Tendons are strong fibrous cords that attach muscle to bone and allow the skeletal system to function. It is the Achilles tendon that allows the muscles of the leg to bend and stabilize the ankle joint, maintains balance while walking, running and jumping and works with the nervous system so individuals know where their feet and body are in space. With overuse, or poor muscle support, the Achilles tendon can become irritated and inflamed, resulting in pain and swelling.
Anatomy
The Achilles tendon connects the calf muscle to the heel bone. The calf muscle comprises two sides, a lateral gastrocnemius and a medial gastrocnemius. The top of the tendon connects to the bottom of both sides of the calf muscle, running down the back of the lower leg and connecting at the heel bone. At the point of the heel bone, the Achilles tendon inserts on both sides and the rear of the bone.
Function
According to physicians at the Center for Orthopedics and Sports Medicine in Atlanta, Georgia, the gastrocnemius muscle and Achilles tendon are crucial to the ability to walk, jump and rise up on the toes. As the gastrocnemius muscle contracts it moves the attached Achilles tendon, pulling up the heel bone. This points the toe downward, an action necessary for walking. A tear, inflammation or rupture of this tendon will significantly reduce the ability of an individual to walk or climb stairs.
Injuries
Injuries to the Achilles tendon require attention to prevent chronic damage or rupture that can require surgical intervention. According to the Cleveland Clinic, tendonitis begins with inflammation of the lining around the tendon and can lead to inflammation of the tendon itself. These situations are caused by overuse or increased stress on the tendon. According to researchers from British Columbia who studied 109 runners with Achilles tendonitis, excessive pronation of the foot produces a whipping action of the tendon that contributes to micro-tears in the tendon and the inflammatory response. Virtually all of the cases in this study appeared to be the result of structural or dynamic problems with joint mechanics.
Treatment
Researchers at the British Columbia Sports Medicine Clinic discovered active treatment protocols were required to establish more normal mechanical functioning of the joint, muscles and tendons and prevent recurrence of the injury. Customized foot orthotics are able to improve the biomechanics of foot action and reduce the potential for further injury. In most cases non-surgical intervention will include rest, ice, non-steroidal anti-inflammatory medications, stretching and exercise. In cases where the tendon has ruptured, the American Academy of Orthopedic Surgeons believes that surgery may be required to remove damaged tissue, and either repair the remaining tendon or transfer another tendon from the foot to help support the Achilles tendon.
Prevention
Athletes who perform actions requiring repetitive motion in the Achilles tendon, such as running, jumping or climbing, can prevent or reduce the potential for developing Achilles tedinitis. Athletes should increase their activity slowly, keep the calf muscle stretched and evaluate the need for orthotics to correct any biomechanical issues.
