Achilles tendon injuries

The Achilles tendon (often called the 'Achilles') is the thick cord at the back of your ankle. It attaches the calf muscle to the back of your heel.

The 2 most common injuries of the Achilles tendon are:

• Achillies rupture (break)
• Achilles tendinopathy

Achilles rupture is a common injury that occurs when your tendon is stretched past its natural range.

Achilles tendinopathy is a long-term condition that weakens your Achilles tendon. This happens when your Achilles tendon is not able to heal from many small tears keep occurring. This is a degenerative condition.

Achilles tendinopathy was previously called 'tendinitis'. Tendinitis is a type of inflammation of the tendon.

The symptoms of Achilles tendinopathy include:

• the Achilles tendon being sore to touch
• swelling around your heel and lower leg
• pain when walking or jumping
• stiffness, mostly in the morning or after being still for some time

If you tear your Achilles tendon, it can feel like a strike to the back of your ankle. You may also hear a popping sound.

If you have pain under your heel, it is usually not an Achilles tendon problem.

Achilles tendinopathy is caused by overloading or weakening of your Achilles tendon. This may happen because of:

• a sudden change in physical activity
• less rest time between activities
• exercising in cold weather
• tight or weak calf muscles
• getting older
• a family history of tendon problems

Achilles tendon rupture usually happens because of a sudden load. This can be due to:

• jumping
• sudden bursts of running
• some medicines, such as certain antibiotics, that weaken your tendons

To diagnose a tendon injury, your doctor or physiotherapist will ask about your symptoms and feel the Achilles tendon and calf.

They may also ask you do physical tasks such as hopping or standing on your toes.

You may need an ultrasound or MRI to help confirm the problem. This is often not needed.

You should see a doctor or physiotherapist for advice if:

• the pain started after a sudden movement like running
• you feel weakness or can't move your foot down
• the pain is severe
• you have swelling
• your pain does not improve over a few days

If your pain has not improved after treatment, go back to your doctor or physiotherapist. They can change your treatment plan. It can sometimes take months for your symptoms to get better.

Most Achilles tendon injuries can be treated without surgery.

Self-care at home

Depending on the type of injury, your doctor or physiotherapist may advise you to:

• take pain relief medicine — like paracetamol
• avoid activities that increase your pain
• wear supportive shoes or even a small heel lift
• do gradual exercises to improve your calf strength
• tape your foot and heel

Medicines for Achilles tendon injuries

Check with your doctor if anti-inflammatory medicine is right for you.

Other treatment options

In some situations, you may need surgery to repair your torn Achilles tendon, but often this is not needed.

Most people need a program for rehabilitation. The time it takes for a full recovery will depend on factors such as age, activity level and overall health.

A common complication of Achilles tendon rupture is deep vein thrombosis (DVT). Surgery can also result in wound complications

Achilles tendons can tear again.

You can help protect your Achilles tendons by:

• slowly building up your level of physical activity
• resting between workouts
• doing exercises that strengthen your calf muscles
• changing or avoiding activities that cause you pain

For more information about the causes, diagnosis and management of Achilles heel injuries, visit Sports Medicine Australia.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.