Topics > Ankle > Achilles Tendon
Achilles Tendon
The largest tendon in the body which connects the calf muscles to
the heel bone. It can handle forces of nearly 1,000 pounds. Despite this
fact, it is also the most frequently ruptured tendon and is subject to
a common overuse injury and inflammation both in professional and weekend
athletes. This inflammation of the tendon is called Achilles tendonitis
and is caused by the small tears in the tendon from overuse.
Achilles tendonitis attack is commonly triggered by the following events:
- Overuse,
such as too much running, especially up or down hill.
- Trauma, such
as a kick to the tendon.
- Lack of flexibility in calf muscles
or insufficient stretching before exercise.
- Shoe
pressure on the tendon or just above it.
- People who have been wearing
high heels for a prolonged time may develop a shortened Achilles
tendon and thus, are at highest risk of developing
this condition.
Symptoms of Achilles tendinitis include:
- Gradually worsening pain after
mild exercise.
- Pain, sometimes severe, along
the tendon associated with running.
- Tenderness
of the tendon or about an inch above it in the morning after night
bed rest.
- Stiffness that’s relieved by stretching and warm-up.
- Swelling around
the tendon with activity.
This diagnosis must be made by
the orthopedic surgeon, because several conditions such as a partial
tendon tear and heel bursitis have similar
symptoms.
Treatment depends on the degree of injury to the tendon, but
usually involves:
- Rest,
which may mean stopping running or exercise for a week, or simply
switching to a less stressful exercise, such as swimming.
- Nonsteroidal anti-inflammatory
medication, such as aspirin or ibuprofen (Advil) to ease the pain.
- Icing of the tendon area several times a day for
20 to 30 minutes.
- Orthoses
to help align the heel bone properly.
- Wearing of a restrictive
bandage to help decrease tendon motion.
- Stretching,
massage and exercises to strengthen the weak muscle group in front
of the leg.
- Surgery is a last resort option. Some studies show that,
without an operation, the tendon has a 38% chance of rupturing again.
Some experts
suggest surgery
for active persons and nonsurgical treatment for elderly. Surgery
helps to remove the thick fibrous tissue that develops over the tendon
after
continuous friction on the bone. Recovery is slow, may require a
temporary cast and includes a rehabilitation program to avoid weakness.
Surgical
complications can include a scar, infection, and muscle atrophy.
Prevention:
- Choose your running shoes with sufficient cushion for the
heel strike.
- Do
not over-exercise.
- Walk and stretch to warm up gradually before running.
- Make sure you stretch
the calf muscles.
- Increase your running distance
and your speed gradually, in increments no greater than 10% a week.
- Avoid sudden strenuous sprinting, hill running.
- Cool down properly after
exercise.
