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Achilles Tendon Injuries

The two main Achilles tendon injuries are:

Achilles tendinopathy.

This refers to tiny tears (microtears) in the tissue in and around the tendon. These tears are caused by overuse. This is often called Achilles tendinitis.

Achilles tendon tear or rupture.

An Achilles tendon also can partly tear or completely tear (rupture). A partial tear may cause mild or no symptoms. But a complete rupture causes pain and sudden loss of strength and movement.

Problems with this tendon may seem to happen suddenly. But in most cases they are the result of many tiny tears in the tendon that have happened over time.

Other conditions can affect the Achilles tendon area. They include:

  • Achilles paratenonitis.
  • Retrocalcaneal bursitis.
  • Insertional Achilles tendinopathy.
How can you help prevent an Achilles tendon problem?

Most Achilles tendon injuries occur during sports. If you had an Achilles tendon problem in the past, it's even more important to try to prevent another injury. Make sure to:

  • Warm up. Before any sport or intense activity, gradually warm up your body by doing 5 to 10 minutes of walking or biking.
  • Cool down and stretch. After intense activity, gradually cool down with about 5 minutes of easy jogging, walking, or biking. Then do 5 minutes of stretches.
  • Avoid any sport or intense activity that you aren't in condition to do.
  • Wear shoes that cushion your heel during sports or any strenuous activity.
  • Wear heel pads or other orthotics that are designed to reduce stress on the Achilles tendon.
How are Achilles tendon problems diagnosed?

To diagnose Achilles tendon problems, such as tendinopathy or a tear, most doctors ask questions about your past health and do a physical exam. The exam includes checking for tenderness, watching how you walk and stand, and comparing the range of motion of your two legs.

Other tests may be done to clarify a diagnosis or to prepare for surgery. These tests include:

  • Ultrasound. It may be used to see if there is a tendon tear or signs of tendinopathy.
  • X-rays. These are used to check the heel bone.
  • MRI scan. It may be used to check the tendon for signs of tendinopathy or a tendon tear. An MRI is also used to evaluate the heel bone.
Who can diagnose and treat Achilles tendon problems?

Health professionals who can diagnose and treat an Achilles tendon problem include:

  • Emergency medicine specialists, for sudden and severe (acute) Achilles problems.
  • Family medicine physicians or internists who are familiar with foot and ankle injuries.
  • Podiatrists who are familiar with sports injuries.
  • Sports medicine specialists.
  • Orthopedic surgeons, particularly for an Achilles rupture.

You may be referred to a physical therapist for exercises to rebuild strength in your Achilles tendon and leg muscles.

How is rehab used to treat Achilles tendon problems?

Rehabilitation (rehab) is part of the usual treatment for an Achilles tendon injury.

  • For Achilles tendinopathy, rehab can decrease your pain. It helps you gradually return to normal activities.
  • For an Achilles tendon rupture, rehab can strengthen the tendon and help it heal.

Your doctor or physical therapist will design a program for you. You will likely need rehab after an Achilles tendon injury whether or not you have surgery.

Rehab may include:

  • Stretching and flexibility exercises. These help your tendon heal without shortening and causing long-term pain.
  • Strengthening exercises. They help you regain strength in the tendon. And they will help protect you from another injury.
  • Ultrasound heat therapy. It improves blood flow. This may aid the healing process.
  • Deep massage. It helps with flexibility and blood circulation in the lower leg. It can also help prevent further injury.
  • Endurance activities, such as riding a stationary bike.
  • Coordination and agility training.