Achilles Tendon Injuries (Tear, Rupture) Causes, Symptoms, Diagnosis, Treatment, Prevention

Achilles Tendon Injuries (Tear, Rupture) Causes, Symptoms, Diagnosis, Treatment, Prevention


The Achilles tendon is the largest tendon in the body. Tendons are long, tough cords of tissue that connect muscle to bone. The Achilles tendon is located in the back of the foot and connects your heel bone to your calf muscle. It helps you to walk, run and jump. The Achilles tendon is able to endure stress, but sometimes injury can occur to the tendon when overly stressed.


What is Achilles Tendon Injuries (Tear, Rupture) ?


The Achilles tendon is an important part of the leg. It is located just behind and above the heel. It joins the heel bone to the calf muscles. Its function is to help in bending the foot downwards at the ankle (this movement is called plantar flexion by doctors).

If the Achilles tendon is torn, this is called an Achilles tendon injuries. The tear may be either partial or complete. In a partial tear, the tendon is partly torn but still joined to the calf muscle. With complete tears, the tendon is completely torn so that the connection between the calf muscles and the ankle bone is lost.

What Can Cause Achilles Tendon Injuries (Tear, Rupture)?


An Achilles tendon injury might be caused by:

  • Overuse
  • Stepping up your level of physical activity too quickly
  • Not stretching enough before exercise
  • Wearing high heels, which increases the stress on the tendon
  • Problems with the feet. An Achilles tendon injury can result from flat feet, also known as fallen arches or overpronation. In this condition, the impact of a step causes the arch of your foot to collapse, stretching the muscles and tendons.
  • Muscles or tendons in the leg that are too tight
Achilles tendon injuries are common in people who participate in these sports:

  • Running
  • Gymnastics
  • Dance
  • Football
  • Baseball
  • Softball
  • Basketball
  • Tennis
  • Volleyball
You're more likely to tear an Achilles tendon when you start moving suddenly. For instance, a sprinter might get one at the start of a race. The abrupt tensing of the muscle can be too much for the tendon to handle. Men older than age 30 are particularly prone to Achilles tendon injuries.

What are the symptoms of Achilles Tendon Injuries (Tear, Rupture)?


Symptoms usually come on gradually. Depending on the severity of the injury, they can include:

  • Achilles pain, which increases with specific activity, with local tenderness to touch.
  • A sensation that the tendon is grating or cracking when moved.
  • Swelling, heat or redness around the area.
  • The affected tendon area may appear thicker in comparison to the unaffected side.
  • There may be weakness when trying to push up on to the toes.
  • The tendon can feel very stiff first thing in the morning (care should be taken when getting out of bed and when making the first few steps around the house).
  • A distinct gap in the line of the tendon (partial tear).

To diagnose an Achilles tendon injury, your health care provider will give you a thorough physical exam. He or she may want to see you walk or run to look for problems that might have contributed to your Achilles tendon injury.

Diagnosis for Achilles Tendon Injuries (Tear, Rupture)


A detailed history, and examination by an appropriately qualified health professional, will allow a diagnosis to be made. An ultrasound or MRI scan can confirm the diagnosis.

Other causes of symptoms in the area, such as those referred from the lumbar spine and local infection, should be excluded.

What's the Treatment for an Achilles Tendon Injury?


As debilitating as they can be, the good news is that minor to moderate Achilles tendon injuries should heal on their own. You just need to give them time.

To speed the healing, you can:

  • Rest your leg. Avoid putting weight on your leg as best you can. You may need crutches.
  • Ice your leg. To reduce pain and swelling, ice your injury for 20 to 30 minutes, every three to four hours for two to three days, or until the pain is gone.
  • Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down swelling.
  • Elevate your leg. Prop you leg up on a pillow when you're sitting or lying down.
  • Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. However, these drugs have side effects, such as an increased risk of bleeding and ulcers. They should be used only occasionally unless your health care provider says otherwise and should be taken with food.
  • Use a heel lift. Your health care provider may recommend that you wear an insert in your shoe while you recover. It will protect your Achilles tendon from further stretching.
  • Practice stretching and strengthening exercises as recommended by your health care provider.
Usually, these techniques will do the trick. But in severe cases of Achilles tendon injury, you may need a cast for six to 10 weeks, or even surgery to repair the tendon or remove excess tissue.

How Can I Prevent an Achilles Tendon Injury?


It is important to maintain a personal training log, to monitor training changes, and to recognise, and hopefully prevent, injury. And – if you are unfortunate enough to sustain an injury – to recognise where mistakes were made and prevent further errors.

There are things you can do to prevent an Achilles tendon injury. You should:

  • Always stretch your leg muscles and Achilles tendons before and after exercise -- more often if your muscles and tendons are tight.
  • Cut down on uphill running.
  • Wear shoes with good support that fit well.
  • Always increase the intensity of your physical activity slowly.
  • Stop exercising if you feel pain or tightness in the back of your calf or heel.

What Kind of Physical Therapist Do I Need?


All physical therapists are prepared through education and experience to treat Achilles tendinopathy. However, you may want to consider:

  • A physical therapist who is experienced in treating people with Achilles tendinopathy. Some physical therapists have a practice with an orthopedic or musculoskeletal focus.
  • A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic or sports physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you're looking for a physical therapist (or any other health care provider):

  • Get recommendations from family and friends or from other health care providers.
  • When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people who have Achilles tendinopathy.
  • During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.