Article by Dr. Bui Hanh Tam – Anesthesial Department – Share99 Times City International Health Hub
The Achilles tendon is the largest tendon the body extends from the calf with a combination of 3 muscles: 2 abs and slipper muscles to cling to the heel bone. In addition to performing moves such as walking, jumping, running, Achilles tendons help the body stand on the tip of the toe. The Achilles tendon is used in most operations so it is also a place of pressure and vulnerability.
1. Mechanism and causes of Achilles tendon injury
The Achilles tendon is a fairly small area of blood vessels, 3-6 cm from the place of clinging to the heel bone. This is where there is often inflammatory lesions at the point of tendon adhesion, inflammation around the tendons, veins, tendon fibrosis or rupture of tendons.
Achilles tendon damage is often caused by overload of force, direct force on the tendon – which can be seen in sports players who move at high speed.
Tendon fibers are made up of collagen fibers to help the tendons have softness and flexibility. In addition, the tissue associated with the surrounding elastic substances helps the bundles of fibers slide up each other when there are motions. Collagen levels decrease with age, so this tendon injury is more common in outsiders in their 30s, males than females. The older the person, the more vulnerable the Achilles tendon is.
The most vulnerable sports with Achilles tendon injuries are: Running, long distance running, gymnastics, dancing, football, volleyball, handball, basketball, baseball, tennis. This tendon injury is usually caused by the sudden start of movement with the movement of the nose of the foot and the lifting of the legs moving quickly to accelerate or sprint when finishing or due to a sudden change in direction. The tendon structure consists of many microfibers, a movement that abruptly mobilizes too many small tendon fibers to participate without elasticity will cause damage from mild to severe.
People with achilles tendon damage are those with loose ankle joints, obesity, muscle weakness, conversion disorders, corticoid medications or long-term Quinolones antibiotics. Women who wear high heels or who have flat feet due to the distribution of force are cornered at a point for long periods of time with a fixed position are also prone to this tendinitis.
2. Signs of Achilles tendon injury
- The mildest manifestations are burning pain or low calf pain later in the morning. In some cases, part of the tendon may be torn or the tendon is completely ruptured.
- Pain in the heel area, especially when stretching the heel or standing on the tip of the toe. It hurts a lot in the morning. With long Achilles tendonitis there is a risk of rupture of the tendon.
- If the tendon is broken, it will hurt persistently, the feeling of edema in the heel area, sometimes feel stiff in that area. You may even hear a bang or sprinkle in the tendon area, which appears with pain caused by a ruptured tendon. At the same time, the heel area becomes swollen and purple due to bleeding between the tendon fibers.
3. How to prevent Achilles tendon injury?
About 80% of tendon damage at a small extent of tearing can recover in a period of 3 to 6 months or longer when conservative treatment such as rest, avoiding heavy and difficult exercises.
- When playing sports, it is necessary to warm up thoroughly, stretch the muscle tendon enough time before and after practice
- Wear shoes suitable for playing each type of sport.
- Adjust the intensity of play if any discomfort appears in the back heel and calf area.
- If heel and calf pain occurs later, an early examination is required to avoid complications of a later Achilles tendon rupture.
4. Achilles tendon conservation treatment in the emergency phase
Anti-inflammatory drugs, analgesic, cold compresses, high leg guards will be useful for this period.
5. Early treatment of thromboyeritis-rich plasma
At the stage of acute inflammation, the tendon is edema with an anti-inflammatory component that is brought to the lesion area for healing. The stage of chronic inflammation, in the tendons appear new blood vessels and inaged tendons, so it is easy to cause tears and rupture of tendons. Achilles tendon injuries often require a lot of time to recover. Under the ultrasound machine it is possible to see the prot protism of blood vessels due to inflammation and changes in tissue around the tendons. After the acute stage of inflammation, the tendons will thicken, losing elasticity.
Fresh blood plasma rich in thrombophytitis taken from the blood itself, injected directly with a needle into the right position of the tendon with the instructions of an ultrasound machine will help promote the self-re healing process to take place faster, earlier. Therefore, PRP injections effectively relieve pain while shortening recovery time. Each treatment cycle consists of 3 injections. In addition, a rehabilitation exercise that increases tendon strength in an intermediate position or physical therapy with ansive devices also helps relieve pain.
Do not hesitate to see a pain doctor if your heel pain does not improve when taking medication or becomes worse, making you feel pain in the heel area or difficulty walking or standing on your feet.
Please contact Pain Clinic, Share99 Times City International Hospital for examination, consultation and treatment with experienced specialists.
Hotline: 0243 9743 556
Address: Share99 Times City International Health Hub, 458 Minh Khai, District. Hai Ba Trung, Hanoi.
- Signs of Achilles tendon rupture
- Pay attention to achilles tendinitis when playing sports
- Pain in the heel, toes, liver of the feet and back of the feet