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In Greek mythology, Achilles was the hero killed in the Trojan War as a result of a lingering injury to his only vulnerable spot, his heel. Anatomically, the Achilles tendon connects the calf muscle to the heel, and, though considered one of the longest and strongest tendons in the body, able to withstand 1,000 pounds of pressure, it is the most frequently ruptured.
An injury to the Achilles tendon can range from irritation of the bursa (bursitis) between the heel bone (calcaneous) and the tendon; to tendonitis, an inflammation of the tendon or the tendon sheath; to an actual rupture of the tendon. A ruptured tendon may be the cumulative result of tendonitis.
Injuries to this tendon are common in runners, especially following a dramatic change or increase in exercise routine.
Choosing properly designed athletic shoes, strengthening calf muscles, and increasing exercise gradually can reduce risk of developing this condition.
This type of injury is more common in older age groups.
Bursitis and tendonitis are generally treated with rest, application of ice, and anti-inflammatory medications like ibuprofen.
Physical therapy, stretching, ultrasound, and massage can help to lessen existing symptoms, and prevent additional symptoms.
Orthotics may relieve pain by supporting the affected muscles and maintaining proper foot mechanics.
Surgery is used as a last resort in cases of tendonitis but is sometimes performed to remove the inflamed tendon or a degenerative portion of the tendon.
A ruptured tendon, will require surgery and is followed by six to eight weeks in a cast or brace. Physical therapy to regain strength and motion will follow.
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Pain and irritation at the back of the heel may indicate bursitis or tendonitis. Redness, swelling and discomfort when wearing shoes may also be indicators of irritation at the site of attachment of the Achilles tendon to the heel.
Tendonitis may be indicated by the presence of increasing pain along the tendon above the heel bone during or after exercise. Tenderness in the morning above the heel; stiffness prior to warm-up; and some swelling are additional indicators of Achilles tendonitis.
A ruptured tendon is usually unmistakable; it can be accompanied by an audible snap, severe pain, and an inability to raise up on the toes.
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Experiencing the symptoms described for a ruptured tendon.
Pain, tenderness, or swelling persists after a period of rest and consistent icing.
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A dramatic increase or change in your exercise routine including hill running, stair climbing, additional mileage, or increased speed.
Abruptly starting strenuous exercise after a period of rest.
Insufficient stretching, warm up, or cool down.
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Recovery can be long and slow. Rehabilitation for both a minor or severe tendon injury is required to achieve and complete recovery.
Persistent weakness and/or re-injury is a serious concern in the absence of rehabilitation.
It is possible to re-rupture the tendon, especially if a non-surgical option is chosen.
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About the Clinical Review Team
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