The Achilles tendon, which connects the calf muscle to the heel of the foot, is a key player in how well the legs, feet, and ankles work together. This tendon is susceptible to injuries and can tear partially or completely. Tears require immediate treatment.
How to Know If You Need Treatment
You may not have symptoms if you have a small tear in your Achilles tendon. If the tear is severe, however, then you may experience swelling, weakness, decreased range of motion and pain. The pain tends to be very sharp and have a sudden onset, although it may not present until the tendon gets a chance to rest and circulation decreases to the site of injury. Sometimes it is described as a pop or a snap. The area may be stiff, especially in the morning when the tendon and surrounding tissues have not warmed up fully. Any of these symptoms is a sign that treatment is needed.
Rest is recommended for Achilles tendon tears and ruptures. This means a cessation of physical activities that involve the calves, ankles, and feet, such as soccer or running. You may need to be on crutches as the tear heals so that you do not put pressure on the tendon. Note that this is the exact opposite treatment for Achilles tendinosis, which is degeneration of the tendon tissue. You also should apply ice, compress the area, and elevate the ankle. This is known as the RICE method of treatment (Rest, Ice, Compress, Elevate).
Depending on the severity of the tear, you may need to have your ankle braced or splinted. Walking boots or a cast may also be used. These are placed on the ankle so that the tendon is not strained by further movements.
Severe tears may warrant surgical treatment in which the tendon is reattached. Those who have to have surgery have the option of having open surgery (one large incision) or percutaneous surgery (several small incisions). Re-rupture rates are similar between the two types, but the incision from open surgery may not heal as well, and nerves can be damaged during percutaneous surgery. Regardless of type, surgery sometimes has to be put off for a week or so until the swelling has gone down. You will need a cast for at least 6 weeks with surgery.
Pain medications such as Ibuprofen may be taken for relief from Achilles-tendon-tear pain and swelling. If you have had surgery, then your doctor can decide if a stronger prescription is necessary to keep you comfortable. Again, make sure you are dealing with a tear and not tendinosis--with tendinosis, anti-inflammatory pain medications can mask the problem and make it worse.
Exercise and Stretches
Once your Achilles tendon has had a chance to heal, your doctor may suggest gentle stretches such as bending forward with both feet flat on the ground. He also may suggest strengthening exercises such as riding a stationary bike. Apply cold packs after stretching or exercising the tendon to keep inflammation down.
If your Achilles tendon continues to give you pain after treatment, try a change in footwear. Use a shoe that has at least a 2 cm heel. This relieves pain by shortening the tendon and thereby reducing the amount of stretching and work that it has to do.