Understanding Achilles Tendon Damage
What Is An Achilles Tendon?
The Achilles tendon, connecting your calf muscles to your heel bone, is the largest and strongest tendon in your body.
It’s crucial for activities like walking, running, jumping, and standing on tiptoes. Despite its strength, it’s susceptible to damage, which can sometimes require surgery.
Let’s dive into what happens when this tendon gets injured and how it’s treated.
Tendon Degeneration and Tears
Achilles tendon issues can range from mild to severe.
Here’s a breakdown of the common problems:
1) Degeneration and Inflammation:
Sometimes, the Achilles tendon degenerates over time, especially in middle-aged individuals or athletes.
This can lead to inflammation of the paratenon (the tissue covering the tendon), known as paratendonitis. It causes pain and discomfort and might require surgery if non-surgical methods don’t help.
2) Acute Tears:
A sudden, painful tear of the Achilles tendon is often the result of intense physical activity, such as a sudden sprint or jump.
This is common among athletes involved in sports like basketball or tennis. When there’s a complete tear, a decision needs to be made between surgery and nonoperative management.
Causes & Risk Factors
Common Causes of Achilles Tendon Injuries:
- Overuse
- Repetitive strain
- Sudden increases in physical activity
- Improper footwear
- Biomechanical issues
Additional Risk Factors:
- Age
- Poor flexibility
- Certain medical conditions
Groups at Higher Risk:
- Athletes, especially runners
- Individuals involved in sports with frequent jumping and pivoting
Prevention Strategies
Preventing Achilles tendon injuries is crucial for long-term health.
Here are some tips:
- Gradual Increase in Activity: Avoid sudden increases in physical activity. Gradually build up intensity and duration to prevent overuse injuries.
- Warm-Up and Stretching: Always perform dynamic warm-ups and stretches before engaging in exercise. This prepares the tendon for activity and reduces injury risk.
- Proper Footwear: Wear supportive and well-cushioned shoes, especially during high-impact activities. Avoid worn-out or ill-fitting shoes.
- Strengthening Exercises: Incorporate exercises like heel raises, calf stretches, and eccentric exercises into your routine to strengthen the tendon and improve flexibility.
- Lifestyle Choices: Maintain a healthy weight, avoid smoking, and listen to your body. Rest if you experience any pain or discomfort in the tendon area.
Management and Treatment
Achilles tendon injuries can be debilitating and require proper management and treatment for a successful recovery.
Diagnosis and Tests
Accurate diagnosis is key to effective treatment.
Here’s how it’s done:
- Imaging Techniques: Ultrasound and MRI help visualize the tendon’s condition. Ultrasound creates real-time images to detect abnormalities, while MRI provides detailed views of both the tendon and surrounding tissues.
- Physical Examinations: Assessing swelling, tenderness, and range of motion helps in diagnosing the injury. Functional tests, such as the Thompson test, check the tendon’s ability to function properly.
Non-Surgical Treatments
Before considering surgery, several non-surgical treatments can be highly effective for Achilles tendon issues:
- Physical Therapy: Focuses on strengthening the tendon and improving flexibility. Customized exercise plans and rehabilitation techniques are crucial.
- Rest and Immobilization: Resting the tendon and using a brace or cast can aid in recovery by protecting and supporting the area.
- Ice and Heat Therapy: Applying ice reduces inflammation and pain, while heat promotes blood flow and healing.
In addition to conservative treatments, orthotics and supportive devices play a crucial role in the recovery process.
Orthotics are custom-made shoe inserts that provide support, correct alignment, and reduce stress on the Achilles tendon.
At the Jackson Clinics, we have a team of Foot & Ankle Specialists who can assess your foot mechanics and recommend the most appropriate orthotics or supportive devices to aid in your recovery.
TJC Locations specializing in custom orthotics include: Burke, Centreville, Manassas, Alexandria, Arlington, Oakton, Sterling, Tysons, and Worldgate.
Post-Surgery Pain and Rehabilitation
Achilles tendon conditions that require surgery are potentially very painful before and after surgery. In fact, getting a patient to the point of being pain free is one reason that rehabilitation may last so long—sometimes, up to one year.
In other words, recovering from Achilles tendon surgery can be quite a journey.
Here’s what you might expect:
- Pain Management: Pain can be significant both before and after surgery. A large incision, made in an area with less blood supply, increases the risk of poor healing and infection. Patients may need to wear a brace for up to two months to protect the repair and the incision.
- Rehabilitation Process: Rehabilitation involves several stages.
- Initially, you’ll start with range-of-motion and conditioning exercises while wearing a brace. A removable brace/splint can minimize the likelihood of blood clots, muscle atrophy and joint stiffness associated with a cast, and with it, more rehabilitative physical therapy can begin earlier, perhaps within a few days after surgery.
- Once the brace comes off, you can begin more intensive therapy, including exercises in a pool to reduce stress on the tendon.
- A little later, strengthening exercises may be performed in a pool, allowing the tendon to start to regain its function in the safety of water’s buoyancy.
- Exercises carried out on land will involve both legs to “share the load.”
Recovery and Exercise Programs
Of course, recovery and rehabilitation rates differ for each patient.
Generally, a person with a surgically repaired Achilles tendon should be able to walk and swim six weeks post-surgery, while running and other sports drills may be possible within four to six months.
- Six Weeks Post-Surgery: Most people can walk and swim.
- Four to Six Months: Running and other sports activities might be possible.
- Gradual Return: Athletes often start a gradual return to their sports activities around the six-month mark, though some pain may persist.
Although some pain may linger for a while , at the six-month mark many athletes are ready to initiate a gradual return to sport activities.
Our team can work with your physician to create a personalized exercise program tailored to your recovery rate, helping you regain strength and mobility safely.
Did you know you have Direct Access* to Physical Therapy? No referral, no problem!
Heel-ing Your Achilles Tendon
By understanding and addressing the symptoms, causes, and treatments for Achilles tendon issues, you can better manage and prevent these injuries. For personalized care and tailored treatment plans, consulting with professionals is always a great step towards recovery.
Reach out to us today! Our physical therapists can work with your physician to design an exercise program individualized to your rate of recovery.
This way, you can regain strength and range of motion that will permit you to resume your sports activities pain free.