The Achilles tendon is a band of tough tissue that connects the calf muscles to the heel bone. It helps with walking by raising the heel off the ground. The Achilles tendon is prone to disabling injury. It withstands forces of up to 12 times body weight during sprinting. Contributing factors to injury include ignoring the initial pain or discomfort, sudden increases in training and excessive heel cushioning in the heels shoes.
RICE
Rest, Ice, Compression and Elevation help reduce inflammation and pain and reduce the damage to collagen fibers in the Achilles tendon. The American College of Foot and Ankle Surgeons recommends that patients who treat the injury in the early stages use these treatment protocols to reduce further damage and get an athlete back to practice and performance as soon as possible.
Training Modifications
Dr. Stephen Pribut, from Podiatric Medicine and Surgery in Washington DC, recommends cutting back on training and workouts in the initial stages of treatment. Runners should not run on hills and should cut back on any speed work to decrease the workload on the Achilles tendon. Depending on an athlete's previous training level and severity of the injury, this rest may mean stopping all running or cutting back by half.
Correcting Predisposing Factors
Predisposing factors for an Achilles tendon problem include poor foot mechanics, the wrong shoes, poor stretching and over training. In their book, "Clinical Sports Medicine," Peter Brukner and Karim Kahn caution athletes to take great care when evaluating these factors. Even if the Achilles tendon has healed, it will continue to be injured when the athlete returns to the field if these factors have not been eliminated. Treatment should include a structured stretching and strengthening program and an evaluation of foot mechanics to ascertain the need for orthotics.
Night Splints
Using a night splint to keep the foot in a neutral position at 90 degrees helps to stretch the Achilles tendon during the night hours, according to the American College of Foot and Ankle Surgeons. During the night hours, the foot extends, causing the Achilles tendon to shorten as the toe points. This is normally a comfortable position, but when the Achilles tendon is injured, this shortening can extend the time necessary for rehabilitation.
Oral Medications
In some instances, oral anti-inflammatory medications are helpful to reduce the inflammation and pain. The American College of Foot and Ankle Surgeons recommends the use of ibuprofen or other non-steroidal anti-inflammatory medications in the early stages of healing to reduce pain and swelling.
Physical Therapy
Physical therapy for an Achilles tendon injury includes a biomechanical evaluation of the foot and gait, stretching and strengthening programs at the right intervals and ultrasound therapy to help speed healing. According to Dr. Pribut, a sports medicine therapist may also recommend a small heel lift initially. This helps reduce the workload on the tendon since it will not completely stretch during walking.
