The Achilles tendon is a large tendon at the back of the ankle. The tendon is an extension of the gastrocnemius and soleus (calf muscles), running down the back of the lower leg attaching to the calcaneus (heel bone). The Achilles tendon connects the leg muscles to the foot and gives the ability to push off during walking and running.
The two most common injuries of the Achilles tendon are Achilles Tendinopathy, and tearing or rupturing of the tendon. Achilles Tendinopathy can be due to one or a number of causes which may result in excessive loading on the Achilles, including:
- A sudden increase in the intensity, frequency and duration of activity.
- A decrease in recovery time between activity.
- Wearing inadequate or incorrect footwear.
- Excessive pronation (force on achilles tendon increases).
- Running on hard or uneven surfaces.
- Change of surface (seasonal).
- Poor muscle flexibility (e.g. tight calf muscles, weak calf muscles).
- Decreased joint range of motion (e.g. stiff ankle joint).
- Inadequate warm up, stretching and cool down.
An Achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping or pivoting, or sudden accelerations of running can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping. Achilles tendon ruptures are most often seen middle-aged people participating in sports in their spare time. Less commonly, illness or medications, such as steroids or certain antibiotics, may weaken the tendon and contribute to ruptures.
- Wearing appropriate shoes for the activity.
- Using correct technique to limit excessive stress on the Achilles tendon.
- Strapping and taping the ankle to assist in creating a more secure structure.
- Warming up, stretching and cooling down.
- Undertaking training prior to competition to ensure readiness to play.
- Participating in regular strengthening and stretching sessions to maintain muscle strength and flexibility.
- Gradually increasing the intensity and duration of training.
- Allowing adequate recovery time between workouts or training sessions.
- Avoiding activities that cause pain. If pain does occur, discontinuing the activity immediately and commencing RICE.
Signs and Symptoms
- Mild to severe pain and tenderness in the Achilles tendon area (tenderness may be more noticeable in the morning).
- Stiffness that may diminish as the tendon warms up with use.
- Decreased strength and movement; a feeling of sluggishness in the leg.
- Achilles Tendinopathy is graded from 1–4 according to its severity.