Achilles Tendon

Achilles Tendon Tears: How Do They Happen And How Are They Fixed The recent news regarding professional soccer star David Beckhams Achilles tendon tear last week has renewed interest in this injury. Unfortunately, injuries of this type are not uncommon, and prompt treatment is required to prevent long term problems from occurring, some of which can lead to chronic pain and disability. This article discusses the nature of Achilles tendon ruptures, and how they are best treated.

The Achilles tendon is a strong, firm rope-like tissue that allows the muscles in the back of the legs to move the foot and ankle. This motion effectively moves the ankle downward, and resists it from moving too far upward. The Achilles tendon is powerful and sturdy, but is not always resistant to injury. A tremendous amount of force is constantly applied to this tendon as it connects the foot to the leg during walking and standing. The tendon has a natural weak area a couple inches above where it connects to the heel, called the watershed region. Chronic stress and strain can eventually cause tissue in this spot to weaken and fray. This chronic stress and strain can come from walking on slopes, stairs, ladders, or other uneven surfaces regularly, or from simple repetitive athletic activities when one has not stretched their calf properly. Over time the damage will gradually increase. The tendons weak spot has less blood supply than the rest of the tendon, so any low grade damage will multiply over time as the tendon is less able to heal itself in this spot. Once the damaged area is weak enough, only a relatively minor injury is needed for the tendon to tear and rupture. This is especially seen in people who have chronic Achilles tendonitis (inflammation) that ignore the warning pain and do not seek treatment.

The Achilles tendon can also be forcefully ruptured when it is strong and healthy. This injury occurs when the ankle is violently forced upward while ones foot is resisting by pushing the ankle downward. This can also occur when the knee is forcefully straightened while the ankle is flexed upward. Direct injury to the tendon, such as cutting injuries like slicing the heel on glass or a lawnmower blade can also rupture the Achilles tendon. Heavy pressure (without breaking the skin) directed exactly on the Achilles tendon can create the same injury.

Sometimes, one does not even need to have a significant injury or chronic strain to cause the Achilles tendon to rupture. Certain diseases can produce a state in which the Achilles tendon is naturally weaker and more prone to rupture. These include rheumatoid arthritis, gout, lupus, and tuberculosis. The long term use of steroid medication for inflammation, or the injection of cortisone-like steroid in the Achilles tendon region can lead to a weakening of the fibers that compose the tendon itself. A certain class of antibiotics can also produce the same effect.

Once the Achilles tendon has ruptured, walking becomes incredibly difficult and unsteady. Those who have ruptured their Achilles tendon have reported hearing a popping or snapping sound, and feeling like they have been punched in the back of the heel. It can be a searing pain that is soon followed by bruising, swelling, warmth increase to the skin, redness, and sometimes even a depression under the skin in thinner people if the Achilles tendon is prominent. The foot will have more of a tendency to flop upwards, and bending the ankle downward will be difficult, if not impossible. Because of this instability, walking on that leg will be very difficult.

Achilles tendon ruptures are fairly easy to diagnose for most physicians, although an MRI is often performed to confirm the rupture and assess the amount of tissue damage. Upon examining, the doctor will note the swelling and pain, as well as a possible gap where the Achilles tendon is usually located. The calf muscle may feel balled-up, and certain functionals tests will be performed to assess the strength and functional loss of the calf muscles. The MRI will help guide the doctor in planning surgery to fix the tissue rupture, and will show if there is any other special injury pattern that needs to be considered, such as chronic tendon degeneration or a significant retraction of the tendon up into the leg.

Treatment usually requires surgery to repair the ruptured ends of the tendon. The vast majority of these injuries are treated with surgery, as non-surgical treatment does not necessarily allow for the strongest repair and healing potential. When needed, non-surgical treatment consists of placement in a below knee cast with crutches. This can be performed on partial ruptures, but those with full ruptures of the Achilles tendon will need surgery. There are those for whom surgery is not advisable due to age, health reasons or other complications, and that is why non-surgical care is sometimes performed in a full rupture. Surgery consists of bringing the ruptured ends of the tendon back into a position where they are touching, stitching the ruptured ends together with strong non-absorbing suture, and holding the ankle locked into position for four to eight weeks while the split ends heal together. It is very important the ankle does not move during this time, as the tendon could re-rupture prior to its healing if there is enough force to rip through the stitched areas. When surgery is delayed for too long (weeks to months) following the injury, the tendon can retract up the leg, widening the gap between the torn ends. This makes repair very difficult, and the tendon needs to be lengthened or grafts need to be used to bridge the gap and allow tendon tissue to creep across the severed ends. Tendon lengthening can be done by making small cuts in the tendon substance above the rupture to stretch it downward, or it can be accomplished by releasing tight tissue near the calf muscle belly that holds the tendon suspended. If this is not enough to bring the tendon ends back down together, then graft material has to be used to replace the lost tendon length. This graft can be from another human, or it can be from an animal or artificial substance. Regardless of what must be done to complete the repair, Achilles tendon repair surgery is usually followed by four weeks of non-weightbearing with a below knee cast and crutches, with at least four weeks of protective weightbearing to follow. Physical therapy and rehabilitation is necessary after the tendon is strong enough not to rupture again in the post-operative time period. A return to full activity, especially for a world class athlete like David Beckham, can take many months all together.

As one can see, Achilles tendon ruptures are serious injuries that, although not life threatening, can lead to serious disability if not promptly and correctly treated. Surgery is usually necessary, and a protective recovery period is needed for the best results.

Frequently Asked Questions

  1. QUESTION:
    Achilles tendon?
    im doing a gym paper and i have to do Achilles tendon and i wanted to know:

    how do you get a torn Achilles tendon??
    do you need crutches or a cast??
    and which one it worse…a torn Achilles tendon, a ruptured Achilles tendon, or Achilles tendinitis??
    and which one heals slower?? thanks=]

    • ANSWER:
      a torn achilles can come from any kind of explosive movement like jumping or sprinting. If it’s torn you will more than likely need an MRI and possible surgery. A torn and a ruptured achilles tendon is the same thing. Tendinitis is simply an inflammation of the tendon and just requires rest….a tear requires surgery usually but some opt not to do it.

