ATHLETIC EDGE
Sports Medicine
Sports Injury Prevention & Rehabilitation
 540 BRYANT ST, PALO ALTO, CA 94301
(650) 815-6552

Voted Best Sports Therapy Clinic in the San Francisco Bay Area 2010-2016!

Achilles Tendon Tear

Also known as Achilles Tendon Partial Tear, Achilles Tendon Strain)
 
What is a partially torn Achilles tendon?
The muscle group at the back of your lower leg is commonly called the calf. The calf comprises of 2 major muscles one of which originates from above the knee joint (gastrocnemius) the other of which originates from below the knee joint (soleus). Both of these muscles insert into the heel bone via the Achilles tendon.
During contraction of the calf, tension is placed through the Achilles tendon. When this tension is excessive due to too much repetition or high force, the Achilles tendon can be torn. Tears to the Achilles tendon can range from a small partial tear whereby there is minimal pain and minimal loss of function, to a complete rupture which may require surgical reconstruction.

Cause of a partially torn Achilles tendon
Achilles tendon tears most commonly occur when a patient attempts to accelerate from a stationary position or when lunging forwards such as while playing tennis or squash. Occasionally they may occur due to repetitive strain associated with overuse (e.g. walking or running excessively).
Signs and symptoms of a partially torn Achilles tendon
Patients with a partially torn Achilles tendon typically experience a sudden onset of achilles pain during the causative activity. Symptoms may increase during activities placing strain on the achilles tendon such as walking (especially uphill), going up and down stairs, running, jumping or hopping. It is also common for patients to experience pain after these activities with rest especially upon waking in the morning. Swelling and tenderness may also be present in the Achilles region.

Diagnosis of a partially torn Achilles tendon
A thorough subjective and objective examination from a physician may be sufficient to diagnose a partially torn Achilles tendon. Diagnosis may be confirmed with MRI scan or Ultrasound investigation.

Treatment for a partially torn Achilles tendon
Most patients with a partially torn Achilles tendon heal well with an appropriate physiotherapy program. The success rate of this program is largely dictated by patient compliance with the program. One of the key components of the program is that the patient rests sufficiently from ANY activity that increases their pain until they are symptom free (crutches are often required). This allows the body to begin the healing process in the absence of further tissue damage. Once the patient can perform these activities pain free, a gradual return to these activities is indicated provided there is no increase in symptoms.
Patients with this condition should follow RICE in the initial phase of injury. RICE is beneficial in the first 72 hours following injury or when inflammatory signes are present (i.e. morning pain or pain with rest). RICE involves rest from aggravating activities (crutches are often required), regular icing, the use of a compression bandage and keeping the leg elevated. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation.
A graduated and pain-free flexibility, strength and return to activity program under direction from a physical therapist is vital to ensure an optimal outcome.  

Prognosis of a partially torn Achilles tendon
With appropriate management, patients with minor Achilles tendon tears can usually recover in one to three weeks. With larger tears, recovery may take four to eight weeks or longer depending on the severity.

Contributing factors to the development of a partially torn Achilles tendon
There are several factors which can predispose patients to developing an Achilles tendon tear. These need to be assessed and corrected with direction from your physical therapist. Some of the factors which contribute to the development of this condition include:
  • poor flexibility
  • inappropriate training
  • poor biomechanics
  • poor foot posture
  • inadequate warm up
  • muscle weakness
  • inadequate rehabilitation following a previous ankle, calf or Achilles tendon injury

Physical therapy for a partially torn Achilles tendon

Physical therapy is vital to hasten the healing process and ensure an optimal outcome in all patients with this condition. Treatment may comprise:
  • soft tissue massage
  • electrotherapy (e.g. ultrasound)
  • anti-inflammatory advice
  • the use of crutches
  • stretches
  • joint mobilization
  • ice or heat treatment
  • exercises to improve strength, flexibility or balance
  • education
  • activity modification advice
  • biomechanical correction

Further intervention for a partially torn Achilles tendon
Despite appropriate physical therapy management, some patients with a partially torn Achilles tendon do not improve. When this occurs the treating physical therapist or doctor will advise on the best course of management. This may include pharmaceutical intervention, corticosteroid injection, autologous blood injection or referral to appropriate medical authorities who will advise on any interventions that may be appropriate to improve the condition.