BY DENA FLORCZYK
Editor’s Note: In the final installment of a monthly series on common sports injuries, Dr. Dena Florczyk, from the Arthur Ashe Student Health and Wellness Center, discusses Achilles tendon injuries.
The Achilles’ heel is named after the mythological Greek warrior Achilles. Having received a prophecy of her son’s death, his mother dipped him into the River Styx to protect him from harm, but while doing so she held on to his heel, thus rendering the area weak as it was untouched by the water.
During the Trojan War, Achilles was struck in the heel by an arrow, and died. The moral of this story is that the Achilles tendon or Achilles heel is a vulnerable part of the body.
The Achilles tendon, which connects the calf muscles to the heel bone, is the largest tendon in the body. It is critical for walking, running and jumping activities.
Most commonly, Achilles tendinitis occurs due to an overuse injury. Symptoms include swelling and tenderness, pain when rising onto your toes or stretching the calf and tendon.
Achilles tendinitis can occur with a rapid increase in training, running on hills, using running cleats or switching to shoes with less heel lift or decreased heel cushioning. Additional risk factors for development of Achilles tendinitis include having tight calf muscles or flattened arches of the feet.
An Achilles tendon can tear suddenly, especially when performing strenuous and explosive motions such as sprinting, jumping or pivoting. A complete tear of the Achilles tendon can result from an acute injury, chronic tendinopathy or the combination of these two.
Many patients describe feeling as if they were struck violently in the back of the ankle and experience a pop followed by severe acute pain. With a complete tear of the Achilles, you will be unable to point your toes or lift your heel off the ground, making walking difficult.
A partial tear of the tendon may improve with conservative measures, such as rest and physical therapy, but a complete tear warrants a surgical consultation.
Initial treatment of Achilles tendinitis includes resting from aggravating activities, placing ice packs on the heel for 10 to 20 minutes every four to six hours and taking a non-steroidal anti-inflammatory medication, such as ibuprofen (Motrin, Advil) or naproxen (Aleve).
Other treatments may include using a heel lift insert for your shoe, wearing shoe inserts for flat feet or overpronation or, in severe cases, using a boot or cast to allow the tendon to rest.
During recovery from Achilles tendinitis, changing your activity – such as switching from running to swimming – may be helpful. It is also recommended to work on the strength and flexibility of the calf muscles and muscles on the bottom of the foot.
In some cases, working with a physical therapist can help with recovery and return to activity.
You should see your health care provider if your heel pain persists despite the above measures, if you are unable to return to your previous level of activity due to pain or weakness or if you are unable to bear weight or walk due to your heel pain.
Dr. Florczyk is a sports medicine physician at the Arthur Ashe Student Health Center.