Achilles Tendon Injury

An Achilles tendon injury can affect both professional and amateur athletes.

The Achilles tendon is one of the longer tendons in your body, stretching 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 allows you to extend your foot and point your toes to the floor.

Unfortunately, it's a commonly injured tendon. Many Achilles tendon injuries are caused by tendinitis, in which the tendon becomes swollen and painful. In a severe Achilles tendon injury, too much force on the tendon can cause it to tear partially or rupture completely.

What Can Cause Achilles Tendon Injuries?

An Achilles tendon injury might be caused by:

  • Overuse
  • Stepping up your level of physical activity too quickly
  • Wearing high heels, which increases the stress on the tendon
  • Problems with the feet; an Achilles tendon injury can result from flat feet, also known as fallen arches or overpronation. In this condition, the impact of a step causes the arch of your foot to collapse, stretching the muscles and tendons.
  • Muscles or tendons in the leg that are too tight

Achilles tendon injuries are common in people who participate in these sports:

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

You're more likely to tear an Achilles tendon when you start moving suddenly. For instance, a sprinter might get one at the start of a race. The abrupt tensing of the muscle can be too much for the tendon to handle. Men older than age 30 are particularly prone to Achilles tendon injuries.

What Does an Achilles Tendon Injury Feel Like?

Symptoms of an Achilles tendon injury are:

  • Pain along the back of your foot and above your heel, especially when stretching your ankle or standing on your toes; with tendinitis, pain may be mild and worsen gradually. If you rupture the tendon, pain can be abrupt and severe.
  • Tenderness
  • Swelling
  • Stiffness
  • Hearing a snapping or popping noise during the injury
  • Difficulty flexing your foot or pointing your toes (in complete tears of the tendon)

To diagnose an Achilles tendon injury, your health care provider will give you a thorough physical exam. He or she may want to see you walk or run to look for problems that might have contributed to your Achilles tendon injury.

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What's the Treatment for an Achilles Tendon Injury?

As debilitating as they can be, the good news is that 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 your leg. To reduce pain and swelling, ice your injury for 20 to 30 minutes, every three to four hours for two to three days, or until the pain is gone.
  • Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down swelling.
  • Elevate your leg. Prop you leg up on a pillow when you're sitting or lying down.
  • Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) will help with pain and swelling. However, these drugs have side effects, such as an increased risk of bleeding and ulcers. They should be used only occasionally unless your health care provider says otherwise and should be taken with food. Check with your doctor before taking these if you have any allergies, medical problems or take any other medication,
  • Use a heel lift. Your health care provider 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 health care provider.

Usually, these techniques will do the trick. But in severe cases of Achilles tendon injury, you may need a cast for six to 10 weeks or even surgery to repair the tendon or remove excess tissue.

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When Will I Feel Better?

Of course, what you really want to know is when you can get back in the game. Recovery time may take months, but it really depends on how serious your Achilles tendon injury is. Different conditions heal at different rates.

You can still be active while your injury heals. Ask your doctor about a new activity that won't aggravate your Achilles tendon, such as swimming.

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 start pushing yourself before your Achilles tendon injury is fully healed, you could wind up with permanent pain and disability.

How Can I Prevent an Achilles Tendon Injury?

There are things you can do to help prevent an Achilles tendon injury. You should:

  • Cut down on uphill running.
  • Wear shoes with good support that fit well.
  • Always increase 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 Melinda Ratini, DO, MS on November 24, 2014

Sources

SOURCES: 

American Academy of Orthopaedic Surgeons: "Achilles Tendon." 

Mazzone, M.F., and McCue, T., American Family Physician, May 1, 2002. 

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

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