Achilles tendon

The Achilles tendon connects the calf muscle to the heel bone. It lets you rise up on your toes and push off when you walk or run.

Achilles tendon

 

Problems with the Achilles tendon may seem to happen suddenly. But usually they are the result of many tiny tears to the tendon that have happened over time.

Achilles tendinopathy. Achilles tendinopathy includes one of two conditions:

  • Tendinosis. This refers to tiny tears (microtears) in the tissue in and around the tendon caused by  overuse.  In  most  cases Achilles  tendon  pain  is  the  result  of  tendinosis,  not tendinitis. Some experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis to describe a tendon injury.

Achilles tendon tear or rupture. An Achilles tendon also can partially tear or  completely tear (rupture). A partial tear may cause mild or no symptoms. But a complete rupture causes pain and sudden loss of strength and movement.

Achilles  or  heel  (calcaneal)  bursitis:  Low-riding  shoes  can  irritate  the  bursa,  a  sac  of  fluid cushioning the Achilles tendon at the heel. Pain in the back of the heel, worse with shoes on, is the common symptom.

Symptoms

Achilles  tendon  problems  are  most  often  caused  by  overuse  or  repeated  movements.  These movements  can  happen  during  sports,  work,  or  other  activities.  Being  out  of  shape  or  not warming up before exercising may also cause Achilles tendon problems. So can shoes with poor arch supports or rigid heels.

Symptoms  of Achilles  tendon  problems  include  swelling  in  the  ankle  area  and mild  or severe pain. The pain may come on gradually or may only occur when you walk or run. You may have less strength and range of movement in the ankle.

A rupture of the Achilles tendon may cause a sudden, sharp pain. Most people feel or hear a pop at  the  same  time. An Achilles  rupture  is  most  often  caused  by a  sudden,  forceful  motion  that stresses the calf muscle. This can happen during an intense athletic activity or even during simple running  or  jumping.  Swelling  and  bruising  may  occur,  and  you  may  not  be  able  to  walk efficiently, point your foot down or stand on your toes.

Achilles tendon1

Diagnosis

The doctor will perform a physical exam to see if a tendon is tender, swollen and preserves its integrity. X-rays are often needed to evaluate the heel bone. In some cases, a Ultrasound or MRI may be needed

Treatment

An Achilles  tendon  rupture  may be  treated  with  surgery and  rehabilitation  or by using  a  cast, splint,  brace,  walking  boot,  or  other  device  that  will  keep  your  lower  leg  from  moving (immobilization) and rehabilitation. Consider the following when making your decision:

  • Both surgery  and  immobilization  are  usually  successful. Another  rupture  is  less  likely after surgery than after immobilization, but immobilization has fewer complications.
  • If you are younger and/or active, surgery is often recommended.
  • If you are older and/or inactive, immobilization is often recommended. Regardless the treatment type, full recovery might take from 6 weeks up to 6 months.

 

Prevention

Prevention can be as simple as wearing the right shoes or as complicated as extensive training for athletes.

  • Wear proper  shoes  for  the  activity.  Always  wear  stable  shoes  that  give  your  proper support. High-top basketball shoes, high heels or platform shoes are a good choice
  • Keep the  calf  strong  and  flexible.  Consult  with  physical  therapist  for  strengthening exercises.
  • When participating in a sport, consider having calf taping, as taping offers extra support.

Wearing an ankle brace while playing may also help.

  • Make sure a playing field (or home environment) is clear of any holes or obstacles to help avoid injury.
  • Prior to  any sport  activity,  take  some  time  for  warm-up  and  make  stretching  exercises afterwards.