One story about the Greek hero Achilles that most people seem to vaguely recall is the myth about how his mother, Thetis, tried to make him immortal by dipping him in the River Styx when he was a baby. She held him by the back of the heel, so that became his only vulnerable spot. From this tale, we get the term “Achilles heel,” meaning a person’s particular weakness. We also get the name for the tendon at the back of the heel.
The Achilles tendon is a band of fibrous tissue that connects the calf muscles to the heel bone. It is the largest and strongest tendon in the body, much like Achilles himself, who was the largest and strongest warrior in the Trojan War.
Most of the time, we are not even consciously aware of our Achilles tendons, even though they do the very important work of making it possible to flex and point our feet and help us to stand on our toes, walk, run, jump, and dance along to The Nutcracker Suite.
Unfortunately, sometimes we are completely aware of our Achilles tendons because (again, like Achilles), they are vulnerable to injuries, due to the tension they are under. There is no mistaking the pain that accompanies injuries to this part of the body.
Some symptoms of Achilles tendonitis (inflammation of the Achilles tendon):
- Mild ache in the back of the heel or calf after running, stair climbing, or other activity
- Tight calf muscles
- Difficulty flexing your foot
- Swelling in the back of the heel
- Skin feels warm or hot to the touch
These problems may get better or worse, depending on your level of activity, but eventually, the pain could become quite severe. Most people begin with home remedies, such as RICE, known to all athletes.
Rest — stay off the injured ankle for a day or two. Crutches may help you avoid stretching the tendon if you have to get around.
Ice — Like all inflammations, tendonitis is helped by icing the injury for 15-20 minutes at a time.
Compression — Don’t limit blood flow, but use a bandage to keep your ankle from moving.
Elevation — Raise your foot higher than the level of your chest. This would have been easier last year when you still had episodes of Tiger King to watch on Netflix, but you could always use this resting time as a chance to catch up on Edith Hamilton’s Mythology!
Anti-inflammatory drugs such as naproxen or ibuprofen may help with pain and swelling.
Wearing a heel lift (shoe insert) can help prevent your tendon from further stretching as it heals.
Physical therapy — At True Sports Physical Therapy, we use cutting-edge therapies and treatments to help all athletes recover from any foot, ankle, or heel injury they come to us with. Since Achilles tendon injuries are common to athletes, helping them recover with appropriate exercises and stretching is an area where our therapists excel.
If your discomfort doesn’t improve, or if the pain is severe, it’s time to consult your physician. He or she may suggest cortisone shots, but these are controversial as a treatment for Achilles tendonitis, so it may be wise to seek a second opinion.
If the tendon has torn or completely ruptured, you will probably need surgery to repair it. According to the National Institutes of Health, an acute rupture of the Achilles tendon is one of the most common tendon injuries in the adult population.
Another problem that may affect your Achilles tendon is called tendinopathy (or sometimes tendinosis). This happens when the collagen in your tendon breaks down or degenerates. When the problem is mild, it is treated the same way as tendonitis, but if it gets worse or persists, you may need surgery.
Surgery for mending a ruptured or torn Achilles tendon involves slicing into the bottom of the calf and sewing the tendon back together. For tendinopathy, the surgeon may remove another tendon from your foot and use it to replace the damaged tendon.
The recovery period for Achilles tendon injuries is quite long and involves a lot of physical therapy.
- You will need to wear a cast or walking boot for 6 to 12 weeks after your surgery.
- You will need to avoid putting your full weight on the injured ankle for a few weeks.
- You may be able to cautiously begin playing sports again after 4 or 5 months, but you will not have full use of your ankle back for at least six months.
- Rehabilitation exercises are extremely important in your recovery. This will help you avoid scar tissue, and will also help you regain flexibility.
- Physical therapy is vital
At True Sports, we perform one-on-one patient care in state-of-the-art facilities. We will tailor a recovery plan to you and your injury. Let’s get you back to your best and on to what’s next.
What are the risk factors for Achilles conditions?
Studies have shown that a majority of AT ruptures occur during sports participation and primarily in middle-aged men. If you fall into this category (and even if you don’t), there are ways to lessen your risk factors:
- Don’t run on uneven or hilly terrain.
- Make sure that your running shoes fit you well and are not worn out.
- Do warm-up and stretching exercises before you exercise or play sports.
- Try to avoid sudden pivots.
- Avoid repetitive movements that could wear down your tendon.
- Keep track of your blood pressure – people with high blood pressure are at an increased risk from Achilles tendon injuries.
- Ease into new sports or training activities gradually; don’t suddenly ramp up your level of activity.
- Listen to your body and rest when you need to.
If you are recovering from an Achilles tendon injury or condition, schedule an appointment with the expert physical therapists at True Sports Physical Therapy. Call (410) 946-1672