What is it?

This is the tendon which connects the calf muscles to the heel bone. It is the largest tendon in the human body and is very powerful.

What Problems are associated with it?

It is the most frequently ruptured tendon. In addition both professional athletes and "weekend warriors" athletes can suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.

Factors leading to Achilles problems include:

  • rapidly increasing your running mileage or speed
  • adding hill running or stair climbing to your training routine
  • starting up too quickly after a layoff
  • trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort such as in a final sprint
  • overuse resulting from the natural lack of flexibility in the calf muscles

Symptoms of Achilles Tendon problems include:

  • Mild pain after exercise or running that gradually worsens
  • A noticeable sense of sluggishness in your leg
  • Episodes of diffuse or localized pain, sometimes severe, along the tendon during or a few hours after running
  • Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone
  • Stiffness that generally diminishes as the tendon warms up with use
  • Some swelling
  • Nodules or "knots" within the tendon

Other conditions can mimic Achilles tendon problems, and it is recommended you seek orthopaedic consultation to receive the proper diagnosis.

How are Achilles tendon problems treated?

Treatment depends on the location, duration and severity of symptoms. Treatment options include:

  • Rest, which may mean a total withdrawal from running or exercise for a week, or simply switching to another exercise, such as swimming, that does not stress the Achilles tendon
  • Nonsteroidal anti-inflammatory medication
  • Orthoses, which are devices to help support the muscle and relieve stress on the tendon such as a heel pad or shoe insert
  • A bandage specifically designed to restrict motion of the tendon
  • Stretching, massage, ultrasound and appropriate exercises to strengthen the weak muscle group in front of the leg and the upward foot flexors

Surgery is often an option of last resort. If friction between the tendon and its covering sheath makes the sheath thick and fibrous, surgery to remove the fibrous tissue and repair any tears may be the best treatment option. Recovery is slow, may require a temporary cast and includes a rehabilitation program to avoid weakness.

Complete tears of your Achilles tendon may be treated with a cast or with surgery.

Your doctor will help you determine the plan of treatment most appropriate for you.

How can I prevent Achilles problems?

Several steps may be taken to lower your chance of having problems with your Achilles tendon:

  • Choose your running shoes carefully so that they provide adequate cushioning for your heel. Occasionally an orthotic device can be prescribed.
  • Walk and stretch to warm up gradually before sports activities.
  • Focus on stretching and strengthening the muscles in the calf.
  • Increase your running distance and your speed gradually
  • Avoid unaccustomed strenuous sprinting, hill running and the like.
  • Cool down properly after exercise with post exercise Achilles stretching a key component of your workout regimen