Achilles tendon injury

Damage to the ankle tendon, at the back of your lower leg, above your heel bone can vary in level. The Achilles tendon fibres can swell or stiffen, typically can be caused by overuse or exercising. If the tendon tears, this is often referred to as a rupture.

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Different types of Achilles tendon injury

What is Achilles tendinopathy?

The Achilles tendon is one of the largest tendons in the body located between the foot and ankle, connecting your calf muscles to your heel bone. The Achilles is needed to stand on tip toes and is essential for walking, jogging and running. Tendinopathy is a condition which causes swelling and pain in the Achilles tendon and can occur after injury or overuse.

There are two types of Achilles tendinopathy;

Insertional at its lower end, where it attaches to the heel bone
Non-insertional higher up the tendon towards the calf.

Achilles tendinopathy is most likely to be an overuse injury, where small micro tears can occur following an increase in activity or a change in training pattern, but could occur if you change your footwear. Typical symptoms include swelling and pain in the back of the heel. The symptoms are often worse on exertion, for example during sports, but if left untreated may get worse and start to effect everyday activities such as walking.

What is a ruptured Achilles tendon?

Your Achilles tendon connects your heel bone to your calf muscles. A complete tear can often happen during sport or exercise that involves pushing off the ground sharply, like basketball, gymnastics, tennis, squash or badminton, especially in less conditioned athletes. It's a serious and painful injury which needs treatment.

At the time of your injury, you'll usually feel a sudden and severe pain in the back of your ankle. There may also be a snapping or popping sound. Most people think they've been hit on the back of their ankle. You might find the pain soon settles down into a dull ache. You may also have difficulty pointing your toes downward or standing on tip toes and experience a lack of control in your foot movements.

Foot and ankle twists and falls during sport

How is an achilles injury diagnosed

Your consultant will start by carrying out a full clinical assessment to look at your biomechanical alignment as well as for any obvious thickening along your Achilles tendon. They will also test all your other joints for an underlying rheumatological cause.

You might require an ultrasound scan or an MRI scan to confirm the diagnosis. Your consultant may ask about pain levels and give advice on how to manage these as well as come up with a recommended treatment plan. You may also require an X-ray or blood tests if other conditions are suspected.

What treatments are available for an achilles injury?

There are several treatment options available and your consultant will talk to you about which are best for you. Most cases of Achilles tendinopathy respond to a specialised physiotherapy rehabilitation programme.

Other treatments may include a combination of:

orthotics, or foot posture
Shockwave® therapy
steroid (cortisone) injections, which are only used in rare circumstances
surgery, which may be recommended for cases not responding to non-operative measures

There are two main options for managing an Achilles tendon rupture, which have similar healing times and will be discussed in full with your consultant.

The first is to immobilise the tendon in a plaster cast, brace or protective boot, most likely with your toes pointed down. You'll have to use crutches and keep the weight off it for at least four weeks. It will usually take 10-12 weeks to heal fully.

The second is a surgical procedure to reattach the separated tendon ends. It will then need rest in a plaster or a protective boot as it heals. A surgical repair is associated with a slightly lower chance of re-rupture than non-operative management.

Book an appointment with an Achilles tendon specialist

Achilles injuries need prompt action to address the pain and difficulty walking. The severity of the injury will need to be assessed by a specialist to avoid any long-term effects. Contact us today to book an appointment with a consultant to treat your Achilles injury and if required, schedule surgery to repair the rupture.

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