A physiotherapist explaining what is Achilles Tendon, symptoms and treatments
By Shatha Khattab, Physiotherapist
What is the Achilles Tendon?
Your Achilles tendon is the biggest and strongest tendon in the body. It joins your calf muscle and the heel bone in the foot and enables you to perform physical movements such as running, jumping, walking and pushing yourself up. Due to the constant absorption of energy, the Achilles tendon can be susceptible to injury, especially if there is too much load on it. Injuries to the Achilles tendon may be from minor irritation to inflammation up to tendon ruptures.
Symptoms of an Achilles Tendon Injury
The signs appear gradually but one may suffer a sudden Achilles tendon injury due to participation in sporting activities and physical exertion. Identification of the symptoms will enable prevention of aggravation of the condition.
Symptoms usually include:
• Pain in the back of the heel or ankles
• Stiffness upon waking which gets better with movement
• Tenderness when pressing on the tendon
• Swelling on the affected areas
• Pain when walking, jogging, and climbing stairs
• Weakness when lifting the foot up
Snap sound or sudden sharp pain in case of a tendon tear
A “pop” sound or difficulty in rising on tiptoes is a sign of tendon tear which requires immediate medical intervention.
Achilles Tendon Injuries – Causes
The cause of Achilles tendon injuries is the continued stress placed on the tendon due to continuous use. Such injuries are common among runners, footballers, and other athletes who suddenly increase their level of activity.
Risk factors may include:
• A sudden increase in the level of exercise
• Tight calves
• Poor footwear
• Lack of proper warming up before exercising
• Repeated jumping and running
• Past Achilles tendon injury
The aging process may be a risk factor as well due to decreased flexibility of the tendon with age.
Diagnosis of Achilles Tendon Injury
As physiotherapists, we begin by questioning you on your symptoms, lifestyle, and situation in which the injury took place. We then do a physical examination to check your walking pattern, mobility of your ankle joint, and strength of your calf muscles. If your doctor suspects that you have a tear of the tendon, you may be referred for an ultrasound or MRI examination. Diagnosis is very important because tendon injuries can result in a chronic injury.
Treatment Methods
The treatment method will vary according to the extent of the injury.
Most injuries of the Achilles tendinopathy can be treated without using surgery. The approach to therapy is through minimizing irritating activities, changing the exercise routine, and being involved in a certain physiotherapy regimen.
There is surgical and non-surgical management of a complete rupture of the Achilles tendon depending on a person’s age, activity level, and overall health condition. In all cases, however, rehabilitation is going to be an essential component of therapy.
How Physiotherapy helps
Physiotherapy is considered one of the best methods for treating tendon injuries. Our aim is to decrease the level of pain, increase the tendon capacity, and allow patients to resume their daily activities.
The physiotherapy process will begin with reducing the pain and decreasing the excess loads on the tendon. Also, we teach the patients how to modify activities without restricting them completely, because loading of the tendon is an essential component of its recovery.
With improvement of the symptoms, our main emphasis will be on strength exercises. Loading of the tendon will increase gradually.
We also consider potential contributing factors such as weakness in the calf muscles, tightness in the ankles, balance problems, and movement patterns. Fixing these problems will decrease your chances of injuring yourself in the future.
Athletes may advance into exercises related to their sport, which involve running, jumping, and agility drills prior to returning to play.
Can Achilles Tendon Injuries Be Prevented?
While not all injuries can be avoided, you can follow several recommendations to minimize the risks:
• Gradually increase your training load
• Regularly perform exercises strengthening your calves
• Warm-up correctly prior to exercising
• Improve flexibility of your ankles
• Wear shoes suitable for your activities
• Have sufficient rest after intensive training sessions
All these recommendations will allow you to maintain healthy tendons and good limb function.
When should you visit a Physiotherapist?
If you experience pain in the back of your ankle, which persists for several days, gradually becomes worse while performing some physical activity and interferes with your ability to move and train, you should visit a physiotherapist.
An early intervention will help you diagnose the problem, avoid chronic tendon injury, and create an effective treatment program according to your needs.
Conclusion
Injury to the Achilles tendon can be one of the reasons behind your heel pain or your ankle pain; however, there is no need to stay away from your favorite activities just because of it. By getting an accurate diagnosis and having a proper rehabilitation program, your chances to fully recover are very high.
Never neglect the heel pain you feel in your Achilles tendon that will not go away. Have yourself examined for the problem and immediately begin treatment.
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