What are Achilles tendon injuries?
-
Achilles tendinitis
Tendinitis (ten-duh-NY-tis) happens when a tendon becomes irritated and inflamed from overuse. The overuse can be from repeating a certain activity (like jumping or sprinting) or from doing too much activity too soon, without allowing enough time to build up your strength and flexibility. Achilles tendinitis causes soreness in the back of the heel. It’s usually temporary and gets better with rest and treatment. But if the Achilles tendon is regularly irritated and inflamed, the tendon will start to break down. This makes it vulnerable to tears and ruptures.
-
Torn Achilles tendon
The Achilles tendon can tear when it’s weakened by tendinitis or has sudden stress on it, or both. The tendon can have a partial tear or tear completely.
Symptoms for Achilles Tendonitis
Soreness & Stiffness
The back of the heel may be sore and stiff, especially first thing in the morning or after an activity like running or walking. It may also feel sore when you try to stand on your toes.
Swelling
You may notice some thickening or swelling on the back of your heel. The swelling may get worse throughout the day, especially if you are doing a lot of walking or other activity.
Symptoms for Achilles Tendon Tear or Rupture
Pain
The moment of injury can be quite painful, and the injured area can be sore for a while until the injury heals. The pain may feel like a severe bruise as if you’ve been hit in the calf. Pain usually gets worse when you try to use the foot or put weight on it.
Swelling, Redness, & Warmth
The area behind the heel is often swollen and red right after it is injured, and may also be warm to the touch. It may also swell in the days after the injury, getting worse as the day goes on.
Weakness
You may have trouble flexing your foot and walking. If a tear is bad enough, you may not be able to stand on your toes or push off your toes to walk.
Diagnosis, Tests & Treatments
Diagnosis & Tests
- Your healthcare provider will ask about your injury, where the pain is, and when it hurts most. Your healthcare provider will look at the shape of your foot and may ask you to move it in certain ways.
- Imaging tests, such as an x-ray, may be recommended to look for a heel spur or hardening (calcification) of the tendon.
- An MRI may be recommended to examine the Achilles tendon for tears.
Treatments
-
Rest
You may to take a break from your usual activities. Even for mild tendinitis, it is a good idea to switch to activities that don’t irritate the Achilles tendon.
-
Ice
Cold packs may help to reduce pain and swelling. Ice the injury right after it happens, and then 3 or 4 times a day while it is healing. Put ice in a towel or cloth and ice for only 20 minutes at a time. Don’t put ice directly on your skin. When you get back to your usual activities, it may help to ice the area that was injured for 20 minutes after activity to prevent swelling. -
Nonsteroidal anti-inflammatory medicine (NSAID)
NSAIDs like ibuprofen can reduce pain and swelling after the injury. Ask your doctor about the appropriate dose for your injury and how long you should take them. -
Boot or splint
A walking boot can help you get around without straining your Achilles tendon while it heals. You may also need a splint to keep your foot in the right position while you sleep. -
Exercise and physical therapy
Exercises that stretch and strengthen the calf muscles and tendon may help it heal. A physical therapist will teach you the correct way to do these exercises and coach you as you do them when you first start your exercise program. -
Orthotics and supportive shoes
An orthotic is an insert that goes in your shoes to support your foot and help you use it the right way. Sometimes a tendon injury changes the shape of your foot and which may require special support. -
Surgery
If you have a severe tear or a tendinitis that won’t heal, surgery may be recommended to repair or replace the tendon. Surgery may also be done to remove any inflamed tissue around the tendon, remove a bone spur, or repair damaged muscle.