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Complete Guide To Achilles Tendon Injury And Pain

The Achilles tendon is a strong band of fibrous tissue which serves as a connection between the calf muscles and the heel bone (calcaneus). It is also known as the calcaneal tendon. 

It is a union of the gastrocnemius and soleus muscles (calf muscles) which combine into a ring of tissue. This ring of tissue is known as the Achilles tendon and it is located at the lower end of the calf. It is then inserted into the calcaneus and supported at the heel by small sacs of fluid called the bursae.

The Achilles tendon is the biggest and robust tendon in the body. When you flex the muscles of the calf, the Achilles tendon pulls on the heel. This motion enables you to stand on your toes while walking, running, or jumping. Despite its durability and resilience, the Achilles tendon is also susceptible to injuries, because of its insufficient supply of blood and intense pressure put on it.

Conditions that affect Achilles Tendon

  • Achilles tendon tear.
  • Achilles tendon rupture.
  • Achilles tendinosis.
  • Achilles Peritendinitis.
  • Achilles retinopathy.
  • Achilles bursitis.

Causes of Achilles tendon Pain

Achilles tendon injuries are commonly seen among people who perform activities that include speeding up, slowing down, or pivoting. These exercises include;

  • Running.
  • Gymnastics.
  • Dancing.
  • Football.
  • Baseball.
  • Softball.
  • Basketball.
  • Tennis.
  • Volleyball.

These injuries often occur when you start moving abruptly, while you push off and raise your foot instead of when you land. For example, a sprinter might get one at the beginning of a race as they bolt off the starting block. 

The sudden action might be too much for the Achilles tendon to bear. Men above the age of 30 are more susceptible to having Achilles tendon injuries. The tendon can also develop an injury if it is burdened with intense activities. They are known as injuries caused by stress from repetitive actions (repetitive stress injuries). 

Other causes of Achilles tendon pain include:

  • Wearing high heels causes tension to the tendon.
  • If you have flat feet, also known as fallen arches. This simply means that every time you walk, the shock makes the arch of the foot collapse, straining the muscles and tendons. 
  • If the muscles of your legs and tendons are too tight.
  • If you have bone spurs.
  • Increasing the time you spend on exercise daily or adding more intense activity. 
  • Starting a new form of exercise.
  • Wearing shoes that don’t fit or are not suitable for the physical activity you perform.
  • Working out on rough surfaces.

What is Plantar Fasciitis

Plantar Fasciitis is a discomfort in the bottom of the heel. The Plantar fascia is a coarse, web-like ligament that acts as a connection between your heel and the front of your foot. It plays the role of a shock absorber and plays a supporting role for the arch of the foot, helping you to walk.

Plantar Fasciitis is one of the commonly seen orthopedic issues. The plantar fascia ligament faces a lot of wear and tear through everyday use. Putting too much strain on the feet can harm or rip the ligaments causing the plantar fascia to become inflamed resulting in discomfort and stiffness.

The major symptom of Plantar fasciitis is discomfort or irritation at the bottom of the heel or oftentimes, the bottom mid-foot area. Oftentimes, it affects just one foot, but in very rare cases, it can affect both feet. 

The discomfort felt from plantar fasciitis often builds up over time. It can either be a sharp, piercing pain or a dull ache, and it can sometimes be felt as a burning feeling on the bottom of the feet to the heel. 

The discomfort is felt more sharply in the morning, especially when you get off from bed while trying to take your first steps. It is also felt if you have been sitting or lying in a single position for a long time. The pain felt can make ascending the stairs very hard. People between the ages of 40 and 70 are more susceptible to having plantar fasciitis and it is often seen in women when compared to men.

The symptoms of plantar fasciitis are similar to Achilles tendon pain which is why they are often mistaken for each other, but plantar fasciitis is quite different from Achilles tendon pain.

Plantar fasciitis can be treated by;

  • Massaging the affected foot.
  • Putting on an ice pack.
  • Stretching exercises.
  • Using toe separators.
  • Strengthening exercises.

Achilles Tendonitis 

The Achilles tendon connects the calf muscles to the heel bones or calcaneus. This tendon enables us to walk, jump, run and stand on the balls of our feet. 

