Do you have an Achilles Injury?
Achilles tendon injuries used to be the stuff of nightmares for a footballer. A snap at the back of the ankle would mean a season write off – or even the end of a career.
THE START: Andy Cole checks some discomfort at England training. Achilles tendon injuries are a problem.
The Achilles is one of the body's longest tendons. It connects the calf [gastrocnemius & soleus] muscles to the heel bone [calcaneus].
Pain at the back of the ankle or lower calf can signal Achilles trouble.
- Heavy or changed training schedule intensity
- Change in playing surface - soft (grass) to hard (astro) and vice versa
- Calf muscles that are tight or weak
- Pronation - foot rolling inward
- Ankle instability
- Regular wearing of raised footwear can shorten the Achilles tendon
- Decreased blood supply to tendons with age can make them injury prone
- Feet with high arches are linked with Achilles tendinopathy risk
- A leg-length difference can cause extra load on the Achilles tendon
AND RUN: The Achilles tendon is used for jumping & explosive sprinting.
What to look for
• Localised Achilles pain, particularly in the lower calf where the tendon and muscle tissue meet
• Swelling and stiffness of the tendon more noticeable in the morning
• The area is tender when touched, feels warm and appears red
• Reduced strength in the lower leg and/or ankle
• Ankle range of motion is reduced with difficulty when flexing
• Presence of a Haglund's deformity, a bony formation on the back of the heel (also called a "pump bump")
PAINFUL MATCH BREAK: David Beckham ruptured his Achilles playing for AC Milan.
Confirming the problem
Doctors may order diagnostic imaging to get a detailed view of the tendon or to rule out other conditions.
Magnetic resource imaging (MRI) provides detailed views of the Achilles tendon. It can reveal tendon thickening or micro-tears in the tendon linked to tendinopathy or partial Achilles tendon ruptures.
Ultrasounds give a still view or when the tendon is moving. Ultrasound testing is used with colour Doppler effects to assess whether the Achilles tendon is vascular or has blood flow (blood does not flow to the Achilles tendon in an uninjured state).
X-rays are not used to diagnose damage to tendons. However, they do help to find hard bone problems that can cause Achilles pain. Examples are bone spurs or stress fractures.
AGONISING DIAGNOSIS: Scans show damage to soft tissue like muscles, ligaments & cartilage.
Achilles problems are usually quite noticeable and the player will feel them, however, to get a clear understanding of how serious the injury is, a physician needs to be consulted.
Recovery after an Achilles injury takes time. Whichever method is used following the treatment, a player would then need intense training sessions to get the flexibility back in the tendon and more importantly, the strength back in the muscles.