The Achilles is a large thick tendon that attaches your calf muscle to your heel, and is the strongest tendon in the body. The calf muscle is one of the strongest muscles in the body. Due to the fact that it has to support a player’s entire body weight, the achilles becomes one of the most stressed tendons. For football players, it is a very commonly injured tendon due to repetitive stresses placed on it daily. Whether you are a lineman that requires power off the line, or a wide receiver that relies on speed, quickness, and the ability to quickly change direction, the Achilles plays an integral part in controlling a body in motion, as well as adding stability to the ankle. Any injury to this tendon, will limit function and performance on some level, regardless of a players position.
Function of the Achilles
The Achilles tendon is a thick connective tissue that connects the gastroc muscle (calf) to the heel bone. The calf muscle is one of the strongest muscles in the body, which when contracted, places a great amount of stress on the Achilles tendon. It is the most stressed tendon in the body, because it has to support a player’s entire body weight. Without this tendon, the gastroc muscle would not be able to generate any power. It also helps to stabilize the ankle joint for activities such as running, jumping, landing, and overall balance.
Types of Achilles Injuries
Tendonitis – Tendonitis is an inflammation of the tendon, usually due to overuse. It causes localized pain, sometimes swelling, and difficulty with activities such as running and jumping. If severe enough, it may cause pain while walking or even standing. Return to play – varies, about 2-4 weeks (Difficult to predict due to pain levels and tendon healing. It can be very difficult to treat at times. Anti-inflammatory medications are often used. Cortisone injections are rarely used at this site, due to the possibility of tendon ruptures)
Grade I = Mild strain; few tendon fibers torn; mild tenderness; minimal if any swelling;
treated with conservative therapy. Return to Play – about 1-2 weeks
Grade II = Moderate tearing of fibers (<50%); pain and tenderness; varying degrees of swelling and
bruising; unable to walk, run, or jump without pain; weak (may be unable to perform a heel raise);
usually treated with conservative therapy. Return to Play – about 4-6 weeks
Grade III = Complete rupture of tendon (hear a pop or feel a “shot” to the calf); initial pain; s
swelling; unable to generate any power to push off toes with walking, running, or jumping; Surgery
needed to repair. Return to Play – 1 Year
For non-surgical cases, it is difficult to give an exact time for return to play. Pain, healing potential, and strength play a large role in a player’s recovery. The severity of the player’s symptoms dictates their ability to return to play. Physical Therapy is the most common treatment for tendonitis and strains. The focus is to reduce any swelling, promote tissue healing, restore motion, and return the player to full strength. The player must be able to perform a single leg heel raise for 10-15 repetitions without pain or weakness, run, jump, and any other position specific activity, before returning to play. Most players will be spatted (tape around outside of the cleat), for added support on the field.
For surgical cases, it will take one year from the date of surgery to return to full contact. The player will undergo physical therapy during this time, reaching certain bench marks of recovery throughout the year. The surgeon will dictate the rehab protocol, depending on the procedure used to repair the tendon. Occasionally, a player may return after 9 months, but again, will most likely be a lineman, who isn’t required to cover much yardage each play. Wide receivers, cornerbacks, and running backs would have a difficult time retuning before one year.
All time frames are based on prior player’s ability to return to sport. Player desire and MD assessment may alter these time frames.