Tendons connect muscles and bones and are classified as connective tissues histologically. The Achilles tendon is the body's strongest tendon, capable of withstanding a one-ton tensile load. It connects the calcaneus to the end of the m. triceps surae and is found on the back of the lower thigh. The Achilles tendon has a diameter of roughly 5 millimeters and a length of 5 centimeters. Despite being the strongest tendon in the body, it is unique in that it lacks its own sheath (peritenonia). The anatomy of the Achilles tendon, various pathologies such as rupture and tendinosis, therapy, and activities to reduce Achilles heel problems are all covered in the sections below.
Anatomy of the Achilles tendon
The anatomy of the posterior tibia must be explained in greater detail in order to better comprehend where the Achilles tendon is placed. The superficial region of the posterior tibia is filled with M. triceps surae. This muscle is made up of two large and powerful muscles that allow you to walk. M. gastrocnemius and m. soleus are the muscles in question. M. plantaris grows next to them, however it isn't found in everyone. M. gastrocnemius has two heads, one medial and one lateral. The tendono calcaneus, or Achilles tendon, joins the end tendons of both muscles to form a common heel tendon termed the tendo calcaneus. The calcaneus, or heel bone, is where the tendon is attached. The synovial sac separates it from the top section of the posterior side of the heel bone (bursa tendinis calcanei). Due to frequent inflammation, this synovial sac is clinically relevant, especially in marathon runners.
The strongest plantar flexor, M. triceps surae, pulls the heel and the entire body to the toes. When walking, M. soleus is more active than M. gastrocnemius, and when jumping, M. soleus is more active than M. gastrocnemius. Then there's the m. gastrocnemius of the m. soleus.
What is the difference between Achilles tendonitis and tendinitis?
A chronically inflamed tendon is known as Achilles tendinitis. Tendinosis is a complication of overexertion. The accumulated micro-damage obtained, for example, when executing the same steady movements, sudden jerky movements... contributes to its development. Playing athletics increases your chances of developing Achilles tendon tendonosis. The Achilles tendon is inflamed and causes pain, which is commonly referred to as the "Achilles heel."
The Achilles' heel is a well-known legend. The hero Achilles, according to tradition, had no vulnerable body parts except his heel. Achilles' heel was not dipped into the Styx River when his mother bathed him in the river after which he was to become eternal. Achilles' heel remained the only portion of his body that could be injured. In a figurative sense, the word Achilles heel denotes weakness despite strength, as tendon injuries are highly prevalent, despite the fact that it is the strongest tendon in the body.
Tendoninosis can be classified into the following categories based on where it originated:
Tendon injury at the muscle-tendon transition location is known as myotendinosis.
Tendinosis of the heel bone is also known as Haglund's disease, and it is caused by a protrusion on the heel bone (calcaneus).
The most prevalent sort of alteration is along the tendon itself.
Tendinitis, unlike Achilles tendonitis, is an acute, inflammatory injury that affects athletes the most. Achilles tendon injuries are common in sports that involve a quick change of direction, such as 100-meter runners. Tendinitis can also occur as a result of stumbling or reflex running, such as when crossing a fast, unexpected road.
Tendon tendon tendonosis can be caused by a variety of factors.
Tendonitis is linked to long-term injury caused by jogging, unexpected movements, and insufficient exercise... In addition to these well-known causes, Achilles tendinitis can be caused by:
Lowered foot (pes valgus) - the tendon is constantly stretched towards the medial side of the foot because the heel is in the valgus position. Lowered feet are caused by a deformation of the arches of the feet, causing the entire sole to contact the ground. Not all dropped feet are problematic; in neonates, fatty pads in the legs cause them to be normal. If you participate in sports and have lowered feet, anatomical insoles or shoes may be beneficial, as injuries are more likely in those with canine valgus. Consider quality medical footwear like DrLuigi, which supports the arches of the feet and follows their anatomical structure.
Sporting activities - Achilles tendinitis is significantly more common in athletes, especially in sports that involve quick movement. Short-distance runners are one example, although injuries can occur in any sport that requires running (football, handball, etc.).
