What is an Achilles Tendon?

The Achilles tendon is the small stretch of tendon that connects the heel bone to the calf muscle. Though small, it contributes to essential foot and ankle movements like standing on your toes and pushing off when you run or walk. If the Achilles tendon becomes injured or impaired in any way, these major movements can become difficult or even impossible, making even routine daily tasks a challenge.

Common Achilles Tendon Problems

The most common injuries related to the Achilles tendon fall into two categories:

  • Achilles tendinopathy: Pain or stiffness in the Achilles tendon caused by repeated minor injuries and continuous strain
    • Tendinitis: An inflammation or irritation of the tendon.
    • Tendinosis: Cellular microtears in and around the tendon caused by overuse. Contrary to popular belief, tendinosis is more common than tendinitis as a cause of pain in the Achilles tendon.
  • Achilles tendon tear or rupture: An overused or strained Achilles tendon can partially or completely tear. While a mild tear can sometimes cause little to no discomfort, a major tear can result in a sudden loss of strength or movement.

Causes

While injuries related to the Achilles tendon may at times seem sudden or unexpected, they are usually the result of countless microtears that have accumulated over time. The most common culprits are overuse of the tendon or repeated strenuous movement. Sports that involve a lot of pushing off from the heel or start-and-stop motions like basketball, baseball, or soccer are most likely to wear down an Achilles tendon, as will any changes in the intensity or frequency of an exercise routine.

Other common sources of pain or tearing of the Achilles tendon include:

  • Intense athletic activity, especially running or jumping
  • Not warming up or stretching before physical activity
  • Shoes with poor arch support, especially high heels
  • Being middle-aged and/ or out of shape

Symptoms

Injuries related to the Achilles tendon are normally painful enough to draw attention quickly, but it’s still important to look out for warning signs. Common symptoms include swelling, inflammation, and tenderness of the ankle area, especially the heel. You may also experience less strength and range of motion.

Pain almost always accompanies a tear in the Achilles tendon. The pain may be gradual or occur only during physical activity like walking or running. A major rupture of the Achilles tendon may cause a sharp, stabbing pain, and most people hear a sudden pop when the tendon tears. Swelling, aching, and/ or bruising may occur, and motions like flexing your foot or standing on your toes may become difficult or impossible.

Diagnosis

A simple physical exam by a medical professional can help easily discern whether or not you’re suffering from an Achilles tendon injury. A doctor can ask about your past health and your exercise routine and conduct a simple exam of the back of your calf and ankle for swelling or pain.

If the injury is severe or difficult to diagnose, a doctor may recommend an X-ray, MRI, or ultrasound exam to more clearly examine the wound. Surgical options are available for any serious or debilitating tears.

Treatment

For small tears, doctors may recommend rest, stretching exercises, and basic over-the-counter pain medications. Switching to more supportive or well-cushioned shoes may reduce stress on the tendon and alleviate pain during athletic activity.

Treatment options for severe tendon injuries, especially fully torn or ruptured ones, include surgery or a cast, splint, or brace to relieve the amount of pressure and strain on the wounded area. Physical rehabilitation and doctor-approved therapeutic exercise routines can help the lower muscle regain strength and flexibility.

Although injuries in the Achilles tendon often take weeks or months to heal, results are almost always positive, and most patients can seamlessly return to their normal exercise and physical routines after treatment is complete.