An Achilles tendon tear is a complete rupture or partial tear in the tendon
running along the back of the lower leg that connects the calf muscles to the heel
bone (calcaneus). Partial and full tears are most likely the result of activities that
involve forceful bursts of jumping, pivoting, or running. The injury commonly occurs
in individuals playing recreational sports. A tear can also be the result of direct
trauma to the Achilles tendon as occurs in an accident or fall. The Achilles tendon
may grow weak with age or prolonged inactivity and become even more susceptible
to injury or rupture.
The Achilles tendon is the thickest and strongest tendon in the human body.
A tough band of fibrous tissue, it is also known as the calcaneal tendon or heel cord.
The Achilles tendon is formed as the gastrocnemius and soleus muscles (calf
muscles) unite into one band of tissue at the low end of the calf. Its terminal
insertion is at the back of the heel bone and is cushioned by fluid filled sacs known
as bursae. Although the Achilles tendon has an extraordinary ability to withstand
great stress from running, jumping, and all of the daily activities, it is also prone to
injury from overuse, degeneration, and trauma.
The Achilles tendon has a massive job to do. As the calf muscles contract, the
heel by way of this tendon, is lifted. This action allows one to point their foot and
stand on tiptoe. It also produces the majority of force that allows the foot to push
down, which is an essential component of every step whether it be for walking,
running, jumping or any other related movement.
Although the Achilles tendon is quite strong, due to a limited blood supply
and the massive demands placed on the tendon, it is susceptible to injury. When the
Achilles tendon stretches beyond its biomechanical limits, it may tear. Most cases of
involving a tear are the result of a sports activity. It is an especially common injury
in middle–aged “weekend warriors” who participate in sports during their spare
time. Older individuals, as well as those with a history of previous Achilles tendon
injuries, certain illnesses, or taking certain medications, may have a weakened
tendon and have a higher risk of suffering a tear.
Achilles tendon tears can range from micro-tears, with or without symptoms,
to larger ruptures that cause significant pain, swelling and impairment. Additionally,
a tear may occur suddenly or develop gradually over time.
Symptoms of a complete tear or total rupture may include:
- Immediate acute pain often described as being struck by sharp object in the
- A snap or pop at the time of injury
- Difficulty walking and rising up on the toes
- Swelling on the back of the lower leg
In cases of a partial tear the symptoms may vary. The amount of tenderness,
swelling, pain, stiffness and the degree of impairment depends on the severity of the
Diagnosing a torn Achilles tendon begins with a thorough medical history
and the performance of a physical exam. During the clinical examination the doctor
will examine the foot, ankle, and calf, to check for signs of an Achilles tendon injury.
Range of motion, the ability to perform certain movements, and muscle strength will
be evaluated. Imaging tests may be also ordered to fully assess the damage.
Treatment depends on the severity of the rupture as well as an individual’s
health and activity level. Options include both surgical and non-surgical approaches.
For minor ruptures and for individuals who have medical conditions that preclude
surgery, a non-surgical treatment may be suggested. In instances of a complete tear
of the tendon, surgery is typically recommended.