The job of any tendon in the body is to connect muscle to bone. The Achilles tendon is the largest and strongest tendon in the body. It connects the lower part of the calf muscles to the heel bone or calcaneus. The Achilles tendon aids the calf muscle in plantar flexing the foot (the same motion as pointing the toe or doing a calf raise). The Achilles functions in all activities to move the ankle joint. But when the tendon is inflexible or overworked, it is at risk for injury.
Inflexibility in the Achilles Tendon
When the Achilles tendon is inflexible the ankle joint cannot move correctly. This can put the ankle at risk for injury as it compensates for the lack of appropriate movement. Because the tight Achilles limits the movement of the ankle, an athlete trying to push off of his or her toes will not perform at the highest level.
Injury to the Achilles Tendon
Injuries that may occur in the tendon itself include strain, rupture, or tendinitis. An Achilles strain is often the result of planting the foot and forcing the ankle into dorsiflexion, the movement of bringing the toes upward. Rupture of the Achilles is fairly uncommon and usually occurs in older athletes, or athletes with chronic Achilles tendinitis.
An athlete with chronic tendinitis, perhaps over years, may have a breakdown of the fibers of the tendon, causing it to weaken. The most common Achilles injury is tendinitis, which occurs when the tendon is placed under stress from repetitive movements such as running or jumping. The injury may also occur if an athlete changes his or her training program or trains at a level his or her body is not equipped to handle. Inflexibility in the calf muscles can also contribute to Achilles tendinitis.
It is much easier to prevent an Achilles injury than to manage it, especially with tendinitis. Simple prevention strategies include frequent stretching of all the muscles of the lower leg. Stretch one to three times per day for a 15 to 30 seconds each. Another way to prevent injury is to strengthen the calf muscles and Achilles tendon. This is fairly simple to do with standing and seated calf raises. It is important to do both exercises because they work the calf differently.
The sets and repetitions should be done based on the activity in which the athlete is involved. For example, an endurance athlete should perform three sets of 20 repetitions with light weight, whereas a strength athlete should perform four sets of 12 to 15 repetitions with moderate to heavy weight. It is important to note that whatever the activity, the calf and Achilles tendon are being used most of the time. Another way to prevent injury is appropriate training. An athlete should begin with shorter, easier workouts and progress as he or she gets stronger and more aerobically fit.
Basic Injury Treatment
Achilles strain will normally resolve with a couple days of rest and ice. Tendinitis is much more challenging to heal. Tendinitis can hang on for weeks or even months if not properly treated. Resting the area is the best place to start. This does not mean all activity has to stop. For example, if the athlete is a runner, he or she should bike or swim to stay in shape while the tendon rests. This could be on an every other day schedule or every day until the pain improves.
Icing the injury, especially after any activity, is a fundamental way to reduce pain and inflammation. Icing should be done for no longer than 20 minutes and not more often than every two hours. Very light Achilles stretching and massage may also increase healing and decrease pain. Massage should not be performed right after an injury occurs. Achilles stretching is done in the same way as a calf stretch, but with the knee slightly bent.
See the Doctor
- If the athlete is having consistent pain when walking or during daily activities.
- Pain does not decrease after rest or ice.
- The athlete is having difficulty doing a calf raise.
- The athlete is having difficulty pushing off or with dynamic ankle movements.
- The athlete has had chronic tendinitis for a long period of time (three to six months).
- The athlete is uncomfortable treating or caring for his or her injury and seeks more information.