Achilles Tears: Causes, Symptoms, and Treatment

The Achilles tendon, named after the legendary Greek hero Achilles, is the largest and strongest tendon in the human body. Connecting the calf muscles to the heel bone, it plays a crucial role in walking, running, and jumping. Despite its strength, the Achilles tendon is susceptible to injuries, with tears being one of the most common and debilitating.

What Causes Achilles Tears?

Achilles tears can occur due to various factors, including:

1. Overuse: Repetitive stress on the tendon from activities such as running or jumping can lead to microtears. Over time, these microtears can accumulate, resulting in a complete tear.
2. Sudden Increase in Activity: A sudden increase in physical activity, especially without proper conditioning, can strain the Achilles tendon.
3. Age: As we age, the tendon loses flexibility and strength, making it more prone to injuries.
4. Foot Problems: Flat feet or high arches can place extra stress on the tendon.
5. Inadequate Warm-up: Not properly warming up before physical activities can increase the risk of a tear.
6. Medical Conditions: Conditions such as arthritis or diabetes can weaken the tendon.
7. Medications: Certain antibiotics and corticosteroids have been linked to an increased risk of tendon tears.

Symptoms of an Achilles Tear

An Achilles tear can be partial or complete. Common symptoms include:

• Sudden Pain: A sharp pain in the back of the ankle or calf, often described as a feeling of being kicked or hit.
• Swelling: Swelling around the heel and lower calf.
• Inability to Bear Weight: Difficulty walking or standing on the affected leg.
• Stiffness: Stiffness in the ankle and an inability to bend the foot downward.
• Popping Sound: Some people report hearing a popping or snapping sound at the time of the injury.

Diagnosing an Achilles Tear

If you suspect an Achilles tear, it's crucial to seek medical attention promptly. A healthcare provider will typically:

1. Physical Examination: Checking for tenderness, swelling, and range of motion.
2. Thompson Test: Squeezing the calf muscle to see if the foot moves. Lack of movement may indicate a tear.
3. Imaging Tests: Ultrasound or MRI scans can confirm the extent of the tear.

Treatment Options

The treatment for an Achilles tear depends on the severity of the injury and the patient's activity level and overall health.

Non-Surgical Treatment

Non-surgical treatments are often effective for partial tears and for patients who are less active. These may include:

• Rest: Avoiding activities that stress the tendon.
• Ice: Applying ice packs to reduce swelling.
• Compression: Using bandages or braces to immobilize the foot.
• Elevation: Keeping the foot elevated to reduce swelling.
• Medications: Anti-inflammatory drugs to manage pain and swelling.
• Physical Therapy: Exercises to strengthen the tendon and improve flexibility.

Surgical Treatment

Surgery may be necessary for complete tears or for active individuals who want to return to sports. Surgical options include:

• Open Surgery: An incision is made to stitch the torn tendon back together.
• Minimally Invasive Surgery: Smaller incisions are made, and the tendon is stitched using specialized instruments.
• At Garden State Pain and Orthopedics, Dr. Scott Hanauer uses minimally invasive techniques to repair achilles injuries. 

Recovery and Rehabilitation

Recovery from an Achilles tear, whether treated surgically or non-surgically, involves a structured rehabilitation program. This typically includes:

• Immobilization: Initially, the foot is immobilized in a cast or boot.
• Gradual Weight-Bearing: Gradually reintroducing weight-bearing activities.
• Physical Therapy: Exercises to restore strength, flexibility, and range of motion.
• Return to Activity: Gradual return to normal activities, often over several months.

Recovering from an Achilles tear varies based on the severity of the injury, the treatment approach, and individual factors such as age, overall health, and activity level. Most patients take 6-12 months to fully recover. 

Preventing Achilles Tears

While not all Achilles tears can be prevented, you can reduce your risk by:

• Proper Warm-Up: Always warming up before exercising.
• Stretching: Regularly stretching your calf muscles.
• Gradual Increase in Activity: Gradually increasing the intensity and duration of physical activities.
• Proper Footwear: Wearing supportive shoes that fit well.
• Listening to Your Body: Avoiding activities that cause pain or discomfort.

An Achilles tear is a serious injury that requires prompt medical attention. Understanding the causes, symptoms, and treatment options can help you manage the condition effectively and reduce the risk of future injuries. Whether you're an athlete or someone who enjoys an active lifestyle, taking care of your Achilles tendon is crucial for maintaining your mobility and overall health. If you are experiencing any pain and discomfort in your achilles, it is best to see a provider as soon as possible to prevent any further injury. If you are interested in booking an appointment with our Foot and Ankle Specialist, Dr. Scott Hanauer, you can choose a time by clicking our “Book Now” button.