Achilles tendon

The Achilles tendon connects the calf muscles with the heel bone and serves to transfer force. It enables us to walk and stretch the foot. It becomes narrower as it runs from the middle of the lower leg to the heel bone.

Cause: pain in the Achilles tendon

Pain can occur in the Achilles tendon as a result of overloading or incorrect loading - for example due to too much sport. This can be caused by shortened, tense or tired calf muscles, insufficient warm-up or a rapid increase in the training load. Irritation can cause the tendon to become inflamed or even rupture due to heavy acute strain.

Symptoms of an inflamed Achilles tendon

This becomes noticeable through pain. Due to the swollen tendon, the affected person reacts sensitively to strain, for example. They may also experience diffuse, sometimes stabbing pain in various places and limited mobility of the ankle joint.

An Achilles tendon rupture - often in the case of chronic progression or severe acute strain - is often noticeable through a tearing or popping sound. The affected person suddenly feels severe pain in the area of the Achilles tendon or lower calf. Another typical symptom is a limping gait with a twisted foot.

Diagnosis of Achilles tendon rupture

When making a diagnosis, it is important for the treating doctor to know how the pain is triggered, for example by sport, an illness or exercise habits. In most cases, severe swelling and redness develop in the first few hours after the tear occurs and the area turns blue. During the subsequent physical examination, the doctor checks whether the patient can walk on tiptoe or stand on one leg. The ankle joint is tested for pain sensitivity. If the Achilles tendon is torn, the doctor can also feel the tendon a few centimetres above the heel and detect a dent.

Another method of diagnosing a rupture of the Achilles tendon is the so-called calf pinch test. This involves the doctor squeezing the calf muscles. If the foot does not move reflexively downwards with the toe as usual, there is probably a torn Achilles tendon. In an ultrasound examination, the doctor can also see the structures of the Achilles tendon. In the event of a tear, the ends of the tendon and the gap between them can be easily visualized.

Treatment: How is an Achilles tendon tear treated?

In the case of a fresh tear, the Achilles tendon can usually be sutured in an operation. Our specialists often reconstruct older and larger tears with a replacement. It is important that the operation is performed as soon as possible after the accident in order to regain the greatest possible functionality. If there is no tendon left, a donor tendon can be used. To ensure undisturbed healing after treatment, strain should be avoided for the time being.