An Achilles tendon injury is a risk for anyone, regardless of whether they’re an athlete or simply going about their daily activities.
The Achilles tendon, the body’s largest tendon, extends from the heel bones to the calf muscles. It is identifiable as a resilient band of tissue located at the back of the ankle and above the heel. This tendon enables downward toe pointing and tiptoeing due to its robust, elastic fibers, capable of withstanding pressures of up to 1,100 pounds.
However, due to limited blood circulation in this area, the Achilles tendon is susceptible to injury, often referred to as tendinitis or tendonitis by medical professionals. Symptoms may include sensations of burning or stiffness in the lower leg. In severe cases, the Achilles tendon may suffer partial or complete tears, causing intense pain.
Achilles Tendon Injury Symptoms
Here are some typical indicators of an Achilles tendon injury:
- Stiffness and tightness in the Achilles tendon upon waking in the morning.
- Discomfort or pain along the length of the Achilles tendon.
- Experiencing increased pain during physical activity.
- Feeling heel discomfort while wearing shoes.
- Experiencing heightened pain the day after engaging in physical activities.
- Noticeable thickening of the tendon.
- Presence of bone spurs, which are bony growths.
- Persistent or recurring swelling in the affected area.
- Specific pain localized in the Achilles tendon.
The most apparent indication of an Achilles tendon injury is experiencing pain above the heel, particularly when stretching the ankle or standing on tiptoes. Initially, the pain might be mild and fluctuate in intensity over time. However, in cases of tendon tears or ruptures, the pain emerges suddenly and can be intense. Seeking medical attention promptly is advisable in such instances.
Formation of a lump on the Achilles tendon is a common occurrence following an injury. This lump may result from swelling and can signify moderate Achilles tendinitis. Alternatively, if the lump persists for an extended period, it could indicate the ongoing healing process in the area.
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Types of Achilles Tendon Injuries
There are two primary types of tendinitis affecting distinct sections of the Achilles tendon:
- Noninsertional Achilles tendinitis: This type involves the breakdown, swelling, and thickening of fibers within the middle portion of the tendon. It is more prevalent among highly active individuals, particularly runners.
- Insertional Achilles tendinitis: This condition affects the lower segment of the heel, where the tendon inserts or attaches to the heel bone. It often leads to the development of bone spurs. While insertional Achilles tendinitis is common in runners, it can occur in individuals regardless of their activity level. Tight calf muscles are a frequent contributing factor, increasing stress on the Achilles tendon.
Individuals may experience one or both types of tendinitis simultaneously.
Other Achilles tendon-related injuries include:
- Achilles bursitis: Found at the back of the heel, a fluid-filled sac known as a bursa cushions the Achilles tendon as it moves over the heel bone. Overuse, health conditions like arthritis or gout, or wearing tight shoes that rub against the heel can irritate and inflame this bursa, leading to Achilles bursitis, also termed retrocalcaneal bursitis.
- Achilles tendon rupture: A tear in the Achilles tendon, causing a snapping or popping sound upon occurrence. This is distinct from tendinitis. Rupture symptoms include immediate and intense pain, along with bruising, swelling, and difficulty pointing or pushing off the toes when walking.
Achilles tendinitis vs. tendinosis:
- Achilles tendonitis or tendinitis denotes inflammation of the tendons, typically a short-term condition.
- Achilles tendinosis refers to persistent or long-term tendinitis, where tendon cells begin to deteriorate, potentially affecting the functionality of the Achilles tendon.
Achilles Tendon Injury Causes
Achilles tendon injuries frequently occur during activities involving rapid acceleration, deceleration, or pivoting, including:
These injuries typically occur during sudden movements when initiating propulsion and lifting the foot, rather than during landing. For example, a sprinter may sustain an injury at the beginning of a race when surging off the starting block, overwhelming the tendon’s capacity to withstand the force.
Repetitive stress injuries can also result from continually subjecting the Achilles tendon to high-impact activities.
However, you need not be an athlete to experience such injuries. Traumatic incidents like stepping into a hole or falling from a height can also lead to Achilles tendon ruptures.
Achilles Tendon Injury Risks
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