Nicholas Campitelli, DPM | Akron Podiatrist | Foot and Ankle Surgeon

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Achilles tendinitis is a painful inflammation of the Achilles’ tendon with pain occurring to the back of the Achilles’ Achilles tendinitis is a painful inflammation of the Achilles’ tendon with pain occurring to the back of the Achilles’ tendon behind the ankle joint. With Achilles tendonitis, the pain will usually occur within the tendon itself as opposed to bursitis which is a similar condition that effects the back of the heel bone. The pain can present with sharp stabbing pain to the tendon that will be worse in the morning and then improve as you walk around and the tendon “warms up”. Pain will then occur later in the day as the tendon begins to become tired from being on your feet all day. You may feel a “creaking” in the tendon when moving your foot up and down if the sheath overlying the tendon becomes swollen. As the condition becomes chronic one will begin to see thickening or enlargement of the tendon itself. This can take months to resolve and will be painful for a long time if left untreated.

Treatment for Achilles tendonitis begins with rest from aggravating activity, taking anti inflammatories, and beginning stretching exercises. If this fails, immobilizing the ankle in a cam walker to reduce the motion to the tendon and take the stress off of it is the next step. Patients will sometimes need to be immobilized for 6 weeks in a cam walker to all the tendon to heal. After resting the tendon and allowing the inflammatory phase to resolve, strengthening with physical therapy is the next step. One can try eccentric strengthening exercises at home, but going to a physical therapist and receiving hands on treatment will provide more predictable results.

When conservative treatment options fail, the next step is surgical intervention. Surgery can involve an minimally invasive technique where a needle like probe is inserted into the Achilles’ tendon and the chronic inflammatory tissue is broken up and removed. This is a great option for patients who present with thickening of the central portion of the Achilles’ tendon that is not responding to conservative therapy. Severe cases of tendonitis that develop tears within the tendon itself that are seen on MRI may eventually require open repair and augmentation with adjacent tendons.

It is important to treat Achilles tendonitis before the condition becomes so severe that the tendon ruptures. Ruptured Achilles’ tendons can take months or even years to recover from, and will often leave patients with life long symptoms. Ruptured Achilles’ tendons are now being repaired with a minimally invasive technique that Dr. Campitelli performs and allows for a faster recovery.

behind the ankle joint. With Achilles tendonitis, the pain will usually occur within the tendon itself as opposed to bursitis which is a similar condition that effects the back of the heel bone. The pain can present with sharp stabbing pain to the tendon that will be worse in the morning and then improve as you walk around and the tendon “warms up”. Pain will then occur later in the day as the tendon begins to become tired from being on your feet all day. You may feel a “creaking” in the tendon when moving your foot up and down if the sheath overlying the tendon becomes swollen. As the condition becomes chronic one will begin to see thickening or enlargement of the tendon itself. This can take months to resolve and will be painful for a long time if left untreated.

Treatment for Achilles tendonitis begins with rest from aggravating activity, taking anti inflammatories, and beginning stretching exercises. If this fails, immobilizing the ankle in a cam walker to reduce the motion to the tendon and take the stress off of it is the next step. Patients will sometimes need to be immobilized for 6 weeks in a cam walker to all the tendon to heal. After resting the tendon and allowing the inflammatory phase to resolve, strengthening with physical therapy is the next step. One can try eccentric strengthening exercises at home, but going to a physical therapist and receiving hands on treatment will provide more predictable results.

When conservative treatment options fail, the next step is surgical intervention. Surgery can involve an minimally invasive technique where a needle like probe is inserted into the Achilles’ tendon and the chronic inflammatory tissue is broken up and removed. This is a great option for patients who present with thickening of the central portion of the Achilles’ tendon that is not responding to conservative therapy. Severe cases of tendonitis that develop tears within the tendon itself that are seen on MRI may eventually require open repair and augmentation with adjacent tendons.

It is important to treat Achilles tendonitis before the condition becomes so severe that the tendon ruptures. Ruptured Achilles’ tendons can take months or even years to recover from, and will often leave patients with life long symptoms. Ruptured Achilles’ tendons are now being repaired with a minimally invasive technique that Dr. Campitelli performs and allows for a faster recovery.

 

 


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Plantar fasciitis is an inflammatory condition that causes extreme pain to the bottom or plantar surface of the heel. The plantar fascia is a thick band of tissue arising on the heel bone and extends out into the arch of the foot.  Plantar fasciitis used to be referred to as heel spurs but it is now known that the spur is an incidental finding and is not the cause of pain and does not need to be surgically removed. 

When conservative treatment (stretching,  night splints, anti-inflammatories,  orthotics, and shoe gear modifications) fail,  surgical release of the plantar fascia is indicated.  This is a simple outpatient surgical procedure, when performed endoscopically, that takes approximately 5 minutes to perform and has a relatively fast recovery being that only two tiny incisions are performed. 

Immediately after surgery the patient is placed into a walking boot and given crutches.  The crutches are typically only needed for the first 24-48 hours. After 1-2 days the patient is then allowed to walk in the walking boot as tolerated. The sutures are removed in 10-14 days and the patient is able to return to activity as tolerated at this point. 

This procedure as dramatically decreased the recovery time for those patients who previously would have had an open plantar fascia release. Endoscopic plantar fascial release is reserved for those who have failed conservative treatment for plantar fasciitis for several months. 

See Video below on how the technique is performed.


9318 ST RT 43, Streetsboro, OH

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