Achilles Tendonitis Tear
What is Achilles Tendonitis/Tear?
Achilles tendonitis is inflammation of the tendon connecting the calf muscles to the heel bone. A tear (partial or complete) can occur due to excessive stress or trauma.
- Common in runners and middle-aged athletes
- Leads to pain at the back of the heel or calf
Overview of the Condition
Repetitive strain, abrupt increases in activity, or insufficient stretching can injure the Achilles tendon. Severe force can cause a rupture, often felt as a pop with immediate difficulty walking.
Symptoms
- Pain and stiffness in the Achilles tendon, especially in the morning
- Thickening of the tendon, tenderness to touch
- Sudden sharp pain and a 'pop' feeling if rupture occurs
Causes
Overuse from running or jumping, tight calf muscles, inadequate conditioning, or a direct trauma. Chronic degeneration (tendinosis) weakens the tendon over time.
Diagnosis
Clinical exam notes tenderness along the tendon and a reduced calf-raise ability. The Thompson test (squeezing calf) checks for rupture. Ultrasound or MRI confirms extent of injury.
Treatment Options
- RICE protocol and activity modification
- Physical therapy with eccentric calf exercises
- Heel lifts or orthotics to reduce stress
- Surgery for complete tears or severe cases
Conservative Management
Mild or partial tears often improve with rest, immobilization (boot), and a structured rehab program focusing on gradual loading of the tendon.
Rehabilitation Exercises
- Eccentric calf lowers on a step
- Plantarflexion/dorsiflexion with resistance bands
- Progressive weight-bearing and balance exercises
When is Surgery Needed?
Complete ruptures or significant partial tears in active individuals often undergo surgical repair to restore tendon continuity and strength.
Surgical Procedures
- Primary end-to-end tendon repair
- Tendon graft augmentation if tissue quality is poor
- Protective boot or cast post-op, followed by rehab
Anatomy Overview
The Achilles is the largest tendon, connecting the gastrocnemius and soleus muscles to the calcaneus. It endures high loads during walking and running.
Affected Areas
- Mid-tendon area (common for tendinitis)
- Insertional area near the heel bone
- Surrounding paratenon, which can become inflamed
Frequently Asked Questions
| Question | Answer |
|---|---|
| How long is recovery after an Achilles rupture? | Typically 4-6 months for basic functional recovery, though return to high-level sports can take up to a year. |
| Can I prevent Achilles tendon injuries? | Proper warm-up, calf stretching, gradual training increases, and supportive footwear can reduce risk. |
Prevention Strategies
- Gradual progression in running or sports
- Regular calf and Achilles stretches
- Avoid sudden increases in training intensity