What Is an Achilles Tendon Injury?

An Achilles tendon injury can happen to anyone, whether you’re an athlete or just going about your everyday life.

The Achilles tendon is the largest tendon in your body. It stretches from the bones of your heel to your calf muscles. You can feel it -- a springy band of tissue at the back of your ankle and above your heel. It lets you point your toes toward the floor.

Unfortunately, it’s pretty common for this tendon to get injured. It could be mild or moderate and feel like a burning pain or stiffness in that part of your leg. But if it’s severe, it may mean that your Achilles tendon is partly torn or completely ruptured.

Causes

These could lead to an Achilles tendon injury:

  • You overdo activity.
  • You boost your physical activity level too quickly.
  • You wear high heels, which can stress the tendon.
  • You have “flat feet,” also called fallen arches. This means that when you take a step, the impact causes the arch of your foot to collapse, stretching the muscles and tendons.
  • Your leg muscles or tendons are too tight.
  • You take medicines called glucocorticoids, or antibiotics called fluoroquinolones.

Achilles tendon injuries are common in people who do things where you quickly speed up, slow down, or pivot, such as:

  • Running
  • Gymnastics
  • Dance
  • Football
  • Baseball
  • Softball
  • Basketball
  • Tennis
  • Volleyball

Achilles tendon injuries tend to happen when you start moving suddenly, as you push off and lift your foot, rather than when you land. For instance, a sprinter might get one at the start of a race, as he surges off of the starting block. The abrupt action can be too much for the tendon to handle. Men older than age 30 are particularly prone to Achilles tendon injuries.

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Symptoms

The most obvious one is pain above your heel, especially when you stretch your ankle or stand on your toes.

It may be mild and get better or worse over time. If the tendon ruptures, the pain is instant and severe.

The area may also feel tender, swollen, and stiff.

If your Achilles tendon tears, you may hear a snapping or popping noise when it happens. You could have bruising and swelling, too.

You may have trouble pointing your toes if the tendon tears completely.

Diagnosis

Your doctor will do a physical exam. She may want to see you walk or run to look for problems that might have contributed to your injury.

Treatment

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 it. Ice your injury for 20 to 30 minutes every 3 to 4 hours to reduce pain and swelling. Continue this for 2 or 3 days, or until the pain is gone.
  • Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down swelling.
  • Raise (elevate) your leg. Prop your leg up on a pillow when you're sitting or lying down.
  • Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen will help with pain and swelling. Follow the instructions on the label to help prevent side effects, such as bleeding and ulcers. Take them with food. Check with your doctor first if you have any allergies, medical problems or take any other medication. If you need them for longer than 7 to 10 days, call your doctor.
  • Use a heel lift. Your doctor may recommend that you wear an insert in your shoe while you recover. It will help protect your Achilles tendon from further stretching.
  • Practice stretching and strengthening exercises as recommended by your doctor, physical therapist, or other health care provider.

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Usually, these techniques are enough. But in severe cases, you may need a cast for 6 to 10 weeks or even surgery to repair the tendon or remove extra tissue.

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When Will I Feel Better?

It may take months, but it depends on how serious your injury is. Different conditions heal at different rates.

You can still be active while your injury heals. Ask your doctor what’s OK to do. 

Don't rush things. Do not try to return to your old level of physical activity until:

  • You can move your leg as easily and freely as your uninjured leg.
  • Your leg feels as strong as your uninjured leg.
  • You feel no pain in your leg when you walk, jog, sprint, or jump.

If you push yourself too much before your Achilles tendon injury fully heals, you could get injured again and the pain could become a long-lasting problem.

Can I Prevent an Achilles Tendon Injury?

Here are some things you can try:

  • Cut down on uphill running.
  • Wear shoes with good support that fit well.
  • Always boost the intensity of your physical activity slowly.
  • Stop exercising if you feel pain or tightness in the back of your calf or heel.
WebMD Medical Reference Reviewed by Sabrina Felson, MD on November 16, 2016

Sources

SOURCES: 

American Academy of Orthopaedic Surgeons: "Achilles Tendon." 

American Family Physician: “Common Conditions of the Achilles Tendon.” 

Rouzier P. The Sports Medicine Patient Advisor, second edition, SportsMed Press, 2004.

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