An Achilles tendon injury is a problem with the tendon that connects your heel bone to the calf muscle of your lower leg. Tendons are strong bands of tissue that attach muscle to bone. You use the Achilles tendon when you point your foot down and when you walk, run, or jump.
Tendons can be injured suddenly or they may be slowly damaged over time. You can have tiny or partial tears in your tendon. If you have a complete tear of your tendon, itâ€™s called a rupture. Other tendon injuries may be called a strain, tendinosis, or tendonitis.
What is the cause?
Achilles tendon injuries can be caused by:
Overuse of the tendon, such as from lots of uphill running, intense exercise, or sports training or from doing a lot of work that causes you to bend at the knees and ankles
A sudden activity that twists or tears your tendon, such as jumping, starting to sprint, or falling
You are more likely to have an Achilles tendon problem if you:
Have tight calf muscles or a tight Achilles tendon
Change the type of running shoes you wear, or if you wear high heels most of the day and then switch to lower heeled shoes for exercise
Have a problem called over-pronation, which happens when your feet roll inward and flatten out more than normal when you walk or run
What are the symptoms?
Symptoms may include:
Pain, stiffness, weakness, or swelling in the back of your lower leg
Pain in the back of your leg or ankle when you rise up on your toes
Trouble pointing your foot downward
If the tendon is completely torn, you may have felt a pop at the time of the injury. You may not be able to lift your heel off the ground or point your toes.
How is it diagnosed?
Your healthcare provider will ask about your symptoms, activities, and medical history and examine you. Your provider may ask to watch you walk or run to see if your feet flatten more than normal. Tests may include:
An MRI, which uses a strong magnetic field and radio waves to show detailed pictures of your foot and leg
How is it treated?
You will need to change or stop doing the activities that cause pain until your tendon has healed. For example, you may need to swim instead of run.
Your healthcare provider may recommend stretching and strengthening exercises to help you heal.
Special shoes or shoe inserts may help. If you have a severe injury, your healthcare provider may put your foot in a cast or boot for several weeks to keep it from moving while it heals.
If your tendon is torn, you may need surgery to repair the tendon.
The pain often gets better within a few weeks with self-care, but some injuries may take several months or longer to heal. Itâ€™s important to follow all of your healthcare providerâ€™s instructions.
How can I take care of myself?
To keep swelling down and help relieve pain:
Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time.
Do ice massage. To do this, freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over the painful area for 5 to 10 minutes. Do this several times a day while you have pain.
Keep your foot up on pillows when you sit or lie down.
Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you donâ€™t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
Put moist heat on the sore area for 10 to 15 minutes before you do warm-up and stretching exercises. Moist heat may help relax your muscles. Moist heat includes heat patches or moist heating pads that you can buy at most drugstores, a warm wet washcloth, or a hot shower. To prevent burns to your skin, follow directions on the package and do not lie on any type of hot pad. Donâ€™t use heat if you have swelling.
Follow your healthcare provider’s instructions, including any exercises recommended by your provider. Ask your provider:
How and when you will hear your test results
How long it will take to recover
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
How can I help prevent an Achilles tendon problem?
Warm-up exercises and stretching before activities can help prevent injuries. If you have tight Achilles tendons or calf muscles, stretch them twice a day whether or not you are doing any activities that day. If your leg or ankle hurts after exercise, putting ice on it may help keep it from getting injured.
Avoid running uphill if you tend to have Achilles tendon injuries.
Follow the safety rules and use the protective equipment recommended for your work or sport.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-10-21 Last reviewed: 2014-10-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Achilles Tendon Injury: References
DeLee, Jesse C., David Drez, and Mark D. Miller, Orthopaedic Sports Medicine: Principles and Practice, Saunders; 4th ed. 2014.
Greene, Walter B., M.D., Griffin, Letha Y. (Ed), Essentials of Musculoskeletal Care, 4th ed. Amer Academy of Orthopaedic. 2010.
Kisner, Carol, and Lynn Colby, Therapeutic Exercise: Foundations and Techniques, F. A. Davis Company; 6th ed, 2012.