The initial treatment of any Achilles injury is extremely important, as proper care and correct treatment now will go a long way towards a full recovery later.
While some sports injuries are severe and require immediate medical attention, the vast majority of Achilles injuries can be treated immediately to speed healing and reduce serious damage.
The Achilles tendon is a soft tissue and like many other soft tissue injuries, requires only the following R.I.C.E.R. regimen of treatment. Apply the following treatments during the initial 48 to 72 hours after the occurrence of the injury.
- Rest – Immediately stop the exercise and/or activity. This is the first and most important step. Pain is the body’s way of telling you enough is enough; listen.
- Ice – Soft tissue injuries, Achilles tendinitis and Achilles tendon rupture included, mean swelling and inflammation. Ice cools and slows swelling. Ice is key in treating any Achilles tendon injury.
- Compression – Gentle pressure on the calf muscle and tendon with a wrap is a good way to help reduce pain and swelling. If it is painful, back off on the compression slightly, but maintain pressure.
- Elevation – Blood flows to a swollen area, so elevate your feet, and the Achilles tendon(s), while recovering.
- Referral – An Achilles injury can range from mild inflammation (tendinitis) to a complete rupture, where the Achilles tendon literally snaps like a rubber band. If your Achilles injury is severe, or you suspect that you may have a complete (or even partial) rupture, prompt medical attention is absolutely necessary. Casting and/or surgery may be required; see a physician immediately.
While recovering, the first 48 to 72 hours are vital to your long term rehabilitation. During this time avoid the following, as each will increase blood flow, swelling and pain. These are:
- Heat – No heat packs, heat lamps, sauna or mentholated rubs.
- Stretching – Avoid all stretching during the first 72 hours.
- Movement or massage – Of course, walking may be necessary, but limit as much as possible.
- Alcohol – Do not drink to excess; good advice for anyone for that matter.
After these first critical hours the Achilles tendon will begin to repair itself with scar tissue. A torn or ruptured tendon does not repair itself with new tendon but scar tissue. This reformation of scar tissue can be very debilitating because scar tissue is more susceptible to injury than the tendon it replaced.
Scar tissue is inflexible and often does not heal neatly. The scar tissue attempts to draw the tendon back to its normal shape, but in the process of regrowing, masses can develop. These masses are sometimes visible under the skin and may even be felt.
Scar tissue is never as strong as the tissue it replaces. Scar tissue also has a tendency to contract and deform tissue, compromising flexibility – a serious drawback for any athlete. Preventing, minimizing and aligning scar tissue will be the topic of a future blog post. But in the meantime, you can learn more about treatment for Achilles tendinitis and Achilles tendon rupture from my comprehensive, 3 part Achilles tendinitis article.
Until next time, stay healthy, keep stretching and God bless.
The Stretch Coach
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