Achilles tendon injuries

tendonitis and rupture

The Achilles tendon is the largest and strongest tendon in the body. It connects the heel bone to the calf muscle of the leg.

The majority of Achilles tendon problems occur in middle aged athletes and are, in the main, overuse injuries. In some cases, other medical conditions contribute to the weakening of the tendon. A low-arched or high-arched foot may increase the stresses on the Achilles tendon. 
 
As we get older the tendon becomes much less flexible and less able to absorb the repeated stresses and shocks  of running. Eventually small "degenerative" tears start to develop in the fibers of the tendon. The body tries to repair these tears. Sometimes the repair process is successful but the blood supply of the lower part of the tendon is not very good and the combination of this and continued running and the associated stress involved usually means that the tendon may not completely heal. Instead, the tendon and its lining become swollen and  painful and the tendon sometimes feels weak. The combination of degenerative and repair processes in the tendon is called tendonitis (or sometimes tendonosis). . 
 
Sometimes the tendon becomes weakened by the degenerative process to the extent that it tears completely.

 
The suggested treatment for Achilles tendonitis consists of icing, gentle stretching, and modifying or limiting athletic activity like running and jumping. Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen, voltaren or aspirin, can reduce swelling and pain. Physical therapy and the use of an orthotic (heel lift) can also be very helpful. For chronic cases where tendonitis is evident and other methods of treatment have failed, surgery may be recommended to remove and repair the damaged tissue.