What are Achilles tendon injuries?
The Achilles tendon is a fibrous band of tissue that links the muscles in your calf to your heel. The strength and flexibility of this tendon are necessary for all sorts of daily activities, including walking, running, and jumping. The Achilles tendon also bears a significant amount of stress during everyday (and often simple) exercises; therefore, if it becomes swollen or inflamed, one could suffer from tendonitis.
Tendonitis can occur due to overuse or damage to the area. Pain is felt down the back of one’s leg and around the heel. Parts of the tendon become thicker, and hardening occurs because of tendonitis. These symptoms can get worse if not treated. There are two main types of tendonitis:
- Noninsertional Achilles tendonitis. Small tears in the middle fibers of the tendon start to break it down, causing pain and swelling. This type of tendonitis usually affects active, younger adults.
- Insertional Achilles tendonitis. This damage occurs in the spot where your tendon meets one’s heel bone. Bone spurs often form with this type. This tendonitis can happen at any age, even in people who aren’t active.
Tears in your tendon fibers can cause a complete or partial break (or tear) in your tendon. People have reported hearing a ‘pop’ at the back of the heel or calf, which requires immediate medical attention.
Who is at risk for Achilles tendon injuries?
Anyone can develop an Achilles tendon injury. Common risk factors are:
- The increased and irregular intensity of an activity or sport
- Starting a new activity or sport
- Poor calf muscle flexibility when starting an exercise or sport, which can place more stress on your tendon
- Bone spurs on the heel, which can rub against the tendon
- Exercising on an uneven surface
What are the symptoms of an Achilles tendon injury?
Common symptoms of tendon injuries include:
- Pain down the back of the leg (usually near the heel)
- Isolated heal and calf pain that gets worse when one is active
- A stiff, sore Achilles tendon when one wakes up
- Pain in the tendon region the day after exercising
- Swelling with pain that gets worse as one is active during the day
- Thickening of the tendon
- Bone spurs on the heel bone
- Difficulty flexing the affected foot
- A pop sound or sudden sharp pain (or both), which can mean a ruptured tendon
How is an Achilles tendon injury diagnosed?
Injury to the Achilles tendon causes pain along the back of one’s leg near the heel. Several common injuries can make your Achilles tendon painful or prevent it from working well. Healthcare providers occasionally misdiagnose Achilles tendon injuries as sprained ankles.
Your healthcare provider will consider the following when making a diagnosis:
- Your overall health and medical history
- A description of your symptoms
- A physical exam of your Achilles tendon to check for bone spurs, pain, and swelling
- A test to see if you can move your ankle properly (range of motion)
- Imaging tests, such as ultrasound, X-ray, or an MRI
How are Achilles tendon injuries treated?
Treatment depends on how badly injured the tendon is. It may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief
- Specific exercises to strengthen the calf muscles
- Low-impact activities, such as swimming
- Heel lifts in shoes, orthotic shoes, cast, splint, or a walking boot
- Extracorporeal shockwave therapy. This treatment uses high-energy shockwave impulses to help stimulate the healing process in damaged tendon tissue.
Surgery may be considered if the provided treatment(s) don’t work or if the injury is severe. The type of surgery depends on the location and amount of damage to the tendon. It can also depend on other things, such as the severity of the tendonitis. Some of the surgical procedures used include:
- Surgery to lengthen your calf muscles (gastrocnemius recession)
- Surgery to remove damaged tendon tissue or bone spurs and repair the tendon (debridement)
- Surgery to remove your damaged tendon tissue, fix the remaining tendon, and give it extra strength by moving another tendon to the heel bone
What are possible complications of Achilles tendon injuries?
Complications of an Achilles tendon injury may include:
- Severe pain
- Difficulty walking or being active
- Warping of the tendon area
- Tendon rupture from reinjury
Other complications can happen because of the treatments used to care for an Achilles tendon injury. For instance:
- Sometimes cortisone injections can cause the tendon to tear
- Surgery can lead to pain and infection
How can I prevent Achilles tendon injuries?
These steps can help prevent injury to the Achilles tendon:
- Warm up before exercising, playing sports, or other repetitive movements
- Increase activity slowly, rather than all at once
- Wear the correct shoes for your activities
- Don’t exercise on uneven surface
- Avoid activities that cause pain
A few key points about Achilles tendon injuries
- Your Achilles tendon can develop tendonitis. This is when it becomes inflamed, swollen, and irritated
- The Achilles tendon can also tear or rupture, which might sound like a pop that seems to come from the back of your heel or calf. This needs immediate medical attention.
- Anyone can develop an Achilles tendon injury and it’s often linked to repetitive stress on the tendon
- Achilles tendon injuries often cause pain, stiffness, and swelling in the back of your leg near your heel
- Achilles tendon injuries can be treated with rest and medicines to help with the inflammation. Exercises often help too. If needed, surgery can be done to repair the tendon
- You can help prevent these injuries by doing things like increasing activity slowly, wearing the correct shoes for your activities, and not exercising on uneven surfaces
Dr. Bagwe is a leading orthopedic surgeon specializing in ankle and foot reconstruction. If you are looking for an orthopedic surgeon near you then look no further. Dr. Bagwe is an industry leader when it comes to foot and ankle surgery doctors in St. Louis. Dr. Bagwe and his friendly and professional team is ready to welcome you and tell you everything you need to know.
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