The Achilles tendon is named after the famous Greek warrior Achilles, who was fabled for being indestructible. This was until his one weakness was found, a tendon in his ankle. This tendon is considered to be the strongest in the body and plays a vital role in permitting us to walk as well as maintaining balance and posture. Injury to it, therefore, can cause a great deal of pain and strife in everyday life. It is even more debilitating for those who play sport or exercise regularly.
Understanding the symptoms of the injury, how it is treated and how best to rehabilitate it will improve your chance of a full recovery and help you return to full fitness sooner.
Symptoms of an Achilles Tendon Injury
As with any injury, there are distinct signs that your have ruptured or partially ruptured you Achilles tendon:
- You have swelling in your lower leg that is sensitive and painful to touch.
- You will be unable to put your full weight through your ankle.
- You will hear an audible “snapping” or “ripping” noise when it tears. Some sports stars have likened it to hearing a gun shot.
- You will have a limb and be unable to stand on your toes or climb stairs.
- When you first suffer the injury, it will feel as though you have been hit in the back of leg despite their being no contact.
The best way to confirm this injury is for you to go to a hospital where a trained physician will carry out these tests:
- Thompson or Calf-Squeeze Test – You will lie prone on your back while the doctor or nurse will squeeze your calf. If the Achilles tendon is intact, then your foot will bend downwards (a plantar flexion), whereas if there is a partial tear or complete rupture then the foot will not move in this fashion.
- Matles Test – This will involve you lying on your front with your knees at a 90-degree angle. If you have ruptured or partially ruptured the tendon, then the injured foot will bend downwards through the force of gravity. This is considered a more accurate test.
- An ultrasound and Magnetic Resonance Image (MRI) is often ordered to confirm diagnosis too.
These symptoms can vary with the severity of the injury. Those with a chronic or full rupture will experience more acute pain and swelling compared to those who have sustained a partial tear.
Treatment
There are two main approaches to treating an injury to the Achilles tendon:
- Surgery – This process can either be open surgery, which involves one long incision made to reach the tendon to stitch it back together. A more popular option, however, is the use of percutaenous surgery, known as “keyhole” surgery. This involves the use of cameras and small incisions to stitch the tendon back together. This is then followed by the leg being put in a brace to help support the ankle while it heals. This can be for four to eight weeks and is best combined with gentle physiotherapy.
- Non-Surgical Treatment – This approach involves the use of a brace or cast on the ankle and leg to help the tendon heal. The cast will be changed a number of times during the recovery to make sure that the tendon heals in the correct way. This course of treatment will result in a longer rehabilitation period and has a higher incidence of a tendon re-rupture.
This is most suitable for partial tears of the injury.
Rehabilitation
This is often the hardest part of the recovery from this kind of injury. A physiotherapist will start a gentle regime to help build strength and confidence in the ankle. This will gradually intensify to put more strain on the new tendon to ensure it is healing correctly. One major issue is muscle atrophy, which is when the muscle wastes away through lack of use. This will affect your rehabilitation as the muscles that support the ankle will need to be strengthened to prevent further injury.
Good exercises to build confidence as well as maintain strength and fitness are:
- Swimming – This is a low-impact exercise and is a great way to work several muscle groups at the same time.
- Deep Tissue Massage – This can help work out swelling as well as stretch the muscle and tendons to increase strength and improve the recovery time.
- Eccentric Exercise Training – This is favoured by physiotherapists to help build strength in the healing tendon and involves a mixture of standing on your toes and flexing the tendon as well as calf-muscle training.
You can expect to see an improvement in range of movement, strength and confidence over a six-month period, although this can vary between people.
Sources:
- BUPA Healthcare Facsheets
- Achilles Tendon, British Orthopaedic, Foot and Ankle Society
- NHS Clinical Knowledge Summaries
- University of Oxford, England, Medical Sciences Division
Disclaimer: The information contained in this article is for educational purposes only; it should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his/her health should contact a licensed medical professional.
Andrew Stewart - I'm a freelance multimedia journalist who enjoys writing, reporting and presenting pretty much anything. I have a background in Zoology ...
