Tendons act as connectors between muscles and bones. For example, the Achilles tendon is a primary connector in the foot, lying just between the calf muscle and heel bone. Each tendon consists of numerous individual collagen fibers that provide flexibility and support for joints. If enough of these collagen fibers are damaged, a tear may develop.
Several of the individual collagen fibers may weaken and fray, ultimately resulting in a visible tear along the tendon. This may occur directly from excessive force caused by injury or trauma. A tendon may also tear gradually over time from repetitive motion. Consequently, individuals involved in high-impact sports or activities that require repetitive motion, such as running and tennis, are at a higher risk of experiencing torn tendons.
Once a tendon is torn, complications like tendonitis or tenosynovitis may develop. Tendonitis is characterized by swelling of the tendon accompanied by tenderness and reddening of the skin. Tenosynovitis is characterized by inflammation of the tendon sheath, known as the synovium. Both of these complications are mild and typically abate with proper rest and care.
A mild tear or fray in the tendon will usually heal over time. If swelling is present, ice or cold packs applied to the surrounding skin in short intervals—10 to 15 minutes—will reduce swelling and pain. Nonsteroidal anti-inflammatory drugs, or NSAIDs, can also be taken to reduce swelling. The foot should be elevated above the level of the level of the heart. Compressing the foot in a cast or athletic tape will limit involuntary movement and decrease the likelihood of movement-related pain. The foot should be used as little as possible to expedite the healing process.
If a tear completely severs the tendon, it is known as a rupture, in which case surgery is required to reattach the two broken ends of the tendon. After surgery is complete, a cast is typically fitted to keep the foot immobile. A surgeon may also prescribe some level of post-surgery physical therapy to restore mobility to the foot.
Adequate footgear is imperative for individuals involved in strenuous physical activity. Shoes that fit properly should be worn at all times during sports. Pain or tenderness in the feet lasting longer than several minutes should be investigated.