Achilles tendon injury (pain in the Achilles)
The Achilles tendon is tendon at the back of the ankle, which connects the calf muscle to the heel bone. It enables the foot to point down, or push off from the ground during walking, jumping and sprinting. The Achilles tendon is a very strong tendon, but it is prone to overuse and degeneration. There are 3 types of Achilles tendon injuries. They are Achilles tendinitis, Achilles tendinosis and a Achilles tendon rupture.
The Achilles tendon is tendon at the back of the ankle, which connects the calf muscle to the heel bone. It enables the foot to point down, or push off from the ground during walking, jumping and sprinting. The Achilles tendon is a very strong tendon, but it is prone to overuse and degeneration. There are 3 types of Achilles tendon injuries. They are Achilles tendinitis, Achilles tendinosis and a Achilles tendon rupture.
Footwear Matters. (N.D.). [Irritated tendon]. Retrieved from http://www.footwearmatters.com/achilles-tendonitis/
Risk factors of Achilles tendinopathy and rupture
1) Sudden change in frequency and intensity of exercise. E.g. Training 4 times a week from the usual 2, or a 4 hour training session from the usual 2 hours.
2) Tight calf muscles which puts more pressure on the Achilles tendon.
3) Jerky movements E.G. stop and go movements which puts more pressure on the Achilles tendon
4) Lack of warm up
5) Poor arch support in shoes
The above risk factors increase the chances of overuse, and overuse makes the player more prone to an Achilles rupture. The cause of an Achilles tendon rupture is due to the Achilles tendon being overstretched, or when the Achilles tendon receives a huge and forceful impact.
1) Sudden change in frequency and intensity of exercise. E.g. Training 4 times a week from the usual 2, or a 4 hour training session from the usual 2 hours.
2) Tight calf muscles which puts more pressure on the Achilles tendon.
3) Jerky movements E.G. stop and go movements which puts more pressure on the Achilles tendon
4) Lack of warm up
5) Poor arch support in shoes
The above risk factors increase the chances of overuse, and overuse makes the player more prone to an Achilles rupture. The cause of an Achilles tendon rupture is due to the Achilles tendon being overstretched, or when the Achilles tendon receives a huge and forceful impact.
Go barefooting. (June 18, 2010). [Ruptured Achilles Tendon]. Retrieved from http://gobarefooting.files.wordpress.com/2010/06/achilles_tendon_rupture.jpg
Achilles tendinitis is the inflammation of the tendon, while Achilles tendinosis is where there are microscopic tears in the Achilles tendon. Achilles tendinitis and tendinosis have a common term called tendinopathy. There are 4 grades of tendinopathy. Grade 1 is where there is pain in the Achilles when waking up in the morning, or after long period of inactivity. However, the pain disappears as the day goes by. However, the Achilles tendon might feel pain when it is pinched. Grade 2 is where there is pain in the Achilles tendon when waking up in the morning. The pain soon disappears, but resumes during exercise. However, there is no limit to activity. The Achilles tendon might feel pain when it is pinched. Grade2 is where there is pain when waking up in the morning. The pain may persist for a period of time before disappearing but it will come back once in a while. During exercise, there will be pain in the Achilles tendon, limiting activity. Grade 4 is where the pain persists throughout the day after waking up, and hurts so much that the player cannot exercise.
Orthoinfo. (June 2010). [Thickened and degenerated tendon]. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00147
Symptoms for Achilles tendinopathy
1) Swelling at Achilles area
2) Loss of strength
3) Loss of range of movement
4) Pain in the morning which may disappear, depending on the severity of the injury
5) Pain during exercise depending on the severity of injury
6) Painful when the Achilles is pinched
1) Swelling at Achilles area
2) Loss of strength
3) Loss of range of movement
4) Pain in the morning which may disappear, depending on the severity of the injury
5) Pain during exercise depending on the severity of injury
6) Painful when the Achilles is pinched
Arun Shanbhag. (May 14, 2008). [Heel and Achilles Tendon Stretch]. Retrieved from http://achesandjoints.org/2008/05/14/heel-and-achilles-tendon-stretch/
Treatment for tendinopathy
1) Rest. As tendinopathy result from overuse, rest is essential to healing the inflammation or microscopic tear. Rest until symptoms disappear. In the meantime, the player can participate in gentle activities like swimming and riding a stationary bicycle to keep active. Never ever play through the pain.
2) Ice the injury for 15 minutes up to 3 times a day to reduce swelling and to relief pain.
3) A brace or cast should be used to prevent any pressure to be put on the tendon, preventing further damage, and this period of immobilization can help the inflamed area to recover. However, do not wear it for long periods or risk muscle stiffness.
4) Wear shoes that provide greater cushion and support for the feet. This can reduce the pressure on the Achilles. Use sole pads that are customized for the feet for the same reason, thus quickening the healing process. You can use the wet test to determine the right size. Wet your foot and step on a piece of paper and trace the outline of it. If the entire outline of the feet is clearly seen, it means that you are flat footed. Ensure that the shoe you buy is for flat foot.
