Achilles tendon injuries
What is the Achilles tendon?
It is the tight, cord-like tendon on the back of your ankle that attaches your calf muscle (gastrocnemius) to the heel bone (calcaneus).
How is it injured?
The most common injury to the Achilles tendon is a complete or partial tear. This usually occurs during sporting or exercise events, but can occur after falls, tripping, or even just stepping off a curb. Another common injury is tendonosis, where the tendon has evidence of chronic tendonitis and micro-tearing.
What are the symptoms?
Most people describe an audible “pop” and the feeling of someone kicking them in the back of the ankle. Walking and weight bearing is difficult or impossible after this injury, and significant bruising can be seen a few days after injury. Sometimes a gap in the tendon cord can be felt or seen. Achilles tendonitis presents as chronic pain in the tendons, sometimes associated with a bump or bulbous area in the tendon. This is often worse with activity.
How are these injuries treated?
This is controversial. In the case of tendon ruptures, there is research that shows non-operative management in a cast or boot is equivalent to surgery to fix the tendon. This decision depends a lot upon the discussion between you and your surgeon, as well as other variables such as other medical conditions, the condition of the skin near the ankle, etc. As for Achilles tendonitis, most cases can be treated non-operatively in a boot with supervised and directed physical therapy protocols. Rarely surgery to remove the scar tissue in the tendon is required.