Continuous, repetitive, and intense physical activities such as running and jumping can cause swelling of the Achilles tendon. This swelling or inflammation is what is known as Achilles tendonitis or (tendinitis).

There are two variants of Achilles tendonitis:

Insertional Achilles tendonitis

This affects the lower part of your tendon where it connects with the heel bone.

Noninsertional Achilles tendonitis

This affects fibers in the middle part of the tendon and mostly affects younger, more active people. 

Simple home treatments can help treat Achilles tendonitis. But, if the home treatment does not yield positive results, it is advisable to seek a doctor’s help. If the tendonitis becomes severe, it may result in a tear of the tendon, and you might require surgery to relieve the pain. 

Achilles tendonitis often affects athletes, who participate in walking and running exercises. Some of the causes include:

  • Starting an exercise without warming up.
  • Putting pressure on the calf muscles during repetitive physical activities.
  • Sports that require sudden pauses and swift change of direction such as tennis.
  • Putting on old shoes or shoes that don’t fit.
  • Putting on heels for long periods of time. 
  • Old age (the Achilles tendon gets weaker as you grow).

You can treat Achilles tendonitis by resting the affected leg, placing an ice pack over it, taking anti-inflammatory drugs, using a heel lift, and practicing strengthening and stretching exercises as recommended by the doctor. 

Achilles tendon strain

Achilles tendon strain is a discomfort that occurs when there is overuse or overexertion of the Achilles tendon. It is mostly found in athletes who have increased the duration or intensity of their exercises.

Symptoms often include sharp pain above the heels anytime you stretch the ankles or attempt to stand on your toes. It might get milder and get worse depending on the degree of damage. That part of the ankle may also feel soft, swollen, or stiff.

You can treat Achilles tendon sprain by resting, performing low-stress activities such as swimming, and physical therapy.

Achilles tendon Partial Tear

A partial tear of the Achilles tendon occurs when the muscles of the calf are contracted strongly.  A sharp contraction can overburden the tendon, resulting in a tear. This often occurs in sports which includes swift changing of direction, lunging, and jumping.

Symptoms of Achilles tendon partial tear include:

  • A sharp and abrupt pain that feels like a direct blow to the Achilles tendon. There might be a “pop” sound 
  • Severe heel pain.
  • Unable to stand on tiptoe with the affected leg.

To heal a torn Achilles tendon, surgery might be required. However, in some rare cases, your doctor might recommend other forms of treatments first.

Achilles tendon Rupture

This is a partial or complete rupture of the tendon that is just above the heel, which results in the inability to lift the foot. The symptoms for a ruptured Achilles tendon vary from people, but the commonly seen symptoms are:

  • Having a feeling like you just suffered a kick in the calf.
  • Sharp pain in the heel.
  • Swelling or inflammation near the heel.
  • Being unable to face the foot downward.
  • Hearing a “pop” or a “snap” sound.
  • Swift and sudden bruising

While a ruptured Achilles tendon might sound very severe, with the aid of a medical practitioner, and a physical therapist, you can recover from Achilles tendon rupture.

Achilles tendon Injury Relief

Below are some steps you can take to treat or get relief from Achilles tendon injuries:

  • Don’t run on rough or slippery surfaces.
  • Stretching and strengthening the calf muscles.
  • Gradually increasing the intensity of training exercises would decrease the pain.
  • Place an ice pack over the affected area after every exercise.
  • Seek the aid of a physical therapist.
  • Use a brace or walking boots to curb heel movements.
  • Take anti-inflammatory medicines, such as aspirin (Bufferin) or Ibuprofen (Advil) for a short period.
  • Wear shoes with a built-up heel to remove pressure from your Achilles tendon.
  • Place the affected foot over an elevated surface to reduce swelling.
  • Consider changing to a less rigorous sport.
  • Reducing your physical activities.

Achilles tendon injury stretches

If you have injuries in your Achilles tendon, doing stretching exercises might aid your recovery. Injuries to the Achilles tendon are often caused by excessive and vigorous physical activities. Symptoms often include tightness, feelings of weakness, pain, and limited range of movement.

