So as the weather warms I am seeing an influx of Achilles
related injuries. So I wanted to shed some light onto what the Achilles is and what injuries are associated with it.
What is the Achilles tendon?
-
The
Achilles tendon (calcaneal tendon) is the common tendon of the ankle that
attaches the calf to the foot. The “calf” muscle is comprised of 2 major muscle
groups of the gastrocnemius (gastroc) and the soleus. These two muscles are in
charge of flexing the foot down towards the floor or technically referred to as
plantarflexion. You can feel your Achilles tendon by touching the back of your
ankle and feeling for the large cord like tendon that extends down to the heel.
Why is the Achilles often injured?
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The tricky part about Achilles issues is that it
can caused by many things. The Achilles plays a major function in all weightbearing
movement from standing to sprinting. Any issue with the Achilles will
drastically affect ones function throughout a normal day. Some problems with
the Achilles are the following:
o
Located in a vulnerable area susceptible to
injury from outside forces such as a slide tackle.
o
Takes the majority of the load during jumping
activities.
o
Used constantly throughout day and exercise.
o
Relatively small tendon for girth of muscle it
attaches to.
o
Tendon attaches to calcaneus (heel) but also
shares tissue with bottom of heel and effects plantar fascia.
What are some common injuries?
-
Some
common injuries sustained to the Achilles tendon and possibly associated with
the Achilles tendon are:
o
Achilles tendinitis or tendinosis – Inflammation
of Achilles tendon. This is indicated by pain when touching the Achilles and
pain with all running and jumping activities. May see slight swelling of
tendon.
o
Achilles rupture – Tendon ruptures are very
painful and require immediate medial attention. Full Achilles ruptures are
immensely painful and require surgical repair and can be diagnosed by use of
the Thompson test. The Thompson test is when the effected calf is squeezed and
a positive finding is when the foot does not flex down (plantarflex). Partial tears can be seen when a dip in the
actual tendon (looks like a pothole in the tendon).
o
Achilles apophysitis (mostly just children) –
Also called Severs Disease, Achilles apophysitis is when the Achilles tendon
pulls away from the heel causing pain and swelling. Much care must be taken to
avoid over stretching.
o
Heels Spurs (secondary) – Tight Achilles will
sometimes contribute to heels spurs which are boney growths are an attachment
of a plantar fascia.
o
Plantar fasciitis (secondary) – Inflammation of
the plantar fascia of the foot (arch of the foot). Tightness of the Achilles
will contribute to plantar fasciitis by placing the foot in poor alignment and
causing increases stress across the plantar fascia.
What are some causes for injury?
-
Some causes for Achilles injuries are often
preventable
o
Over use – Weekend warriors and avid runners
with poor running technique will sometimes develop Achilles tendinitis. See my last post about running technique.
o
Tight calves – Stretching is very important. One
way you can tell if your calfs are tight is if you are unable to flex your foot
towards your head >90 degrees. Be sure to warm up >10mins before
stretching any muscles.
o
Improper footwear – High heeled shoes and flip
flops do not support your foot properly and could eventually cause Achilles
injuries.
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