The Achilles Tendon & Tendonitis.

The Achilles tendon is a fibrous band of tissue that connects the heel of the foot to the muscles in the back of the lower leg. These muscles are often referred to as the ‘Calf muscles’. The muscles of the legs are considered to be some of the most powerful muscles in the human body. The Achilles tendon is the strongest & thickest of all tendons from head to foot. On contraction of the calf muscles a pulling action is exerted on the Achilles tendon. This contraction action lifts the heel upwards and pushes the forefoot downward (foot plantarflexion). The resulting effect (if occuring simultaneously L+R) is that of standing on tiptoes. Plantarflexion is the main push action of running, or jumping. The Achilles tendon is subjected to a person’s entire body weight just prior to the swing of that leg. Depending upon speed of movement, stride length, additional weight being carried or pushed, the Achilles tendon could be subjected to somewhere between three and twelve times the person’s body mass. The subjected load is commonly higher during a short distance sprint or push off to begin such a sprint.

Tendons.
Tendons are commonly strong bands of non elastic connective tissue. They are very fibrous and can be variable in length. They connect muscle to bone. Tendons are considered to be the body’s highest strength connective tissue. Tendons consist of layers of elongated cells and collagen fibers. The collagen fibres are layered very closely together. The layers run in parallel to the direction of force applied on the tendon. The collagen fibres (fibrils) are arranged into small bundles of fibres (fascicles) which are infiltrated with blood vessels and nerves.

Causes of Injury.
Overuse.
Misalignment.
Poor footwear support.
Medication side effects (Injectable Corticosteroids) and/or accidents can all result in tendon injury.
Multiple causes acting simultaneously can cause/contribute to very severe levels of Achilles injury.

Footwear Proper functional footwear can be proven to be very significant in preventing injury. Proper footwear can also aid in the recovery time after an injury. In order to prevent the reoccurrence of Achilles injuries again footwear palys a central role. Simply put improper footwear can cause or exacerbate existing injuries. Selecting the proper sports shoes or ‘trainers’ in terms of support and cushioning of the arch of the foot is always of great benefit. Great results are often achieved when the footwear is capable of controlling excess foot pronation. Many patients experience significant relief and benefit from some extra padding / soft filler in below the liner of the shoe (right under the heel area). Short term heel padding/heel lifts help reduce the length that the Achilles tendon has to reach from Calf muscle to heel bone insertion. People commonly find Anti-pronator shoes of referred to as ‘Motion control’ shoes extremely helpful. Some others require foot orthotics. Foot orthotics are individually custom made foot supports. Foot orthotics commonly control excessive ankle motion (Sub-Talar Motion) and do not protrude up out of the shoe. Orthotics are designed specifically for individuals left and right. Their individaul requirements of foot control are based on the needs of their feet activities and footwear. In some more extreme situations a brace may be required to immobilise an injured tendon.

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           Foot Health Matters is a HCPC Registered Podiatry Practice in South Belfast. Northern Ireland BT10 0DR Tel: 028-90-611619.