The mythical warrior Achilles was said to have been dipped in the River Styx up to his heel, granting him near-invulnerability. Our Achilles tendon reflects this hero, being the largest and strongest tendon in our body, responsible for providing power, stability, and flexibility to your ankle. So, what should we do when our own Achilles is not feeling so heroic?
1. What is the achilles tendon?
The Achilles tendon is the strongest and thickest in your body. It is formed by the two large calf muscles: the soleus and the two-headed gastrocnemius. The tendon itself attaches these calf muscles to your heel bone, giving you the ability to stand on tiptoe or run at full speed. Achilles tendon injuries are common among athletes, but if identified early they can be healed with proper treatment
2. Types of achilles tendon injuries
Injuries to the Achilles tendon come in two forms: traumatic injuries (ruptures and tears) and overuse injuries, which are far more common. Something that begins as a minor injury may become a long-lasting or even debilitating problem after being walked on for an extended period.
Overuse injuries
While ruptures are generally caused by acute trauma, overuse injuries are caused by repetitive physical activities, often sports- or activity-related. Whether you just began a new walking program, started a new sport, or helped a friend move apartments, These injuries are most often caused by an event or group of events which required more work from the Achilles tendon than it was ready for. Continued use of the tendon (sometimes just living our busy lives) can perpetuate and worsen that minor injury into a larger one.
3. Signs and symptoms of an injury to the achilles tendon
An injury to the Achilles tendon can be difficult to deal with. Luckily, there are a few telltale signs that will help you recognize any issues quickly. Symptoms of an achilles tendon injury include pain and swelling in the back of the heel, along with redness and heat at the same location.
This type of Achilles injury, commonly referred to as ‘tendinitis’–tissue inflammation due from overuse caused by repetitive stress–begins as an ache, swelling, or pain in the back of the heel. Some patients also report a feeling of stiffness, a ‘twinge’, or heat localized to the same spot. Others report a tight feeling in their calves or have difficulty walking without pain.
4. Treatment for an injury to the achilles tendon
Early treatment is often the most effective for Achilles pain, and depends on the severity of pain and location of any inflammation. Initial treatments center on rest, fighting inflammation, and preventing another injury. To treat achilles tendinitis caused by overuse and/or strained muscles, it’s important to rest from activity. Proper rest will allow swelling to go down before beginning rehabilitation exercises like deep tissue massage or calf massages. Some of the most effective early treatments are to back off on the new exercise, change to a supportive athletic shoe, icing, or trying a heel-cup temporarily.
Persistent pains can be treated short-term with over-the-counter non-steroidal anti-inflammatory medications like Ibuprofen. Many pharmacies also carry a topical over-the-counter NSAID (diclofenac 1% gel), which can be applied to the skin over the heel, which is particularly useful for inflammation of a superficial tendon like the Achilles. For those who are unable to take NSAID medications, ice is a helpful tool for fighting inflammation and carries a very low risk for side effects.
The first thing you can before seeing your doctor is an ice bath, being careful not to immerse your leg in cold water for more than 10-15 minutes, or any longer than is comfortable for you. Icing the area may also work for short term relief, but don’t put off making an appointment with your doctor as soon as possible if discomfort continues for more than 24-hours.
5. Prevention methods for injuries to the achilles tendon
The best way to prevent an injury is by taking care of your feet, and a key component is to wear proper footwear. Good shoes will cushion your feet, have ample room for your toes to move and spread naturally, and provide strong arch support. It’s also important to avoid running too much–make sure you prioritize rest between long runs or bouts of exercise. If possible, try not to train on slick or loose terrain, or sharp objects like gravel or stones. No matter what activity you’re doing, always make sure you adequately warm up before any strenuous exercise. Finally, try icing down those painful ankles afterwards for relief from any inflammation caused by muscle over-exertion.
Finding pain relief for your feet and ankles is easier than you think. Our team of exceptional podiatric physicians at the Des Moines University Clinic will work with you to treat your pain and help you find ways to stay active while you heal. We are currently offering in-clinic and virtual appointments for patients. Visit the DMU Clinic website or call 515-271-1731 to learn more.
