Achilles Tendon

What is the Achilles tendon?

The Achilles tendon extends from your lower leg into your foot, down the back of the heel. It’s the large, fibrous tissue you can see at the back of your ankle and is the thickest, strongest tendon in your body.

The Achilles tendon connects the heel bone to your calf muscles, so when you flex your calves, the tendon pulls on your heel. This action enables you to stand on your toes so you can walk, run, and jump.

This tendon is extremely strong, but can be vulnerable to injury due to the amount of force exerted on it and its limited blood supply. The Achilles tendon is one of the most frequently injured tendons.

What could go wrong with my Achilles tendon?

Problems with your Achilles tendon often start as an acute injury when you’re taking part in some form of physical activity, or they may develop gradually over time from continued wear and tear. The most common Achilles tendon conditions are:

• Microtears or partial tear
• Achilles tendon tear or Achilles tendon rupture
• Achilles tendinitis
• Achilles peritendinitis
• Insertional Achilles tendinitis
• Achilles tendinosis
• Heel bursitis

An acute injury is one you feel as it happens. Some even say they feel like they got hit with a bat to the back of the leg or they hear a popping sound as the tendon is rupturing. On the other hand, chronic conditions develop over time, as the tendon continues to operate under too much stress and strain.

If you have an Achilles tendon problem, you’re likely to feel pain, which can be severe if the tendon is badly damaged. Other pathologic Achilles tendon symptoms include:

• Stiffness
• Morning pain
• Swelling
• Warmth
• Thickening
• Discoloration

How are Achilles tendon problems diagnosed?

Your foot and ankle specialist at Kalmar Family Podiatry will perform a complete lower extremity examination to determine the extent of your Achilles tendon injury. An Achilles tendon rupture test is always performed to evaluate the function and integrity of the Achilles tendon. The most common Achilles tendon rupture test is known as the Thompson test. If the tendon doesn’t respond normally, this indicates a potential rupture.

Further diagnostic testing may include:

• Digital X-ray: performed in the office to look at the bone structure and for potential heel spurs
• MRI (magnetic resonance imaging) scan
• Achilles tendon ultrasound
• CT (computed tomography) scan

How are Achilles tendon problems treated?

For minor injuries, following the principles of PRICE therapy usually solves the problem. PRICE stands for protection, rest, ice, compression, and elevation. Patients should rest the ankle in a raised position, use an ice pack to reduce any swelling, and apply a sports bandage. You can also take over-the-counter pain and anti-inflammatory medications.

Other treatments include:

• Achilles tendon stretches either with an at home program provided by Kalmar Family Podiatry or through a formal physical therapy program.
• Heel lifts
• Over-the-counter inserts
• Custom orthotics
• Foot and ankle splint/brace
• Immobilization in a walking boot to immobilize the tendon and allow it to heal
• Class IV Deep Tissue Laser Therapy
• Shockwave Therapy
• Shockwave therapy produces micro-trauma to the tissue causing the tendinitis
• Your body reacts by signaling for increased blood flow to the painful area, assists in breaking down the injured tissue. This causes an acute response and signals your body to heal itself
• Read more about shockwave therapy
• Platelet Rich Plasma (PRP)
• This treatment takes the patient’s own blood and concentrates the platelets using a centrifuge. The blood is then re-injected into the affected tendon. The growth factors in the platelets stimulate healing and break up scar tissue
• Read more about PRP
• For a completely torn Achilles tendon, either cast immobilization or surgery is required

If you have pain in your ankle or foot or believe you may have a damaged Achilles tendon, call Kalmar Family Podiatry today, or book an appointment online.