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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5164
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I've had Achilles tendonitis 6 months, a mri showed small

Customer Question

I've had Achilles tendonitis for almost 6 months, a mri showed small tears in tne gendon.At times unbearable pain, other times mild, but ne er totally gone since April. Physical therapy worsened the pain. It is my left ankle, which is also the leg with a partial knee replacement. A couple weeks ago the intense pain on the back of my ankle was suddenly gone, but my leg and knee felt tight, like swollen. Then I began to feel a clicking in my artificial knee, but no pain. Exray showed all knée parts in correct spot. I thought perhaps a piece of the spur on the ankle had chipped off, traveled a d lodged in the knee, but my orthopedic dr. Said it would show on the xray. He told me he really didn't know what was causing it, unless bits of broken tendon were snapping g off and ,a Di g around my hamstring. He said it would correct itself, but everyday it seems to move around. Today I felt the clicking in my ankle, Monday it was in my knee. Right now my calf feels very tight, knee feels swollen and I feel like I'm going to get those bad calf cramps.
my question is could this be continuous pieces of tendon snapping off? If yes, how long before too much is gone to be usable? Is my standing and walking up to 12 hours a day making it worse? And how to fix? My dr. Said if it were fixed by survery, it would just start time tear again.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Bob replied 1 year ago.

Hi there. Pieces of tendon do not snap off, so you do not need to worry about that. Clicking is usually the sound caused by a tendon slipping over the edge of a bone or slipping temporarily out of a groove in the bone. This would not be unusual in a case like yours in which there is damage to the tendon as well as mechanical changes stemming from your knee replacement surgery.

Expert:  Dr. Bob replied 1 year ago.

Standing and walking 12 hours a day is likely making your tendinitis worse, or at least interfering with its ability to heal. This is especially true if you are walking barefoot or in flats. Having a slight lift in the heel helps to shorten and rest the tendon and tends to make it feel better. Conversely, flat shoes tend to cause the tendon to stretch more with every step, leading to more irritation, inflammation and micro-tears.

Expert:  Dr. Bob replied 1 year ago.

One approach would be to work with a physical therapist on rehabing the knee, strengthening your quads and keeping your calves gently stretched. While this is occurring, you should also consider seeing a podiatrist who can focus on how your feet and footwear may be adding to the problem. For instance, if you have shallow arches or flat feet (i.e. pes planus) this can greatly add to the "wringing" motion of the tendon during ambulation. You might need arch supports...in addition, of course, to a heel lift that keeps the tendon shortened.

Expert:  Dr. Bob replied 1 year ago.

Does this make sense? Let me know if you have any follow up questions.

Expert:  Dr. Bob replied 1 year ago.

Hi There. Let me know if you have any additional questions.

If not, don't forget to accept my answer so I get paid for my time assisting you.

Thank you.