Aging - As we become older, our tissues lose their suppleness. The tendon becomes brittle and inelastic when wrinkles emerge on the skin of the face and the skin relaxes. As a result, elderly persons are more likely to develop Achilles tendon tendonosis, particularly if they move quickly and unpredictably.
Injuries are more prevalent on flat running surfaces than on uneven terrain, such as mountainous terrain.
Injuries can be caused by worn sports shoes, which are often overlooked as a risk factor. Sports shoes that have been worn do not follow the anatomical structure of the feet, do not support the arch, and put the wearer at danger of injury. Footwear is crucial not only for foot health but also for overall posture. DrLuigi footwear is an example of useful and comfy footwear.
Increasing the load in training without adjusting the body's response - for example, doing strenuous sports only on weekends when the body has no opportunity to "warm up." These patients are known as "weekend warriors."
Achilles tendon tendinosis, sometimes known as the Achilles heel, does not happen suddenly; rather, the damage builds up over time. Fortunately, we have control over a number of elements such as footwear selection and workout intensity.
Simptomi tendinoze I tendinitisa are two different types of tendinitis.
When walking, jogging, or playing sports in general, a person with Achilles tendon tendinosis will experience pain. The emergence of this pain at the start of the activity, the lowering of discomfort during the activity, and the re-intensification of pain at rest after the activity are all unique features of this pain. There's also morning stiffness that goes away with stretching.
We employ eccentric strengthening exercises and muscle stretching activities to relieve the symptoms of Achilles tendon tendinitis. Follow the instructions below to complete the exercises.
Stretching exercises for the Achilles tendon
Place your hands at eye level on the wall. Instead of a wall, a chair can be used. Step forward with one leg while bending the other at the knee. Stick to the wall by standing on your toes with your leg straight. Lift yourself until you feel a slight stretch in the tendon, but not so much that it hurts. Each time you lift your toes, repeat the exercise five times, holding each posture for 30 seconds each time.
Lifting the toes to stretch the tendon - face the wall with your hands against the wall. Get up on your toes with both feet and hold that position for a few moments. Return to the starting position after 30 seconds and repeat the workout 15 to 20 times more.
Stretching a tendon with the help of a step - this exercise is identical to the previous ones, with the exception that you use a step or another item that raises one foot as well. Place a pad beneath one leg and bend the other leg at the knee, or use a step if it is not too high. Stand on your toes with the front of your foot on the elevation you've chosen and the other leg bent at the knee. Then, leaning on your heel, return to the beginning position. Rep the exercise 3–5 times more. Because the workout is more challenging, stay close to the stairwell wall or handrail.
Exercises to Strengthen Triceps - You should definitely strengthen your triceps in addition to stretching the Achilles tendon, as this will lessen the likelihood of sports injuries.
Elevating the heel when sitting – lifting the heel strengthens the triceps. Take a seat in a chair or on the bed's edge. Spread your legs as wide as possible and elevate your heels as high as possible. Stop when you feel a slight strain and slightly drop your heels. This exercise should be repeated 20 to 25 times throughout the day. 5.6 times is the ideal ratio.
Use an elastic band for this exercise to engage your muscles against resistance. Stretch your legs by sitting on the floor or in bed. Bend the leg at the knee and wrap the elastic band around the heel. Pull the strap towards you and use your heel to push the strap against the resistance. You can do two sets of this exercise if you repeat it 10 to 20 times.
Exercise safety tips
It is vital to exercise regularly, even if no discomfort in the Achilles tendon is present, in order to attain optimal outcomes. Furthermore, it is critical to complete the activities correctly. As a result, exercising under the supervision of a physiotherapist is encouraged, as is seeking expert advice before undertaking the exercises. It is critical to stop exercising if you experience pain. Stretching exercises are conducted until the tendon feels somewhat tightened, however this should not result in considerable sharp discomfort. Stop exercising immediately if you get severe pain. Excessive muscle strain might be harmful to your health.
Gradually increase the amount of time you spend exercising. Never make too many abrupt changes in exercise intensity. This can cause more harm than good, making recovery even more difficult. Take your time and see how things change over time.
Avoid bouncing since quick and fast motions generate fresh micro-damage in the tendon, causing the overexertion syndrome to develop. To allow the muscles to progressively activate, you must exercise slowly.
