Ruptures of the Achilles Tendon

A rupture of the Achilles tendon is one of the most devastating injuries an athlete can suffer.   Although it is not as common as lesser conditions like tendonitis, it is much more difficult to treat. Achilles tendon injuries are not entirely avoidable, but there is much that can be done to reduce your chances of suffering such problems.

First, it is necessary to understand the anatomy of the area.  The tendo calcaneus (Achilles tendon) is the thickest and strongest tendon in the human body.  It is approximately 15 cm long and begins in the mid-aspect of the calf and extends distally (towards the foot) to its insertion on the heel bone (calcaneus).  It actually consists of three separate muscles which join together to form the strong muscular group that is responsible for pushing the foot downward to provide the “push-off” for propelling the body forward.  This is area is especially important in sports such as squash where a rapid push-off is required. When this tendon ruptures, it is a major cause of concern.

This injury usually occurs in males, although it certainly occurs in females as well.  It most commonly affects people in the 30-50 age group, but can cross all age groups.  Unfortunately, it particularly affects athletes, and will occur as they are pushing off or in the ready position anticipating forward movement.  Usually, the athlete will feel a sudden pain in or just below the calf, and due to the sudden nature of the pain and the sensation of a direct blow, turns around to see who hit them.   The sudden pain stops play immediately and medical attention should be sought without delay.

The medical and surgical treatment of this issue is controversial at times.  Treatment is difficult and there is no one simple answer to the problem.  The leg can either be operated on or casted for a prolonged period of time, and there are proponents of both types of treatment.  However, in either case, there is a long period of immobilization of up to ten weeks with a long and arduous course of physiotherapy.  Surgical repair is most commonly advocated for the more distal (lower) injuries which are closer to the insertion on the calcaneus (heel bone).   Often, at higher levels of competition, it is considered a career-ending injury even with of vigorous surgical or casting treatment.  Although the athlete is able to recover, they rarely attain the high level of sport which they were at prior to the injury.

The best thing to do with Achilles Tendon ruptures is to avoid them in the first place.  This can be done with stretching exercises prior to the workout.  All stretching exercises, whether they are done for the Achilles tendon or for any other muscle group in the body, should be done with the speed of a glacier; that is to say that they should not be rapid twisting motions or pumping motions up and down.  The affected area should be put in a stretch and then held for 15 seconds just below the feeling of discomfort. This promotes flexibility as well as protecting the tendon from injury.

By far the best treatment of this injury is prevention itself, and although the stretching exercises take a few minutes of time, they are well worth the effort and should be part of every athlete’s warm-up to avoid this devastating injury.