  2. QUESTION:
    achilles tendon?
    i know you can’t pull your foot downward if you tear your achilles tendon..but can you raise it?
    i need this for bio homework

    • ANSWER:
      Yes, you can raise your foot if your Achilles’ tendon is torn. The muscles of the anterior thigh (tibialis anterior) and lateral thigh (peroneal muscles) attach to the foot with different tendons.

      It would be quite painful, though.

  3. QUESTION:
    Achilles Tendon?
    I think I hurt my Achilles tendon but I am not sure. Here is what I feel let mek now what you think!?!?
    Pain when flexing my right foot.
    the outside of my heel is numb and tingeling.
    Pain when certain things touch my heel.
    Walking sometimes kills me.
    When I sit or get up in the am I can barely walk.
    I am taking Ibu for swelling and Tylenol for pain. could it be that achilles tendon or something else.

    • ANSWER:
      Sounds like it could be your achilles tendon or a stone bruise in your heel. I have had achilles tendonitis, and it is really painful, but it affects the calf muscle alot more than the heel. Don’t get me wrong the heel does hurt, but your tendon and calf hurt more! I had to the point that I couldn’t walk without crutches and had to do the electro-massage therapy (can’t remember the correct term. It really sounds like a possiblity. If not that then it could be a stone bruise which can develope into other problems. I have added really informative links from orthoinfo.aaos.org. Look them over. Remember, if it changes your daily life, you have problems sleeping, or lasts more than 3 days, you SHOULD have it checked out! Only a doctor can give you a solid answer and the care you need to get back to being 100%, so just go! Good luck!
      P.S. There is also another condition that sounds like what you are describing called plantar faciitis. I have included that link as well.

      http://orthoinfo.aaos.org/topic.cfm?topic=A00147 (achilles)
      http://orthoinfo.aaos.org/topic.cfm?topic=A00159 (heel pain)

      http://orthoinfo.aaos.org/topic.cfm?topic=A00149

      (plantar faciitis)

  4. QUESTION:
    My Achilles tendon is making a popping noise when a I walk. How do I treat it?
    I overdid my run this morning. My Achilles tendon is sore and popping when I walk on it. This happened once before and I just stayed off of it. Before I go to bed tonight, what can/should I do? Heat pad? Ice? Elevate?
    Any specific stretches?

    Ideas and suggestions wanted. I know how important and fragile this Achilles tendon is.

    Please be as detailed and specific as possible.
    THANK you for the help on this.

    • ANSWER:
      rest, ice, compression, elevation
      if you need to, get an ankle brace or even go to the orthopedic

  5. QUESTION:
    What causes a tight achilles tendon? How can it be diagnosed and treated?
    I’m just wondering how a tight achilles tendon is diagnosed and what causes it along with how it can be treated?

    • ANSWER:

      There are 2 conditions which may cause a tight achilles tendon.

      1) Achilles Tendon Bursitis
      2) Achilles Tendinitis

      In the first one, achilles tendon bursitis, is where a tissue on the back of your heel called teh bursa, becomes inflammed. You will know if you see a mildly red sowllen tender spot on the back of your heel. This is commonly caused by your footwear or the way you walk somehow repeatedly applies pressure to your bursa, resulting in inflammation.

      In the second one, achilles tenditis, occurs when stresses placed on the tendon are greater than the tendon’s strength. Running uphill or downhill repeatedly can overwork your achilles tendon. Or wearing a stiff-soled shoes (shoes that don’t bend particularly well) can overwork your achilles tendon as well.

      Hope that helps

  6. QUESTION:
    How long after I injure my achilles tendon before I can return to tennis?
    While serving in tennis, I felt my achilles tendon “give”. It almost felt like my heel stayed on the ground. After a week of ice and rest it felt better. I tried tennis for 45 minutes with no problems. The 2nd time I tried tennis I felt the “give” in my achilles again. After a few days I can walk fine, and even run w/o pain. What is going on?

    • ANSWER:
      maybe working to hard ask a doctor tell him you still want to play you might not be resting it enough :P

  7. QUESTION:
    What happened to David Beckhams achilles tendon lastnight?
    I saw on the news that he has now got a fractured achilles tendon and that he is having it examined in Finalnd today. What actually happened as I missed the match .
    Sorry not fractured ruputured I meant sorry :)

    • ANSWER:
      it got torn… tendons don’t get fractured, they are not bones.

  8. QUESTION:
    How much effect does the achilles tendon play in plantar fasciitis?
    My podiatrist says all the pain is caused from the tight achilles tendon, is it true.

    • ANSWER:
      It very well could be. If the achilles tendon is too tight, it would be causing constant pressure (pulling) on the Plantar facia, thus making it tired / sore.

  9. QUESTION:
    How can I do to treat/prevent soreness in my achilles tendon?
    About a month ago I began my career in law enforcement. My duty uniform requires that I wear tactical type boots. My achilles tendon(s) do not bother me while wearing my boots but anytime I jog my achilles hurts badly, so bad to the point where I am unable to run (which sucks because I need to stay in shape for my job). I came across this article and think this may possible be my problem.

    “Women who wear high-heeled shoes often and switch to sneakers for exercise also can develop Achilles tendonitis. The Achilles tendon and lower leg muscles gradually adapt to a shortened position because the shoes prevent the heel from stretching all the way to the ground.

    When this occurs, wearing sneakers or flat shoes forces the Achilles tendon to stretch further than it is accustomed to, causing inflammation. If high heels are worn everyday, stretching should be done every morning and night to keep the Achilles tendon lengthened.”

    What if anything else can I do to relieve my pain?

    • ANSWER:
      i would suggest getting some like dr sholls sols for your shoes and when ever you dont have to where the shoes dont . you could even get a new apir of sheos if tha would help at all? work out your tendon …..

  10. QUESTION:
    How long does it take for an achilles tendon injury take to heal?
    I started a running regimen 6 weeks ago. I got up to 4 miles a day, 5 days a week. One day i over did it and ran 12 miles within 24 hours. My achilles tendon started hurting the next day. It still hasn’t healed and it has been 3 weeks since the injuiry. I don’t think its ruptured because I still have full use of it. Any suggestions?

