If you remember Greek mythology, you’ll remember Achilles, the warrior hero who fought in the Trojan War. When he was a baby, his mother dipped him into a sacred river, which rendered him almost impervious to injury.
I said, almost…
Because she had to hold him by the heel, the waters of the river were unable to cover that part of his body, making that his only “weak” area. Achilles was ultimately killed by an arrow that struck his “Achilles heel.”
Achilles tendon injuries don’t just happen to high level athletes and runners. They can affect literally anyone, and the injury can result from many different causes.
Most people associate Achilles tendon ruptures with sporting activities – football, soccer, baseball, basketball; sports that involve running and jumping. Many have heard it is a “weekend warrior” injury. While this is in large part true, because most recreational athletes don’t pay enough attention to stretching and keeping “limber” which causes a “tight Achilles tendon” and increases risks of injury, this injury can occur from climbing ladders and stairs, or merely stepping the wrong way.
What is the Achilles tendon?
Tendons connect muscles to bones, mainly so these muscles can make body parts move. The tendon is connected to the calf muscle and this mechanism causes the foot to point down, useful in jumping and “pushing off” when running.
What does is feel like when the Achilles tendon ruptures?
Most people describe a sensation as if someone just “kicked” them in the back of the leg/ankle; a sudden snap or “popping” followed by pain and difficulty walking.
Diagnosis can be made in different ways. The most common method of diagnosing a ruptured Achilles tendon is by direct physical examination. With the person lying on his/her stomach, the calf muscle is compressed or squeezed.
If the tendon is intact or not fully ruptured, this squeezing will cause the foot to point downward, called plantar-flexion. If the tendon is indeed totally ruptures, the foot will not move. This is called the Thompson Test.
MRI examinations can also help in more difficult diagnosis situations. Additional examination usually confirms the presence of a distinct “depression” over the location of the rupture.
Symptoms and treatment
In addition to the popping sensation felt at the time of injury, difficulty walking with weakness in the push off stage of your gait pattern. Additionally, there may be the inability to stand on your tip-toes on the affected side. Pain and swelling over the back of the ankle is usually present as well.
Many years ago, the standard treatment consisted of casting of the foot and ankle in a plantar-flexed (foot pointing downward) position in hopes of placing the opposing ends of the tendon close enough to heel. Typically the foot had to be placed in such an extreme amount of plantar-flexion that making a cast “walk-able” was a challenge.
Surgical repair is another common treatment option. The opposing ends of the tendon are re-attached and protected after surgery for upwards of 12 weeks, with limited and gradual restoring of motion along the way. In cases of partial rupture casting, or the use of these relatively new “walking boots” is a widely utilized treatment option. So, if you walking along, minding your own business and feel a pop, you may well have suffered what Achilles the Warrior suffered, but without the arrow and, you lived to tell about it.
Get it checked out, sooner rather than later…
Did you know?
Every time you step forward, you use 54 muscles (No wonder I get tired so quickly…)
Chisholm’s expertise in nursing, orthopedics and surgery spans more than 30 years. For more information on orthopedic-related topics, visit www.bone-and-joint-pain.com. Submit questions or comments to Ken at
Achilles tendon injuries can affect literally anyone, and the injury can result from many different causes. Photo courtesy of the Journal of the American Association of Physician Assistants (J.A.A.P.A.)