Achilles Tendon injuries are commonly caused by a sudden movement that places a large amount of stress on the area. Sprinting, jumping or large steps down without properly warming up are common culprits of achilles tendon injuries. It can also be injured when the calf muscle is not as strong or flexible as it needs to be to do a certain activity, and the Achilles bears too much of the strain.
For example, the Achilles tendon can become irritated or torn if you are not conditioned for physical activity but do weekend chores or leisure activities that require leg strength and flexibility.
The most common Achilles tendon injuries are:
- Achilles tendinitis – happens when a tendon becomes irritated and inflamed from overuse. The overuse can be from repeating a certain activity (like jumping or sprinting) or from doing too much activity too soon, without allowing enough time to build up your strength and flexibility. Achilles tendinitis causes soreness in the back of the heel. It’s usually temporary and gets better with rest and treatment. But if the Achilles tendon is regularly irritated and inflamed, the tendon will start to break down. This makes it vulnerable to tears and ruptures.
- Torn Achilles tendon The Achilles tendon can tear when it’s weakened by tendinitis or has sudden stress on it, or both. The tendon can have a partial tear or tear completely. This is also known as a tendon rupture.
What is Achilles Tendinitis?
Achilles tendinitis is the inflammation and irritation to the Achilles tendon,a strong fibrous cord present behind the ankle that connects your calf muscles to the heel bone. Certain activities can cause an overuse injury to the Achilles tendon, particularly in middle-aged people participating in sports activities occasionally.
Risk Factors
The common risk factors that may cause Achilles tendinitis include:
- Sports and Exercise
- Insufficient warming up before exercise
- Poorly-fitting footwear while running
- Running on uneven surfaces or uphill
- Quickly changing your speed
- Sports such as football, baseball, volleyball and tennis
- Medical Conditions
- Stiff muscles
- Bone spurs
- Psoriasis
- High blood pressure
- Certain medication
- Glucocorticoids
- Fluoroquinolones
Symptoms
You may hear a snapping or popping sound during the injury. The common symptoms of Achilles tendinitis include:
- Morning pain and stiffness along the Achilles tendon
- Severe pain while running, climbing and exercising
- Thickening of the tendon
- Inflammation at the back of your heel
- Inability to rise on your toes
Diagnosis
Your doctor will take a medical history and perform a physical examination. Imaging tests such as X-ray, MRI or CT-scan will confirm the diagnosis.
Treatment
Your treatment plan may include the following:
- Rest: Rest your foot by refraining from the activities that may cause further injury.
- Ice packs: Use of ice packs may be suggested to reduce inflammation.
- Compression: Wrapping with an elastic bandage or compression stocking can help minimise swelling and support your foot.
- Elevation: Elevating your leg above heart level will also help reduce swelling and pain.
- Pain medications: A combination of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids may be used to manage pain.
- Exercise: Physical therapy exercises will be taught to enhance your flexibility, range of motion and strength.
- Shoe modifications: Your doctor may suggest a shoe with heel lifts to prevent further injury.
- Injection therapy:This involves administering steroids through a needle at the back of your heel to relieve pain and inflammation.
Surgery may be recommended by your doctor if you do not respond to non-surgical treatment options. Depending on the severity, any one of the following surgeries will be performed:
- Gastrocnemius Recession: This procedure involves surgical lengthening of your calf muscles to improve flexibility and motion of the ankle.
- Debridement and Repair: The damaged part of the Achilles tendon is surgically removed and a tendon transfer may be performed. Debridement of bone spurs may be performed followed by placement of plastic or metal anchors to hold the tendon until your bone heals.
Prevention
Achilles Tendinitis can be prevented by avoiding the risk factors that may cause overstretching or an injury.
What is an Achilles Tendon Rupture?
The Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to the heel bone. It is used when you walk, run and jump. The Achilles tendon ruptures most often in athletes participating in sports that involve running, pivoting and jumping. Recreational sports that may cause Achilles rupture include tennis, football, basketball, and gymnastics.
What are the Symptoms of Achilles Tendon Rupture?
When the Achilles tendon ruptures, you will experience severe pain in the back of your leg above your heel, swelling, stiffness, and difficulty standing on tiptoe and moving the leg when walking. A popping or snapping sound may be heard when the injury occurs.
How is an Achilles Tendon Rupture Diagnosed?
Your doctor diagnoses the rupture based on the symptoms, history of the injury and by performing a thorough physical examination. Your doctor may also feel a gap or depression in the tendon, just above the heel bone. Your doctor will gently squeeze the calf muscles. If the Achilles tendon is intact, there will be flexion movement of the foot, if it is ruptured, there will be no movement observed.
What is the Treatment for an Achilles Tendon Rupture?
An Achilles tendon rupture is treated using non-surgical methods or surgery. Non-surgical treatment involves wearing a cast or special brace that lifts your heel and allows the tendon to heal.
Surgical treatment involves opening the skin and suturing the torn tendon together. Surgery helps to lower the recurrence of the Achilles tendon rupture.
With either treatment, physical therapy is recommended to improve the strength and flexibility of the leg muscles and the Achilles tendon.
How do you Prevent an Achilles Tendon Rupture?
To help prevent an Achilles tendon injury, it is a good practice to perform stretching and warm-up exercises before participating in any exercises or sports activities. Gradually increase the intensity and length of time of the activity. Muscle conditioning may help to strengthen the muscles in the body.