    • ANSWER:
      yeah its probably nothign bad, but you should tape your ankle everywhere you go, even if your just walking to work, you want to have maximum support. stop runnig if you havent done so yet. i got one of those during fball season and i just stopped doing stuff for a week (comp0letely) not even jogging, and it healed in a little over a week

  11. QUESTION:
    How can I increase mobility in my achilles tendon?
    As a ballet dancer you need to have long achilles tendon for deep demi-plies, however I was unfortunately born with short ones so my demi-plies are very short and do not support the beautiful illusion of the ballerina I need to obtain. Does anyone know how to help me increase mobility in my achilles tendon? Thank you!
    How exactly do I stretch it with a towel?

    • ANSWER:
      hey!

      the best way that i can suggest is to make sure that you do demi-plies everyday as this is continuing to stretch your achilles. (don’t let your heels come off the floor when you practice these). try sitting in your plies for a few minutes slowly edging lower if possible then shaking out and doing it again. another thing that i would suggest is standing with you legs together feet parallel and the squatting down as low as you can go without lifting your heels. the aim of that stretch is to put your bottom on you heels or the floor. you’ll notice that they will lengthen after doing that stretch for a while. hope this helps =)

  12. QUESTION:
    How long does the achilles tendon healing?
    I ripped my achilles tendon, so how long would it take me to heal it?

    • ANSWER:

      https://www.youtube.com/user/TandMProductionCo

  13. QUESTION:
    How long does Achilles Tendon rupture pain last?
    I ruptured my Achilles Tendon a week ago and have never known such pain. Is this normal? It is getting worse by the day.

    • ANSWER:
      Because of the fact that this pain is getting worse by the day I would recommend going to see your doctor for further evaluation of the situation.

  14. QUESTION:
    Why does my achilles tendon hurt when I wake up?
    I’ve had tightness and pain in my right, and sometimes left, achilles tendon for the past several weeks. The strange thing is, it only seems to be when I first wake up in the morning. As the day progresses it feels as though it gets stretched out and back to normal.

    I’ve done nothing physically that could have caused this, no over-exertion of the area through running or other sports.

    Any idea what/why this could be?

    • ANSWER:
      I get this as well and was confused as to why. It turned out to be a simple answer. I at times sleep on my stomach and sometimes on my back. Both ways lead to my toes pointing down. So when I wake up and start to move especially when I step on the floor my achilles then start to stretch causing some discomfort. I find that if I wake at all during the night I flex my feet back and forth or due so before I get out of bed and it alleviates most of it.

  15. QUESTION:
    What are the signs of a pop achilles tendon?
    From time to time i will tip toe and hear and feel my achilles tendon snap or pop, the pain is bearable but it is still there when it happens… Other than the initial pop their is no other pain in my achilles…. What is it and what should i do?

    • ANSWER:
      i don’t know why the Achilles’ would make popping sounds. it’s definitely not torn or else you wouldn’t be able to tip toe. it could be a little arthritis in your ankle joint.

      try going to a physical therapist to get it checked out. in the mean time, don’t do anything that hurts the area or makes it pop.

  16. QUESTION:
    What can I do for my achilles tendon pain?
    I don’t know what I did to it, but my achilles tendon started hurting a couple days ago and has been getting gradually worse, mostly when I walk. It’s starting to make this creaking sound when I move it around too. Kinda icky.

    So does anybody have any advice on what to do for it? I can’t stay off it all the time though. I have places to be, and no car.

    • ANSWER:
      Treatment approaches for Achilles tendonitis or tendonosis are selected on the basis of how long the injury has been present and the degree of damage to the tendon. In the early stage, when there is sudden (acute) inflammation, one or more of the following options may be recommended:

      •Immobilization. Immobilization may involve the use of a cast or removable walking boot to reduce forces through the Achilles tendon and promote healing.
      •Ice. To reduce swelling due to inflammation, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice directly against the skin.
      •Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation in the early stage of the condition.
      •Orthotics. For those with over-pronation or gait abnormalities, custom orthotic devices may be prescribed.
      •Night splints. Night splints help to maintain a stretch in the Achilles tendon during sleep.
      •Physical therapy. Physical therapy may include strengthening exercises, soft-tissue massage/mobilization, gait and running re-education, stretching, and ultrasound therapy.

  17. QUESTION:
    How much weight does it take to break an Achilles tendon?
    I searched quite a bit for the answerer, but to no avail:
    If you were to take an average, healthy Achilles tendon and hang a weight off of it, how much weight could it take?

    (I structured the question like this because I don’t want to know the force or pounds per square inch, but rather the actual weight.. KG, stone or pounds).

    Cheers.

    • ANSWER:
      300 maybe 350

  18. QUESTION:
    What is this dry skin on my achilles tendon?
    I’ve recently developed a thick layer of dry skin where my Achilles tendon is. Is this exema or athletes foot? How do I treat it?

    • ANSWER:
      Haglunds….google it.

  19. QUESTION:
    What would happen if you cut your achilles tendon with a razor blade, like in the movies?
    I have been told that if you got your achilles tendon cut like that, the tendon would shoot all the way up your leg ripping through your flesh and skin since the tendon is under so much tension to start with it would be like a broken spring… is that right or what would happen step by step… and please don’t leave out the gory stuff, just since it’s Halloween season.

    • ANSWER:
      You sound like the kind of person who’d pull out their ‘eye tooth’ just to see if your eyeball would come with it.

  20. QUESTION:
    Why can’t the body successfully heal an achilles tendon injury or degeneration?
    The body can do all sorts of amazing things to heal itself but it seems to me that its one weak point is the achilles heal. No pun intended. I’ve had achilles problems for two years and have done everything under the sun to treat it, and still have pain all the time. Why is this? Why can’t it heal a tendon like it does throughout other parts of the body?

