June 16, 2018

Did I Tear My Achilles

By: Susan Leung

Physiotherapist

Achilles Tendon Tears

First, Kobe Bryant tears his Achilles tendon in 2013. And just a few months ago, it was announced that Marcus Decousins had done the same. What is happening to all these NBA stars? What is the Achilles tendon? Is there something that can be done to prevent these terrible injuries if I’m a basketball player? Well, you have just landed yourself on the right blog. Prepare to be enlightened.  

The Achilles Tendon

We have talked about tendons in the past, click here for a refresher on tendons.

We have a few calf muscles: the gastrocnemius and soleus. The gastrocnemius muscles are primarily responsible for plantarflexing the ankle (pointing the ankle down into the ballet pointe position) with the knee is straight, and secondarily helps to bend the knee. The soleus, on the other hand, is found deeper to the gastrocnemius; it primarily causes plantar flexion of the ankle while the knee is bent, and secondarily helps to stabilize the knee. The Achilles tendon itself can absorb and store potential energy, which can later get released to help us perform plyometric movements. And since basketball is such a fast-paced sport with a lot of lateral cutting, jumping, and quick sprints up and down the court, it’s no wonder why so many basketball players end up with ankle and Achilles tendon injuries.

Individuals who have Achilles tendonitis or tendonosis are more likely to develop either a partial or complete Achilles tear. Check out our previous blog post on tendonosis and tendonitis if you are unfamiliar with said terms.

Preventing an Achilles Tear

There are a few factors which may increase ones’ risk of developing Achilles tendonitis – poor calf strength and ankle dorsiflexion range of motion (Mahieu & Witvrouw & Stevens & Van Tiggelen & Roget, 2006). Therefore, it may be wise to incorporate gastrocnemius and soleus strengthening exercises into your current strengthening routine if you’re looking to prevent an Achilles injury from occurring. Examples of these may include standing heel raises with the knees straight, as well as standing heel raises with the knees bent. The next progression would be to complete the exact same movement off a step to allow your heel to drop below the level of your toes. This allows for greater dorsiflexion to occur at the ankle joint, thereby creating more tensile stress along the entire length of the Achilles tendon. Such stresses will cause microtrauma within the tendon itself, which will later manifest itself as a stronger tendon. Please note that this eccentric strengthening approach may be particularly useful for someone who is in the subacute or chronic phase of heeling.

Clinically Diagnosing an Achilles Tear

If you have a full thickness Achilles tendon tear, the above-noted exercises will not be appropriate for you. Most individuals may often recall hearing loud ‘pop’ at the time of injury, followed by the inability to bear weight or rise-up on their heels during gait. The Thompson test is often used to help diagnose a tear, where the patient is laying on the stomach and we squeeze the calf to see if the ankle goes into a downward motion. If the ankle does not move at all, then the likelihood of a tear is increased.

Therefore, it is important to seek timely care to resolve your Achilles pain before it manifests to become a full-blown tear. You may not want to procrastinate on this one if you play sports that involve a lot of quick bursts of movement. If you have already tried these exercises and still experiencing symptoms in the Achilles tendon, then book an appointment and let us get you back to your usual self!

References

Mahieu, N. N., Witvrouw, E., Stevens, V., Van Tiggelen, D., & Roget, P. (2006). Intrinsic risk factors for the development of achilles tendon overuse injury. The American Journal of Sports Medicine. Available at: http://journals.sagepub.com/doi/abs/10.1177/0363546505279918

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