The Achilles tendon is a fibrous band of tissue that connects the heel bone to the calf muscle. It is the largest, strongest tendon in the human body. The strength and flexibility of this tendon are important for jumping, running, and walking. The Achilles tendon can endure stress, but sometimes injury can occur to the tendon when it is overly stressed.
Achilles Tendonitis
Achilles tendonitis is usually due to overuse or damage to the Achilles tendon. It can cause pain, irritation, and inflammation down the back of your leg and your heel. It is a common sports injury for runners or anyone who puts a lot of stress on their feet, such as basketball or tennis players or dancers.
Achilles tendonitis is caused by overuse of the tendon and calf muscles. Symptoms may include mild pain after exercise that worsens gradually, stiffness that disappears after the tendon warms up, and swelling. Without treatment, the problem can become chronic and make it difficult to walk.
You should seek immediate medical attention if the achilles tendon pain is severe or your incapacity is significant, as you may be signs of a ruptured tendon.
Achilles Tendon Rupture
In an Achilles tendon rupture, the tendon that connects the heel bone to the calf muscle tears, and the fibers separate.
Rupture usually occurs during high-stress activities such as running, cutting, or jumping, but sometimes the tendon becomes chronically weakened and can give way during simple activities such as walking.
Achilles Tendonitis Treatment
Achilles tendonitis usually responds well to self-care and non- and minimally invasive treatments. However, it is crucial that it is treated as soon as possible after the onset of symptoms. Steps that you can take for self-treatment include:
- Taking a break from the activity that is causing the problem.
- Stretching your Achilles tendon before you exercise.
- Icing the tendon after exercising.
- Using a nonsteroidal anti-inflammatory drug such as ibuprofen or naproxen to ease pain and inflammation.
If your symptoms persist or are significant, your doctor may recommend other treatment options including:
- Physical Therapy
- Wearing a splint or cast to immobilize the aching tendons.
- Orthotic devices to elevate your heel, provide a cushion and relieve strain on the tendon.
- Steroid injections.
Treatment for Achilles Tendon Rupture
If you suspect that your Achilles tendon is ruptured, you should see your doctor right away. If left untreated, a ruptured Achilles tendon can heal improperly or with scar tissue, which will inhibit you from resuming normal activities. Achilles tendons can take time to heal because the blood supply to the tendon is limited.
There are two main treatment options to treat an Achilles tendon rupture, surgical and nonsurgical, although surgery is the most common treatment.
Nonsurgical Treatment
For some patients, it may be best to avoid surgery. Nonsurgical treatment for Achilles tendon rupture focuses on allowing the tendon to heal naturally while it’s immobilized in a boot or cast. The foot and ankle are flexed downward to bring the tendon’s torn ends in proximity, allowing the tendon to slowly heal over time.
Usually, the boot or cast will stay on anywhere from 8 to 12 weeks. Physical therapy then follows after it is removed. Typically with this nonsurgical approach, however, the tendon rarely regains full strength or endurance, and there is an increased risk of re-rupture compared to operative treatment. At the same time, by avoiding surgery, the chances of skin breakdown or infection are reduced.
Surgical Treatment
The goal of surgery for Achilles tendon ruptures is to stitch the tendon back together. Sometimes an extra piece of tendon taken from another muscle in the calf is stitched around the reattached ends to reinforce them.
This approach usually allows for quicker healing and typically results in a much stronger tendon post-surgery in comparison with nonsurgical treatment. However, there can be complications after surgery with swelling and the relatively poor blood supply that is typical for the Achilles tendon.
Top athletes almost always use the surgery option to provide a stronger tendon that is less likely to re-rupture. Complete recovery takes at least three months, including an exercise rehabilitation program to help you regain full range of movement and to reduce stiffness.