incidence for those medicated with either oral or injectable corticosteroids. The foot and ankle are in dorsiflexion and the knee is extended with a contracted soleus muscle in rapid eccentric loading where these injuries usually occur. An eight percent strain, the tendon will fail and break the collagen cross links. A pop is felt by the patient. Short-term may not be intense, but the onset of edema and ecchymosis causes discomfort and an inability to continue activity (Soma and Mandelbaum, "Repair" 239-247).
Achilles tendinitis is a common injury in sport; it effects mature male athletes engaged in running and jumping activities. Intrinsic factors are found to include abrupt increases in the duration, intensity, or frequency of running leading to an inflammatory condition from overuse. Extrinsic factors include athletic shoes with an inadequately padded heel wedge or a soft heel counter with a lack of stabilization of the hindfoot. Pathogenetic factors are tibia vara, tight or underdeveloped hamstrings, and the cavus foot (Soma and Mandelbaum, "Achilles Tendon" 811-823).
Chronic tears of the achilles tendon result in a lengthening of the tendon from progressive microtear and scarring or a large, fixed gap from complete rupture, with secondary contraction and fibrosis of the gastrocnemius-soleus complex after an inadequately diagnosed or treated rupture. These situations are harder to treat surgically than the acute tendon rupture. The chronic rupture of the Achilles tendon is a debilitating injury that has been difficult to treat effectively. Untrea
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