    • ANSWER:
      I have the exact same problem. My achilles tendons have been giving me serious problems for over 2 years now. It all started when I suffered a small tear in my left achilles 2 years ago and I’m pretty much positive that if I had let it heal in the right manner, then I wouldn’t be having any problems today. I however, just kept walking on it and continuing to go to work and it healed all messed up and with scar tissue preventing the proper blood flow needed to regenerate. I think that the blood flow issue plays a big role in why the achilles won’t heal if there’s a bunch of scar tissue with low blood flow in place where healthy tissue should be. I’ve read that when scar tissue builds up, it can do so while containing very few capillaries at first and the tissue will have a very hard time regenerating until new ones find their way in. Also, chronic tendonitis can lead to tendinosis where constant stressing leaves fibers of the tendon wavy and disoriented making their structure much weaker and inelastic. Normal tendon fibers are lined up and oriented nicely which give them strength and elasticity. Check out this page on what I’m talking about:

      http://eccentric-exercises.blogspot.com/

      My achilles doesn’t look abnormal in any way when looked at externally so it’s not like there’s tons of scar tissue built up but there must be a blood flow issue because healing is slow to non existent and the tendon is extremely weak. I try to rest it as much as possible, I hardly walk around on it at all. I get around the house by scooting around on my butt while hearing athletic pants that slide on the carpet easier. It wasn’t always that bad but it’s gotten worse over time. Accidental overstresses, trips while walking, overuse and accidental over stretching have all lead to it’s demise.
      I know, isn’t that crazy how the tendon just doesn’t seem to get better no matter what you do? The funny thing is, people who rupture their achilles completely and have it surgically repaired, casted and healed in a non-weightbearing manner, can return to pretty much full activity.
      There is a female olympic gymnast named courtney kupets who has suffered TWO complete achilles ruptures and is still competing in gymnastics. The stress that an achilles has to suffer during gymnastics is insane and I saw her the other day just tearing it up on the floor exercise event with no problems at all. That’s funny because all I had was a very tiny tear in my achilles and it’s two years later and my achilles is so weak that I can barely walk.
      It’s all in how the whether or not the achilles is given the right conditions to heal properly I believe. There’s simply no other explanation for it. I’ve heard stories from other people who have suffered achilles injuries that weren’t total ruptures who continued to walk on them and end up just like you and me.
      It’s so unbelievably messed up that it is what it is as far as that when they get bad, they seem to stay bad. It has ruined my life COMPLETELY and if I had my choice between a billion dollars or my achilles back, I would take the achilles for sure. I’m sure that you
      eel the same way. The scary part is that I’ve never heard a story of a person having an achilles injury that
      asted for over 2 years and recovered from it, although I’m sure that it happens, I’ve just never heard it.
      We should keep in touch and report if we find anything that really helps or with any success stories. Right now, my achilles are so weak that I can’t even stretch them but you should check out this stretching technique and see if it helps you. I posted it in response to another achilles question:

      http://answers.yahoo.com/question/index;_ylt=AtSr.dnaOcLgJXP0wTTQKXfsy6IX;_ylv=3?qid=20090211113212AAN4iBs&show=7#profile-info-AA11180253

      My email is wdbwdb111@yahoo.com, maybe you could tell the story of how your injury started and how it got to where it is today, I’d be interested to hear it.

  21. QUESTION:
    What can I do to reduce the pain in my achilles tendon?
    Yesterday, I began to feel pain in my achilles tendon. I think I hurt it by sitting in an awkward position yesterday. What home remedies can I do to reduce the pain? Thanks.

    • ANSWER:
      An old Irish home remedy I learned from my grandmother when I was a young lad in Cork was to ice it down and take over-the-counter pain killers.

  22. QUESTION:
    How to prevent vans shoes from blistering your achilles tendon?
    I just wore my knew vans and after an hour i had my achilles tendon blistered on both feet and i was wondering if there’s a way to prevent the blistering for next time or that i have to break them in and if so how?

    • ANSWER:
      Just they don’t fit!

  23. QUESTION:
    How long does it take for a ruptured achilles tendon to heal?
    My oldest brother Kristofferson (22) ruptured his achilles tendon during a soccer/football match this morning.
    How long will he be out?

    • ANSWER:

      http://www.achillestendonblog.com/

  24. QUESTION:
    Why does my Achilles tendon hurt when I run?
    Several months ago I sprained my ankle pretty badly and had to stay off it for a while. The ankle is fine now, however, sometimes when I run, and this has only happened since the sprain, my Achilles tendon starts to hurt pretty badly. I saw a specialist about it and was told it’s just weak from under usage when it was injured. Does this seem accurate or could something else be wrong after the sprain?

    • ANSWER:
      It probably was part of the injury. You might try wrapping it and also put ice on it afterwards. Also topical arnica. But I am not a doctor!

  25. QUESTION:
    Who are some professional athletes with achilles tendon injuries?
    I am looking for some names of professional athletes (it doesn’t matter which sport) who have experienced Achilles tendon injuries lately?
    If you could provide me with links to articles about the person and the injury that would be great.

    • ANSWER:
      Sadly Achille’s tendon tears and injuries are common in professional sports. Actually a recent study came out that said 1/3 of the NFL players are sidelined with an Achille’s tendon injury, whether it be a tear, rupture or tendonitis. Typically, this are non-contact injuries.

      David Beckham
      Vanessa Zamarippa
      Fabian Hambuechen
      Vinny Testaverde
      Misty May-Treanor
      Usain Bolt
      Thomas Vermaelen

  26. QUESTION:
    If you model the Achilles tendon as a spring, what is its spring constant?
    When you walk, your Achilles tendon, which connects your heel to your calf muscles, repeatedly stretches and contracts, much like a spring. This helps make walking more efficient. Suppose your Achilles tendon is 15 long and has a cross-section area of 110 , typical values.

    How do i solve this when i’m not given a force?

    • ANSWER:
      been too long since I had physics but i just have to say that this is an awesome question

  27. QUESTION:
    Do you enjoy massaging your achilles tendon?
    I really enjoy applying pressure to my achilles tendon by flexing my foot forward and massaging it with the back of my thumb and the knuckles of my finger. It’s painful, but it’s a good kind of pain and I find it also soothing and relaxing. I’ve been massaging my achilles tendons mostly everyday for a really long time. I was just curious to see if anyone had the same habit.

    • ANSWER:
      Yeah, it does. I try to fit it in with my yoga. Body stimulation is always good.

  28. QUESTION:
    How much would a tattoo on the side of my achilles tendon hurt?
    I’m looking to get 3 small “x” going vertically down either the inside, or outside of my achilles tendon. I was wondering how much this would hurt in comparison to other body parts

    • ANSWER:
      i hope someone answers this question because i want to get my second tatt done there also..

