Achilles tendon is the most used when you run, so injury to that can be heartbreaking, writes Deepthi Velkur.
Sports injuries both acute and chronic can be very debilitating in nature and the recovery time is prolonged and frustrating. Injuries can lead to weakness in a particular area and may increase the chance of re-injury if neglected.
Some of the most common injuries suffered by sportspersons need professional attention and proper diagnosis under their guidance can lead to quick recovery causing no side effects. Achilles tendonitis is one of the most common athletic injuries. Any person who runs or participates in a sport that involves running risks experiencing Achilles tendonitis. Most injuries caused to the tendon are a result of gradual wear and tear to the tendon from overuse or aging.
Understanding ‘Achilles Tendonitis’
The Achilles tendon is a band of tissue that connects the calf muscles to the back of your foot and is considered to be the strongest tendon in your body. When you run, there are a lot of forces working on your Achilles tendon that cause microtraumas that are usually repaired by the body while resting. When there is lack of proper rest between training sessions, these traumas don’t fully recover causing an inflammation to occur. Joe Uhan, a physical therapist, coach and ultrarunner quotes “ Achilles Tendonitis is an acute inflammation of the tendon that runs along the back of the ankle”. He also adds by saying” Achilles tendinitis can be confused with other injuries, such as heel problems, but the hallmark sign is “if you’re pinching the Achilles and it’s really sore,”. If one experiences symptoms such as severe pain, swelling, tightness, redness or increased temperature, checking with a sports doctor or physiotherapist is recommended.
- Change in training surface
- Flat feet
- Tight hamstring and calf muscles – could be a lack of proper warm-up or cooling down stretches
- Constant use of high heels
- Poor footwear
- Hill running
Some recommended treatment options
- Adequate rest for the damaged tendon is important.
- Orthotics is a simple yet effective treatment is to wear heal pads which reduces the tension on the tendon.
- Ice helps in reducing the pain and inflammation.
- Professional physiotherapy will provide for deep transverse frictions as part of the exercise routine. A massage as well as ultrasound treatment will help improve blood flow to the area and realign the damaged fibers to promote healing.
- Low impact exercises activities like swimming and cycling exert less strain on the Achilles tendon than running and jumping.
- Stretching is a must in treating the Achilles tendon. When the calf muscles are stiff, stretches help in reducing the tension on the tendon. Stretching to be avoided when the resisted plantarflexion (e.g. rising up onto your tiptoes) is pain-free else it can lead to further damage.
- Strengthening Exercises – Strengthening of calf muscles helps reduce the strain on the tendon. Simple exercises like keeping one knee straight, lean forward against the wall and place heel on the ground. The second exercise would be to bend the knee, place the other leg in front and push your hips toward the wall in order to stretch the calf muscles and the heel cord. Hold the position for 10 seconds, relax and repeat the exercise for 20 times for each foot.
- Eccentric Exercises – This involves working the muscles by increasing tensile strength and the length of the tendon, and causing hypertrophy where the tissues increase in volume thereby helping in relaxation and lengthening of the tendon.
Process of Recovery
Recovery is usually slow as the supply of blood to the tendon is poor, reducing the oxygen circulation and nutrients required for the healing process. It takes between three and six months of consistent Achilles tendonitis treatment to recover completely. A good amount of rest from aggravating activities will allow the tendon to heal faster. It is advised by leading physiotherapists to start treatment of Achilles tendonitis early to avoid aggravating the injury.