The Achilles tendon is the strongest and most powerful tendon in the body. It is also unfortunately one of the most frequently injured tendons as well. Achilles pathology and trauma account for up to 11% of all running injuries. While most injuries are mild and consist of tendonitis, sometimes a tendon rupture may occur. Considering the types of Achilles tendon ruptures, mid-substance ruptures are the most common, which account for about 73% of all Achilles ruptures.
Anatomy:
The Achilles tendon is formed by the joining of the gastrocnemius and soleus muscles in the back of the leg and attaches to the calcaneus or heel bone. The watershed area, an area of poor blood supply located about 2-6 cm from the insertion into the calcaneus, has a higher susceptibility to rupture and injury.
Causes:
The most common causes of Achilles rupture are overuse and training errors which result in repetitive micro-tears in the tendon. The ‘weekend warrior’ type of individual is also a very likely candidate to rupture the Achilles tendon due to their participation in strenuous activities without the proper amount of training beforehand. The typical presentation of a rupture is generally hearing a loud “pop” or “snap” which many relate to feeling as if they were kicked or shot in the back of the leg.
Diagnosis:
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X-ray
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Clinical exam
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MRI
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Ultrasound
Treatment:
Initial treatment for tendon ruptures are rest, ice, and NSAIDs (Ibuprofen, Aleve). Depending on the severity of your injury two treatment options are available: cast immobilization or surgery. After appropriate investigation into the severity of your Achilles tendon rupture, your podiatrist will determine which course of action is best suited for you.
Prevention:
Hindsight is always 20/20, but if you are continually experiencing calf or heel pain during or after running, have this problem evaluated. This could be a serious issue such as the beginning stages of an Achilles tendon rupture or degradation. Also, try to avoid constantly running on hills or uneven terrain because this will likely put more stress on your Achilles tendon over time.
On another note, all of the ‘weekend warrior’ athletes out there, if you signed up for 5k race or these new obstacle styled races, make sure you adequately train for it! This doesn’t mean you have to run 3 miles a day in preparation, however, understand the risks of inactivity mixed with sporadic weekends of strenuous activity. Do your Achilles and body a favor with appropriate training, and don’t over do it!