  29. QUESTION:
    How can you tell if you pulled your achilles tendon?
    I played soccer (causually, not like a game) a few days ago but now when I walk on my right foot my achilles tendon feels stretched and sore. It hurts less when i bend my foot back probably because i’m not stretching it. Now I’m not sure if anything’s wrong with it. How can I tell what’s wrong, if anything?
    It also looks a little swollen compared to my left tendon.

    • ANSWER:
      If you lay on your stomach and try to flex your foot and then try to point your toes. If this is difficult for you to do you might want to check it out with a doctor.

  30. QUESTION:
    Is it possible to tear your achilles tendon and not have any swelling?
    I accidentally stepped in a hole earlier today, I guess those things normally do happen on accident right. :) I did hear a pop and think I may have torn my achilles however I am not sure because there is no swelling only severe pain. Is it possible to tear a tendon and have no swelling?

    • ANSWER:
      I had the same thing happen to me. You need to pay real close attention to what I’m about to tell you because I spend alot of time every day wishing that I could go back to the point in time during my injury that you are in now.
      I had that same small pop in my achilles tendon and there was alot of pain afterwards but no swelling. The tendon looked and felt normal to the touch but I was walking with quite a limp. I thought that it might clear itself up and just kept walking on it, although I did no exercising whatsoever, only walking. Well, it’s almost 2 years later and the injury is still extremely bad. It is very weak, very inflexible and I can’t walk or stand for too long without making it worse.
      I’m so glad that I looked at this question today because now I have a chance to relay some very important information to you that is coming from direct experience and from the same situation. I would honestly give a million dollars to go back the stage of my injury that you are in now, knowing what I know now. My injury was the result of overuse and finally a quick movement led to what felt like a small pop or a light-to-moderate finger flick on the back of my achilles.
      What you have suffered is most likely a partial tear. Your symptoms and the fact that there is no swelling and that a pop was felt really make me believe that you have an injury that is very similar to what I had. If you had a complete rupture (torn in half) I think that there would be a lot of swelling and you would be able to feel an impression or hole where the tear was. A way to test for a rupture is to use the Thompson Test. You can give this to yourself or someone else can do it for you, look it up on line and here’s a video of it being performed. http://www.youtube.com/watch?v=AmDi08rlR3I
      I strongly believe that I had a small tear and I still suffer to this day because I didn’t do the proper things that would have allowed it to heal properly. I just kept walking on it, although I really cut down on the amount of walking that I did. The fact that I kept using it and walking on it prevented the injury from being able to heal properly due to the constant stress and pulling apart during each step. When muscles or tendons tear, the way that they are repaired is by the small vessels and capillaries bleeding and this blood solidifies and becomes scar tissue. Over time, this scar tissue matures and if let to heal properly can become almost as strong and elastic as the original tendon. If this scar tissue is repeatedly disrupted and pulled apart, more and more scar tissue will be built up and the orientation of the fibers in the tissue will become gnarled and disoriented. The proper orientation of the fibers is really important to strength and elasticity. Fibers are stacked in a straight pattern which gives them strength and the ability to stretch. When they are disoriented, they are nowhere near as strong and stretching them causes the gnarled mass to be pulled apart easily due to the inferior design of its structure.
      Here are some pictures of what I’m talking about along with short articles:

      http://www.athleticadvisor.com/Injuries/General_Inj/tendosis.htm

      http://eccentric-exercises.blogspot.com/

      The condition that I’ve developed is called tendinosis and it is the same one that you will develop if you don’t treat the injury like I should have. Tendinosis is a result of improperly healed tissues and built up scar tissue as well as disrupted blood flow to the tissue from the damaged capillaries. The result is a “failed” healing and the tissue that is in place of the injury is nothing like the original healthy tissue. This improperly healed tissue is very weak and can’t be stretched much at all or it becomes irritated or causes further injury. I can’t stretch my calves very hard at all and not really hard enough to make much of a stretch in order to elongate them and I can’t extend my foot upwards at much more that a 90 degree angle and this makes it really difficult to walk. The tendons eventually shorten as a result of not being able to stretch them which causes reinjury. If you let the tissue heal properly it will be strong however, strong enough to be stretched and brought back to normal length in order to make regular walking possible and allowing the injury to eventually heal back to normal strength. Here’s the best site that I’ve been able to find on tendinosis: http://www.tendinosis.org/
      First off, I think that it’s of paramount importance that you go and see a doctor and ASAP. I truly, truly believe that the best treatment for you is going to be to certainly at the minimum to be put on crutches and possibly to be put into a cast. Let me tell you from direct experience that if you don’t use crutches, your injury will heal like crap. If I had the chance to go back, I know for a fact that this would have been the proper treatment for me, and I strongly believe that it will be what’s best for you. If you felt a pop and are having severe pain, then you most likely have a small tear. This is serious business and is a very dangerous situation without the proper care; and without the right knowledge on what’s happening and which steps to take, it’s almost certain disaster. Lucky for you, someone who has been in your exact situation just happened to view your question so take what I’m saying very seriously.
      Go see a doctor ASAP and see if he recommends casting. I’m telling you right now, that you should absolutely use crutches from this moment on, no matter what anyone says. It’s great that your injury is still very fresh and you have a really good chance to clear this up if you treat it properly. If you don’t you will be in psychological misery like I am due to the debilitating aftermath of what comes from the neglect of this injury. My life is literally 50% as good as it was before and I don’t want to see this happen to someone else.
      In the mean time you need to be icing it. Ice for 15-20 min. every 2 hours. Take 800mg ibuprofen 3 times a day also, both of these will help reduce the inflammation which will aid in healing. These are both very standard treatments for this injury or any muscle or tendon injury and were prescribed to me by every doctor I’ve ever seen for a muscle or tendon injury.
      My neighbor had this happen to him too. He hyperextended his foot upwards (just like you) by putting his foot down hard while riding a four-wheeler. He went to the doctor and ended up with a partial tear and was put into a cast for 2 or three months, I can’t remember which, I think 2. He said that it took a year until it was back to normal and now he’s doing fine. I think that he had an MRI done to diagnose his injury and if you don’t have insurance, they cost over 00. If you do have insurance, tell them that you want one done and if you don’t have insurance, they should be able to assume by your symptoms what kind of treatment you should have. Let them know about these storys and that you’re willing to be put on crutches and casted if necessary. If they want to send you to a specialist, then use crutches form this point on until you get the yes or no on crutches or casting. I’m telling you that you most likely will need them by what you describe and they certainly can’t hurt in any way. Even if the injury is minor (which if you felt a pop is not considered minor) crutches will definitely help regardless and if the injury is what I believe that it is, then crutches will prevent a disaster.
      I’ve read stories from others who had the same thing I had happen to them also, it’s very real and could happen to you too. Take care of this now and don’t let this ruin your life like it’s ruined the hell out of mine. Email me by all means if you want at werqwed@yahoo.com and good luck.

