Achilles Tendon Injuries
The achilles tendon is the largest tendon in the body. It connects the muscles in the back of the lower leg to the heel bone (the calcaneus) and must withstand large forces during sporting exercises and pivoting. There are two main types of injuries that affect the achilles tendon: 1) overuse and inflammation, called achilles tendonitis, and 2) a tear of the tendon.
Achilles tendonitis often occurs when an individual rapidly increases the intensity of training or starts new types of training when the body is not fully conditioned. The patient may experience mild pain after exercise that gradually worsens. Mild swelling, morning tenderness, and stiffness may also occur, but may improve with use. Severe episodes of pain along the length of the tendon several hours after exercise may also be experienced.
Because other symptoms may be present, it is best to see a doctor for full evaluation of an achilles injury. Treatment depends on severity and typically involves rest and non-steroidal anti-inflammatory medications (NSAIDs) to relieve pain and inflammation. A brace may be needed to relieve the stress on the tendon and to support the ankle, and bandages may be applied to restrict joint movement.
Surgery is sometimes an option to repair any tears and remove any inflamed or fibrous tissues. Recovery generally includes rehabilitation to avoid future weakness in the ankle.
The achilles tendon may tear if it is overstretched, usually while playing sports. The tear may be partial or complete and most commonly occurs just above the heel bone. A snap or crack sound may be heard at the time of injury. Pain and swelling near the heel and an inability to bend the foot downward or walk normally are signs that the tendon may be ruptured.
Surgery is typically needed for a complete rupture. After surgery, the ankle will be kept stable in a cast or walking boot for up to 12 weeks. A torn ligament may also be managed non-surgically with a below-knee cast, which allows the ends of the torn tendon to heal on their own. This nonsurgical approach may take longer to heal, and there is a higher chance that the tendon could re-rupture. Surgery offers a better chance of full recovery and is often the treatment of choice for active people who wish to resume sports.
If you suspect that you have signs or symptoms of an achilles tendon injury, please see your doctor for further evaluation and discussion of treatment options.