Stretches and strengthening
1) Eccentric tendon strengthening. First, warm up your calf muscles through stretching. Stand on the balls of your feet on a step and hold onto something sturdy for support. Next, tip toe, while still standing on the balls of the feet. Next, remove your left leg. Then slowly lower yourself by lowering the heel, until your heels are level with the steps. Repeat for the other leg. Do 15 times per set, and do it every 2 days.
2) This exercise is similar to the first, just that the player uses both heels. Stand on the steps with the balls of the heel, and hold onto something sturdy for support. Next, tip toe, while still standing on the balls of the feet. Then, slowly lower your bodies by lowering your heels until heels are level with the steps. Do 15 times per set, and do it every 2 days.
3) Gastrocnemius stretch. Stand facing the wall and put both hands on the wall, leaning towards it. Stretch the injured leg out, while the other leg is kept in. Both the feet should point towards the wall and the whole foot must be in contact with the ground. The knee of the injured foot is kept straight. Feel the stretch on the calf and hold 30 seconds. Do 2 sets of 10 reps, 3 times a day.
4) Stand facing the wall and put both hands on the wall, leaning towards it. The injured foot should be behind the other foot with both feet pointing towards the wall. While ensuring that the whole of both feet is in contact with the floor, slowly bend your back knee until you feel a heel stretch in the back leg.
5) Sit down on the floor or on a chair. Sit straight with the legs straightened. Use a towel and loop it over the ball of the foot, and holding the 2 ends of the towel, pull it back. Feel the stretch on the calf. Hold it there for 15 seconds and repeat 3 times. Do the exercise thrice per day.
1) Rest. As tendinopathy result from overuse, rest is essential to healing the inflammation or microscopic tear. Rest until symptoms disappear. In the meantime, the player can participate in gentle activities like swimming and riding a stationary bicycle to keep active. Never ever play through the pain.
2) Ice the injury for 15 minutes up to 3 times a day to reduce swelling and to relief pain.
3) A brace or cast should be used to prevent any pressure to be put on the tendon, preventing further damage, and this period of immobilization can help the inflamed area to recover. However, do not wear it for long periods or risk muscle stiffness.
4) Wear shoes that provide greater cushion and support for the feet. This can reduce the pressure on the Achilles. Use sole pads that are customized for the feet for the same reason, thus quickening the healing process. You can use the wet test to determine the right size. Wet your foot and step on a piece of paper and trace the outline of it. If the entire outline of the feet is clearly seen, it means that you are flat footed. Ensure that the shoe you buy is for flat foot.
Stretches and strengthening
1) Eccentric tendon strengthening. First, warm up your calf muscles through stretching. Stand on the balls of your feet on a step and hold onto something sturdy for support. Next, tip toe, while still standing on the balls of the feet. Next, remove your left leg. Then slowly lower yourself by lowering the heel, until your heels are level with the steps. Repeat for the other leg. Do 15 times per set, and do it every 2 days.
2) This exercise is similar to the first, just that the player uses both heels. Stand on the steps with the balls of the heel, and hold onto something sturdy for support. Next, tip toe, while still standing on the balls of the feet. Then, slowly lower your bodies by lowering your heels until heels are level with the steps. Do 15 times per set, and do it every 2 days.
3) Gastrocnemius stretch. Stand facing the wall and put both hands on the wall, leaning towards it. Stretch the injured leg out, while the other leg is kept in. Both the feet should point towards the wall and the whole foot must be in contact with the ground. The knee of the injured foot is kept straight. Feel the stretch on the calf and hold 30 seconds. Do 2 sets of 10 reps, 3 times a day.
4) Stand facing the wall and put both hands on the wall, leaning towards it. The injured foot should be behind the other foot with both feet pointing towards the wall. While ensuring that the whole of both feet is in contact with the floor, slowly bend your back knee until you feel a heel stretch in the back leg.
5) Sit down on the floor or on a chair. Sit straight with the legs straightened. Use a towel and loop it over the ball of the foot, and holding the 2 ends of the towel, pull it back. Feel the stretch on the calf. Hold it there for 15 seconds and repeat 3 times. Do the exercise thrice per day.
Sports injury Clinic. (Sep 22, 2010). Strengthening exercise for Achilles tendon injury. Retrieved May 13, 2013, from http://www.youtube.com/watch?v=y5-C4t1fRd4
Symptoms of Achilles rupture
1) Swelling
2) Bruising
3) Tenderness
4) Stiffness
5) Inability to point toe down
6) Popping sensation when injury is sustained.
Treatment for Achilles tendon rupture rupture
In the case of an Achilles tendon rupture, immediately seek medical advice. Do not put any weight on that injured foot at all. Usually, surgery is required to repair the Achilles tendon. Research has shown that surgically repaired Achilles tendon has a smaller chance of being ruptured again than non operative means. An Achilles rupture usually takes up to 6-9 months to heal.
1) Swelling
2) Bruising
3) Tenderness
4) Stiffness
5) Inability to point toe down
6) Popping sensation when injury is sustained.
Treatment for Achilles tendon rupture rupture
In the case of an Achilles tendon rupture, immediately seek medical advice. Do not put any weight on that injured foot at all. Usually, surgery is required to repair the Achilles tendon. Research has shown that surgically repaired Achilles tendon has a smaller chance of being ruptured again than non operative means. An Achilles rupture usually takes up to 6-9 months to heal.