During exercising, always completely descend your heels to the ground. The Achilles tendon will not stretch enough when lifting the feet if the heels are not dropped, and the exercise will be ineffective.
What are the options for treating Achilles tendon tendinosis?
If the Achilles tendon has ruptured, surgical therapy is the only option. If you have tendinosis, on the other hand, you can still be treated with conservative non-surgical approaches. The following are some examples of non-surgical treatments:
Rest - If discomfort occurs when participating in sports, it is recommended that you stop doing so. Swimming, on the other hand, is not forbidden because it does not put a strain on the tendon.
Non-steroidal anti-inflammatory medicines (NSAIDs) as paracetamol, ibuprofen, and ketoprofen can be acquired without consulting a doctor. It will help to reduce inflammation and soreness. Medications are not a cure-all, although they can be extremely helpful in the case of acute pain.
Cold compresses or ice can help relieve acute acute discomfort. Ice should not be applied directly to the skin since it can cause inflammation. Keep the ice wrapped in a cloth in the hurting place. Ice contains antiedematous (swelling-prevention) and analgesic properties.
Achilles tendinitis, unfortunately, takes a long time to heal. Even with these treatments, pain can linger up to 12 weeks, and if it does not go away after 6 months, surgical surgery should be considered.
Orthotic insoles and footwear
Footwear and orthopedic insoles are particularly important in preventing Achilles tendon injury. Orthopedic insoles can be custom-made in a specific workshop or purchased at a pharmacy based on your foot measurements. Individual insoles made of leather and natural materials avoid excessive sweating and, as a result, side effects like fungal infections. Orthopedic insoles with a slightly elevated heel (approximately 2 cm) and a soft back in the shape of a heel pad are used to treat Achilles heel troubles.
DrLuigi shoes can be customized to the patient's specifications. A three-dimensional scanner is used to do 3d foot diagnostics in collaboration with the Institute of Interdisciplinary Technologies. It is possible to make footwear that is elevated exactly as desired by the patient based on the data acquired by scanning the feet. If you just have a difficulty with the grip of the Achilles tendon on your left foot, for example, you can build shoes with a 2 cm elevation on the left foot and no elevation on the other. DrLuigi takes an individual approach to each person, and in addition to the aforesaid benefits, the wonderful natural materials from which the shoes are constructed are worth mentioning. The shoes have a good breadth, are comfortable, and have a lot of functionality. Walking activates all of the sole muscles since the polyurethane base is flexible and malleable.
The Achilles tendon ruptures (ruptures).
Tendon rupture can occur as a result of erroneous motions, rapid jumping, or an injury sustained while participating in sports. Additionally, due to accumulated damage produced by overexertion syndrome, the tendon may rupture. The so-called "weekend warriors" are frequently affected by ruptures. These are amateur athletes, mostly middle-aged men, who begin training at an excessively high intensity. It is critical to be aware of your capabilities when exercising and to progressively add more demanding workouts. Without preparation, the locomotor system is significantly more vulnerable to new injuries. Tendon ruptures are most common in the spring, when recreational athletes are attempting to shed the pounds gained during the winter.
The therapy for an Achilles tendon rupture is always surgical, followed by a lengthy recovery period. Surgical suturing is used to repair a damaged tendon. The wounded leg is immobilized with a splint for 6 weeks after tendon suturing. Physical therapy follows, which includes a variety of procedures such as electrotherapy, exercises that combine triceps strengthening and Achilles tendon stretching, thermotherapy, medical massage, and so on.
The time it takes to heal completely varies and can extend up to a year.
The patient is referred for surgical therapy after a half-year of ineffective conservative treatment. The tendon is shifted from the thumb to the lower leg if more than half of the tendon tissue is destroyed. Surgical techniques have been developed to the point that the patient has no functional loss following surgery.
Cleaning (debridement of the tendon) is performed if the injury only affects half of the tendon.
The gastrocnemius muscle is lengthened, the tendon from the thumb is transferred, and the tendon is debrided during surgery...
The time it takes for athletes to return to training as intensely as they were before surgery varies on the amount of the damage, and it can take up to a year. Patients usually resume normal activity after a few months.