Whether you are a weekend warrior athlete, a seasoned runner or an Olympic champion figure skater, suffering an Achilles tendon rupture is very traumatic. The Achilles tendon—which attaches the calf muscles to the heel—is the largest and strongest tendon in the body. It is a true workhorse tendon allowing you to push downward with your foot and ankle to jump, walk and climb. It is also very exposed because it runs up the back of the ankle. It is in this area—about 1-3 inches up from the heel, that ruptures (partial or complete tearing of the tendon) occur.
Ruptures of the Achilles tendon often occur spontaneously in healthy individuals who are, usually, between the ages of 30-50. These individuals often participate in some physical activity, at a novice level right up to a professional level. The tendon sometimes ruptures with blunt trauma (getting stepped on in a basketball game as a player comes down from a rebound) or it can happen while just running or stepping down hard. Often there is existing tightness and previous injury to the area.
Biomechanical imbalances straining the calf muscles may contribute to ruptures. When you consider that the action of the Achilles tendon allows you to push your entire body weight forward with each step, and that in running, forces up to 10 times your body weight are managed through this tendon, it is no wonder that it can become vulnerable to injury.
Diagnosis of an Achilles tendon rupture is made by your doctor. Usually, a person reports a popping sensation, followed by some pain in the tendon. Some people, however, experience very little pain. Someone with a true rupture cannot raise the affected heel off the ground and stand on tiptoe, but may still be able to point the foot downward. A distinct limp occurs. Running or climbing stairs is out of the question. The calf may become swollen.
Other biomechanical imbalances can also contribute to chronic tension of the calf muscles, which may set the stage for a rupture. Standing with knees hyperextended (locked, with the back of the knee flattened) may be an indication that weight is shifted farther forward than is optimal. In turn, this can cause the calf muscles to work much harder than they should. Certain foot problems, like over-pronation (a flattening of the arch during weight shifts), may also contribute to chronic calf tightness. A thorough biomechanical evaluation is always recommended any time an orthopedic problem persists.
Treatment for a total Achilles tendon rupture involves a surgical repair of the tendon. Usually, the leg is then immobilized for up to 12 weeks in a series of casts. Physical therapy usually begins after the cast is removed.
Rehabilitation involves strengthening, stretching and restoring full function to the leg and tendon. Athletes can regain their pre-injury status with persistence and hard work in therapy.
To decrease the chances of developing problems with the Achilles tendon, there are several steps you can take. Stretch your calf and hamstring (back thigh) muscles slowly, gradually and at least once each day, but not right after you get out of bed. It is important not to rapidly increase your workouts over a short period of time. If you develop tenderness or inflammation in the Achilles tendon area, see your health provider or physical therapist.
Bear in mind that there are reports that sneakers with exercise heel cushioning may contribute to irritation of the Achilles tendon. This happens because, upon impact, the heel continues to stretch downward as the cushion gives.
The more aware you are of your body’s condition, the better off you’ll be. Help your body help you by giving it proper rest, nutrition and regular exercise in keeping with your physician’s advice.