The Achilles tendon is located in the back of your leg. It begins at the back of your calf and extends down your leg and ends at your heel. You can follow it using two of your fingers on either side of the tendon from the middle of your leg straight down to the top of your heel bone at the back of your foot. This extraordinarily strong structure is what allows you to get on your “tippy toes” by lifting your heels off of the floor.
However, its strength contradicts the injuries that frequently occur. From sub-acute tendonitis to a partial tear and to even a complete rupture, these injuries result in painful and debilitating symptoms that affect your ability to move and daily activities.
The entire tendon is made up of many connected longitudinal tendrils that are, in fact, elastic. This gives the entire structure the ability to stretch and contract. When these so-called tendrils become inflamed due to overuse or injury, pain and swelling occur. These structures may become so over stretched that they separate from their corresponding tendrils. Thus, a partial rupture of the tendon occurs. If the injury is more severe, a complete rupture of the tendon is a possibility.
An Achilles tendon injury can be caused by:
- A foot-type such as flat foot, causing a collapse of the longitudinal arch of the inside of the foot. As a result, an “over-stretching” of the muscles and tendons of both the foot and the lower leg occur
- Increasing your level of physical activity too quickly, causing the Achilles tendon and its neighboring structures to perform at levels that it might not be able to handle the stress that is required
- Repeatedly performing your daily activities at your job or at home over an extended period of time
- Wearing high-heeled shoes that place undue stress on the Achilles tendon by continuous contracture
A symptom of an Achilles tendon injury is pain in the back of your leg above your heel either to touch or when you extend your toes to the floor. There may also be swelling or a lump present as well. Symptoms may have started after either an abrupt and sudden change in your activity or a long-standing inflammation that suddenly exacerbated into an acute injury. In either case, you should seek care from one of our practice’s professional medical physicians without delay.
Treatment for a mild Achilles tendon injury really depends on the extent and seriousness of the symptoms. Treatments include:
- Anti-inflammation medications such as aspirin or Tylenol® or over-the-counter non-steroidal anti-inflammatory medications such as Aleve® or Advil® (if your physician approves and your digestive system allows) can and should be used in order to allay pain and swelling
- Applying an elastic bandage from below the knee to beyond your ankle towards the middle of your foot
- Conservative care such as heel lifts in order to decrease the excessive contracture of the Achilles tendon in both gait and in physical activity. Our sports medicine experts can also structure the proper orthotic in order to help prevent future tendon injury
- Placing an ice pack to the back of your leg in order to decrease the swelling and pain
- Taking pressure off your injured leg either by using crutches or complete bed rest with elevation of the limb. Place a pillow at the foot of the bed in order keep the limb elevated
Treatment for moderate or severe Achilles tendon injury depends on the actual severity of the injury. The pathology may vary from a partial to a complete tear of the tendon. Obviously, conservative care may or may not be the treatment of choice. In some cases, a below-the-knee fiberglass or plaster cast may be sufficient. Unfortunately, it may be necessary to undergo surgical intervention. This can be what is referred to a primary closure of tendon at the rupture site. A procedure of this type is usually reserved for a recent acute injury. Ruptures that have been present for longer periods require more extensive surgical intervention with possible tendon grafting. Hence, it is important for the patient to be seen and evaluated as soon as possible after symptoms as described earlier in this article become evident. Our experienced physicians can and will explain the full treatment regimen to you concisely.
Of course, recovery time varies from individual to individual depending on the ambulatory or exercise requirements of the patient. Physical therapy is a must treatment regimen following either immobilization and/or surgical intervention. Treatment goals are met when the patient can move the involved leg as easily and freely as the unaffected leg. Hence, the goal of our physicians is to get our patient back to his or her prior normal activity so that there is no pain in the leg and/or foot when he or she walks, jogs, sprints or jumps.
For more information or to schedule an appointment with one of our specialists, contact Essex Union Podiatry today.