Updated: March 13th, 2012

Achilles

Achilles


The Achilles tendon is the large tendon situated at the back of the ankle. It attached the calf muscle to the heel bone. As this tendon gets a lot of use during running exercise, Achilles injuries are suffered by many runners from time to time as the tendon is forced to work too hard. This is most likely when you change your training regime or if you do not wear the correct running footwear which correctly supports your foot and allows it to move as it should while you are running.
In such cases, scar tissue may even form over the Achilles tendon. The scar tissue, which is much less flexible than the tendon should be, may tear or rupture with further over-use. Here in this article, we will take a look at two of the most common medical problems which can occur with the Achilles tendon: tendonitis and a tendon rupture.

Achilles tendonitis

This condition is caused when the Achilles tendon, found behind the ankle, gets inflamed or irritated. This is a common injury when the tendon is over-used, such as through running, particularly in those previously unused to such exercise.

The two most common reasons for a person to suffer from Achilles tendonitis are a lack of flexibility or overpronation, where the foot bends too much in running and tends to go to the side, stressing the tendon so that if becomes inflamed.When the tendon is inflamed it swells and becomes painful. There may also be slight tears which occur in the Achilles tendon too; these tears make a rupture of the tendon more likely. The pain of Achilles tendonitis can be felt at any point over the tendon, but is most likely to be felt just above the heel. The ankle may also be stiff and redness and heat may be felt. Upon touching the area, you may feel a lump, if scar tissue has formed over the Achilles tendon.
Achilles tendonitis is most often caused by over-exercising tired and stressed muscles, perhaps through working out on muscles which have not been warmed up properly, or by increasing the distance you run too dramatically. Too much speed running or hill running can also help to create Achilles tendonitis. Pain is usually felt early on in these activities as the Achilles tendon becomes stressed.

Running shoes which have inadequate flexibility can add to the strain on the Achilles tendon too, so it cannot stretch properly and instead becomes twisted and stressed. People whose running gait makes their foot rotate too far inwards are also particularly prone to developing Achilles tendonitis.

Treatment for tendonitis, because it is usually caused by over-exertion is, first and foremost, rest. Anti-inflammatory medications which are readily available over the counter can reduce the swelling and pain and ice packs should also be applied to the affected area over the Achilles tendon at the back of the calf. Massaging your leg with arnica or an anti-inflammatory gel can also help the condition, especially if you can feel a knotted area on the tendon. Three times daily massage away from the hard area all the time, in circular motions will help. Otherwise, keep the leg elevated and rest it until the hard nodule is gone and can no longer be felt at all. After this point, gentle stretching exercises will help to reinstate flexibility in the Achilles tendon. You should refrain from running until you can once again do heel raises comfortably. Weight bearing exercises are to be avoided but swimming can be helpful to your recovery. Be patient, because with Achilles tendonitis, this can take 6-8 weeks. However, if you feel that treating yourself is not creating improvement within 2 weeks, you should seek medical advice.

To avoid a recurrence of Achilles tendonitis, you should do some training aimed at strengthening your Achilles tendon. You should also perform stretches and warming up routines thoroughly before any running activity, to protect the tendon from further damage.

Achilles Tendon Rupture

Tendon which attaches the calf muscle to the heel can actually rupture, rather than being merely strained. This is a particularly common injury in people who are not used to exercising and who therefore have little or no flexibility in their Achilles tendon. When the tendon is stretched too far, there ma be a sharp pain, experienced as a snapping or popping, when it ruptures. It can feel like you have been kicked in the back of the heel. Swelling and bruising is common, as is difficulty in pointing the toes.

People taking Fluoroquinolone antibiotics, such as for respiratory infections, urinary tract infections, and other bacterial infections are particularly susceptible to ruptures of their tendons, although it is not clearly identified why this should be so.

If the Achilles tendon ruptures, the most common treatment is surgery to attach the tendon back into its normal position once more. However, several months of having the leg in a cast may be an option to correct the Achilles tendon rupture, particularly if the sufferer leads a largely sedentary life, where casting would not be a problem.

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