Achilles tendon injuries
The Achilles tendon is a thick fibrous tissue that connects the calf muscles (gastrocnemius, soleus, and lesser known plantaris) to the heel (calcaneus). The Achilles tendon plays a crucial role in absorbing load and transferring energy from your foot to your leg as you stand, walk, jog, run, and jump.
The most common Achilles injuries are tendonitis/tendinosis and tendon ruptures.
Insertional tendonitis/tendinosis: occurs where the tendon inserts on the bone. This is often accompanied by bone spurs and can be acute inflammation or chronic irritation.
Non-insertional tendonitis/tendinosis: pain above the insertion point, usually 2-6 cm above the heel. This type is more common in dancers, runners, and athletes who play sports involving sprinting, jumping, and cutting.
Tendon ruptures: full tear of the tendon, usually 2-6 cm above the bone. This most often occurs with quick loading of the tendon in athletes between the ages of 30-40.
Some risk factors include previous ankle injuries resulting in ankle instability, decreased calf strength, improper footwear, arch structure, obesity, diabetes, use of corticosteroids, overtraining or quick increase in running mileage or plyometric training.
Like most injuries, treatment for Achilles injuries depends on the nature and severity of the injury. Because tendons have less blood supply than bone and muscle, it can take weeks to months to fully recover. In most cases, tendonitis/tendinosis responds well to physical therapy and conservative treatment for 3-6 months while Achilles ruptures almost always result in surgical intervention and a 9-12 month recovery time.
The best injury prevention includes a deep dive into your personal risk factors, developing a training or running protocol that allows for proper intervals and rest, finding shoewear for your foot structure, and balancing calf flexibility with calf strength and power.
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Medina Pabón MA, Naqvi U. Achilles Tendinopathy. [Updated 2023 Aug 17]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538149/