Imagine that while you are playing cricket, running, or climbing stairs, you suddenly hear a 'tuck' sound from the back of your leg, just above your heel, and you feel unbearable pain. Or do you always feel tightness and pain above your heel when you get out of bed in the morning? The main reason for this could be a problem with your Achilles Tendon. Although we have all heard that this injury occurs in athletes, in reality anyone can develop this condition. So today, let's talk about the Achilles, which is one of the strongest and most important tendons in our body.
What is this Achilles Tendon?
Simply put, the Achilles tendon is a strong band-like structure on the back of your leg, just above your heel. It connects your calf muscles to your heel bone (calcaneus). It is also known medically as the ``Calcaneal tendon''.
Now you might be wondering, "What is a tendon?" A tendon is a very strong, flexible band of tissue that connects a muscle to a bone in our body. It's like a rope. They're found all over our bodies.
This tendon got its name from a very interesting story. In Greek mythology, there is a hero named Achilles. The only weak spot on his body was this part above his heel. He was killed by an arrow that hit there during a battle. That's why this tendon got its name.
What is the main function of the Achilles tendon?
The Achilles tendon is what helps the calf muscles move your foot and ankle. Think about what happens when your calf muscles contract. Then this Achilles tendon pulls up and lifts your heel. In other words, it works like a lever. When the muscle contracts, the tendon pulls on the bone, causing it to move.
Many of the things we do every day are essential to this Achilles tendon.
- While walking
- While running
- When jumping
- When climbing the stairs
- When you stand on your tiptoes
Your Achilles tendon is the main thing that works in all of these activities. So now you understand how important it is, right?
Where is this tendon located? How big is it?
The Achilles tendon starts in the middle of your shin bone. From there, it runs down your leg and attaches to your heel. You have two of these tendons in each leg.
The Achilles tendon in an adult is usually between 15 and 26 centimeters (6-10 inches) long. Most importantly, it is the thickest and strongest tendon in our body. It is so strong that it can withstand a force of about four times your body weight.
What is the Achilles tendon made of?
This strong tendon is made up mainly of two types of proteins.
1. Collagen: This is the most abundant protein in our body. Collagen makes up about a third of the total protein in the body. It provides the strength needed for tendons.
2. Elastin: This is what gives the tendon its stretchiness. It is this elastin that helps the tendon stretch and return to its original shape when we move.
This tendon receives its blood supply from two blood vessels in the lower leg. Its sensation and function are controlled by two nerves, the sural nerve and the tibial nerve.
What are the most common injuries to the Achilles tendon?
The Achilles tendon is a common injury, especially among athletes. However, it is also common among the general population. Here are some of them.
| Injury Name | Simply put... |
|---|---|
| Tendinitis | Swelling, redness, and pain occur due to overuse or stress of the tendon. This is an inflammatory condition. |
| Achilles tendon ruptures/tears | A complete or partial tear of a tendon. This can happen in an accident or when excessive force is applied. It is accompanied by a sharp pain with a "pop" sound. |
| Heel bursitis | Swelling of the fluid-filled sac called the bursa between the tendon and the heel bone. This causes pain in the back of the heel. |
| Haglund's deformity | An extra bone spur develops at the back of the heel bone, where the Achilles tendon attaches. This can put pressure on the tendon and cause pain. |
How does a doctor diagnose this disorder?
When you go to see a doctor with this kind of pain, the first thing he or she will do is carefully examine your lower leg, foot, and ankle. He or she will ask you about your symptoms.
- When did the pain start?
- What were you doing before the pain came?
- When does the pain increase?
Your answers to questions like these can help the doctor get a better idea of the disease.
In addition, special physical tests, such as the Thompson test, may be performed to check for a torn tendon. To confirm the diagnosis, one or more of the following tests may also be performed.
- X-ray
- Ultrasound scan
- MRI Scan (Magnetic Resonance Imaging - MRI)
- CT scan (Computed Tomography - CT) scan
These scans can clearly see the condition of the tendon and surrounding tissues.
How is an Achilles injury treated?
The type of treatment you need will depend on factors such as the type of disability you have, its cause, and your normal activity level. Your doctor will prescribe the treatment that is best for you.
Remember, not everyone needs surgery. In most cases, this condition can be managed with simple treatments.
Here are some common treatments used for these disorders.
| Treatment Method | What happens to it? |
|---|---|
| The RICE method | This is the most basic treatment. Rest , Ice , Compression , Elevation . This will reduce pain and swelling. |
| Medication | To reduce pain and swelling, your doctor may prescribe painkillers such as NSAIDs. In some cases, they may also prescribe anti-inflammatory medications such as corticosteroids. |
| Immobilization | You will be given a special brace or walking cast to keep your leg immobile until the tendon heals. |
| Physical therapy | Under the guidance of a physical therapist, perform special exercises that strengthen the muscles around the tendon and increase flexibility. |
| Orthotics | Using special shoe inserts that fit inside the shoe and provide support for the foot and ankle. These can be made to fit your foot. |
| Surgery | Most people do not need surgery. However, in severe cases, such as a complete rupture, surgery may be required to reattach the tendon. |
Can this type of disorder be prevented?
Sometimes it's hard to prevent injuries from accidents like falls or jumps. But in general, you can follow these steps to reduce your risk.
- Wear the right protective equipment: Wear the right shoes that protect your feet, depending on the sport or job you are doing.
- "Don't play with the pain": If you feel pain during or after exercising, don't ignore it and continue doing it. Give your body a break.
- Rest and recovery: After strenuous activity, give your body the time it needs to recover.
- Before and after exercise: Warm up well before exercising. Stretching, especially of the Achilles tendon, can greatly reduce the risk of injury. Also, cool down after exercise.
Can you walk even if you have damaged a tendon?
This is a question that many people ask. Yes, you may be able to walk and move your ankle even if the tendon is torn or damaged. But it can be very painful and uncomfortable.
The most important thing is, even if you are able to walk and put weight on your leg, if you have even the slightest suspicion that you have an Achilles tendon injury, see a doctor immediately.
If you continue to use your leg and put weight on it, the injury may get worse. Until you see a doctor, it's best to use a support such as crutches if possible.
Does the Achilles tendon heal on its own?
Some people may find that minor pain can be reduced by changing the type of shoes they wear and avoiding activities for a while. However, don't assume that the condition will go away on its own without treatment.
If you start to feel pain above your heel, especially if the pain is severe and accompanied by a popping sound, see a doctor without delay.
The Achilles tendon is like a hero who serves our body very well. Therefore, it is our responsibility to take good care of it. If you experience pain, do not ignore it and seek proper medical advice. Then you can recover quickly and return to your normal activities.
Take-Home Message
- The Achilles Tendon is the strongest tendon in the body, essential for all your movements, such as walking, running, and jumping.
- If you have pain, stiffness, or swelling in the back of your leg, above your heel, it could be an Achilles problem.
- If you experience a sudden, severe pain with a popping sound, it could be a tendon rupture. In such cases, seek medical attention immediately.
- Don't ignore the pain. Don't just assume, "This will go away in a little while," but definitely see your doctor and get proper advice.
- Warming up and stretching before exercise can significantly reduce the risk of these types of injuries.
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