Achilles tendon injuries are common injuries in physically active individuals, especially athletes. Achilles tendon injuries have a significant impact on a person's mobility and performance. Therefore, it is important to understand the role of physical activity and exercise in the occurrence of these injuries.
The Achilles tendon is a tendon located at the back of the leg and is the largest tendon in the human body. This tendon connects the calf muscles ( gastrocnemius and soleus muscles ) with the heel bone ( calcaneus ). The Achilles tendon plays an important role in foot movement, especially activities that involve plantar flexion (the downward movement of the foot). These tendons produce the strength and thrust needed to walk, run, jump, and perform other physical activities. Apart from that, this tendon also plays a role in maintaining balance and stability of the legs when standing. Achilles tendon injuries often occur due to a sudden upward movement of the leg that is in the lower position.
Symptoms and Examination of Achilles Tendon Injuries
The most common symptoms are pain in the heel and weak leg movements, especially downward movements, making it difficult to walk. Patients also hear a sound when this tendon is injured/severed. Other symptoms include swelling and bruising in the area above the heel and a palpable gap at the severed part.
To confirm the diagnosis of Achilles Tendon Injury, an examination is usually carried out by a doctor which is confirmed by supporting examinations such as ultrasonography (USG), X-ray and MRI.
Types of Achilles Tendon Injuries
There are two types of injuries that commonly occur in the Achilles Tendon:
- Partial Achilles tendon injury
The tendon was partially damaged, but not completely severed.
- Total (complete) Achilles tendon injury
The tendon completely breaks, separating the calf muscle from the heel bone. These injuries often require more serious medical intervention and may require surgery.
Risk Factors for Achilles Tendon Injury
Several factors can increase the risk of Achilles tendon injury, including:
- Age
More common in individuals over the age of 30 years.
- Intense physical activity
Sports and physical activities that involve jumping, running or turning quickly can increase the risk of injury (football, basketball, tennis, badminton, volleyball, sports involving jumping and long distance running).
- Lack of warm-up and stretching
Inadequate warm-up and stretching can cause stiff tendons to become susceptible to injury.
- Unbalanced muscle strength
An imbalance between the strength of the calf muscles and the surrounding muscles can affect the load received by the Achilles tendon. Weakness or lack of flexibility in these muscles can increase the risk of injury.
- Genetic
Some individuals may have genetic factors that make them more susceptible to injury.
- Sudden increase in duration and intensity of exercise.
- Wearing inappropriate shoes.
- History of consumption or injection of certain drugs.
Prevention of Achilles Tendon Injuries
The correct way to exercise is very important in preventing Achilles tendon injuries. Some steps you can take to prevent injury include:
- Warmup
Includes muscle and tendon stretching movements to prepare the Achilles tendon for more intense movements.
- Strength and flexibility training
Perform special exercises aimed at strengthening the calf muscles, increasing flexibility, and increasing leg stability.
- Gradual increase in intensity
Avoid increasing exercise intensity suddenly. Give the Achilles tendon time to gradually adapt to heavier loads or more intense movements.
- Correct movement technique
Learn and apply proper movement techniques in your sport or physical activity.
- Exercise duration
Prolonged sports activities without adequate rest can cause fatigue in the Achilles tendon and increase the risk of injury.
- Use of protective equipment
In some sports, proper use of protective equipment can help prevent injury. For example, using shoes with additional cushioning and support in the heel to reduce the load on the tendons.
Management of Achilles Tendon Injuries
- Conservative approach
Rest: Can provide sufficient time for the tendon to recover and avoid activities that stress the Achilles tendon. - Surgical approach
Indications and surgical procedures: In some cases of Achilles tendon injury, especially injuries/complete ruptures, a surgical approach is required. The surgical procedure involves reconnecting the tendon or using a donor/ tendon graft from another part of the body to strengthen the injured area. Postoperative recovery involves immobilization with a special cast or brace that allows the tendon to heal optimally. - Physiotherapy and rehabilitation
Has an important role in the recovery of Achilles tendon injuries. It involves specific exercises aimed at strengthening the muscles around the tendon, increasing flexibility, and improving movement coordination. A physiotherapist can provide guidance in carrying out an appropriate rehabilitation program and gradually introduce movement and weight training. Post-operative physiotherapy and rehabilitation aims to restore strength, flexibility and normal function to the Achilles tendon.
Conclusion
It is important to remember that an Achilles tendon injury can have a significant impact on the health and function of the foot. Therefore, injury prevention through attention to physical activity and proper exercise is essential for individuals participating in such activities. If an injury occurs, appropriate treatment, such as a conservative approach or an operative approach can help improve recovery and reduce complications.
Article written by dr. Rudi Hadinata, M.Ked, Sp.OT (K) Hip & Knee (Specialist in Orthopedics & Traumatology, Hip & Knee Consultant at EMC Cibitung Hospital).