Sports Injuries: The Achilles Tendon

The Achilles tendon in the lower body is very important. It's a key component in the movement of the foot, and therefore crucial for participation in different sports.

The Achilles tendon is known for its distinctive name and for its strength. It’s located in the lower part of the leg and ankle. The capacity for moving the foot depends greatly on this tendon. Do you know what kinds of injuries can occur in your Achilles tendon?

Those who participate in sports that involve running are generally aware of the possibility of injury to their Achilles tendon. Recovery from this can be a long process. A rupture in a soccer player, for example, might leave him or her out of the game for months.

We usually mention tendons to refer to the parts of the musculoskeletal system that connect bones with muscles. The Achilles tendon connects the muscles in the back of the calf to the heel bone. From outside, it appears as a thick fibrous cord that runs down the back of your ankle to the back part of your heel.

This anatomic structure can become inflamed, degenerate over time, suffer from inflammation from surrounding areas, or can even snap. As we’ll see below, some of these injuries of the Achilles tendon are not as serious. However, others may even need surgical intervention to heal.

Causes of injuries in the Achilles tendon

One notable aspect of sports injuries in the Achilles tendon is that these can occur either because of overuse or because of a lack of use or training. That is to say, there might be two different people with the same injury, for instance. One might be an elite athlete, while the other might be someone who plays occasional recreational sports.

When the tendon is overused, you run the risk of it becoming inflamed and rupturing. And on the other hand, if someone almost never plays a sport, and then out of the blue overdoes it, they could injure their Achilles tendon by a sudden increase in stress on the tendon from movements that they’re not used to.

Past traumas are also a cause of injuries. An accidental kick from behind, a blow that destabilizes the foot and makes it twist, or a trip over an obstacle are all potential causes of injuries in the Achilles tendon. This can happen either at that moment or in a future time of stress on the tendon.

What about aging as a cause of injury? Well, the risk is relative. However, it’s a known fact that from 30 years of age and onward, tendons start to degenerate faster.

This is exactly what a publication in Acta Ortopedica Mexicana (from 2007) explains. The tendons become stiffer and more susceptible to injuries with age. This means you should take more precautions, above all making sure you have good, appropriate shoes.

The most common injuries in the Achilles tendon

Let’s see what potential injuries there are for the Achilles tendon when someone is playing sport. Apart from the obvious, a complete rupture, there are also other less known complications that you should be aware of.

Tendinitis

Tendinitis is the inflammation of a tendon. When the Achilles tendon becomes inflamed, fluid accumulates. Where is the classic appearance point of this condition? It’s generally in the part of the tissue that’s closest to the heel bone.

Tendinitis is painful and can cause a decrease in the function of the tendon. It’ll be hard to move the foot, and if you touch the area, the pain can be intense. Tendinitis can progressively worsen, which means the athlete might not take much notice if the pain isn’t bad at the start. If they continue training as per normal, the tendinitis will become worse.

Treatment is based on immobilization. A cold compress or ice pack can help at the beginning of treatment. Using anti-inflammatory medication is another option, depending on the severity of the injury. Recovery usually involves manual physiotherapy, and sometimes ultrasound therapy can help too.

Non-insertional Achilles tendinopathy

Although it’s not the same as tendinitis in the strictest sense, non-insertional Achilles tendinopathy is somewhat similar. Symptoms include pain, swelling, and being tender to the touch, besides having limited movement. However, one difference is that the pain will subside when you rest.

The problem with it is that tendinopathy reoccurs. This is annoying for an athlete and can force them to change routines to adapt or to limit the length of training sessions.

What are some options for recovery? Well, tendinopathy doesn’t respond well to anti-inflammatory medicines, and surgery is only a last resort. So, the treatment generally includes supplements that can strengthen the tendon tissue. Some of these supplements might be hyaluronic acid and essential fatty acids.

Rupture of the Achilles tendon

The worst-case scenario of injury is a rupture of the Achilles tendon. This can happen when the tendon is stretched beyond its capacity. When this occurs, the tendon can partially or completely snap.

If the rupture is only partial or small, surgery may not be necessary, but this isn’t always the case. In general, the recovery process requires some surgical intervention to artificially join the two ends of the tendon. What’s more, the surgery can’t wait more than a week after injury for it to be successful.

Recovery can be slow and implies a lot of rest and physiotherapy. This process is explained in detail in the publication Mexican Magazine of Physical Medicine and Rehabilitation. It notes that the Achilles tendon is large and needs time to heal and return to normal.

Achilles tendon injuries in sports

Proper treatment for sports injuries to the Achilles tendon is very important. In professional practice, these injuries represent a constant preoccupation. This is due to the time of inactivity and the length of recovery involved. And of course, recovery isn’t completely guaranteed.

Surgical techniques have improved, however, and physio-therapeutic treatments have too. The success rate of recovery is higher today than it was decades ago. And of course, progress has been made in the field of sports medicine. All of this combines to provide athletes with the information they need so that they can progressively return to training.