什么是跟腱损伤?

The Achilles tendon is a fibrous band of tissue that links the muscles in your calf to your heel. The strength and flexibility of this tendon are important for jumping, running, and walking. Your Achilles tendon bears a lot of stress and pressure during everyday activities, 在运动和娱乐活动中也是如此. If it becomes inflamed, swollen, and irritated, it's called tendonitis. 

什么导致跟腱损伤?

跟腱损伤可由以下原因引起:

Tendonitis

肌腱炎可能是由于过度使用或该区域受损所致. It can cause pain down the back of your leg and around your heel. You might notice that parts of your tendon are getting thicker and hardening because of tendonitis. 如果你不治疗，情况会变得更糟. 肌腱炎主要有两种类型:

• 非插入性跟腱炎. Small tears in the middle fibers of your tendon start to break it down. 这会引起疼痛和肿胀. 这种类型的肌腱炎通常影响活跃的年轻人.

• 插入性跟腱炎. This damage occurs in the spot where your tendon meets your heel bone. 骨刺(额外的骨骼生长)通常与这种类型形成. This type of tendonitis can happen at any age, even in people who aren't active.

Rupture

The tears in your tendon fibers can cause a complete or partial break (or tear) in your tendon. You might hear a pop that seems to come from the back of your heel or calf. This may be a tendon rupture, which needs immediate medical attention.

跟腱炎:Q&A with Dr. Nigel Hsu

- Watch on YouTube

Dr. Nigel Hsu answers common questions about diagnosis and treatment of Achilles tendinosis.

跟腱损伤要点

• 你的跟腱会发展成肌腱炎. 这是当它变得发炎，肿胀和刺激.

• 跟腱也会撕裂或断裂, which might sound like a pop that seems to come from the back of your heel or calf. 这需要立即就医.

• 任何人都可能患上跟腱损伤 and it’s often linked to repetitive stress on the tendon.

• 跟腱损伤通常会引起疼痛, stiffness, 在你腿后部靠近脚跟的地方肿胀.

• Achilles tendon injuries can be treated with rest and medicines to help with the inflammation. 锻炼也有帮助. 如果需要，可以通过手术来修复肌腱.

• You can help prevent these injuries by doing things like increasing activity slowly, 穿合适的鞋子参加活动, 不要在凹凸不平的地面上锻炼.

谁有跟腱损伤的风险?

任何人都可能患上跟腱损伤. 它们通常与重复性压力有关. 最常见的风险因素有:

• 增加:活动或运动增加的量或强度

• 开始一项新的运动

• Tight calf muscles when starting an exercise or sport, which can place more stress on your tendon

• 脚后跟有骨刺，会摩擦跟腱

• 运动时穿错了鞋

• 在不平坦的地面上锻炼

• 用抗生素氟喹诺酮治疗

跟腱损伤的症状是什么?

肌腱损伤的常见症状包括:

• 腿后部或脚跟附近疼痛

• 当你活动时疼痛会加重

• 刚起床时跟腱僵硬酸痛

• 运动后第二天肌腱疼痛

• Swelling with pain that gets worse as you're active during the day

• 肌腱增厚

• 跟骨上有骨刺

• 难以弯曲受影响的脚

• A pop sound and sudden sharp pain, which can mean a ruptured tendon

如何诊断跟腱损伤?

Injury to the Achilles tendon causes pain along the back of your leg near the heel. Sometimes healthcare providers misdiagnose Achilles tendon injuries as sprained ankles. It’s important to get the right diagnosis so you can get the right treatment. Several common injuries can make your Achilles tendon painful or prevent it from working well.

Your healthcare provider will consider the following when making a diagnosis:

• 你的整体健康和病史

• 你的症状描述

• A physical exam of your Achilles tendon to check for bone spurs, pain, and swelling

• A test to see if you can move your ankle correctly (range of motion)

• 成像测试，如超声波、x射线或MRI. An X-ray shows bones and can show bone spurs and if the tendon has become calcified or hardened. Your provider will usually use MRI to see how severe the tendon damage is and what treatment is best for you.

跟腱损伤如何治疗?

治疗取决于你的肌腱受伤的严重程度. 它可能包括:

• Rest

• Ice

• Nonsteroidal anti-inflammatory drugs for pain relief, such as ibuprofen or naproxen

• 加强小腿肌肉的特殊锻炼

• 物理治疗

• 偏心力量训练. This type of exercise helps strengthen your calf muscles to take pressure off your tendon

• 低影响的活动，比如游泳

• Heel lifts in shoes, orthotic shoes, cast, splint, or a walking boot

• 体外冲击波疗法. This treatment uses high-energy shockwave impulses to help stimulate the healing process in damaged tendon tissue. 这种治疗方法并不常用. However, your healthcare provider may recommend it to see whether you can improve without surgery

If these treatments don't work or if the injury is severe or complete, surgery may be considered. The type of surgery depends on the location and amount of damage to the tendon. It can also depend on other things, such as the severity of the tendonitis. 使用的一些外科手术包括:

• 延长小腿肌肉的手术(腓肠肌后缩)

• Surgery to remove damaged tendon tissue or bone spurs and repair the tendon (debridement)

• 手术切除你受损的肌腱组织, 固定剩余肌腱, and give it extra strength by moving another tendon to the heel bone

跟腱损伤有哪些可能的并发症?

跟腱损伤的并发症包括:

• 疼痛，可能很严重

• 行走困难或不活跃

• 肌腱区域或跟骨翘曲

• 肌腱再损伤断裂

Other complications can happen because of the treatments used to care for an Achilles tendon injury. For instance:

• 有时注射可的松会导致肌腱撕裂

• 手术会导致疼痛和感染

如何预防跟腱损伤?

以下步骤可以帮助你防止跟腱受伤:

• Warm up before exercising, playing sports, or other repetitive movements.

• 慢慢地增加活动，而不是一下子全部增加.

• 穿适合你活动的鞋子.

• 不要在凹凸不平的地面上运动.

• 停止导致疼痛的活动.

• Be aware of the risks of fluoroquinolone and exercise with caution if you’re taking this medicine.

如何处理跟腱损伤

• Follow your healthcare provider’s advice to get rest and manage pain and swelling.

• 选择其他积极的方式.

• Try low-impact activities that don't place a lot of stress on your tendon, 比如游泳或骑自行车, 而不是像跑步这样的高强度运动.

• Always let your healthcare provider know if these strategies don’t help reduce pain, swelling, 以及功能丧失.

我应该什么时候给我的医疗保健提供者打电话?

Call your healthcare provider right away if you hear a pop sound and have sudden pain in the back of your leg or heel. Otherwise, schedule an appointment if pain or trouble moving affects your regular daily activities.