  31. QUESTION:
    what to do for a strained Achilles tendon?
    I strained my achilles tendon and I heard that stretching it is going to make it worse. Is this true? If so should I be using crutches since it hurts and stretches when I walk?

    • ANSWER:
      Yes stretching will make it worse. You don’t want to stretch it until it has healed enough to stand up to the stretch that you are putting into it. An injury will not heal because it is being stretched, it needs rest which will allow it to recover, then you can stretch it.

  32. QUESTION:
    How do I help a sore achilles tendon?
    So I have to run the 3200 in track 2 days from now. I’m pretty much ready except my achilles tendon has been hurting for the past 3 days. I’ve tried icing it, using that icy hot stuff, and massaging it. What else can I do to make it feel better?

    • ANSWER:
      Be really careful that you don’t do damage to that achilles by overtraining it when it’s injured like that or I can guarantee you’ll be very sorry you did. I’ve suffered from achilles injuries for a while and they are really hard to clear up and the worse they get they harder they are to clear up. It’s also very possible that if you beat up on it too much, that it will never be the same again, I’m dead serious about that.

      Achilles tendons don’t heal well by nature due to a small blood supply and the fact that they have to endure huge amounts of force. And once they get bad, the tissue that heals in the injured area is nowhere near as strong as the original tissue so the key is to avoid getting deep into trouble in the first place. This is one tendon that you really, really need to be able to rely on in life and if you can’t because of a nagging injury, the feeling is utterly devastating.

      I tell you what, I’d rather have my fully functional achilles tendons back more than anything on earth. I’d pass up a trillion dollars no joke to have them back so listen to this now and watch what you’re doing very, very carefully or you could end up doing something that will ruin your life. A track season isn’t worth ruining your life over, the first priority for you is that tendon, take it from me and listen well.

      See a doctor and get their advice and remember, the achilles always comes first!

  33. QUESTION:
    How can Edge return to the Royal Rumble if he tore his achilles tendon?
    How can Edge return to the Royal Rumble if he tore his achilles tendon?
    How will he return January 24th 2010? He tore his achilles tendon won’t that take about a year to heal? He got injured July 3rd 2009.

    • ANSWER:
      Maybe they will push it back a little to give Edge time to rehab his injury. I am 100% sure he will be #30 at the Royal Rumble.

      My predictions for #30:

      Batista:No he will return by Late Fall/Winter
      Undertaker:Sceduled to return at Breaking Point
      Jeff Hardy:He might be on Hiatus, after Summerslam. I doubt they will give #30 to Jeff because he would not be as over with the fans as a Face version of Edge.

  34. QUESTION:
    how do I treat a torn achilles tendon bump?
    Tore my Achilles tendon last year at the join with the calf. Now have a bump much further down near the heel. It is aggravated by physio toe raise exercises. Any ideas what the bump might mean? Professionals seem flummoxed. Injury triggered blood clot which is receding.

    • ANSWER:
      Strains are injuries that affect muscles or tendons, thick bands that attach muscles to bones. They occur in response to a quick tear, twist, or pull of the muscle. Strains are an acute type of injury that results from overstretching or over contraction. Pain, weakness, and muscle spasms are common symptoms experienced after a strain occurs.

      Sprains are injuries that affect ligaments, thick bands of cartilage that attach bone to bone. They occur in response to a stretch or tear of a ligament. Sprains are an acute type of injury that results from trauma such as a fall or outside force that displaces the surrounding joint from its normal alignment. Sprains can range from a mild ligamentous stretch to a complete tear. Bruising, swelling, instability, and painful movement are common symptoms experienced after a sprain occurs.

      RICE is the acronym used for Rest, Ice, Compression, and Elevation. It is used as the best initial treatment of soft tissue injuries such as sprains, strains, and contusions. The combination of RICE helps reduce inflammation that occurs after acute injury. It is important to remember that the earlier this treatment is put into place, the more effective it is.

      Rest: Rest and protect the injured area. If it hurts to bear weight on the injury, use crutches, or a cane.

      Ice: Apply ice to the injury. The cold will reduce swelling and pain at the injured site. This step should be done as soon as possible. Apply the frozen object to the area for 20 minutes three times a day for the first 48 hours.

      Compression: Compress the injured site. This will decreases swelling of the injured region. Although the wrap should be snug, make sure it is not too tight as this can cause numbness, tingling, or increased pain.

      Elevation: Elevate the injured area above the level of the heart as much as possible. This technique will also assist in reducing the amount of swelling to the injured site.

      Once the pain and swelling are eliminated, you should start gradual range of motion exercises but not to the point of pain. Each day your range of motion will increase slightly. Continue until you have complete range of motion. Than start gentle strengthening exercises to re-build the strength in the ankle.

      The stiffness will go away over time.

      Good Luck

  35. QUESTION:
    How do I know if I seriously injured my achilles tendon or just bruised it?
    I’m a cheerleader and today at practice my coach was spotting me on a skill and I somehow kicked his elbow and ever since then my achilles tendon has been really sore and it hurts to walk on it or stretch it out. I’ve iced it and rested it but it still hurts, should I be worried?

    • ANSWER:
      Don’t push it too hard if it still hurts to walk. It is possible that you damaged your achilles tendon, but if you CAN walk, its probably not that bad. If it doesn’t seem to be improving in 4-6 days, go see a doctor.

  36. QUESTION:
    How long does it take to return to basketball after surgery on an achilles tendon?
    basically they want to cut half of my achilles tendon where it attaches to the bone and clear out scar tissue and stuff from an old surgery I’d had as a baby… anyone have any ideas how long that’ll take to heal so i can play again and what the actual surgery and recovery would include?

