Paratenonitis and Plantaris

What Is Achilles Paratenonitis?

Achilles Paratenonitis is an acute inflammation of the covering of the Achilles tendon, which connects the calf muscles to the heel bone. 

Achilles Paratenonitis is also known as Achilles Peritendinitis, Tenovaginitis or Tenosynovitis.

Achilles Paratenonitis can cause scarring that restricts the motion of the Achilles tendon but respond well to pain management. 

Who Does Achilles Paratenonitis Affect?

Achilles Paratenonitis usually affects marathon runners and athletes who are heavy runners, as this injury is caused by overuse. 

It is also seen in individuals who have repeated movements and wear improperly fitted shoes. 

How Does Achilles Paratenonitis Occur?

Achilles Paratenonitis occurs due to acute repeated straining of the Achilles tendon. The sheath becomes severely inflamed due to the overuse and becomes very painful. 

Causes of Achilles Paratenonitis

Achilles Paratenonitis occurs due to acute overuse. Other risk factors for Achilles Paratenonitis development include:
  • Heavy running and jumping, despite stiffness and discomfort,
  • Obesity,
  • Shoes that fit poorly,
  • Running or jogging on hard surfaces, and
  • Flat feet or high arches.

Symptoms of Achilles Paratenonitis

The symptoms for Achilles Paratenonitis include:
  • Swelling in the Achilles area,
  • Tenderness in the Achilles area, and
  • Moderate to severe pain.
The symptoms become worse during the aggravating activity.

Stages of Achilles Paratenonitis

There are no stages of Achilles Paratenonitis, however, the pain gets worse with repeated activity without intervention in symptomatic cases.

How Is Achilles Paratenonitis Diagnosed?

The diagnosis for Achilles Paratenonitis is made by taking a complete history and performing a complete physical examination. 

The tendon appears severely inflamed, often adapting a sausage like appearance. 

How Is Achilles Paratenonitis Treated?

Rest

Rest is the main treatment for Achilles Paratenonitis. Pain caused by Achilles Paratenonitis responds well to over the counter anti-inflammatory medicines (NSAIDs) such as Ibuprofen and Tylenol.

Stretching exercises, physical therapy, icing, more suitable appropriately fitting footwear are all appropriate to treat the inflammation and to prevent it from happening again.

What if Achilles Paratenonitis Is Untreated?

If left untreated or improperly managed, Achilles Paratenonitis can aggravate to such an extent that the individual is unable to perform any amount of running in the future without incurring pain.

Treatment Process

Preparation for Surgery

  • Provide a complete list of your medications so you can be advises which to stopped prior to surgery,
  • Treat any tooth, gum, bladder or bowel problems before surgery to reduce the risk of infection
  • Stop anti-inflammatory medications (NSAIDs) at least seven days before the procedure.
  • Stop or cut down smoking to reduce your surgery risks and improve your recovery
  • Consider losing weight (if overweight) before surgery

Day of Surgery

  • Report any infections to me prior to surgery as the procedure cannot be performed until all infections have cleared up.
  • Do not consume alcohol - 24 hours prior to treatment,
  • Do not eat or drink anything, including water, for 6 hours before surgery
  • Avoid vigorous physical activity or exercise 24 hours prior to surgery,

During Surgery

  • Administration of general anesthesia or sedation and local anesthesia
  • The entire procedure can take 60 minutes to two hours.
  • Procedure is performed and sent to recovery room, for observation
  • Pain medications are prescribed to help with pain during the recovery phase. 

After Surgery

  • Do not consume large amounts of alcohol after surgery,
  • Avoid vigorous physical activity or exercise until advised,
  • Follow the Post Surgery Treatment Plan proscribed by the surgeon and post op care specialists.
  • Any questions or complications should be communicated directly to the surgeon

Common Questions

If you have a specific question about your treatment, we recommend contacting the clinic
  • Hospital Discharge?

    The patient is then discharged from the hospital in a day or two after the procedure. 


    Patients are advised on the steps to keep the wound dry and clean and on scar management.


    The patient is advised to maintain a strict elevation of the joint for ten days. 

    • arrange help to assist with chores, and
    • avoid putting any weight on the joint, with the help of crutches and walkers. 
  • Recovery After Paratenonitis and Plantaris?

    Even minor injuries can have a prolonged recovery period. 


    Patients are normally immobilised in a below-knee cast or boot for 6 weeks.


    Other conditions include:

    • no weight-bearing during this time, and 
    • often a further 4-6 weeks in a boot is required once walking is started. 

    Return to maximum function often takes up to one year after the injury.

  • Wound Management?

    At the time of discharge patients are advised on:

    • The necessary steps to keep the wound dry,
    • Wound care and Cleaning, and 
    • On scar management. precautions.
  • What if I Am Pregnant?

    It is not recommend surgery while pregnant, as the risks are uncertain due to the lack of information available about the effect on the fetus. 


    For more information please call us on and request to speak with one of our medically-trained registered doctor or nurse.

  • Post Surgery Treatment Program

    Long term outcomes depend on the severity of the initial injury. 


    Some patients won’t get back to their pre-injury function or sport, even with well-performed surgery. 


    Ten Days After Surgery

    X-rays are repeated ten days after the procedure to determine the situation. 


    Physiotherapy

    For the best possible outcome, postoperative physical therapy plays an important role in proper recovery following your procedure. 


    This postoperative management includes regular scheduled visits with a physical therapist 


    Extended Recovery Period

    The patient is advised to limit their activities for six to eight weeks after the surgery.


    Certain activities such as driving are also restricted for up to six weeks post-surgery. 

  • Possible Risks or Side Effects?

    The procedure carries all the risks associated with surgery, such as 

    • infection, 
    • bleeding and 
    • a severe allergic reaction to anesthesia. 

    Redness and bruising at the site of injection may be seen which should resolve over time. 


    You may experience post operative pain for prolonged period or other serious side effects contact your surgeon, as well as:

    • damage to the structures around the operative zone such as nerves, blood vessels, tendons, muscles,
    • chronic pain due to nerve entrapment
    • delayed healing
    • wound infection or breakdown.
  • Possible Complications of Surgery?

    If this condition or injury is missed or untreated can result in the collapse of the arch of the midfoot with significant pain, and the development of arthritis. 


    When surgery is performed, risks include damage to the structures around the top of the foot (nerves, blood vessels, tendons, muscles), as well as a risk of wound infection or breakdown.


    It is common to sustain cartilage damage at the joint surfaces during the initial injury, and some people develop midfoot arthritis and ongoing pain down the track. 


    Some patients require further surgery to fuse the midfoot joints to relieve arthritis pain.

  • Do You Offer Discounts?

    Due to strict regulations set by the Australian Medical Board it is against the law to offer surgical inducements. 


    Discounted treatments should raise alarm bells when you are choosing which specialist to trust your treatment to. 


    The surgeon's skill is more important than price. Effective surgery will maximise your health outcome.