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The Achilles tendon is a tough band of fibrous tissue that connects the calf muscles to the heel
bone (calcaneus). The Achilles tendon is also called the calcaneal tendon.
The gastrocnemius and soleus muscles (calf muscles) unite into one band of tissue, which
becomes the Achilles tendon at the low end of the calf. The Achilles tendon then inserts into the
calcaneus. Small sacs of fluid called bursae cushion the Achilles tendon at the heel.
The Achilles tendon is the largest and strongest tendon in the body. When the calf muscles flex,
the Achilles tendon pulls on the heel. This movement allows us to stand on our toes when
walking, running, or jumping. Despite its strength, the Achilles tendon is also vulnerable to
injury, due to its limited blood supply and the high tensions placed on it.
Overuse
Problems with the feet. An Achilles tendon injury can result from flat feet, also known as
fallen arches or overpronation. In this condition, the impact of a step causes the arch of
your foot to collapse, stretching the muscles and tendons.
Achilles tendon injuries are common in people who participate in these sports:
Running
Gymnastics
Dance
Football
Baseball
Softball
Basketball
Tennis
Volleyball
You're more likely to tear an Achilles tendon when you start moving suddenly. For instance, a
sprinter might get one at the start of a race. The abrupt tensing of the muscle can be too much for
the tendon to handle. Men older than age 30 are particularly prone to Achilles tendon injuries.
Pain along the back of your foot and above your heel, especially when stretching your
ankle or standing on your toes. In tendinitis, pain may be mild and worsen gradually. If
you rupture the tendon, pain can be abrupt and severe.
Tenderness
Swelling
Stiffness
Difficulty flexing your foot or pointing your toes (in complete tears of the tendon)
To diagnose an Achilles tendon injury, your health care provider will give you a thorough
physical exam. He or she may want to see you walk or run to look for problems that might have
contributed to your Achilles tendon injury.
Rest your leg. Avoid putting weight on your leg as best you can. You may need crutches.
Ice your leg. To reduce pain and swelling, ice your injury for 20 to 30 minutes, every
three to four hours for two to three days, or until the pain is gone.
Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down
swelling.
Elevate your leg. Prop you leg up on a pillow when you're sitting or lying down.
Use a heel lift. Your health care provider may recommend that you wear an insert in your
shoe while you recover. It will protect your Achilles tendon from further stretching.
Usually, these techniques will do the trick. But in severe cases of Achilles tendon injury, you may
need a cast for six to 10 weeks, or even surgery to repair the tendon or remove excess tissue.
You can move your leg as easily and freely as your uninjured leg.
You feel no pain in your leg when you walk, jog, sprint, or jump.
If you start pushing yourself before your Achilles tendon injury is fully healed, you could wind
up with permanent pain and disability.
Always stretch your leg muscles and Achilles tendons before and after exercise -- more
often if your muscles and tendons are tight.
Stop exercising if you feel pain or tightness in the back of your calf or heel