Achilles Tendon Injuries

Your Achilles tendon is the band of tissue that connects your calf muscles to your heel bone. Sometimes called the “heel cord,” it plays a big role in everyday movement, from walking and climbing stairs to jumping and running.

An Achilles tendon injury can involve short-term inflammation, chronic tendon damage, or a partial or complete tear. Achilles tendonitis is often in the acute inflammatory stage. It commonly develops after repetitive stress or a sudden increase in activity. Without appropriate treatment and recovery, ongoing stress can lead to Achilles tendinosis. This chronic condition occurs when weakened tendon fibers begin to form microtears.

If the damage is more severe, it can eventually result in an Achilles tendon rupture, in which the tendon tears partially or completely. The best treatment approach will depend on the type and severity of your injury, which is why having an accurate diagnosis is an important step toward relieving Achilles tendon pain and protecting your mobility now and into the future.

Achilles tendonitis and tendinosis are often classified as overuse injuries. Repeated stress can cause small injuries within the tendon fibers, especially when the tendon doesn’t have enough time to recover between activities. These types of injuries can lead to inflammation, thickening, and weakening of the tendon.

Specific activities and physical factors can place additional stress on the Achilles tendon. Common contributors include:

• A sudden increase in exercise or training intensity
• Repetitive running, jumping, or other high-impact activities
• Tight calf muscles
• Frequent uphill running
• Sports or occupations that continuously load the feet and ankles
• Sporadic high-intensity exercise without regular conditioning
• Excessive pronation, or flattening of the arch
• Wearing worn or poorly supportive footwear

Achilles pain can also occur where the tendon attaches to the heel bone. This is known as insertional heel pain and may be associated with Haglund’s condition. In some cases, bone spurs in this area can further cause irritation and discomfort.

Symptoms may vary depending on whether you have Achilles tendonitis, tendinosis, or a more serious tendon injury, but there are still some patterns to look for:

• Pain and stiffness: You may feel aching, soreness, or tenderness anywhere from right above the heel to below the calf muscle. Pain may flare up in the morning or after resting, resolve somewhat as you move, and return or worsen with activity.
• Tenderness: The tendon may be painful or sensitive when squeezed or touched from the sides.
• Thickening or nodules: With chronic degeneration, areas of the tendon may enlarge or form noticeable nodules.

A ruptured Achilles tendon can cause different symptoms. If you notice sudden sharp pain, a popping sound, or difficulty walking, it may be a sign of a partial or complete rupture. Seek medical attention quickly.

Finding the right treatment starts with understanding what exactly is causing your Achilles pain. Your foot and ankle physician will examine the affected area and monitor for any swelling, tenderness, and range-of-motion restrictions.

If Dr. Kristina Jay, Dr. Paul Bishop, or Dr. Rebecca Varney suspects an Achilles tendon rupture, they may perform additional tests to determine whether the tendon is intact. They may also use X-rays, ultrasound, or MRI imaging to look for degeneration or tearing, measure the severity of the injury, and help guide your treatment plan.