Achilles tendinitis and Achilles peritendinitis are both conditions that affect the Achilles tendon, but they involve different parts of the tendon and its surrounding structures.
Achilles Tendinitis
Definition: Achilles tendinitis refers to inflammation of the Achilles tendon itself. The Achilles tendon is the strong band of tissue that connects the calf muscles to the heel bone (calcaneus).
Cause: Achilles tendinitis typically results from overuse, especially in athletes or individuals who engage in activities that involve repetitive stress on the tendon, such as running or jumping. It can also be caused by a sudden increase in the intensity or duration of physical activity.
Symptoms:
Pain and stiffness along the Achilles tendon, especially in the morning or after periods of inactivity.
Pain that worsens with activity or exercise, particularly when running or climbing stairs.
Swelling and thickening of the tendon.
Tenderness when the tendon is squeezed.
Achilles Peritendinitis
Definition: Achilles peritendinitis, also known as paratenonitis, involves inflammation of the paratenon, which is the sheath or tissue surrounding the Achilles tendon. Unlike tendinitis, the inflammation here is not within the tendon itself but in the surrounding tissue.
Cause: Achilles peritendinitis is also caused by overuse or repetitive stress, similar to Achilles tendinitis. It can occur independently or in conjunction with tendinitis. The condition is often seen in athletes, especially runners.
Symptoms:
Pain around the tendon, which may be more diffuse and located in the tissue surrounding the tendon rather than within the tendon itself.
Swelling and thickening of the tissue around the tendon, sometimes with a creaking sensation (crepitus) when the ankle is moved.
Pain that can be felt both during and after physical activity, with a broader area of tenderness compared to tendinitis.
Key Differences
Location of Inflammation:
Achilles Tendinitis: Involves inflammation of the tendon itself.
Achilles Peritendinitis: Involves inflammation of the tissue surrounding the tendon (the paratenon).
Pain Characteristics:
Achilles Tendinitis: Pain is often more localised to the tendon and may feel more intense when pressure is applied directly to the tendon.
Achilles Peritendinitis: Pain is more diffuse around the tendon, with tenderness in the surrounding tissue, and may be accompanied by a creaking sensation.
Treatment Approach:
The treatment for both conditions generally involves rest, ice, anti-inflammatory medications, physical therapy, and modifications to activities that stress the tendon. However, the specific focus of treatment might differ slightly depending on whether the tendon or the surrounding tissue is primarily affected.
Understanding these differences is important for accurate diagnosis and effective treatment, as both conditions require careful management to prevent further injury and promote healing.
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