The Achilles tendon runs from the bottom of your calf muscle to the back of your heel bone. Achilles injuries are some of the most common complaints among athletes, especially runners. When you hurt your Achilles or tear it, you run the risk of a worse injury if you don’t treat it right away.
There are different levels of Achilles injury. They range from irritation and swelling (tendinitis) to a full rupture. Treatment might involve resting for a few days with your foot up or having surgery. Here’s a rundown of what you can expect if you injure your Achilles.
Achilles Tendinitis and Tendinosis
If the back of your ankle is bothering you and is inflamed or swelling, that’s Achilles tendinitis. It usually happens with overuse, especially if you’ve just added a lot of running and jumping into your exercise routine.
Tendinitis shouldn’t last long -- if you take care of yourself. But it can turn into tendinosis if the damaged tendon starts to break down and get tiny tears.
Listen to your body at the first sign of a problem in your Achilles. If you address it right away, you may avoid problems down the road.
If you injure the area or feel pain in your Achilles, don’t push it. Use the “RICE” method to prevent any further damage:
- Rest. Try to take it easy and walk as little as possible. Take over-the-counter pain meds.
- Ice. Lay a thin towel over the back of your ankle and apply an ice pack for 20 minutes of every hour.
- Compression. To prevent swelling, wrap your ankle in an elastic bandage.
- Elevation. While you’re resting, try to keep your foot at or a little above heart level.
If this works, you might not have to see a doctor. If it doesn’t, your doctor might send you to physical therapy for massage, stretching, and strengthening. If the way you walk is causing your Achilles issues, you might need a cast, walking boots, or night splints to keep the tendon from moving and stretching in the wrong way.
If you tear your Achilles, you’ll probably realize that you need to see a doctor as soon as possible. But until you can get there, you should use the RICE method to keep yourself comfortable.
Once you’re in the doctor’s office, they’ll give you the option to have surgery or not have it. The decision will be based on three factors:
- Your age
- Your activity level
- The amount of damage to the tendon
The younger and more active you are, the more likely that surgery will be the best option. In many cases, your doctor will recommend doing physical therapy before deciding on surgery.
If you need surgery, you should have it within 4 weeks of the injury. Your surgeon will make a small incision in the back of your ankle and sew the Achilles back together. Sometimes they’ll need to sew other tendons in to make things even stronger. Between 80% and 90% of these operations are successful. If you have surgery, you’ll likely lower your odds of another rupture.
What If I Don’t Have Surgery?
Your doctor could decide not to do surgery if you’re older and less active, or if you have only a partial tear.
The nonsurgical route will involve lots of physical therapy and doing stretches and exercises on your own. You might also have ultrasound or shockwave therapy. You may have to wear a cast, walking boot, or heel cups to take pressure off the tendon and keep it from moving.
You won’t have to go through the stress of surgery, but you’ll have a longer road to full recovery. The tendon might not heal perfectly, so there could be scar tissue in the gap left from the tear. You’ll also run a bigger risk of reinjuring the tendon -- and if you do need surgery for that, it’ll be more difficult.
Preventing Another Achilles Injury
Surgery or no surgery, you need to make sure your Achilles stays strong and you don’t have to deal with this again. Here are the main things you can do to protect yourself from another injury.
- Stretching and strengthening your calves might be the single most important way to keep your Achilles healthy. Keeping those muscles loose will help the tendon absorb more force.
- Mix up your exercises. If you tend to do a lot of running and jumping, throw in some other activities that won’t be so hard on your Achilles, like yoga or Pilates.
- Watch your feet. If you’re running and jumping, make sure you’re on a good, solid surface where you’re less likely to slip or fall. And wear proper-fitting shoes.
- Take it easy, at least at first. You risk more injury if you dash out of the gate too fast. Doctors recommend increasing your activity 10% every week.