Achilles Tendon Injuries

Achilles tendinitis has these symptoms:

• Soreness and 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.

An Achilles tendon tear or rupture has these symptoms:

• 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, and 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.

See a doctor if you think you have injured your Achilles tendon. Tendons heal best when you get the right treatment as soon as possible after the injury. Resting and treating Achilles tendinitis helps to prevent more serious injury.

Causes of Achilles tendon injury include:

• Overuse. Athletes like runners put a lot of regular stress on the Achilles tendon and are at risk for tendinitis.
• Too much activity too soon. The Achilles tendon can become inflamed or torn when you don’t regularly strengthen and stretch the legs tries and then take part in vigorous physical activity. This puts too much pressure on the Achilles tendon.
• Falls. Falling from a high place and landing on your feet, or stepping into a hole, can cause a tear in your Achilles tendon.
• Sudden stress. This is a common cause of Achilles tendon tears in athletes. For example, football players are at risk for Achilles injuries because they push off their toes for sudden sprints as a play begins.
• Bone spurs. A bone spur is extra bone growth on the heel. Bone spurs can rub against the Achilles and cause irritation.

• 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.

Treatment depends on how serious the tear is, but may include any of the following:

• 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.

It’s not always possible to prevent injuries, but you can lower your risk of an Achilles tendon injury by t keeping your calf muscles strong and flexible. Know your limits and don’t push your muscles to do what they are not ready to do.

If you have Achilles tendinitis, you can prevent further damage and future tears by getting the right treatment.

• American College of Foot and Ankle Surgeons
• American Academy of Orthopedic Surgeons

A tendon is a band of tissue that connects muscle to bone and is made up of many fibers. The Achilles tendon is important for walking, running, and jumping. It is the largest tendon in the body. An Achilles (uh-KIL-eez) tendon injury is when the tendon that connects the calf muscle to the heel bone gets stretched, torn, irritated and inflamed.

The Achilles tendon is often injured during a period of sudden high stress. For example, the Achilles can tear when an athlete sprints or if a person falls from a height and lands on the feet. It can also be injured when the calf muscle is not as strong or flexible as it needs to be to do a certain activity, and the Achilles bears too much of the strain. For example, the Achilles tendon can become irritated or torn if you are not conditioned for physical activity but do weekend chores or leisure activities that require leg strength and flexibility.

The most common problems with the Achilles tendon are:

• 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.