The Achilles tendon is located in the lower leg, just above the heel. It is the strongest tendon in the body and connects the calf muscles to the back of the heel bone. This structure is responsible for allowing you to point your foot downward and stand on your toes. It is also essential for proper walking mechanics, as this tendon allows us to push off when walking.
Sometimes, physical activity and overuse can cause repeated stress to the Achilles tendon, causing it to become inflamed and painful. When this happens, this is referred to as Achilles tendonitis. Additionally, if overstretched, the Achilles tendon can tear, resulting in a partial or whole rupture.
Symptoms of Achilles Tendonitis/Rupture
If you are experiencing the following symptoms in the area of the Achilles tendon, at the lower portion of the back of the leg or just above the heel, talk to your doctor. These may be signs of Achilles tendonitis:
- Stiffness in the morning
- Aching and a burning sensation
- Pain that gets worse with physical activity
- Swelling that increases with physical activity
- Bone spur, or bump, on the bone
If the Achilles tendon is ruptured, you may experience:
- Pain and swelling close to the heel
- The inability to stand on your toes
- The inability to point your foot downward
If you feel a snapping or a popping sensation in your heel, call your doctor immediately. This could indicate a rupture in the Achilles tendon.
Causes of Achilles Tendonitis/Rupture
Part of the Achilles tendon receives less blood circulation compared to other tendons, placing it at a higher risk of injury. Additionally, as we age, the Achilles tendon can weaken and become more susceptible to injury.
Achilles tendonitis and/or rupture can be caused by increasing the amount and/or intensity of exercise abruptly, especially activities that involve jumping and repeated impact such as running. An Achilles rupture can also be caused by sudden events such as falling or stepping into a hole unexpectedly.
What to Expect at Your Appointment
At your appointment, you will be asked to describe what you are feeling. Your doctor will then examine your foot for signs of tendinitis or a rupture. Your doctor may also ask you questions regarding the pain, such as if the pain goes away when you rest or if you have recently changed your exercise routine.
If clarification is needed to understand the severity of the rupture, your doctor may ask you to get an ultrasound or an MRI scan in order to obtain an image of the Achilles tendon and surrounding tissues.
Non-surgical Treatments for Achilles Tendonitis/Rupture
Often times, Achilles tendinitis can be treated conservatively using the following treatments:
- Rest and/or reducing the amount of exercise
- Anti-inflammatory medications
- Light stretching and/or physical therapy
- Icing the affected area after physical activity Wearing a shoe insert to lift the heel and relieve strain on the tendon
In the case of an Achilles rupture, if the tendon is partially torn, you may choose to wear a cast or boot that that will elevate the heel and relieve strain on the tendon, allowing it to heal. If the tendon is completely torn, surgery is often recommended.
Surgical Treatment for Achilles Tendonitis/Rupture and Post-treatment
If pain associated with Achilles tendonitis does not subside after six months, your doctor may present you with the option of a surgical procedure.
Rehabilitation after surgery for both Achilles tendonitis and rupture will be necessary in order to restore mobility in the lower leg, ankle, and foot. Individuals typically return to normal activities four to six months from the time of surgery.
Your doctor will present you with treatment options that best meet your needs based on the severity of the injury, your age, your activity level, and other factors.
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