The Achilles’ tendon is the largest tendon in the human body. It is made up of three different muscles and has a different type of sheath than the other tendons – a porous one, allowing blood to flow to the tendon itself. These particularities of the Achilles’ tendon explain in a great measure why its injury is considered one of the most serious ones both by doctors and physical therapists.

How do you know that you have hurt your Achilles’ tendon? In the lighter forms of the injuries, you feel constant pain in the heel and its back. This kind of pain usually signals an inflammation, either of the porous sheath or of the tendon itself. Left untreated properly (i.e. when you only apply topical treatment for pain relief), the inflammation may get worse over time and lead to rupture – the most serious form of Achilles’ tendon injury that leaves patients unable to walk properly, run or climb stairs.

Stage 1 – Diagnose

If you believe that you have suffered an Achilles’ tendon injury, it is very important to seek medical attention immediately and not attempt to put further stress on the injured leg. As explained above, even intermittent pain in the heel may signify an injury of the Achilles’ tendon, so do not self-treat the pain, ignoring its cause.

The most common test performed by doctors to determine a clear diagnosis is called the Thompson test: you will be asked to lie on your stomach, while the examining doctor will squeeze your calf. In healthy individuals, this action will result in a flexion of the foot. If your tendon is injured, your foot will not produce this response.

Stage 2 – Treatment

Depending on the severity of the case, the doctor may recommend either surgery or non-surgical treatment. The most common form of treatment is surgery, which is a routine procedure for medical professionals. It is the first choice for treatment in young, active athletes, and healthy individuals which do not suffer from conditions which pose a high risk in case of surgery.

Achilles’ tendon surgery can be either open or closed. Open surgery involves an incision allowing the surgeon to see the tendon clearly. Closed surgery is performed through several small incisions.  However, in both situations a cast or postoperative boot is applied on the injured leg to allow complete healing without risk of renewing the injury.

Stage 3 – Recovery

Once your doctor confirms that your injury has healed and you may begin the recovery phase, you should contact a physical therapist, who will develop a specific routine to regain mobility in your ankle. The purpose of the recovery plan after Achilles’ tendon injury is to strengthen the tendon again, and to recover the mobility and stability in walking and running.

The most common types of physical therapy are:

Stretching – Stretching and flexibility routines are essential for a complete recovery. Your therapist will start with light routines, and progressively increase their complexity until you achieve complete mobility in your ankle.

Deep massage – Professional massage therapy is aimed at stimulating blood flow, helping your muscles and tendons recover, and preventing further injuries.

Throughout the treatment and recovery procedures, it is extremely important to follow your doctor’s and therapist’s recommendations and not attempt any kind of physical effort involving the injured leg. Achilles’ tendon injuries are some of the most serious types of running injuries and, if untreated properly, may leave you unable to run properly and unable to put your full body weight on your leg.