Achilles tendon – injuries, treatment, home remedies. Inflammation and rupture of the Achilles tendon

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The Achilles tendon is a connective tissue formation that connects the calf bone with the calf muscles. A torn or strained tendon is one of the most common injuries involving the lower limbs. Read what can cause Achilles tendon injuries, how to diagnose and treat them.

Achilles tendon – characteristics

The Achilles tendons, which take their name from the mythological Greek hero, are the largest and strongest tendons in the human body. On average, they are about 15 centimeters long and 5 millimeters thick. The Achilles tendon is extremely important when walking, running and jumping. Achilles tendons are made of strong fibrous tissuebut this tissue does not have the greatest blood supply and is therefore predisposed to trauma and fractures. Overstretching or overstraining can cause a tendon to rupture.

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Achilles tendinitis – causes and symptoms

Achilles tendinitis (Achilles tendinopathy) is an ‘irritation’ of the Achilles tendon. The term “tendinopathy” applies to any problem with the tendon, whether it is short or long term. Achilles tendon transfers power from the calf muscles down to the foot as the person bounces the foot off the ground (e.g. when running or jumping) and helps to control the position of the ankle as the foot touches the ground back.

Achilles tendinitis occurs when the strength of the tendon is less than its ability to function. The condition can occur after a single incident (acute trauma) or after repeated irritation or “microtrauma” (chronic trauma).

Most often, Achilles tendinitis is associated with several different factors, including:

1. calf muscle stiffness
2. calf muscle weakness,
3. abnormal foot structure,
4. incorrect foot mechanics,
5. inappropriate footwear,
6. a change in the exercise or sports activity program,
7. overweight and obesity.

The main symptom of Achilles tendinitis is pain, often described as a burning sensation, that gets worse with activity. Pain can be anywhere along the tendon. The most common area of ​​feeling tenderness is the area just above the heel (known as mid-section Achilles tendinopathy), although it can also occur where the tendon meets the heel (known as Achilles attachment tendinopathy).

Compression bands can be used to support the Achilles tendon and the problems associated with it, which improve microcirculation and reduce discomfort arising from overload or inflammation. We recommend a compression band for the calf and ankle joint – OS1st FS6 + in black, white, pink or yellow. You can buy the wristbands in the size of your choice on Medonet Market.

Also read: Heel spur – symptoms, diagnosis, treatment

Achilles tendinitis – risk factors

A number of factors can increase your risk of Achilles tendonitis, including:

1. gender – Achilles tendonitis is most common in men,
2. age – Achilles tendinitis occurs with age,
3. the naturally flat arch of the foot can put more stress on the Achilles tendon. Obesity and tight calf muscles can also increase tendon tension.
4. running in worn shoes can increase the risk of Achilles tendonitis. Tendon pain is more common in cold weather than in warm weather, and running over hilly terrain can also predispose you to Achilles tendon injury.
5. people with psoriasis or high blood pressure are more likely to develop Achilles tendinitis,
6. some types of antibiotics, called fluoroquinolones, are associated with a higher rate of Achilles tendinitis.

To reduce the risk of problems with the Achilles tendon, try the OS1st AF7 Ankle and Achilles Tendon Compression Cable left or right version.

Achilles tendon rupture – causes and symptoms

As with any muscle or tendon in the body, the Achilles tendon can rupture if it is subjected to a lot of force or strain. This can happen with activities that require strong foot push – for example, football, running, basketball, diving and tennis. The repulsive movement takes advantage of the strong contraction of the calf muscles, which can put excessive strain on the Achilles tendon.

The Achilles tendon can also be damaged from injuries such as falls. If the foot is suddenly forced into an upward position – this movement stretches the tendon. Sometimes the Achilles tendon is weakened, making it more prone to rupture.

Factors that weaken the Achilles tendon include:

1. corticosteroids (such as prednisolone) – mainly when used as long-term treatment
2. injection of corticosteroids near the Achilles tendon,
3. some rare conditions, such as Cushing’s syndrome, in which the body makes too much of its own corticosteroid hormones
4. Achilles tendinopathy,
5. other conditions that can make a tendon more prone to rupture: for example, rheumatoid arthritis, gout, and systemic lupus erythematosus
6. some antibiotics may slightly increase the risk of Achilles tendon rupture. These are quinolone antibiotics such as ciprofloxacin and ofloxacin. The risk of an Achilles tendon rupture with the use of these antibiotics is actually very low, and mainly affects people taking concomitant corticosteroids.

