Table of ContentsView AllTable of ContentsAchilles TendonitisAchilles TendinosisAchilles Tendon RuptureSelf-CareWhen to See a ProviderTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Achilles Tendonitis
Achilles Tendinosis
Achilles Tendon Rupture
Self-Care
When to See a Provider
Treatment
Prevention
Injury to your Achilles tendon can cause pain, burning, redness, and swelling. The Achilles tendon is a thick tendon that attaches your calf muscles to your heel bone. It is crucial for walking, running, and jumping.
When the Achilles tendon is stretched beyond its limits, it becomes inflamed (tendonitis) or tears (rupture). Stress or injury to the Achilles tendon can cause discomfort that can range from a slight ache and stiffness to severe Achilles tendon pain. Over time, this can develop into a degenerative condition called tendinosis.
This article covers Achilles tendonitis,tendinosis, and rupture and how they can cause Achilles tendon pain. It will also discuss when to see a healthcare provider, what diagnosis entails, and how Achilles tendon pain can be treated and prevented.
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The two most common causes of Achilles tendon pain are Achilles tendonitis and Achilles tendinosis.While these conditions sound similar, they describe two different problems.
Achilles tendonitis is an inflammatory injury of the Achilles tendon. It most commonly affects athletes, particularly runners, and people who play sports like tennis that require lots of starts, stops, and turns.
If you have Achilles tendonitis, you may experience pain or burning, in addition to warmth, redness, and swelling in and around the tendon itself.
Causes of Achilles Tendonitis
More often than not, repetitive stress to the Achilles tendon is the cause of Achilles tendonitis. Rarely does an injury cause tendonitis.Some of the exercise problems that can lead to Achilles tendonitis include:
Other factors that may be triggers include:
Certain health conditions or medications can also increase your risk for developing Achilles tendonitis.
Symptoms of Achilles Tendonitis
Signs you may have Achilles tendonitis include:
The exact site of the pain may vary. It can be felt closer to the bottom of the calf muscle, along the actual tendon, or lower down near the heel bone.
Wearing orthotics, doing light Achilles tendon stretches, and taking pain medications can help.
Some people have tendonitis without Achilles tendon pain. They don’t actually know there is a problem, so they don’t seek treatment. This can cause the condition to progress to tendinosis.
Achilles tendinosisdescribes a chronic (long-term) tendon condition. It results from untreated tendonitis. With tendinosis, the collagen fibers that make up the tendon break down.
The primary symptom of Achilles tendinosis is pain. You may also experience burning in the tendon area but without warmth, redness, and swelling seen in Achilles tendonitis. That’s because tendinosis is a degenerative disease, not an inflammatory one.
The causes of Achilles tendinosis are less clear. Theories include overuse, decreased blood supply and tensile strength with aging, muscle imbalance or weakness, insufficient flexibility, and more.
How Tendinosis Differs From Tendinitis
Though rare, an Achilles tendon rupture can also be the cause of Achilles tendon pain. An Achilles tendon rupture happens when the tendon fibers tear and separate, either completely or in part. You may or may not need surgery depending on the extent of your injury and other health factors.
Causes of Achilles Tendon Rupture
Achilles tendon rupture can occur when a sudden force is exerted upon the tendon, which often happens with sudden pivots of the foot (e.g., when playing basketball). Even a sudden step off a curb or a simple trip can sometimes be enough to overstretch and tear the tendon.
Rupture of the Achilles tendon is often seen in athletes who aren’t very consistent in their training.If you’re a “weekend warrior,” make sure to stretch and strengthen your calf muscles appropriately and wear good, supportive shoes.
Degeneration can also cause the Achilles tendon to rupture. Degenerative changes break down and weaken the structure of the tendon, and this weakened tissue may tear easily.Certain chronic medical conditions such as rheumatoid arthritis, lupus, gout, and diabetes can cause these changes in your Achilles tendon, making it more prone to injury.
Fluoroquinolone can also lead to tendon rupture. This injury usually occurs shortly after this class of medication is started. Of the fluoroquinolones, levofloxacin is associated with the greatest risk of tendon rupture.
Symptoms of Achilles Tendon Rupture
When the Achilles does rupture, some people hear a “pop” or “snap” along with severe heel pain. Many people feel as if someone kicked them in the back of the heel and they turn around to find that no one is behind them.
There may be a visible gap where the tendon is torn.Usually, with a tendon rupture, a person cannot walk or bear weight on their foot, although a small subset of people still can.
