Achilles Tendonitits Strain Causes, Symptoms & Treatment Options
An Achilles strain is a sudden injury to the Achilles tendon, the strong band of tissue that connects the calf muscles to the heel bone. It often happens during sports or activity when pushing off, jumping, or sprinting. This injury can cause sharp pain, swelling, and difficulty walking or running right after it occurs.
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The calf is made up of two primary Achilles muscles: the gastrocnemius and the soleus. These muscles join together to form the Achilles tendon, a strong, fibrous band that runs down the back of the lower leg and attaches to the heel bone.
The Achilles tendon plays a crucial role in providing push-off strength, balance, and stability during everyday movements such as standing and walking, as well as higher-impact activities like running and jumping. When the tendon is overstressed, it can become strained or partially torn, leading to pain, stiffness, and difficulty walking or running.
An Achilles strain happens suddenly from an injury, while Achilles tendonitis develops slowly over time from repeated overuse.
Repetitive sports activities, sudden increases in training intensity, or improper footwear can also contribute to Achilles overuse and strain.
What causes Achilles Strain Causes, Symptoms & Treatment Options?
An Achilles tendon strain occurs when the calf muscle contracts forcefully while being stretched at the same time. This often happens during sudden movements and high-impact activities. Repeated stress, tendon microtears, calf tightness, poor flexibility, or inadequate warm-up can increase the risk, especially during intense physical activity.
- How the Injury Occurs: The injury develops when sudden force or repeated stress exceeds the tendon’s ability to absorb load.
- Common Everyday Causes: Walking uphill, climbing stairs, wearing unsupportive footwear, sudden increases in daily activity, or prolonged standing.
Achilles tendon strains are most common in these sports:
- Tennis and other racket sports: Quick direction changes and explosive push-offs overload the tendons.
- Soccer: Sprinting, jumping, and sudden stops place repeated strain on the Achilles tendon.
- Running: Repetitive impact and overtraining gradually weaken the tendon fibers.
Symptoms
Achilles tendon strains usually come on suddenly. Athletes with this injury find it difficult to push off the injured leg when walking. The most common symptom of an Achilles tendon strain is pain in the back of the heel. Other symptoms include difficulty walking and exercising. In many cases, these symptoms are a result of cumulative Achilles overuse.
When to see a doctor
If you experience an injury and have pain in the back of your heel or leg, or if you experience difficulty walking due to pain or weakness during push off, you should see your doctor. During your visit, your doctor will inspect your calf and make sure that you do not have signs of rupture, such as tenderness, swelling, a gap in the tendon, or shortening of the calf. To help diagnose an Achilles tendon injury, your doctor may perform a test called the Thompson test. During this exam, you lie face down while your knees are bent. The doctor gently squeezes the calf muscle.
In a normal Achilles tendon, squeezing the calf causes the foot to move downward. If the Achilles tendon is completely torn, the foot does not move. If the tendon is strained or only partially torn, the foot usually still moves, but it may be painful or weaker than normal. Your doctor may also order imaging tests, such as a magnetic resonance imaging (MRI) test, to make sure you do not have an Achilles tendon rupture.
Non-operative treatment
Treatment for Achilles tendon strains is almost always non-operative and focuses on reducing pain, supporting healing, and restoring Achilles tendon function.
Conservative treatments may include:
- Using crutches: Reduces weight-bearing to allow the tendon and calf muscles to rest and heal.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen or naproxen help manage pain and inflammation.
- Applying ice: Helps decrease swelling and provides pain relief in the early stages of injury.
- Compression: Supports the tendon and limits swelling in the lower leg.
- Wearing a brace or boot: Restricts ankle movement to protect the tendon during recovery.
- Physical therapy or home exercises: Improves flexibility, strength, and circulation to promote healing.
Try these exercises to help address your condition:
Below is a PDF of the Exercise Program
Surgical Treatment
If an Achilles tendon strain doesn’t improve with conservative treatment after several months, your doctor may refer you to an orthopaedic surgeon. Surgery may be needed to remove scar tissue, repair the damaged tendon, extend the calf muscle, or address other issues identified by your doctor.
Recovery
Recovery from an Achilles strain will vary depending on the extent of damage to the tendon. For some athletes, strains will resolve in a matter of days with treatment. For others, a much longer recovery time will be required before they can return to play. Physical therapy or a home exercise program will be an important part of the rehabilitation process and will help to ensure that the problem will not occur again.
Dr. Jay Kimmel is a board-certified orthopedic surgeon specializing in sports medicine, arthroscopic surgery, and shoulder and knee disorders. He completed his orthopedic training at New York-Presbyterian/Columbia University Medical Center and a Sports Medicine Fellowship at Temple University.
Dr. Kimmel previously served as the Director of the Connecticut Sports Medicine Institute at Saint Francis Hospital and has held faculty appointments as Clinical Assistant Professor in the Departments of Orthopedics and Family Medicine at the University of Connecticut. He has extensive experience caring for athletes as a team physician for high school and collegiate programs and continues to teach in the athletic training departments at Westfield State University and Springfield College.
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/MonthFrequently Asked Questions
Can I continue to exercise following an Achilles strain?
It's important to avoid activities that worsen your symptoms. Low-impact exercises like swimming or cycling may be safer alternatives, but you should consult your doctor or physical therapist before continuing any physical activity. Ignoring the pain and pushing through it could lead to more severe injury.
How long does it take to recover from an Achilles strain?
Recovery time depends on the severity of the strain and how early treatment begins. Mild cases may resolve within a few days to weeks with proper care, while moderate to severe strains may take several months to fully heal. Adhering to a structured rehabilitation plan, including physical therapy, can speed up recovery.
What are the signs that my Achilles strain may be something more serious, like an Achilles rupture?
Severe pain associated with swelling and inability to push off may be signs of something more serious, like a tendon rupture. If you experience a sudden "pop" or loss of function, seek medical attention immediately to rule out a rupture.
Can an Achilles strain be prevented?
Yes, preventive steps can reduce your risk. These include regular calf stretching and strengthening exercises, proper warm-up before activities, wearing supportive footwear, and gradually increasing the intensity of physical activity. Maintaining flexibility and strength in the lower leg muscles is key to preventing Achilles overuse injuries.