So You Want to be a Fitness Trainer: Don't be a heel. Protect your Achilles !

Achilles was a mythical Greek warrior. According to legend his Mother dipped her infant son in the River Styx that separates the world of the living from the world of the dead. The river's sacred water made him invincible in battle. The Mother didn't want the poor kid to get swept away and drown so she held him by his heel. The heel did not get the effect of the river's power. Achilles was a fierce and indestructible fighting machine. However during the Trojan war an arrow shot into his heel killed him. That is why a person's weakness is often referred to as their Achilles Heel.

Muscle attaches to a connective tissue known as tendon. Tendon is a fibrous link attaching the muscle to a bone.

The Achilles Tendon is the thickest tendon in the human body. It is also known as the heel cord or the calcaneal tendon. This tendon attaches the the muscles of the rear lower leg - the Plantaris, the gastrocnemius (calf muscle) and the soleus - to the heel bone also known as the calcaneus.
These muscles, through the tendon attachment, pull the foot away from the ankle in a movement known as plantar flexion. Standing up on the toes and lifting the heels is an example of
plantar flexion.
Any forward, backward or upward propulsion of the body involves plantar flexion and its opposite movement dorsi flexion in which the toes are pulled towards the shin.
The anatomy and location of the Achilles tendon make it a key cog in forward, backward or upward movement. As a result it can be a vulnerable part of the body susceptible to injury:

The more dynamic the movement of the foot in motion the greater the force impact on the Achilles tendon.
The longer and more continuous the movement , eg. distance running, the greater the possibility of developing a repetitive strain injury.
Overuse or a sudden strain can cause inflammation resulting in Achilles tendinitis. This results in micro tears to the tendon tissue.
Achilles tendinitis can develop into Achilles tendinosis. This is a condition in which the collagen or structural protein of the tendon degenerates. The tendon can begin to calcify.
Physical force or tendinosis can also cause a partial rupture of the tendon.
Severe physical force or chronic tendinosis can cause a complete rupture of the tendon.

Are some activities more likely to place undue pressure on the Achilles tendon? In the words of a famous Vice Presidential candidate "You betcha!"

Risk factors include; tight calf muscles, bone spurs, weak arches, and unsuitable footwear.
Risky activities include sprinting, jumping, running in soft sand, running on hard surfaces.
Sports with a high incidence of Achilles tendon injuries, especially ruptures, include track and field, volleyball, football, soccer and basketball.
Sports like hockey and downhill skiing encase the ankle in foot ware with a protective shell. Therefore the Achilles tendon may be one of the few body parts not in danger. However in an infamous hockey injury, Ottawa Senator star Erik Karlsson had his Achilles tendon accidentally (???) severed by another player's skate.
Use of antibiotics such as Ciprofloxacin can weaken the Achilles tendon thus making it susceptible to tearing or rupturing.

Prevention is the first line of defense in protecting the Achilles tendon:

Stretch the calf muscles and the tendon after workouts.
Don't over train. Middle and long distance runners especially seem to feel that 'more is better'. You won't get fitter if you get injured.
Increase workout volume only in small gradual increments.
Increase workout intensity only in small gradual increments.
Plyometric training -explosive jumping exercises - can help the body prepare for dynamic sports movements. However, this form of training should be done carefully and properly. preferably under the guidance of a qualified Fitness Trainer. There are many examples of athletes rupturing the Achilles tendon in the off season while performing plyometric exercises.

Ideally, you want to nip an Achilles tendon issue in the bud:

Stop any impact exercises if there is pain in the back of the lower leg or heel.
Do not resume impact exercises until pain is completely gone.
RICE - Rest, Ice, Compression, Elevation - may provide short term relief.
Using ice for injuries is currently being questioned by the sports science community. Until it has been totally ruled out as an effective treatment, I would continue to recommend ice therapy.
Do not hesitate to see a sports medicine doctor if pain persists.
A doctor will likely give a referral for physiotherapy.
A cortisone shot may reduce inflammation however this may weaken the tissue over the long term resulting in a tendon rupture.

The worst case scenario is a partial or complete Achilles tendon rupture.:There are different possible treatments:

Non-operative treatment number 1 - The torn ends are pulled together and the foot is put in a cast. It is hoped the the tendon will regenerate itself if kept immobile.
Non-operative treatment number 2 - Platelet rich plasma treatment in which the patient's own blood is spun in a centrifuge and transfused back into the patient. This is a new and less orthodox methodology that is not without controversy.
Operative - Surgery in which the torn tendon ends are sewed back together. This is followed by a period of immobilization.
All methods would require physiotherapy afterwards.
The choice of treatment would depend upon which physician you go to for treatment. Do your homework on the sports medicine practitioners in your region.

The most important considerations are obvious.
Proper training can prevent possible Achilles tendon issues.
Achilles tendon issues should not be ignored.
Give proper time to heal your heel !