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What is Achilles Tendinitis and Rupture?

The Achilles tendon is named for the Greek hero Achilles, who was dipped in a river by the gods to make him indestructible. But where he was held – at the back of his ankle – the river water did not touch. And this was his only weakness – his Achilles heel. Although Achilles died when struck by an arrow in his heel, Achilles tendinitis and rupture is not life threatening. But it can be quite painful and debilitating.

The Achilles tendon is a large tendon that connects the two major calf muscles to the back of the heel bone. When the calf muscles contract, they pull on the Achilles tendon, causing the foot to point down. This pulling is what allows us to stand on our toes, run, climb, and jump.

Achilles tendinitis is an inflammation of the tissues surrounding the tendon, causing weakness in the tendon as well as pain and irritation, especially when the tendon is being stretched. Achilles tendon rupture is difficult to miss. There may be a snapping sound, accompanied by sharp pain, swelling, and inability to stand on the toes. A gap in the tendon can be felt soon after the injury.

Causes of Achilles Tendinitis and Rupture

Achilles tendinitis is a common problem for athletes. It can be caused by tight or tired calf muscles, which increases the work that the tendon must do. Jumping across a puddle in the street is a common way to tear the tendon.

For athletes or anyone exercising, the condition can be brought on by overuse of the tendon through improper warm-up, a sudden increase in activity or its intensity, running programs that overtrain, do not provide enough rest or include too much hill work.

Contributing factors include age, since the tendon tends to weaken as we become older, shoes that fit poorly or are not proper running shoes or that rub on the tendon. High arches in the foot, deformity in the heel bone, and overpronation can also play a role. Shoes with heels, especially high heels, can, over time, cause the Achilles tendon to shorten and increase its susceptibility to inflammation. A direct blow to the lower leg, foot, or ankle – such as from a long jump or from contact sports like football – can cause trauma to the tendon that results in an Achilles Tendon strain or even rupture.

Symptoms of Achilles Tendinitis

  • Pain and irritation at the back of the heel
  • Swelling over the tendon
  • Pain (dull or sharp) anywhere along the back of the tendon
  • Development of a nodule (a lump of scar tissue) on the tendon
  • You may hear a "crackling" sound from the nodule rubbing against the tendon
  • Pain in the lower part of the calf muscle
  • Orthotic devices

Symptoms of Achilles Rupture

  • Intense, sharp pain
  • A sharp snapping sound
  • Heavy swelling
  • Inability to stand or lift off the toes and a painful gait.

Treatments of Achilles Tendinitis and Rupture

As with many injuries that can result from exercise, the best treatment is prevention. Proper warm-up will prevent many Achilles injuries from occurring.

If you are experiencing any of the symptoms described for tendinitis, stop exercise immediately. Take aspirin, ibuprofen, or other anti-inflammatory drugs for the pain and inflammation. Ice applied every fifteen minutes to the area will help with swelling and pain, as will massage.

There are two main treatments for a ruptured Achilles tendon – surgery and use of a cast without surgery. The latter is somewhat controversial. Surgery for a ruptured Achilles tendon consists of re-attaching the ends of the torn tendon, followed by six to eight weeks in a cast.

Whether you have experienced irritation, swelling, or an Achilles rupture, you should ease gradually back into use of the ankle. Do exercises to stretch the Achilles and strengthen the calf muscles to avoid reoccurrence of the condition.

The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician.

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