Is your Achilles tendon causing you pain? You may have an injury that needs treatment. Learn about the types of Achilles tendon injuries that exist and how to recognize them.
The Achilles tendon, or calcaneal tendon, is a long, thick cord that runs along the back of the leg and connects the calf muscles to the heel bone or calcaneus. Together, the calf muscles and tendon and the allow your ankle to flex downward (bringing your toes away from your shin).
Though it's the thickest tendon in the body and quite strong, its constant use during walking makes it one of the most injury-prone tendons in the body. Athletes often strain or even tear or rupture an Achilles tendon when jumping, running, or making sudden, powerful, pushing-off movements. Non-athletes are more likely to hurt their Achilles tendons by wearing unsupportive footwear, twisting an ankle, or intensifying a new exercise program too quickly. Whether you are an athlete or not — how will you know if you've injured your Achilles tendon?
Achilles tendon injuries are not all the same. Some symptoms can be managed with RICE therapy (rest, ice, compression, and elevation) until the injury heals itself. Other injuries may require physical therapy or surgery.
You may develop Achilles tendinitis if you overtrain or do too much too soon — for example, if you begin running long-distance without gradually increasing your mileage. Having tight calf muscles can also contribute to this injury; tight muscles can put too much strain on the tendon.
The two types of Achilles tendinitis are:
In some cases, Achilles tendinitis can lead to damaged tendon fibers calcifying (hardening). If you have Achilles tendinitis, you may be at risk for a tendon tear or rupture in the near future.
Treatment of tendinitis usually starts out with conservative management of the injury: limiting activity, immobilizing the tendon, stretching and doing heel lifts, or taking anti-inflammatory medications. If the Achilles injury doesn't respond to these approaches within a few months, physical therapy may be helpful. Special shoe inserts (orthotics) to raise the heel or support the arch of the foot may also be beneficial.
Tendinosis is the term used to describe chronic degeneration of the collagen fibers of your Achilles tendon. The damage to your tendon happens at the cellular level. Tiny micro-tears occur, usually in the mid-portion of the tendon at the back of the calf. Your body tries to heal itself, which increases blood flow and cell repair production at the site of the injury.
Typically, tendinosis does not involve inflammation, though an examination with MRI or ultrasound may reveal that your tendon is thickened. Symptoms can include tightness and stiffness of the calf, pain, and swelling.
Achilles tendinosis is often age-related, affecting individuals who are middle-aged or older. It is sometimes found in individuals with arthritis or with vascular (blood flow) issues.
If you're diagnosed with this form of Achilles tendon degeneration, you may be at higher risk for a calf muscle tear in the future.
Often, patients with tendinosis who are having trouble walking require surgical intervention to remove scar tissue and repair micro-tears.
A partial tear of the Achilles tendon can result from over training or activity. Full thickness tears can happen suddenly as the result of activity, or they can result from tendinitis getting worse over time. If you suddenly have trouble walking, putting weight on your foot, or flexing your ankle, you may have a tear. Some minor tears heal on their own with rest and corrective footwear. However, if you experience symptoms of an Achilles tear, see an orthopedist; partial tears can develop into full ruptures. Achilles tendon ruptures can generally be treated with immobilization or surgery.
Contributors to Achilles problems include:
Sports where Achilles injuries are common:
If your Achilles has been bothering you, see an orthopedic specialist to discuss your options. How you choose to heal and rehab your Achilles tendon injury depends on factors like age, activity level, general health, and the architecture of your foot.
Your orthopedist may recommend a mix of treatment and rehab techniques, including (but not limited to):
Many options exist to treat your Achilles tendon problems. If you live near Corpus Christi, Texas, give Coastal Orthopedics a call or book an appointment online today: (361) 994-1166
Article written by: Rob Williams, MD