Achilles Tendon Injuries: Causes, Symptoms, and Treatments
Doctor SpotlightOct 19, 2023
Medical disclaimer: This content is for general educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Seek medical care for a sudden injury, severe pain, or trouble walking, and call emergency services if you believe you have a medical emergency.
The Achilles tendon connects your calf muscles to your heel bone. It helps you walk, run, climb stairs, and jump. Because it handles a lot of force, it can get irritated over time or tear suddenly.
Key takeaways
- Most Achilles pain is from overuse (often called Achilles tendonitis or tendinopathy).
- A sudden “pop,” sharp pain, and trouble pushing off can be signs of a rupture (tear).
- Early evaluation matters, especially if you can’t walk normally or your pain is severe.
What problems can affect the Achilles tendon?
1) Achilles tendonitis / tendinopathy (overuse)
Achilles tendonitis is usually an overuse injury. The tendon gets stressed again and again without enough recovery time. As Dr. Paul Maloof of Tidewater Orthopaedics explains, “The word ‘itis’ means inflammation,” but many cases also involve wear-and-tear changes in the tendon (often called tendinopathy).
Common triggers include:
- Suddenly increasing walking, running, or sports
- Starting a new workout plan
- Hill training or speed work
- Changing shoes (or worn-out shoes)
- Tight calves or limited ankle flexibility
2) Achilles tendon rupture (tear)
A rupture often happens during sports or quick movements (like pushing off, cutting, or jumping). Many people feel or hear a “pop.” After that, it may be hard to push off the foot or stand on tiptoes.
Symptoms to watch for
Symptoms of Achilles tendonitis / tendinopathy
- Pain or soreness in the back of the ankle or lower calf
- Stiffness, often worse in the morning
- Swelling or thickening along the tendon
- Pain that gets worse with activity
Symptoms of Achilles rupture
- A sudden “pop” sensation
- Sharp pain in the back of the ankle or calf
- Weakness and trouble pushing off the foot
- Difficulty walking normally
Types of Achilles tendonitis
Insertional Achilles tendonitis
This happens where the tendon attaches to the heel bone.
- Pain is often right at the back of the heel.
- Shoes can rub and make it worse.
- Some people develop extra bone at the attachment point (often called a bone spur).
Non-insertional Achilles tendonitis
This happens higher up in the tendon, above the heel. It is common in active adults and is often related to overuse.
When to get urgent care
- You felt or heard a “pop” and now have sudden pain or weakness.
- You can’t push off the foot or can’t walk normally.
- You have severe swelling, new numbness, or worsening pain.
How Achilles injuries are diagnosed
A clinician will ask about your symptoms and activities and examine the ankle and calf. If a rupture is suspected, your provider may do specific tests and may order imaging (like ultrasound or MRI) depending on the situation.
Treatment options
Conservative care (often first for tendonitis / tendinopathy)
Many cases improve with non-surgical care. Your plan may include:
- Activity changes (reducing impact and allowing the tendon to calm down)
- Physical therapy to improve strength and flexibility
- Short-term immobilization when needed
- Shoe changes, heel lifts, or inserts to reduce strain
Surgery is usually considered only if symptoms do not improve after a full trial of non-surgical treatment.
Treatment for Achilles rupture
Ruptures may be treated with surgery or with non-surgical options, depending on the patient and the tear. If surgery is chosen, the tendon may be repaired by bringing the torn ends back together. A structured rehab plan is important either way.
Recovery and rehabilitation
Recovery time depends on the exact injury and the treatment used. After a rupture, rehab commonly takes months. Many people need around 6–12 months to get back to higher-impact activities, but timelines vary.
Rehab often focuses on:
- Safe return to walking
- Restoring ankle range of motion
- Building calf strength
- Gradual return to running, jumping, and sport when appropriate
Personalized care at Tidewater Orthopaedics
Achilles problems can limit work, exercise, and daily life. Tidewater Orthopaedics’ foot and ankle team evaluates the cause of your pain and builds a plan that fits your goals. If you’re dealing with Achilles pain, consider scheduling an evaluation.
Q&A
What does the Achilles tendon do?
It connects the calf muscles to the heel bone and helps you push off when you walk, run, and jump.
What is the most common cause of Achilles pain?
Overuse. This can happen after doing “too much, too soon,” changing workouts, or switching footwear.
What’s the difference between insertional and non-insertional Achilles tendonitis?
Insertional pain is where the tendon attaches to the heel bone. Non-insertional pain is higher up in the tendon.
How do I know if I tore my Achilles?
A rupture often causes a sudden pop, sharp pain, weakness, and trouble pushing off the foot. If this happens, get evaluated right away.
How long does recovery take?
It depends on the injury and treatment. Overuse injuries may improve over weeks to months with a structured plan. After a rupture, rehab commonly takes months, and many people need around 6–12 months before returning to higher-impact activity.
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