Self-care strategies can be used to treat Achilles tendonitis. They also may help in the immediate care of a possible Achilles tendon rupture.
The RICE Method
RICE stands for rest, ice, compression, and elevation.
For a suspected Achilles tendon rupture, place ice immediately on the injury site. Don’t bear weight on the leg, and keep your leg elevated while you’re on the way to the emergency room.
OTC Pain Relievers
Nonsteroidal anti-inflammatory drugs (NSAIDs)such as aspirin and Advil (ibuprofen) can help reduce pain and inflammation. Tylenol (acetaminophen) only treats pain. If you’re not sure which OTC pain reliever to take, talk to your healthcare provider about which one is best for you.
Comparing Acetaminophen and Aspirin
When to See a Healthcare Provider
It’s important to seek medical attention if you develop Achilles tendon pain. This may be pain and/or swelling and warmth in the back of your leg, anywhere from your heel to your calf.
Some symptoms suggest a possible Achilles tendon rupture. They include sudden, severe pain at the back of the leg and/or trouble bearing weight on it. If this happens, seek immediate medical care.
Diagnosis
A medical history and physical exam are needed to diagnose Achilles tendon pain. The physical exam may include inspecting and pressing the area around the Achilles tendon to check for pain, swelling, warmth, and physical signs of an injury. Your healthcare provider will also ask you questions about your symptoms and perform specific physical tests that help identify Achilles tendon weakness or rupture.
An X-ray may be ordered to examine the bones. This will help to identify any issues like bone spurs, degenerative damage, or fracture. Injuries to the tendon can be identified withmagnetic resonance imaging (MRI)or an ultrasound.
Medical Treatments for Achilles Tendon Pain
After diagnosing your Achilles tendon pain, your healthcare provider may prescribe certain treatments, including:
It can take at least two to three months for Achilles tendonitis to go away. It could take longer if you don’t follow the advice you are given about stretching, wearing orthotics, and limiting certain activities.The key to healing and recovery is to stay on top of your care and follow your treatment plan from start to finish.
Support
Using ice and resting may help, but you also want to keep your tendon from moving around too much. Wrap your ankle with an elastic bandage or tape if you have Achilles tendonitis.
For Achilles tendinosis, it’s a good idea to beginexercises that strengthen the calf muscleas soon as your healthcare provider thinks you’re ready. Toe raises, balancing on your toes, and wall stretching can help.
Surgery
An Achilles tendon rupture may need surgical repair within days of the injury.An orthopedic surgeon will suture (stitch) the two ends of the tendon back together. Full recovery can take about four months.
Whether or not you need surgery for a partial tendon tear depends on your age, medical history, your normal level of activity, and how severe the tear is.
Surgery may also be used in tendinosis to remove abnormal tissues and lesions, restore blood flow, and stimulate healing. The type of surgery will be based on the extent of the damage.
Physical Therapy
If you need surgery for an Achilles tendon rupture, physical therapy may be recommended afterward to help you regain strength and mobility. If you have a partial tendon tear, physical therapy or home exercises prevent loss of muscle strength in the foot and ankle.
Some of the physical therapy techniques that may be recommended include:
Cortisone ShotsCorticosteroid injectionsare not recommended for Achilles tendon pain. Corticosteroids can weaken the Achilles tendon, making it more prone to tendonitis and rupture.
Cortisone Shots
Corticosteroid injectionsare not recommended for Achilles tendon pain. Corticosteroids can weaken the Achilles tendon, making it more prone to tendonitis and rupture.
Exercise Program for Achilles Tendon Rupture
Preventing Achilles Tendon Pain
People tend to ignore early warning signs and push through the pain. If your Achilles tendon is sore or aches, you need to pay attention and rest it immediately.
Other tips that may help to prevent an Achilles tendon injury include:
Summary
Tendonitis is common among athletes and results from repetitive stress. It can also stem from health conditions like obesity or a bone spur and, in rare cases, injury. If tendonitis is not treated, you may develop Achilles tendinosis, a more serious and chronic condition. People with tendinosis may need a special rehabilitation program, orthotic shoes, and lifestyle changes.
The sudden, severe pain of an Achilles tendon rupture requires immediate medical attention. A healthcare provider is likely to recommend surgery to repair the rupture as soon as possible. For any Achilles tendon pain, speak to a healthcare provider so that you can get the right diagnosis and treatment before the condition gets worse.
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