Achilles Tendon Injuries

The Achilles tendon links your calf muscle to your heel. It helps you perform daily activities like walking, running and jumping. 

Achilles tendon injuries can happen to anyone, but they are more common in people between the ages of 45 and 60. They often occur when you start or increase physical activity, like a new sport or exercise regimen.

There are two categories of Achilles tendon injury: tendonitis (also called tendinopathy) and rupture.

Achilles Tendonitis

Achilles tendonitis results from repeated stress (overuse) on the tendon. The stress causes a buildup of calcium in the tendon, which leads to painful symptoms.

Common symptoms of Achilles tendonitis include pain, swelling and tenderness on the back of your tendon above your heel (non‑insertional tendonitis). You may also feel pain directly on the back of your heel where your tendon attaches to the bone (insertional tendonitis). 

Achilles Tendon Rupture

A rupture (tear) of your Achilles tendon can occur from a sudden change of direction during physical activity. Jumping up, landing from a jump and starting or stopping a run are all examples of movements that can cause a rupture. 

If your tendon ruptures, you may feel a pop, snap and/or sudden sharp pain in the back of your leg. People often say it feels like they were hit or kicked in the back of the leg. 

You may experience swelling and bruising or discoloration of the skin around the rupture. You may also have difficulty walking and standing up on your toes. 

Most of the time, an Achilles tendon rupture involves a full tear of your tendon. Partial ruptures are rare.

To diagnose an Achilles tendon injury, your provider will discuss your symptoms with you and examine your foot and calf. 

For symptoms of Achilles tendonitis, we may recommend an X‑ray of your foot to look for calcium in your tendon.

For symptoms of an Achilles rupture, we may recommend an X‑ray, MRI or ultrasound to detect a torn tendon. Your provider may also perform a Thompson test. During the test, you will lie on your stomach and your provider will squeeze your calf muscle. If your foot doesn’t move in response, you may have a rupture.

Treatment Options for Achilles Tendonitis

We may recommend one or more of the following non‑surgical treatments for Achilles tendonitis, depending on your symptoms:

• Anti‑inflammatory medication to reduce pain, swelling and tenderness
• Avoiding activities that aggravate your symptoms
• Physical therapy to stretch and strengthen your calf and tendon
• Shoes with a heel or heel lift to help reduce stress on your Achilles

If your tendonitis does not improve with non‑surgical treatment, we may recommend Haglund deformity surgery. During this procedure, a surgeon will partially detach your tendon from your heel bone. They will remove any damaged tendon tissue and calcium and then reattach the tendon to your heel.

Treatment Options for Achilles Tendon Rupture

We offer both non‑surgical and minimally invasive surgical treatments for an Achilles tendon rupture. Both options can provide excellent outcomes.

Your provider will discuss your options with you and make recommendations based on your current health and lifestyle goals.

Non‑surgical treatment involves placing your foot in a protective boot or cast with your toes pointed down. Your foot will remain immobilized for one to two weeks to allow your Achilles tendon to heal. After that, you will begin gradual weight-bearing rehabilitation. 

If you have a surgical repair, your surgeon will make a small (half‑inch) incision at the site of your Achilles tendon rupture. We use state-of-the-art instruments to carefully pull sutures to the rupture and tie it closed. 

Minimally invasive surgery allows for a smaller incision, a smaller scar and a smaller risk of infection than traditional (open) surgery.

The recovery time for an Achilles tendon injury will vary based on your condition and treatment. Following your provider’s rehabilitation instructions is key to recovering and preventing future injuries.

If you have non‑surgical treatment of Achilles tendonitis, you may gradually return to normal activity over a few months if your symptoms continue to improve. 

Recovery from surgical treatment of Achilles tendonitis may take up to nine months. You will need to wear a cast or boot for three months after your procedure, followed by supervised rehabilitation. 

The recovery time for non‑surgical and surgical treatment of an Achilles tendon rupture is the same and may take up to nine months.