Achilles Tendon – Not so Invincible After All

The Achilles Tendon, named after the Greek hero, Achilles of the Trojan War, is the thickest and the strongest tendon in the body. But just like its namesake, the Achilles tendon when severely injured, can cause permanent disability.

The Achilles' tendon. PD image from Gray's Ana...
The Achilles’ tendon. PD image from Gray’s Anatomy, from bartleby.com . (Photo credit: Wikipedia)

The Achilles tendon connects the heel of the foot to the calf muscles, which are  the most powerful group muscles in the body. When the muscles contract, they pull the Achilles tendon which pushes the foot downward. It makes standing on the toes, walking, running and jumping motions possible. Each tendon may be subjected to up to 3-12 times of a person’s body weight during a sprint or push off, depending on the speed, stride, terrain and additional weight be carried.

The most common injuries it can suffer are Achilles tendinopathy and Achilles tendon rupture. Achilles tendinopathy is an over use injury, characterized by a combination of pain, swelling and impaired performance of the tendon, which may be related to the activity done or shoe worn. Achilles tendon ruptures are relatively common. During the last decade, the incidence of torn Achilles tendons has been rising probably because of the increasing keep-fit culture.

Patients usually complain of sudden intense pain on the heel, often described as someone kciked them from the back of the ankle. They usually cannot perform a single heel rise.

Some pointers on how to address Achilles tendon injuries:

1. Stop doing the activity that caused the injury for between a week and a few months. This does not mean you can get out of shape. You may do alternate sports that are easy on the Achilles tendon, such as swimming, cycling or try to focus on upper body training. You may then resume to previous activity level gradually afterwards.

2. Perform proper stretching. This may include other muscle groups besides the calf muscles such as the hamstring and gluteal muscles.

3. Focus on the eccentric strengthening exercises of the calf muscles. You can do this by doing calf raises on a stool or stairs. Concentrate on the eccentric rather than the concentric portion of the exercise (the calf lowering rather than the calf raising portion of calf raises). Be sure to go all the way down on each repetition for a full stretch of the Achilles tendon.

4. Undergo physical therapy with a trained therapist. These may also include other tools such as ultrasound and electric stimulation.

5. Do an ice therapy. Apply the ice pack to the Achilles tendons after exercise or physical therapy.

6. Avoid inflammatory medication/ pain-relievers. These drugs will mask the problem, which is likely to cause  the degeneration to get worse.

7. Be sure to consult a specialist, preferably a Foot and ankle specialist to diagnose the main root of the problem and properly address it. He may recommend  program modification, physical therapy, adjustment of footwear or application of shoe inserts. Recently, studies about platelet-rich plasma injection in the treatment of this cases have shown promising results. In worst cases, after exhausting all conservative measures, surgery may be the last resort. This would include removing  the dead or degenerated tendon. These may be performed through the traditional open method or through a new technique called Achilles tendoscopy.

Staying in good shape, proper warm -up, stretching and strengthening of the Achilles tendons is the best way to prevent these injuries.

Web References:

 

http://www.achillestendon.com/

http://www.arthroscopy.com/sp09009.htm

http://www.beginnertriathlete.com/cms/article-detail.asp?articleid=1694

 

 

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