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Achilles Tendon: Overview, Conditions, Treatments, Injury Prevention

Overview and anatomy

The Achilles tendon is a thick tendon located in the back of the leg. It connects the gastrocnemius and soleus muscles in the calf to an insertion point at the calcaneus (heel bone). It is the strongest tendon in the body and allows people to push off while walking, running and jumping.

Achilles injuries can occur in several places, but the most common area is at the muscle-tendon junction – the area where the calf muscles join with the tendon. Injuries in this area often heal on their own but may do so slowly than injuries in the muscular area of the leg, since there is less of a blood supply to promote healing.

Illustration of lower leg, labeled to show the gastrocnemius muscles of the calf, the soleus muscle and the Achilles tendon.

Conditions and issues

Chronic, long-lasting Achilles tendon disorders range from overuse injuries that cause inflammation or degeneration, to acute traumas such as Achilles tendon ruptures. Pain along the back of the ankle or in the heel are often the result of distinct problems along the course of the Achilles tendon or at its point of attachment to the heel of the foot. This type of pain may also be caused by retrocalcaneal bursitis, which is sometimes called Achilles tendon bursitis. Learn about more specific Achilles tendon conditions in the articles shown below.

Treatments

Most people who have injuries and inflammation related to overuse of the tendon undergo nonsurgical treatments. These can include:

  • rest or other modification of activities
  • physical therapy (rehabilitation)
  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
  • (for some patients) platelet-rich plasma injections (also known as PRP injections)

In rehabilitation, a physical therapist or athletic trainer may employ ultrasound, electrical stimulation, cold therapy (icing) and massage to promote healing. They will also teach the patient specific stretches and strength training exercises to regain function and prevent future problems.

Less often, patients who do not benefit from these therapies may require surgery.

Achilles tendon injury prevention

Since a lack of flexibility is a major cause of injury, proper stretching of the lower leg is the most basic way to prevent Achilles tendon strains or tears. As is the case with many other conditions injuries, it is important to stay as fit as possible during the healing and rehabilitation process. Swimming and other non-impact exercises are best, including bicycling, if that activity does not cause any pain (which would indicate a liklihood of reinjury). Running should be avoided at all costs until a rehabilitation specialist, trainer or doctor advises that sufficient recovery has taken place.

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