    • ANSWER:
      K K, there are a lot of variables to this. One is the shape you are in going into the procedure. The better the shape the better the results. How tight is the tendon? If it is very tight then you are going to require a longer rehab time. The reason for this is that you are going to have to master the use of the extra range of motion. You will also have to develop more strength in an area that the muscle has not worked. What kind of surgery did you originally have and why? These are all important factors in the recovery time. You should count on being out of basketball for about 6 months depending on the severity of the surgery and your dedication to your rehab.

  37. QUESTION:
    Why is there a large bump on the back of my heel after achilles tendon surgery?
    I am 9 weeks out after having a bone spur on the back of my heel removed and my achilles tendon reattached to the bone with anchors. Also, when will I be able to stand on my toes again? It seems impossible at this point. I have been walking again for three weeks.

    • ANSWER:
      You might be interested in looking at http://www.bonespur.com This website tells how people have eliminated their bone spur naturally.

  38. QUESTION:
    How long and how often should I ice my achilles tendon?
    I either have have mild achilles tendonitis or a strained achilles tendon from overuse. Either way it’s a problem. I’ve cut back my workout to just 20 minutes on the treadmill rather than an hour (20 minutes of that hour was running). I’ve been icing it and taking anti inflamatories. My wife says anything over 10 minutes is useless. so how long should I ice it and how many times a day should I ice it? Any thoughts?

    • ANSWER:
      The general rule for an ACUTE injury is RICE: Rest, Ice, Compression and Elevation. The compression would be from an elastic bandage. The ice should only be applied for the first 48 hours after an injury; and then only for 20 minutes at a time. Wait 20 – 30 minutes before applying ice again.The reason for this is that prolonged application of ice can reduce blood flow to such an extent that healing may be delayed or worse, frostbite injury may occur. Practically speaking, however, most ice bags or cold bags will have warmed up some so the risk is somewhat reduced. The purpose of the ice and compression is to reduce swelling. After 48 hours, you switch to mild heat in order to get more blood flow to the area and to speed healing.

      This is the standard advice for an ACUTE injury. However, you indicate that this is an overuse injury and that you are continuing to use the treadmill. So this is no longer an acute injury, but a chronic injury. The advice in this case would be to switch activities. Since the treadmill is continually re-aggravating your injury and preventing the Achilles tendon from healing, why not switch to a bike (uses your quads more and puts much less strain on the Achilles tendon), walking in a pool, putting the treadmill in a decline position (if it allows), or switching to an upper body aerobic activity like a rowing machine.. Avoid exercises that use your calf muscles like skipping rope.

  39. QUESTION:
    How can I help my husband heal from Achilles’ tendon surgery?
    he had surgery on his achilles tendon in march of this year, and he is recovering slowly, or is he?

    • ANSWER:
      Ask your doctor about physical therapy or an orthopedist.

  40. QUESTION:
    How much does it hurt to snap your Achilles Tendon?
    Also, how debilitating would it be for say, a figure skater to snap their Achilles tendon?
    O_O I don’t intend to hurt anyone. I want to make that clear. I’m simply curious.

    • ANSWER:
      Extremely. That could end a skaters career. Don’t go and hurt anyone.

  41. QUESTION:
    I cannot bend my toes inward because my achilles tendon hurts too much, what is the problem?
    I can’t even bend my toes it is not even an option. My achilles tendon really hurts whenever I try to.

    • ANSWER:
      Achilles tendonitis

  42. QUESTION:
    How can you tear your achilles tendon?
    I heard of someone on then seniour basketball team that tore her achilles tendon- how does that work? Like how would u have to fall?

    • ANSWER:

  43. QUESTION:
    Will an ankle brace help keep an inflamed achilles tendon from hurting while running?
    I THINK it’s an inflamed achilles tendon. Pain behind the heel after running long distances? Sounds about right.

    • ANSWER:
      You shouldn’t even be running if you damaged your foot and you think you need a brace.

  44. QUESTION:
    What type of cast do you get right after achilles tendon surgery?
    I’m having a surgery that my surgeon says rehabs exactly like an Achilles tendon rupture. Directly after the surgery do you get an actual cast? and if so do i get to choose the color? or is it just going to be the fiberglass with an ace bandage? if anyone can tell me what to expect right after that would be great too… like if i can watch my team’s basketball game 2 days after surgery

    • ANSWER:
      Hello, Often it varies upon the doctor. You can request that it be put into a cast. It is your treatment option right. You could also have a Cam Walker boot as well.
      As far as color you can choose that too. Often the doctor may not have the color you want. You may also want to think about getting waterproof cast padding. That is something doctors may not have as well. There more information at the link in the source.
      If you have more questions please ask.
      Remember, the doctor will make the treatment to fit the patient. You have to request the kind of treatment that you want as well.

  45. QUESTION:
    How do I define my achilles tendon?
    Okay, I know this sounds really strange and not that important, but I am curious and I’d like some input here.

    My whole life, I’ve never been able to see my achilles tendon. I have a suspicion it’s due to walking on my toes and in heels because of my petite height, therefore making them smaller. What would I do to lengthen and define my achilles tendon? I also would like to achieve slimmer ankles as well, as my legs tend to carry most of my body weight.

    • ANSWER:
      1. Avoid sitting for long periods, as this accumulates fluid in your feet and ankles.

      2. Slimming the legs involves slimming the entire body.

      3. You need to spend a lot more time in flats or barefoot. Put an 8-hour limit on your wearing of heels each day, and walk a mile each day in regular sneakers.

  46. QUESTION:
    How much disability will i receive from va from a ruptured achilles tendon when i get out of the usmc?
    I ruptured my achilles tendon pting for the corp and was just wondering if anyone knows how much money or percentage the va would give me for it. i’ve heard alot of estimates. just wondering if anyone had maybe facts or something close to it

    • ANSWER:
      This is where the VA maintains their schedule of ratings. You need to find the section that deals with your issue and search through there. I would start in “musculoskeletal” if I were you.

      http://www.warms.vba.va.gov/bookc.html

      I hope this helps. Email me if you need further assistance. I am a veteran with a disability rating. I have dealt A LOT with the VA. It can be frustrating and time consuming.

