A tendon is a band of tissue that connects muscle to bone. The Achilles tendon connects your calf muscles to your heel, allowing you to walk, run and jump. Achilles tendinopathy, strain of the Achilles tendon, is a common injury that may affect runners, or people with overpronated (flat) feet or those with high arches or tight calf muscles as well as those who wear runners that are not an appropriate biomechanical fit for them. Some people may have a protruding heel bone (calcaneus) which pulls the Achilles tendon into a position where it is more likely to be strained.
The Achilles tendon is already under strain when the foot pushes off the ground in walking, running or jumping, so when there is extra stress on the tendon due to the above reasons then it is easy to understand why Achilles tendinopathy is common,
Achilles tendinopathy is a painful and quite often a chronic condition that is difficult to treat. If the strain is higher up in the tendon towards the calf, then physiotherapy management of ice, ultrasound, deep tissue massage, stretching, corrective exercises, strapping and advice on footwear is often very successful. If the strain is closer to the insertion at the heel, you may need to see a specialist who may recommend an anti-inflammatory steroid injection at the site or perhaps surgery.
Podiatry is also highly recommended for Achilles tendinopathy and heel inserts can be of great benefit in reducing symptoms.
The primary symptom of an Achilles tendon injury is pain at the back of the heel, which increases with exercise and lessens when exercise stops. Achilles tendinopathy may also manifest itself with warmth, swelling and tenderness at the site. Range of motion may be limited.
Achilles tendinopathy can lead to small tears in the tendon, making it susceptible to rupture, however rupture may also take place without any previous Achilles tendon problems.
Symptoms of Achilles tendon rupture are:
- Sudden pain in the back of the ankle which feels like a kick or a stab. Sometimes a loud snap is heard. It may turn into a dull ache.
- Swelling between the heel and the calf. You may have a ball of swelling where the ruptured tendon has bunched up.
- Difficulty walking or rising up on the toes.
A rupture may be treated surgically or non-surgically, depending on the extent of the damage and your condition. Until you can get professional help, the RICE formula should be applied:
- Rest. This is important as walking may cause further problems.
- Ice. Use an ice pack wrapped in a wet tea-towel. Never apply directly to the skin and leave on for twenty minutes. Repeat every two hours.
- Compression. Bandage the foot to prevent further swelling. Take the bandage off at night when you go to bed.
- Elevate the leg at or above the level of the heart to decrease swelling.
For non-surgical intervention, we will either strap the Achilles tendon or we will recommend a brace, as well as physiotherapy treatment used for Achilles tendinopathy. We will work with you to manage your pain and we will also help you modify your training schedule to match your recovery and advise you on how to prevent further injury.
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