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Named after the eponymous Greek hero, the Achilles tendon bridges the calcaneus (heel bone) and the gastrocnemius and soleus (calf muscles). It is the body’s strongest and biggest tendon, a ring of fibrous tissue that, in essence, lets you stand on your toes whenever you move.
Also known as the calcaneal tendon, the Achilles tendon draws the heel bone once the calf muscles flex. This is because it inserts into the heel bone.
Tiny fluid-filled sacs known as bursae pad the Achilles tendon.
Achilles tendon diseases and conditions
For all your well-meaning healthy lifestyle exercises, the Achilles tendon is susceptible to injury during physical activity. It can easily be torn because of its short supply of blood and the tremendous pressures exerted on it.
An Achilles tendon tear can be tiny, merely a “microtear.” It can likewise be big, limiting movement and causing immense pain and swelling. Once it ruptures completely, the Achilles tendon would make a certain popping sound. An Achilles tendon rupture always necessitates surgery and weeks-long immobilization of the ankle joint.
Habitual walking and running can slowly inflame the Achilles tendon, leading to tendinitis or tendonitis. A stiff sensation in the back of the heels and pain always accompanies this condition. If the inflammation occurs some inches above heel, the condition is called a peritendonitis.
There are cases when the Achilles tendon thickens over time, apparently without getting inflamed. This abnormal thickening, called tendinosis, renders the tendon weak and vulnerable to tearing or injury. Aging or excessive activity of the tendon is often to blame.
You may also experience pain at the back of the heel when you have an Achilles bursitis. This condition occurs when the bursae become irritated, especially by low-riding footwear.
Treating Achilles tendon conditions
Achilles tendon injuries are mostly dealt with using RICE, to mean Rest, Ice (applied on the local area), Compression (with bandage), and Elevation. Patients may alternate ice and heat therapy to treat bursitis.
Meantime, the patient may take over-the-counter pain relief medicines such as ibuprofen, acetaminophen and naproxen. For more severe pain, prescription drugs may be requisite.
However, surgery is the only resort in treating out-and-out Achilles tendon ruptures. After surgery, the ankle should be immobilized for several weeks thereafter. In this view, a caste or a special boot may be required.
Nevertheless, certain stretching exercises can help a compromised Achilles tendon recover. If anything, these exercises make for a good healthy lifestyle routine.
On the whole, investing in good footwear prevents Achilles tendon injuries. Buy shoes that support your feet well. If nothing in the market suits you, you may have orthotics, heel lifts, braces and splints personalized to your needs.
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Tests for Achilles tendon conditions
Determining tendinopathy conditions, i.e. tendinitis and tendinosis, generally need no more than physical examination. Achilles tendon problems manifest themselves outwardly with pain, thickening or discoloration in the heel.
One kind of physical exam, better known as the Matles or knee flexion test, involves lying face down and bending the knee to a certain angle. If the patient has an Achilles tendon rupture, the end of his or her foot must not aim away from the leg.
In another, the Thompson test, the patient is made to kneel on a chair or turn over on his stomach. The doctor then squeezes the calf of the patient. If the end of the foot does not reflexively move from this action, an Achilles tendon rupture may be on hand.
To be accurate, the doctor may order for a computed tomography (CT) scan of the ankle. However, a magnetic resonance imaging (MRI) scan is a more accurate test to identify Achilles tendon ruptures.
Ultrasound can give sound wave-generated images of the Achilles tendon, making it another good test for ruptures. In contrast, a basic X-ray cannot diagnose Achilles tendon conditions, although it can spot anomalies in the ankle joint.