate procedure for you. He looks to combine the best repair techniques with added advanced healing material to provide the best outcome. During the recovery process Dr. Castelein will tailor post-operative protocols for the fastest return to daily and physical activity. He communicates with local physical therapists to ensure continuity of care and adherence to the latest advancements in therapy.

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Client Testimonials

I'm so happy to have found Brighton Foot And Ankle in Brighton. The office staff and assistant are very pleasant. Dr. Bryant Castelein is a great knowledgeable Dr. Who has eased my worry over my medical condition. Plus he's handsome. I would highly recommend this practice for anyone needing podiatry help.
What great people to help you! From receptionist to doctor, they are top notch! You would not regret going here for any of your foot/ankle problems, they will fix you up with the utmost care and compassion.
Yo K
Dr. Castelein and staff were friendly, knowledgeable , efficient and took the time to get to know me and understand my medical needs. I would not hesitate to go to Brighton Foot & Ankle. They go out of their way to treat their patients like family.
Dr. Castelein is great; he is very nice, patient, and professional. His staff is also excellent and friendly. It's only been about three hours since having my big toenail removed and, with acetaminophen and ibuprofen, there is very little pain(sometimes I completely forget about it); he did an excellent job. Overall, I am very impressed with Dr. Casteleins Practice and I would highly recommend his office.
Doctor & staff were so professional, friendly & efficient. I had a high risk condition that they expertly guided me through 5 months of healing. Thankfully a full recovery. I give them my best recommendation.
Very friendly and accommodating front desk staff. Dr. Castelein and Jennifer always take their time and do an amazing job! Great variety of quick pick up over the counter products that are always affordable too. Best experience I have had at an office.
Dr. Castelein is very friendly and extremely knowledgeable in his field. During my visit he did a great job explaining my situation and was very encouraging of any questions. I never felt rushed and I believe to have received the best care possible. Highly recommend this doctor and this facility.
Nicole C
Excellent staff and exceptional doctor. I went in with Bunion issues. Dr. Castelein listened to my concerns and addressed my options. 4 days post-op bunion surgery I can say he did an amazing job. Best experience I have ever had. I would definitely recommend; I promise you won't look further.
The staff and Dr. Castelein are all amazing. They are polite and very respectful. I came to see them in 2019 for bunion and hammer toe issues among some others. Dr. Castelein and his assistant listened to my concerns and gave me my options. He explained everything to me in detail and all my questions were answered.. I have seen other podiatrists and he is beyond the best. I would recommend him to anyone.
Friendly staff and intelligent doctor! I went in for some ankle X-rays and was given a great strategy on the different ways to heal my ankle, and how to progress forward if less invasive treatment doesn't help. I would highly recommend them to anyone with foot or ankle problems!