Achilles Tendon Injuries

Medically Reviewed by Dr. K on 10 March 2021

What Is an Achilles Tendon Injury?

An Achilles tendon injury can affect anyone, whether they're a professional athlete or just going about their daily lives.

The Achilles tendon is the body's main tendon. It extends from your heel bones to your calf muscles. It's a springy band of tissue at the back of your ankle right above your heel that you can sense. It allows you to stand up on your tiptoes and point your toes toward the floor.

This tendon is susceptible to injury. It feels like a burning pain or weakness in that part of your leg, and it may be mild or moderate. Your Achilles tendon can be partially or entirely ripped if the pain is serious.

Another example of injury is Achilles tendinitis, which occurs when a portion of the tendon becomes inflamed. This disease affects various parts of the tendon and is divided into two types:

  • Noninsertional Achilles tendinitis.  The middle fibres of your tendon break down, swell, and thicken.
  • Insertional Achilles tendinitis. The lower portion of your heel, where your tendon inserts or goes into your heel bone, is affected. It has the potential to trigger bone spurs.

Achilles Tendon Injury Symptoms

Pain above your heel is the most noticeable symptom, particularly when you stretch your ankle or stand on your toes. It may be mild at first, then improve or deteriorate with time. The discomfort is immediate and intense if the tendon ruptures. Tenderness, swollenness, and stiffness can also be present.

When your Achilles tendon snaps, you might hear a cracking or popping sound. You can also experience bruises and swelling. When you take a jump, you can still have difficulty pointing your toes and pushing off your toes.

Achilles Tendon Injury Causes

Achilles tendon injuries are typical in people who perform activities that require them to rapidly accelerate, slow down, or pivot, such as:

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

These accidents are most likely to occur when you back off and raise your foot, rather than when you land. A sprinter, for example, might get one when they surge off the starting block at the start of a race. The tendon can be unable to cope with the sudden action. Achilles tendon injuries are most common in men over 30.

If you repeatedly stress your Achilles tendon with high-impact exercises, you risk injuring it. These are referred to as repetitive stress injuries.

Risk factors

These factors can increase the risk of an Achilles tendon injury:

  • Wearing high heels which can stress the tendon.
  • Having “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.
  • When leg muscles or tendons are too tight.
  • Having bone spurs.
  • Add time to your exercise routine or do more intense activity.
  • Starting a new type of exercise.
  • Wearing shoes that don’t fit well or aren’t right for the kind of physical activity you do.
  • Working out on uneven surfaces.
  • Taking medicines called glucocorticoids or antibiotics called fluoroquinolones.

Achilles Tendon Injury Diagnosis

An Achilles tendon injury is often misdiagnosed as a sprained ankle by doctors. Your doctor will begin by doing a physical examination to determine the correct diagnosis. They may want to observe you walk or run so that they may monitor for issues causing the injuries.

They can also perform a test known as the calf squeezing test. On the test table, you’ll kneel on a chair or desk, or lay on your back. On a good knee, the doctor will kindly pinch the calf muscle. This pulls on the tendon, causing the foot to move. They’ll then proceed to do the same thing to your other knee. Your foot can not move if your Achilles tendon is broken and your calf muscle is not attached to your foot.

Your doctor can perform a range of motion test to see whether you can move your ankle normally. They might also perform imaging tests like X-rays or MRIs. These scans will reveal the extent of the tendon injury and assist your doctor in determining the right care option for you.

Achilles Tendon Injury Treatment

Achilles tendon strains that are minor to mild can recover on their own. You will expedite the procedure by:

  • Allow your leg to rest. As far as possible, avoid adding weight to it. Crutches may be used.
  • Ice your injury for up to 20 minutes at a time as needed.
  • Compress your leg with your hand. To reduce swelling, wrap an elastic bandage around the lower leg and ankle.
  • Elevate your leg. When you’re seated or laying down, prop it up on a cushion.
  • Take anti-inflammatory painkillers. Ibuprofen and naproxen are nonsteroidal anti-inflammatory medications (NSAIDs) that can assist with inflammation and swelling. To avoid side effects including bleeding and ulcers, follow the directions on the packaging. Take them with something to eat. If you have any allergies, respiratory conditions, or are on any other medications, see a doctor first. Call the doctor if you need them for more than 7 to 10 days.
  • Use a heel lift. During your recovery, your doctor can advise you to wear a shoe insert. It will aid in the prevention of further stretching of the Achilles tendon.
  • Follow the doctor’s, physical therapist’s, or other health care provider’s recommendations for stretching and strengthening activities.

Achilles Tendon Injury Recovery

It could take months for you to recover, depending on the severity of the injuries. Healing times vary depending on the situation.

As the injury heals, you can continue to be active. Inquire with your doctor on what is permissible. But don’t rush the healing. You should not resume your previous degree of physical exercise until you have done the following:

  • You can move your leg as safely and effortlessly as if it were uninjured.
  • Your leg feels as strong as it did before the injury.
  • Walking, jogging, sprinting, or jumping causes no pain in the body.

If you force yourself too hard until your Achilles tendon fracture heals completely, you will re-injure yourself, and the pain may become chronic. If you swap high-impact exercises like athletics with low-impact fitness, you will be able to prevent any of these problems. Swimming and walking, for example, put less strain on the tendon.

Achilles Tendon Injury Prevention

Here are some suggestions:

  • Reduce uphill running.
  • Wear shoes that are well fitting with good support.
  • Stop exercising if you feel pain or tightness in the back of your calf or heel.


Referenced on 2.3.2021:

  1. American Academy of Orthopaedic Surgeons: “Achilles Tendon.”
  2. American Family Physician: “Common Conditions of the Achilles Tendon.”
  3. British Journal of General Practice: “Achilles tendon rupture: how to avoid missing the diagnosis.”
  4. Rouzier P. The Sports Medicine Patient Advisor, second edition, SportsMed Press, 2004.
  5. OrthoInfo (American Academy of Orthopaedic Surgeons): “Achilles Tendinitis.”
  6. Cedars Sinai: “Achilles Tendon Injuries.”
  7. Johns Hopkins Medicine: “Achilles Tendon Injuries.”

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