  47. QUESTION:
    how can I strengthen my calf muscle and my achilles tendon?
    I have over-compensated on one of my legs so now one is noticeably bigger than the other, only below the knee, what ways are there to bring my legs back to equal strength and size? Also the achilles tendon on the same leg is quite weak how can I strengthen this?

    • ANSWER:
      You can do wall jumps…. stand on the leg the is weaker (on your tippy toes) and jump up and down. Facing a wall. Set yourself a goal on how many to do. You can start out doing as many as you can for a minute. This worked best for me. When you feel your legs are equal size try it on both legs.

  48. QUESTION:
    Is it possible to have an overactive Achilles Tendon?
    A while back, I had ankle problems and my doctor said its an overactive achilles tendon….. my dad and brother think its not real and the doctor was humoring me, to settle this once and for all- is it possible?

    • ANSWER:
      It is possible to have an overactive Achilles Tendon but it has to be caused by something like a tear in the tendon (caused by maybe a sport injury) or some kind of nerve damage or disease causing malfunction such as a disease like Multiple Sclerosis or some kind of Peripheral neuropathy.
      Hope this helped.

  49. QUESTION:
    Is it OK to stretch a pulled achilles tendon?
    Hi. I pulled my achilles tendon 2 days ago, because I’m really tight all over. It was a pretty good pull, and now it’s sore and a little swollen, but not ruptured. I’d like to stretch it even though it hurts a little when I stretch it. Again I’m really tight all over! Is it OK to stretch it some?

    • ANSWER:
      Why would you wanna stretch it? That’d make it worse! What are you looking to accomplish?

      Static stretching reduces speed, power, force production, and doesn’t decrease (can actually increase) the chance of injury.

      What you want to do is a dynamic warm up. Either biking or jogging, running, for 7-10 minutes (more or less depending on the person), or if you’re doing sports:
      High knees
      Butt kickers
      Side shuffles (feet nearly touch in between each rep)
      Backwards running
      Lunges (get low)
      Karaokes
      Arm Swing, circles
      Running, sprints
      Push ups

      Or even a hot shower for 10 minutes. The goal is to raise the body temperature 1-1 1/2º C.

      Now, why is that?

      “When muscles are stretched beyond natural voluntary ranges of motion, the muscles and tendons are stretched unnaturally. Excessive stretching damages tissues and promotes inflammation [which is really bad if you're going to start lifting or doing explosive movements (ie. sports)]” (Yang, Im, & Wang, 2005). Continual stretching can lead to “lengthened” muscles. That condition leads to two performance altering states.

      1) The range of movement of the joint about which the lengthened muscles gird is increased. That results in the range of effective contraction of the muscles being altered. Maximum muscle performance will have to occur in a different range of motion to the original natural range. IF a lengthened muscle is required still to perform in the orginal natural range, then performance in that range will be reduced because of the extra stretch. Maximally lenghtened muscles about a joint are associated often with a loosening of the joint. Increased leaxity can expose the joint to increased injury through collisions or simply through maximum efforts. Intra-joint movements can also stimulate aggravations to other structural tissues as well as bony structures.

      2) If continued for a long time, muscles, tendons, etc… will start to loose some of their elastic properties, which would further decrease power and speed while increasing the risk of injuries.

      From The Science and Art of Baseball Pitching (which in this section, discusses why one wouldn’t want to stretch, and the literature out there that supports it), 44.4: “Running economy is actually improved when muscles are stiff. Craib, Mitchell, Fields, Cooper, Hopewell, & Morgan (1996) concluded running economy needs natural tightness in lower leg muscles and connective tissues to maximize the storage and return of elastic energy, and reduce the need for stabilizing activity. Continuing with the theme that the elasticity of muscles needs to be preserved for high performances, Jones (2002) attributed running performance to metabolism in the muscles and stiffer musculotendinous structures that facilitate a greater elastic energy return during the shortening phase of the stretch-shortening cycle. A certain level of muscle stiffness preservs the storage and return properties of elastic energy that can be used to generate energy in an activity. The contribution of elastic energy to overall muscle performance is as much as 25-40% (Cavagna & Margaria, 1966; Cavagna, Saibene, & Margaria, 1964).

      Nelson, Driscoll, Landin, Young, and Schexnayder, (2005) found that stretching before sprinting, slowed 20-meter sprint times. A review of data-based investigations led to the conclusion that stretching did not improve performance capability (Ingraham, 2003).”

      From The Science and Art of Baseball Pitching (It has over 500 scientific references), page 44.9: ” When an athlete participates seriously in a sport, that sport develops flexibility of sufficient ranges to meet its most common demands. Turner (1977) found that after six weeks of playing basketball, flexibility changed significantly in a control group that did no particular stretching program. Two forms of stretching programs (PNF and SAS) improved flexibility to a greater degree but a large proportion of those gains were lost within two weeks of cessation (which means they stopped playing) in the sport. Athletes in the stretching program regressed to the level that was stimulated by the activities of the game of basketball itself. The excessive flexibility that resulted from training was lost because it was not stimulated by basketball-alone activities. This phenomenon was also noted by Chevrier (1981) with ice-hockey players.
      Chevrier trained collegiated male ice-hockey players to use both PNF and SAS procedures. He found that the training did not increase flexibility over that which already existed. The ranges of movement caused by a pre-scrimmage warm-up were not maintained during the scrimmage, where two-thirds of the time was spent sitting on the benches. However, upon completion of the scrimmage and its warm-down routine, flexibility once again was at pre-scrimmage pre-stretching levels. An interesting finiding of the study was that flexibility was not retained during the simulated competition. It appears that the bench-sitting was sufficient to allow players to parcially ‘tighten-up’.”

      And it even increases DOMS (delayed onset muscle soreness).

  50. QUESTION:
    How can I strengthen my ankles and achilles tendon?
    i have had severe sprains all my life. why do i keep twisting them at virtually nothing? Also my achilles tendon is hurting more and weak. How can i strengthen my ankles and achilles tendons. thanks

    • ANSWER:
      Stand on your toes a lot.

      You can try standing about two and half feet from a wall and lean forward with your hands pressing against the wall. Bring one leg closer to the wall and lean forward so that the back leg hyper extends the calf muscle. Reverse legs and do it again.