The Achilles tendon is the most powerful in the human body and can withstand colossal loads. It connects the calf muscles and the calcaneus, which is why it is also called the calcaneus tendon. With intense sports training, this part of the body is at great risk of injury, the most common of which is the Achilles tendon strain. Fibers wear out and break down. A sharp pain pierces the leg, it swells, and the skin color changes. If these symptoms appear, you should immediately consult a doctor. In order to understand the nature of the injury, it is recommended to undergo ultrasound, MRI, and X-ray.
Trauma features
The Achilles tendon is made up of very strong fibers of dense structure. They are not elastic enough, therefore, during injury, they are prone to stretching and tearing. This is especially true for active athletes who train regularly.
Thanks to this tendon, we can:
- Run.
- Jump.
- Walk the steps.
- Toe up.
The Achilles tendon in the musculoskeletal system serves as the main tool for raising the heel during physical activity, it is formed by two main muscles: soleus and gastrocnemius. If they contract abruptly, such as when running, exercising, or hitting, the tendon can break. That is why athletes warm up this muscle group before starting training. If this is not done, then a "cold start" will occur, in other words - unprepared muscles and tendons will receive a load an order of magnitude higher than they can accept, which will lead to injury.
Sprains are an occupational disease for all athletes, dancers, fitness instructors and other people whose lives are associated with constant movement and stress.
The clinical picture of injury
A stretching of the Achilles tendon is accompanied by an unpleasant crunch and sharp pain in the ankle, it can be so severe that the victim may faint from pain shock. Almost immediately, a tumor appears in this place. When a large number of fibers break, it compresses the nerve endings, and the pain intensifies.
Symptoms of a stretch depend on its severity and may include the following:
- hemorrhage or gradually developing extensive hematoma;
- increasing swelling from the ankle to the ankle;
- the occurrence of a failure in the posterior calcaneal region with complete detachment of the tendon;
- lack of motor ability of the foot.
© Aksana - stock.adobe.com
© Aksana - stock.adobe.com
During the initial examination, the traumatologist evaluates the degree of damage by feeling and rotating the foot. Such manipulations are very painful, but can help determine the extent of damage to the ankle.
First aid for stretching
With a foot injury, in no case should you engage in self-diagnosis and self-medication. Incorrectly selected methods and, as a result, a non-consolidated tendon will not allow you to fully engage in sports and will give a feeling of pain and discomfort for a long time. If an injury is found, you must immediately call a doctor or take the victim to an emergency room.
Before the appearance of a specialist, the leg must be immobilized and a splint should be applied, trying to do this with an extended toe. If you do not have the necessary tools at hand, you can use an elastic bandage to fix the limb, and place a dense roller under it to ensure the outflow of fluid.
© charnsitr - stock.adobe.com
To relieve pain, use:
- Anti-inflammatory tablets (Nise, Diclofenac, Nurofen and others) and antihistamines (Tavegil, Suprastin, Tsetrin, and so on). If they are not at hand, you can take any pain relievers (Analgin, Paracetamol).
- Crushed ice pack or special medical cooling pack. The first or second must be wrapped in cloth to avoid hypothermia of the limb. The duration of exposure should not exceed 15 minutes per hour.
- Alcohol treatment of the edges of wounds in case of damage to the skin and a sterile bandage to protect it from infections.
Diagnostics
Only a doctor (traumatologist or orthopedist) can determine the severity and diagnose a tendon injury during the initial examination of the limb. As a rule, an X-ray is done to the victim in order to exclude or confirm the presence of a fracture. If there is no fracture, then it is recommended to do an MRI or CT scan in order to understand how seriously damaged the fibers, blood vessels, nerves and tissues.
© Aksana - stock.adobe.com
Rehabilitation
The length of the rehabilitation period will depend on how badly the tendon is damaged. In any case, the victim is assigned orthopedic linings in the form of a special boot with a three-centimeter heel. These braces help reduce the stress on the tendon, and can also improve blood circulation in the back of the foot and speed up the healing process.
For pain relief, doctors prescribe anti-inflammatory pain relievers in the form of gels or ointments. This treatment is used for mild sprains. They relieve swelling, improve cell regeneration, relieve pain, prevent complications and relieve inflammation.
Although the foot is firmly in place, it is necessary to train and strengthen the ankle muscles. Physical therapy will help with this. Classes begin gradually. To begin with, the patient alternately relaxes and strains the muscles, with a positive dynamics of treatment, more complex exercises are used - turns, alternating toes and heels when walking, squats.
In addition, recovery includes methods of physiotherapy, which are discussed in the table.
| Physiotherapy procedures | Clinical effect and principle of action |
| UHF therapy | The site of the injury is exposed to electromagnetic fields with an oscillation frequency of 40.68 MHz or 27.12 MHz, which promotes cell regeneration and improves blood circulation. |
| Magnetotherapy | It consists in the effect of a magnetic field for the speedy healing of injury. It has a strong analgesic effect. |
| Ozokerite and paraffin therapy | Ozokerite and (or) paraffin is applied to the damaged area in several layers. This promotes prolonged heating of tissues, which stimulates the flow of nutrients to the injured tissues. |
| Electrophoresis | The Achilles tendon is exposed to constant electrical impulses to enhance the effect of drugs. Anesthetics, chondroprotectors, calcium solutions and anti-inflammatory injections are used. |
| Electrostimulation | By influencing the tendon of a pulsed electric current, the restoration of the tone of the gastrocnemius muscle is accelerated. |
| Laser therapy | Low-intensity laser radiation leads to an increase in temperature in the injured tendon, elimination of edema and bruising. It has anti-inflammatory and analgesic effects. |
Operative intervention
For serious injuries, such as a complete rupture of a tendon, surgery is required. For this, incisions are made over the site of damage, through which the damaged fibers are sutured. After that, the wound is processed and sutured, and a splint or plaster is applied over it.
The operation can be open or minimally invasive. Open surgery leaves a long scar, but its advantage is excellent access to the injury site. With minimally invasive surgery, the incision is small, but there is a risk of damage to the sural nerve, which will lead to loss of sensitivity on the back of the foot.
Complications
If the degree of stretching is light enough and surgery is not required, then the risk of complications is minimal. The main thing is not to expose the limb to intense loads and to postpone training, where legs are involved, for a while.
After the operation, in rare cases, the following complications may occur:
- Infectious contamination.
- Damage to the sural nerve.
- Long-term wound healing.
- Necrosis.
The indisputable advantage of the surgical method of treatment is the reduction in the risk of repeated rupture. Self-fused fibers are more susceptible to new damage. Therefore, with such injuries, people who are inextricably linked with sports, it is better to have an operation than to wait for the tendon fibers to grow independently.
Stretch healing time
The speed of healing of injuries of the Achilles tendon depends on many factors: the severity of the injury, the age of the victim, the presence of chronic diseases, the speed of seeking medical attention, and the quality of first aid.
- With mild stretching, healing occurs rather quickly and painlessly, the fibers are restored in 2-3 weeks.
- The moderate severity of damage with rupture of almost half of the fibers will heal from 1 to 1.5 months.
- Postoperative restoration of fibers with their complete rupture will last up to two months.
Athletes should remember that even with mild tendon injury, it is important to reduce the load on the limb, thereby preventing the problem from worsening.
