Achilles tendinopathy starts with repeated small tears in the tendon, causing no
obvious symptoms or mild to severe pain during movement. As the tearing
continues, the leg may weaken and the tendon pain may become constant. Abnormal
growths (nodules) may develop in the tendon. And it may thicken.
Resting and treating your injured Achilles tendon will likely reduce the pain.
Stretching and exercising in physical therapy or a rehabilitation (rehab) program will
restore flexibility and strength in your lower leg. Warming up the lower leg
and Achilles tendon will help promote healing and keep the condition from
getting worse as you resume more intense activities, such as sports or stair
Without rest and treatment of Achilles tendinopathy,
you may develop long-lasting (chronic) pain.
Achilles tendon tear or rupture
An Achilles tendon
can partially tear or
completely tear (rupture) . If your Achilles tendon has
ruptured, your leg may be weak, and walking may be
A tear usually occurs in the tendon about
1.5 in. (3.8 cm) to
2.5 in. (6.4 cm) above its
attachment to the heel bone. Some doctors believe that this area
is most likely to tear or rupture because of a limited blood supply.
If you treat an Achilles rupture with:
- Surgery followed by a rehab program,
you will likely regain full movement and function.
- A cast, brace,
splint, walking boot, or other device that keeps your lower leg from moving
(immobilization), the tendon will most likely heal but may not be as strong as
before the injury and may be more likely to rupture again. Exercising, in
physical therapy or in a rehab program, will help restore flexibility
and strength in the lower leg.
If you do not treat an Achilles rupture, you will feel
weakness in the first steps when walking, with a feeling similar to that of
walking in the sand. Eventually, walking will become difficult.
Other Achilles tendon problems
can affect the Achilles tendon area alone or along with tendinosis. These other
conditions are caused by inflammation and include:
- Achilles paratenonitis, which is an inflammation of the covering of the Achilles
tendon. Symptoms include tenderness, pain, and swelling in the Achilles area,
all of which are usually worse during activity. This is also called Achilles
- Retrocalcaneal bursitis, which is an
inflammation of the small fluid-filled sac (bursa) between
the back of the heel bone and the Achilles tendon, just above the point where
the tendon connects to the bone. The inflammation causes swelling, tenderness,
and pain on the back of the foot. See an illustration of the
retrocalcaneal bursa .
- Insertional Achilles tendinopathy, which is damage in
the area where the tendon attaches to the heel bone. Symptoms include
tenderness on the lower back of the heel and less ability to overflex the foot.
Pain tends to be worst after exercise and can eventually become constant. This
condition often develops along with retrocalcaneal bursitis.