These stretches will help you increase your speed of recovery:

Runner’s stretch

When the Achilles tendon suffers inflammation, it can become tighter and cause pain. The athlete’s calf or calf stretch will give comfort by releasing or loosening the tendon.

To do this exercise, you will need a wall or other forms of support, like a chair.

  • Put your hands on the wall or the chair. If it is a wall you are using, place your hands at eye level.
  • Place the leg you want to stretch behind you. Make sure your back heel is on the floor and make sure your toes are facing forward.
  • Bend your other knee until it faces the wall while keeping your back leg straight.
  • Gently lean towards the wall until you feel a mild stretch in your calf. Avoid leaning so far that you would feel pain.
  • Hold the position for 30 seconds, finish 3 reps.

If the pain is too severe for you to straighten your legs, you can perform the stretch while bending your knees. Move closer to the wall and bend your back knee until you feel a stretch. Maintain the position and repeat three times.

Toe-to-wall stretch

This exercise is a better option if the runner’s stretch hurts your shoulders. 

It puts a lesser burden on the upper body. Similar to the runner stretch, this exercise aids movement by reducing the pressure on the Achilles tendon.

Follow the steps below using the affected leg:

  • Stand while facing the wall and place your toes against the wall. The higher you put your toes, the deeper the stretch.
  • Bend forward slightly while making sure your heel stays on the ground. (Your other leg is placed behind you, toes facing forward and heel on the ground.)
  • Maintain for 30 seconds. Complete 3 reps.

Other exercises include: 

  • Heel drop
  • Heel raises

Achilles tendon injury treatment.

Physical therapy

Physical Therapy is a procedure that uses physical means such as exercise or heat to treat injuries. Physical therapy is often the best choice for people suffering from Achilles tendon injuries. It helps to reduce your pain and slowly gets you back to your normal routine. A rehab program can help enhance the strength of the tendon and aid in its recovery.

Acupuncture

Acupuncture is a procedure that entails the use of special needles in treating injuries. It is very effective in treating Achilles tendon injuries. It is often recommended because of its swift results. It also has immense benefits for treating both acute and severe cases.

Surgery

While other forms of treatment could be used to treat Achilles tendon injuries, sometimes, it is not effective. In situations such as these, surgery would be recommended by the doctor. An orthopedic surgeon would be in charge of the surgery as only he would know what procedure would be best for you. An example of the surgical method includes an open repair method. In this procedure, the surgeon makes a cut to open your leg just above the heel bone, he then sews the two sides of the ruptured or torn tendon back together and closes the cut.

Personal Trainer

A personal trainer would often recommend a rehab program. A rehab program would help you regain strength in the affected tendon and foot. He will also design a physical activity program for you.

Achilles tendon braces

Your doctor might recommend the use of braces to support your Achilles tendon and prevent the injuries from happening again.

Exercises for Achilles tendon

Below is a list is exercises that can be done to relieve the pain from injuries:

  • Toe stretch
  • Calf-plantar fascia stretch
  • Floor stretch
  • Stair stretch
  • Strength exercise

Natural remedies for Achilles tendon injuries

The best natural remedy for Achilles tendon injuries is the RICE method. The RICE method simply means:

Rest

Refrain from placing much burden on the affected foot for a day or two to avoid stressing the tendon.

Ice

Wrap some blocks of ice in a bag, cover the bag with a piece of cloth and place it against the affected leg. Hold it on your tendon for 15-20 minutes and remove it to let the tendon warm up again.

Compression

Swathe a bandage or athletic tape around the tendon to suppress the injury. You can also tie a piece of cloth around it.

Elevation

Place your foot on an elevated surface raising it above the level of your chest. Since your foot is placed higher than your heart, blood flows back to the heart and reduces the swelling. You can simply do this by laying down and placing your foot on a pillow or any other raised surface.

Ointment 

You can add Joint Mud in addition to RICE to relieve pain and discomfort with natural ingredients so you can use it long-term without any issues. 

Conclusion 

Achilles tendon injuries often go away after a few days of appropriate rest and treatment (including the RICE method). If you keep putting burden or stress on it, recovery might be longer. 

Once you discover the symptoms, try the RICE method. If you do not see any positive results in a few days, do not hesitate to seek your doctor’s aid.

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