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Achilles Tendon Injuries – Causes & Treatment Options

Dr. Philip Gianfortune

Reviewed by
Dr. Philip Gianfortune

Our Achilles tendon is the one that connects our calf muscles to our heel, and it’s the largest, strongest, and thickest tendon in the body. Located at the back of the ankle, it is also known as the calcaneal tendon or the tendon calcaneus.

It is an extension of two muscles in the lower leg: gastrocnemius and soleus. Another muscle, the plantaris muscle, also connects to the Achilles tendon. The Achilles tendon is about six inches long and begins near the middle of the calf.

It consists of fleshy fibers on its anterior (front) surface, almost to its lower end. It gradually becomes contracted as it’s inserted into the middle part of the posterior (back) surface of the calcaneus (heel bone).

A bursa (a small fluid sac that provides cushion between bones and tendons and/or muscles around a joint, found around most major joints in the body) is located between the tendon and the upper part of the posterior surface. It travels up the calf and is pulled when the calf muscles contract.

Achilles Tendon

This pulling pushes the foot downward. Because of this, we are able to walk, run, jump and stand on our toes. With every step we take, we apply our entire body weight to our Achilles tendon.

Depending on factors such as terrain, speed, stride, and additional weight, our Achilles tendon may be subject to three to twelve times our body weight when pushing off or sprinting. Because of this, it’s very common for the Achilles tendon to become injured.

The most common injuries that happen to the Achilles tendon are Achilles tendonitis and Achilles tendon rupture.

Achilles tendonitis is soreness and stiffness that progresses until it’s treated. Achilles tendon rupture is when the Achilles tendon is either partially or completely torn. The condition comes on suddenly and is usually accompanied by a popping sound and debilitation.

What Causes Injuries to the Achilles Tendon?

There are numerous reasons why an injury would occur to an Achilles tendon. Here are some of the most common causes:

  • Overuse
  • Misalignment
  • Improper footwear
  • Side effect from a medication
  • Accident (could be related to anything ranging from sports to vehicular accidents)
  • People with excessive pronation (flattening of the arch)

Preventing Injuries to the Achilles Tendon

The best way to prevent an injury to your Achilles tendon is by warming up or stretching before any exercise or activity that involves use of the tendon. Strengthening your Achilles tendon can also prevent damage.

If you’ve already injured your Achilles tendon, you can prevent further damage by seeking medical attention immediately. Staying in overall good shape and keeping your tendon strong will contribute to a healthy Achilles tendon.

You should also consider your dietary habits. Like your bones, your Achilles tendon needs nutrients such as calcium to remain strong. Insufficient calcium can lead to tight muscles, which can eventually strain your Achilles tendon.

If you suffer from another type of foot ailment or condition, you should seek medical attention for that too.

For example, if you suffer from the condition known as plantar fasciitis because of the way you walk, you are already at higher risk for developing problems with your Achilles tendon. Any type of condition that can alter or limit your walking, running, or jumping abilities can affect your Achilles tendon.

Other things you can do to prevent injuries to your Achilles tendon include:

  • Wearing proper footwear
  • Begin exercise routines in small increments then increase
  • Stretch between and after exercises
  • Receive regular massages
  • Strengthen your leg and calf muscles
  • Test yourself for injuries, especially after working out or exercising

Common exercises to help you warm up and cool down include the:

  • Achilles Tendon Stretch: While standing on a step (such as on a staircase), slowly lower your heel down over the edge of the step as you relax your calf muscles. Hold for about 15 to 20 seconds then tighten your calf muscle to bring your heel back up to the level of the step. Repeat four times.
  • Calf Stretch: While standing in front of a wall, lean forward with one knee straight and the heel on the ground. Place the other leg in front on you with the knee bent. Push your hips toward the wall for ten seconds to stretch the calf muscle and heel cord. You should be able to feel the calf muscle stretching. Doctors recommend repeating this exercise 20 times for each foot.

Treating an Injured Achilles Tendon

Depending on your injury, your doctor may suggest one of the following treatment options for you:

  • Plenty of rest
  • Muscle strengthening
  • Physical therapy
  • Ice or cold compresses
  • Surgery (in severe cases)

Depending on the severity of your injury, you may or may not need surgery. Surgery involves the surgeon reconnecting the severed ends of a torn tendon. Tendons are naturally elastic and are under constant tension.

When the tendon is severed, the two segments snap away from each other. It is sometimes difficult to retrieve the segments. In this case, a large incision may be required to find them and reattach them.

Although tendon repairs are typically successful, in some cases the foot may be stiffer than before the injury.

Who Do You Contact for an Injured Achilles Tendon?

When it comes to your Achilles tendon, there are a few different medical professionals who can diagnose and treat the injury.

Foot doctors, primary care doctors, sports trainers, and physical therapists are all qualified to assist you. You should never leave an injured Achilles tendon untreated.

Talking to Your Doctor

Here are some questions you may want to ask your doctor about your Achilles tendon:

  • What exercise will strengthen my Achilles tendon?
  • What type of shoes do you recommend I wear for the activities I participate in?
  • What complications can arise with my Achilles tendon?
  • Which over-the-counter orthotics will help prevent injuries to my ankle?
  • Do you believe I am susceptible to Achilles tendon injuries?
  • How often should I stretch my tendon?

Medical References:

  1. American Medical Association "Family Medical Guide" 4th Edition (John Wiley & Sons, Inc. 2004) 981-987
  2. M. Beers "Merck Manual of Medical Information" 2nd home edition (Pocket Books, 2003) 424-425
  3. Professor P. Abrahams "A Complete Guide to How the Body Works, The Atlas of the Human Body" (Amber Books, 2009) 215; 228

This page was last updated on October 2nd, 2015



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