Achilles tendon injuries – diagnosis

A thorough physical examination of the foot and ankle is likely key to diagnosing the cause of Achilles tendon pain. The main components of a physical examination include visual inspection and touching (applying pressure) to the Achilles tendon area for swelling, warmth, crackling (a crackling sensation) and tenderness all of these features can be present in acute Achilles tendonitis.

In the case of the Achilles tendon, in addition to the tendon pain on palpation, the tendon may be thickened or there may be small nodules along the tendon, indicating areas of scar tissue and fibrosis.

A doctor can also diagnose an Achilles tendon rupture by touching the tendon. Another physical exam clue that indicates an Achilles tendon rupture is a bruise on the tendon, especially if blood is flowing under the ankle.

For Achilles tendon overload injuries, it is worth using OS1st FS4 compression socks for the ankle joint and heel spurs, available in black or gray. They reduce pain and support treatment.

Achilles tendon – Thompson’s test

As part of the physical Achilles tendon pain test, your doctor will perform a Thompson test, also known as a calf compression test. During this test, the person lies flat on the couch with their feet hanging over the edge. The doctor then compresses the calf muscle, which should bend the toes downwards (called plantar flexion). If it doesn’t, the test is positive and indicates an Achilles tendon rupture.

Achilles tendon – diagnostic imaging

Chronic Achilles tendon symptoms would generally be examined with a foot x-ray, which can identify problems such as bone spurs or degeneration.

An ultrasound or MRI scan is used to make or confirm a diagnosis of Achilles tendon rupture.

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Achilles tendon injuries – prevention

To reduce your risk of problems with the Achilles tendon, follow these tips:

1. stretch and strengthen your calf muscles – stretch your calf until you feel a distinct pull, but not pain. Don’t bounce while stretching
2. Vary Your Exercise – High-intensity alternative sports such as running alternate with low-intensity sports such as walking, cycling or swimming. Avoid activities that overload your Achilles tendons, such as running up hills and jumping
3. choose your running surfaces carefully – avoid or limit running on hard or slippery surfaces. Dress appropriately for cold weather training and wear well-fitting trainers with adequate cushioning in the heels
4. slowly increase training intensity – Achilles tendon injuries often occur after a sudden increase in training intensity. Increase your training distance, duration, and frequency by no more than 10 percent per week.

See: A troublesome ailment for athletes

Achilles tendon injuries – non-surgical treatment

In most cases, non-operative treatment options will provide pain relief, although it may take several months for symptoms to completely resolve. Even with early treatment, Achilles tendon pain can last for more than 3 months.

The first step in reducing your pain is to reduce or even stop the activities that are making it worse. If you regularly perform high-intensity exercise (such as running), switching to low-intensity exercise will put less pressure on your Achilles tendon. Cross training, such as cycling, elliptical exercises, and swimming, are excellent options for those with an Achilles tendon injury.

1. Physical therapy – Physiotherapy is very helpful in treating Achilles tendinitis.
2. Eccentric reinforcement – eccentric strengthening is defined as the contraction (tightening) of a muscle as it lengthens. Eccentric strengthening exercises can damage your Achilles tendon if not done correctly. They should first be performed under the supervision of a physiotherapist. Once you have mastered the exercises with your therapist, the exercises can be done at home. These exercises may cause some discomfort, but it shouldn’t be too much to bear.
3. Cortisone injections – cortisone, a type of steroid, is a powerful anti-inflammatory drug. Injections of cortisone into the Achilles tendon are rarely recommended as they can cause a tendon rupture (rupture).
4. Support shoes and braces – pain from Achilles tendonitis is often relieved by some shoes and also by orthoses. For example, shoes that are softer on the back of the heel can reduce tendon irritation. In addition, a heel lift can relieve the tendon.
5. Extracorporeal Shockwave Therapy (ESWT) – during the procedure, high energy shock wave pulses stimulate the healing process of damaged tendon tissue. The ESWT did not produce consistent results and is therefore not widely performed. ESWT is non-invasive – it does not require a surgical incision. Due to minimal risk, ESWT is sometimes tried before surgery is considered.

