The Achilles tendon is one of the longest tendons in the human body, it connects the calf muscles to the heel bone. This tendon is often referred to as the heel cord. Forces on the Achilles tendon are great, up to 12 times a person’s body weight when sprinting. The Achilles tendon is approximately 6 inches in length and is the thickest tendon in the body, because it is connected to the most powerful muscle group in the body. Tendons as a whole don’t heal well, because there is not much blood flow to them. The heel cord gets its supply from one blood vessel known as the posterior tibial artery which branches out into many smaller vessels that feed the entire tendon. You can feel the tendon work when you stand on your tippy toes.
The Achilles heel has always been a vulnerable part of the body as portrayed in a Greek Myth over 2,000 years ago. The Nymph Thetis wanted her son to be a great warrior that could not be injured, so she held her young son by the ankle and dipped him head first into the River Styx. The magical waters make Achilles body impenetrable, except for the ankle where the water did not touch. This eventually leads to his demise when Paris’s arrow penetrates Achilles’s heel and mortally wounds him. So when someone says, “That’s his Achilles heel.” They mean that is his vulnerable spot.
Over use or over stretching the Achilles tendon can lead to tears in the tendon. Once this happens inflammation and pain set in. High impact sports (jogging, basketball, tennis, etc.) and age will contribute to tendonitis. As we get older, blood flow can decrease to the Achilles tendons making them prone to injury. If an individual is inactive the Achilles tendon becomes weaker and is also prone to Achilles Tendinitis. If you feel pain in the heel area, stop all activities that bring further pain. Rest the Achilles tendon. This is a slow healing injury and may take 3 months or longer. If you wish to continue exercising try bike riding, swimming or other activities that don’t require propulsion by the foot. Icing the tendon will reduce swelling and aid in the healing process. Over the counter medication Advil, Aleve will also reduce swelling and pain. Stretching exercises are recommended once the swelling subsides.
How do I know I have Tendonitis?
Squeeze the tendon on the sides between your finger and thumb, if the pain is more intense than when pressing on the tendon from the back, this is a sign of tendonitis. If pain is felt upon wakening, the pain may improve and then worsen as activity increases, is another sign.
How can I help the healing process?
A walking cast will take the pressure off the Achilles heel, this is used briefly as to avoid weakening of the calf muscles and tendon (cost is @ $40.00). Wearing a Dorsal Night Splint allows the tendon to heal while you sleep, they can be purchased for @ $23.00.
What is a Rupture of the Achilles Tendon?
A rupture occurs when the tendon partially tears or completely tears in two. Often a snapping sound is followed by an intense pain. The pain usually subsides quickly followed by aching in the lower back leg. You may be able to bear weight on the injured leg but will not be able to stand on your toes. Another test “The Thompson Test” requires the person to lie on their stomach then their calf muscle is squeezed. If there is no movement or flexion in the foot, then the Achilles tendon is injured. As a rule of thumb, surgery is recommended for a complete tear and nonsurgical treatment for partial tears.
How will the doctor treat a ruptured Achilles tendon?
If the tendon is completely separated, “tendon transfer” surgery will be performed. This involves a cut just above the heel, the two tendon ends are then sutured together and the cut stitched. This requires @ six weeks of immobilization. There is less than a 5% injury recurrence rate. A partial tear is usually operated on if you are younger and more active. Older people are often treated with a cast for up to 12 weeks, followed by rehabilitation. Partial tears are sometimes treated like complete tears, with surgery and casting. A heel lift is usually used for 6 months to one year following removal of the cast. Rehabilitation to regain flexibility and then to regain muscle strength are also instituted following removal of the cast.