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Achilles Tendon Injuries

by Ron Kurtus (revised 20 February 2012)

The Achilles tendon is a fibrous cord of tissue that connects the calf muscle to the heel bone. This tendon allows you to rise up on your toes and push off while walking or running. Common problems with the Achilles tendon are that the tendon can become inflamed, can tear or can even rupture.

Usually, an examination by a physician is necessary to determine the extent of the injury. Treatment varies from stretching exercises to complete immobilization.

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This lesson will answer those questions. Health Disclaimer



Inflammation

A mild Achilles tendon injury or irritation results in inflammation of the tendon.

Slightly inflammed Achilles tendon

Slightly inflamed Achilles tendon

Causes

Achilles tendon problems are most often caused by overuse during various activities. Excess activity in sports, exercising or even work can fatigue the Achilles tendon, such that it becomes inflamed and will need time to heal.

Sometimes shoes or boots that press against the Achilles tendon can irritate and inflame the tendon, causing discomfort. Also shoes with poor arch support or rigid heels may also result in Achilles tendon problems.

Accidentally bumping the tendon can injure it.

If your blankets are so tight on your bed that your feet are forced at some angle, your Achilles tendon can become irritated, inflamed and sore. Sometimes an overly soft mattress can result in enough constant pressure on the tendon to irritate it.

Symptoms

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

Treatment

For mild irritations of the Achilles tendon, you can diagnose the problem yourself and give the tendon rest until it heals. Use care not to strain the tendon. But also do some mild stretching exercises to help it heal properly.

Your doctor can diagnose an Achilles tendon problem through a medical history and physical examination. The doctor will check for swelling and tenderness of the ankle area. If symptoms are severe or have not improved with treatment, your physician may recommend imaging tests, such as an X-ray or MRI. However, these are seldom necessary.

Micro-tears

Sometimes the ailment is caused be as series of very small tears in the tissue in or around the Achilles tendon. This is called tendinosis. In most cases Achilles tendon pain is from tendinosis and not tendinitis.

Sudden jumping or running motion—especially when the tendon is not warmed up—can tear or rupture the Achilles tendon.

Causes

Aggressive activities, such as repeated push-offs or stop-and-go motion can cause micro-tears in the tendon. These may be not heal quickly or completely. These injuries are more likely if you have not warmed-up enough or are in poor physical condition and are doing a new activity.

Treatment

You need to determine the severity of your injury before applying treatment. You can provide a self-diagnosis, but you often will need to go to a physician to properly find the extent of the injury.

Treatment for Achilles micro-tears includes rest, pain relief medication and stretching exercises. Changes in footwear may be necessary to reduce stress on the tendon. Early treatment is most effective and can prevent further injury. This type of Achilles tendon injury can require weeks to months of rest to allow the tendon to slowly repair itself.

Rupture

An Achilles rupture is most often caused by a sudden, forceful motion that stresses the calf muscle. this may happen during an intense athletic activity, but it can also occur during simple running or jumping, especially for middle-aged adults. A rupture most often occurs in sports that involved sudden movements, stopping or jumping, such as basketball, racquetball, tennis, soccer and softball.

Other factors that can contribute to an Achilles rupture are overstretching the tendon during any activity, inflammation, and small tears or tendinosis. All of these can weaken the tendon.

Symptoms

Symptoms of an Achilles rupture include a sudden, sharp pain, often accompanied by the feeling of a "pop" where the tendon has ruptured. Swelling and bruising may occur. You may not be able to point your foot down or stand on your toes.

The greater the tear, the more pain. A complete rupture of the Achilles tendon is serious and cause great pain and sudden loss of strength and movement.

Treatment

Treatment for an Achilles tendon rupture includes surgery or a cast, splint, brace, walking boot or other device that will keep your lower leg from moving. It generally 6 to 12 weeks for the Achilles tendon time to heal.

Although treatment for a rupture takes time, healing is usually successful. You usually are able to resume most of your previous activities.

Summary

The Achilles tendon connects the calf muscle to the heel bone. Common problems with the Achilles tendon are inflammation, a micro-tear or a rupture. Usually, an examination by a physician is necessary to determine the extent of the injury. Treatment varies from stretching exercises to complete immobilization.


Thoroughly warm-up before exercising


Resources and references

Ron Kurtus' Credentials

Websites

Achilles Tendon Problems - From WebMD

Achilles tendonitis treatment - From Sports Injury Bulletin

General Health Resources

Books

Top-rated books on Being Healthy


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