Achilles Tendon Injury – Symptoms and Causes

This is a common and chronic condition in recreational athletes and sports people. In the past years the treatment options were poor because the right cause for Achilles tendon injury was not known. But in this period there are many studies which are done about condition and the number of treatments is increased. There was a study in which was shown that this is not a condition which is caused by inflammation. Achilles tendon injury is caused by series of tendinosis (microtears) which are weakening the tendon. In the back of the ankle there is a large tendon which is known as Achilles tendon. The extension of the calf muscles (soleus) and gastrocnemius in fact is the tendon. The tendon is running down the back of the lower leg attaching to the heel bone (this bone is also known as calcaneus). The Achilles tendon is connecting our leg muscles to our foot which means that we have the ability to push off during running and walking. [1,2]

Signs and symptoms of Achilles tendon injury

Here are the signs and symptoms of Achilles tendon injury:

• Decreased strength and movement which means that we have a feeling of sluggishness in our leg
• Mild to severe pain and tenderness in the Achilles tendon area (if you have this condition, then you can notice tenderness which is noticeable in the mornings)
• Swelling
• Stiffness that many diminish as the tendon warms up with use
• This condition is graded from 1 – 4 according to severity:

1. Mild grade: You will feel this kind of pain just when you are finished with running
2. Moderate grade: When you have this grade of Achilles tendon, then you will feel a pain before you run and after you have finished with running. During your running you can notice that the pain is gradually lessons.
3. Severe grade: When you have some kind of activities, then you feel a pain that leads to decrease in the volume of your activity.
4. Extreme grade: You have pain during the everyday activities and this kind of pain is progressing or worsening every day.

When we suffer from Achilles tendon injury, then it completely ruptures or partially tear. When you have completely rupture, then this condition causes you a pain that leads to sudden loss of movement and strength. When you have partial tear of Achilles tendon injury, then this condition has the similar symptoms as Tendinopathy [3]. You need to rest if you suffer from Achilles tendon injury. When you are doing some sports activities, then you must wear appropriate shoes. Also you should avoid some activities that can lead to pain. You should allow adequate recovery time between your training sessions or workouts. Also you should limit the excessive stress by using adequate techniques.

Risk factors of achilles tendon Injury

The tearing or rupturing of the tendon and the Achilles Tendinopathy are the two most common injuries of the Achilles tendon. Also there are other injuries that are less common such as Retrocalcaneal Bursitis and Peritendinitis. The Achilles Tendinopaty can be result from one or many causes which are resulting in excessive loading of the Achilles where we can include:

• Inadequate warm up, stretching and cool down
• Decreased joint range of motion (for example stiff ankle joint)
• Poor muscle flexibility (for example tight calf muscles or weak calf muscles)
• Change of surface (seasonal)
• Running on hard or uneven surfaces
• Excessive pronation (force on Achilles tendon increases)
• Wearing inadequate or incorrect footwear [4]
• A decrease in recovery time between activity
• A sudden increase in the frequency, intensity and duration of your sport activity

When the tendon is stretched beyond its capacity, then it occur partial or complete tear of the Achilles tendon rupture. Also there are other situations in which there is overstretch of the tendon that causes a tear such as sudden accelerations of running, forceful jumping or pivoting. Also Achilles tendon injury can be result from tripping or falling. People who are in their middle ages and who are having some sport activities are having increased chances of getting this disease [1,2]. But also there are chances to get Achilles tendon injury if you use some medications such as certain antibiotics and steroids because they can lead to weak tendon which means that it ruptures. [5]

References:

[1] Wertz J, Galli M, Borchers JR. Achilles tendon rupture: Risk assessment for aerial and ground athletes. Sports Health. 2013;5(5):407–9.

[2] Maffulli N, Longo UG, Maffuli G, et al. Achilles tendon ruptures in elite athletes. Foot & Ankle International. 2011;32(1).

[3] Li HY, Hua YH. Achilles tendinopathy: Current concepts about the basic science and clinical treatments. BioMed Research International. 2016;2016:6492597.

[4] Meinert I, Brown N, Alt W. Effect of footwear modifications on oscillations at the achilles tendon during running on a treadmill and over ground: A cross-sectional study. PLoS One. 2016;11(3):e0152435.

[5] Cohen PR. Cephalexin-associated achilles tendonitis: Case report and review of drug-induced tendinopathy. Cureus. 2018;10(12):e3783.