The achilles tendon is the continuation of the gastrocnemius, soleus and plantaris muscles, and attaches them to the heel (calcaneus). Despite being the largest and strongest tendon in the human body, it does still get injured and can even rupture. Although achilles tendon ruptures are uncommon, there have been four reported in the NFL so far this year. So what leads to an achilles rupture, who is most at risk, and what can we do to prevent them?
Mechanism of Injury
Most achilles ruptures happen without contact from another person/player, and there is usually no warning. People often report the feeling of getting kicked in the back of the leg. In sports, achilles ruptures are commonly associated with sudden loading to the plantarflexor musculotendinous unit, aka the calf muscles. This force is seen when stepping/running backwards, jumping, landing and accelerating or decelerating. Achilles tendon ruptures are most commonly seen in American football, tennis, badminton and jumping/landing.
Risk Factors
Achilles ruptures occur mainly during sporting activities. They are more common in people who exercise or participate in physical activity infrequently and are more often seen in middle-aged men. Fatigue and overuse are also thought to be predisposing factors to achilles tendon ruptures, as is decreased strength in the plantarflexor muscle complex. Having a previous achilles injury, such as achilles tendinopathy (aka tendonitis) may also increase your risk of achilles rupture. Like all tendons in the body, the achilles tendon is difficult to heal due to its poor blood supply. This is why it’s not uncommon for achilles tendinopathies to become chronic or return. When our body heals these types of injuries it uses scar tissue to replace the damaged tissue. Scar tissue has a different composition from our normal, healthy tissue, and can be more prone to injury due to its decreased elasticity.
Prevention
Although we cannot prevent 100% of achilles ruptures there are measures we can take to reduce our risk.
Don’t ignore pain:
Injuries to the foot, ankle achilles or calf can alter your mechanics and change how forces are distributed through the foot and up the kinetic chain. There is some evidence to suggest that a history of achilles tendinopathy increases your risk of achilles ruptures in future. This is likely due to the damage that occurs to the tendon, and if not healed, can leave the tendon vulnerable.
Stretch and warm-up: It is important to warm-up before any physical activity to reduce injury risk. Warm-ups help increase our tissue extensibility as well as increase neuromuscular activation. Cold tissues don’t like jumping straight into explosive-type movements.
Avoid overtraining:
Overtraining increases your risk of injury because you are not allowing your muscles and tendons enough recovery time in between training sessions. Neuromuscular fatigue can cause form or technique failure. Make sure you listen to your body and rest when needed, and gradually increase training volume and intensity.
Recovery after an achilles rupture can be a long road, but with the proper management and rehabilitation, you can still get back to the activities you enjoy. Don’t ignore your pain, get ahead of injuries before they turn into something more severe.
Contact me today if you are struggling with an injury or pain, and get back on the road to recovery!
Crystal Bartkowski, B.A.,B.HPED.,CAT(C)
Certified Athletic Therapist