Common injury for runners and shutters
HOW do you know
if you have Achilles Tendinosis? You will feel pain or soreness over the back of
the heel at the lower part of the leg.
Sometimes you will notice that the tendon is swollen and thickened. The
tendon will also have a feeling of stiffness that comes on gradually and
continues to worsen. The greatest pain usually occurs after periods of
Therefore, you will tend to experience pain on the first few steps of walking
in the morning and when getting up after sitting for long periods of time.
Activities, such as running or jumping will aggravate the pain. Achilles
tendinosis usually occurs in the 35-45-year-old age group and is common among
What Causes Achilles tendon injury ?
The most common causes of Achilles tendon injuries are overuse, misalignment,
improper footwear, medication side effects, and or accidents. In many cases a
combination of multiple causes leads to the injury.
Clinical evidence suggests that misalignment of the lower limb due to foot
problems such as flat feet and over-pronation is a common cause in Asia.
Achilles tendinosis is a problem with irritation and inflammation of the
large tendon at the back of the leg. It tends to occur in middle-age
recreational athletes due to overuse. The overuse causes small tears within the
tendon and inflammation that lead to pain and swelling. If left untreated the
tendon can rupture.
On investigation, the main finding is usually degenerated tissue with a loss
of normal fibre structure. The Achilles tendon is susceptible to injury due to
it having a limited blood supply in the area 2-6cm above the heel bone. As such,
healing of the tendon is often slow, due to its poor blood supply.
Each year there are estimated to be at least 200,000 Achilles injuries in US
alone, which accounts for roughly five to 10% of all athletic injuries.
An Achilles tendon rupture is a more severe form of injury. A rupture is a
partial or complete tear of the Achilles tendon. Typically it comes on suddenly,
sometimes a popping sound is heard and often, walking is not possible. A full
rupture is a more severe, but less common injury than a partial rupture.
Treating Achilles tendon injuries
The first thing you need to do is visit your doctor to accurately determine if
you have an Achilles tendon problem.
A joint or sports injury specialist is likely to be the best person to
consult. If your symptoms are severe or have not improved with earlier
treatment, your doctor may want you to get an X-ray or Magnetic Resonance
Imaging scan to determine how severe the problem is.
Once properly diagnosed the treatment for mild Achilles tendon problems
includes rest, pain medication and stretching exercises. Rest can be done in two
ways- complete rest and relative rest. Complete rest involves no sports
participation and little day-to-day activity.
Relative rest means keeping active and changing your sports activity. A great
idea is to go swimming or cycling instead of running, to allow the tendon some
rest. Stretching of the calf muscles is very important and needs to be done
daily for 10-20 minutes.
You will need to make sure your shoes are supportive and well-cushioned and
play sports at a more relaxed pace. Early treatment works best and can prevent
Take note though, even mild cases can take weeks to months of rest for the
tendon to repair itself.
Two effective therapies for a quicker recovery from Achilles problems are
eccentric strengthening exercises of the calf muscles and extracorporeal
Eccentric strengthening should be done daily or every other day. The exercise
is a calf raised on a stair or on a machine in a gym. Start slowly using just
your body weight doing three sets of 10 or 15. When the exercise can be done
without pain, gradually increase the number of repetitions and number of sets.
Concentrate on the calf lowering part (the eccentric part) rather than
raising part of the exercise. Make sure to fully stretch the Achilles tendon on
each repetition. You should only do these eccentric calf raises after you have
already done some other exercises.
Shockwave therapy is a new treatment favoured by professional sportsmen and
women. A world-class sporting organisation that uses it is the AC Milan football
Shockwave introduces a series of high-energy sound waves (shockwaves) to an
area of injury. When the shockwave reaches an area where muscle meets bone a
tremendous amount of energy is released which aids healing.
The treatment initiates an "inflammation-like" response from the body leading
to increased blood circulation and metabolism in the injured area. The shockwave
helps break down scar tissue and aid the body's natural healing processes.
Treatment for more severe problems, such as a ruptured tendon, may include
surgery or a cast on the leg.
Post-surgery, you will need to undertake extensive physical therapy and
rehabilitation to make the lower leg strong and flexible again. The tendon will
take from three to 12 months to properly heal.
In conclusion, although Achilles tendon problems can be debilitating, with
care and by using the latest treatments you can make a return to sports and
other activities. Make sure to get treatment as early.