Achilles tendon injuries – home remedies

Ice – Placing ice over the most painful area of ​​the Achilles tendon is helpful and can be done as needed throughout the day. This can be done for up to 20 minutes and should be stopped sooner if the skin becomes numb. A foam cup filled with water and then frozen to form a simple reusable bag. After the water in the cup freezes, tear off its edge. Then rub the ice on the Achilles tendon. With repeated use, a groove will appear on the cup that fits over the Achilles tendon, creating a “snug” ice pack.

Non-steroidal anti-inflammatory drugs – drugs such as ibuprofen and naproxen reduce pain and swelling. However, they do not reduce the causes of the degenerated Achilles tendon. The use of the drug should always be consulted with the general practitioner.

Achilles tendon injuries – surgical treatment

Surgery should be considered to alleviate Achilles tendinitis only when pain has not subsided after 6 months of non-surgical treatment. The specific type of surgery depends on the location of the tendinitis and the degree of damage it has.

Recession of the gastrocnemius muscle – it is a surgical lengthening of the calf muscles (gastrocnemius). Since the tight calf muscles put an increased strain on the Achilles tendon, this procedure is useful for patients who still have difficulty flexing their feet despite constant stretching.

In a gastrocnemius recession, one of the two muscles that make up the calf is elongated to increase the movement of the ankle. The procedure can be performed with a traditional open incision or with a smaller incision and an endoscope. Complication rates of gastrocnemius recession are low but may include nerve damage.

A gastrocnemius recession can be performed with or without the removal of damaged tissue. Surgical removal of damaged tissues (the tendon has less than 50% of the lesions). The purpose of this surgery is to remove the damaged part of the Achilles tendon. After the damaged part of the tendon is removed, the remaining tendon is sutured.

After removal, most patients can walk in a removable shoe or cast for 2 weeks, although the duration depends on the severity of the tendon damage.

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Surgical removal of damaged tissues with tendon transfer (the tendon has more than 50% damage). In cases where more than 50% of the Achilles tendon is damaged and requires removal, the remainder of the tendon is not strong enough to function on its own. To prevent rupture of the remaining tendon during activity, an Achilles tendon transfer is performed.

The tendon that helps bring the big toe down is shifted to the calcaneus to add strength to the injured tendon. Although it sounds serious, the big toe will still be able to move and most patients will not notice a change in the way they walk or run.

Depending on the severity of the tendon damage, some patients may not be able to resume competitive sports or running.

Achilles tendon injuries – convalescence

Most patients show good results after surgery. The major factor in recovery after surgery is the degree of tendon damage. The greater the amount of tendon involved, the longer the recovery period and the lower the likelihood that the patient will be able to return to sports activities. Physiotherapy is an important part of recovery. Many patients require 12 months of rehabilitation before the pain is completely relieved.

Complications after surgery – moderate to severe pain. It occurs in 20% to 30% of patients and is the most common complication. In addition, infection of the wound can occur and the infection is very difficult to treat at that location.

Achilles tendon – exercises

The following exercise can help strengthen the calf muscles and reduce the strain on the Achilles tendon.

Achilles tendon exercises – calf stretching

lean your front against the wall with your knee straightened and your heel on the ground. Place the other leg in front of you, with your knee bent. To stretch your calf muscles and heel, push your hips towards the wall in a controlled fashion. Hold this position for 10 seconds and relax. Repeat this exercise 20 times for each foot. You should feel a strong pull on your calf as you stretch.

Achilles tendon exercises – bilateral heel drop

Stand on the edge of a staircase or a stable raised platform with only your front half foot on the stairs. This position will allow the heel to move up and down without hitting the stairs. Care should be taken to ensure proper balance to prevent falling and injury. Hold on to the handrail for balance.

Lift your heels off the ground, then slowly lower your heels to the lowest point possible. Repeat this step 20 times. This exercise should be performed in a slow, controlled manner. Rapid movement can create a risk of tendon damage. As the pain decreases, you can increase the difficulty of the exercise by holding a small weight in each hand.

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Achilles tendon exercises – drop of the heel on one leg

This exercise is similar to a double heel drop, except that all weight is concentrated on one leg. This should be done only after the bilateral heel drop has been mastered.

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