Patient education: Achilles tendon injury (The Basics)

What is the Achilles tendon? — 

Tendons are strong bands of tissue that connect muscles to bones. The Achilles tendon connects the calf muscles to the heel bone (figure 1). You use your Achilles tendon when you walk, run, and jump.

If the Achilles tendon is injured, it can cause pain and other symptoms. "Achilles tendinopathy" is a condition that causes pain in the back of the leg, just above the heel. It is sometimes called "Achilles tendinitis." Sometimes, the Achilles tendon tears. This is a more serious injury.

What causes Achilles tendinopathy? — 

It can happen if you:

●Suddenly increase how much exercise you are doing – For example, it can cause injury if you start doing much longer or more difficult runs without working up to this gradually.

●Do the same exercises or activities (such as jumping) over and over

●Don't warm up your calf muscles before exercising

●Exercise in shoes or sneakers that are worn out or not made for exercise

●Have arthritis or a bone growth on the back of your heel bone – This can rub against the tendon and hurt it.

What are the symptoms of Achilles tendon injury? — 

The most common symptoms are:

●Pain in the back of the leg, just above the heel – The pain usually gets worse with exercise and better with rest.

●Stiffness or soreness in the back of the leg, especially in the morning

●Swelling of the skin over the Achilles tendon

●Trouble standing on tiptoe

Sometimes, an Achilles tendon tears. This is called a "rupture." Symptoms of an Achilles tendon rupture can include:

●Sudden, severe pain in the back of the leg (above the heel)

●Trouble putting weight on the foot or walking normally

Is there a test for Achilles tendon injury? — 

No. But your doctor or nurse should be able to tell if you have it by learning about your symptoms and doing an exam. They might order an X-ray or other test to check if another condition is causing your symptoms.

If they think that you have an Achilles tendon injury, you might have an imaging test called an ultrasound or MRI. These create pictures of the tendon.

How is Achilles tendinopathy treated? — 

Achilles tendinopathy usually gets better on its own, but it can take months to heal completely. To help your symptoms get better, you can:

●Rest your Achilles tendon, and avoid activities that cause pain.

●Ice the area – If your pain gets worse after activity, put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours (for up to 6 hours), for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin.

●Wrap your ankle with an elastic bandage (or other wrap) – This can help keep your tendon from moving too much. Your doctor or nurse will show you how to wrap your ankle correctly.

●Take medicine to reduce the pain – Your doctor might recommend that you take a medicine to relieve pain, such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve).

●Do exercises to make your calf muscles stronger and more flexible – Your doctor or nurse will show you which exercises to do. They might also suggest working with a physical therapist (exercise expert).

What if my symptoms don't get better? — 

Your doctor might suggest other possible treatments. These can include:

●A device to wear in your shoe or around your ankle to keep your foot in a position where it can heal properly

●Surgery

How is an Achilles tendon rupture treated? — 

A tendon rupture is usually treated with surgery, especially in people who do sports or other physical activities (such as hiking).

How can I prevent injuring my Achilles tendon again? — 

You can:

●Warm up your muscles before you exercise. For example, if you run, you can warm up your muscles by jogging slowly and then slowly increasing your pace.

●Avoid sudden increases in your exercise or activity. When you begin a sport or activity, start slowly. Over time, you can exercise harder and for longer periods of time.

●Do specific exercises to stretch and strengthen muscles in the area. Your doctor, nurse, or physical therapist can show you exercises that might help.

●Avoid running or exercising outside in cold weather. If you need to be outside, wear warm clothes.

●Wear the correct sneakers or shoes for your sport or activity.

●Replace worn-out sneakers or shoes.

●Avoid running on hard surfaces.