Achilles Tendon Tear
(Also known as Partial Achilles Tendon Tear, Partially Torn Achilles Tendon, 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 (figure 1).
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 which place strain on the Achilles tendon such as walking (especially uphill or on uneven surfaces), going up and down stairs, running, jumping, hopping, or when performing heel raises or calf stretches. It is also common for patients to experience pain after these activities with rest especially upon waking in the morning. Swelling in the Achilles region and pain on firmly touching the Achilles tendon may also be present.
Diagnosis of a partially torn Achilles tendon
A thorough subjective and objective examination from a physiotherapist may be sufficient to diagnose a partially torn Achilles tendon. Further investigations such as a MRI scan or Ultrasound may be required to confirm diagnosis and assess the severity of the Achilles tendon tear.
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. (Those patients with significant partial tears that are almost complete ruptures may need to be treated surgically and/or managed as though it is an Achilles Tendon Rupture).
Treatment for a partially torn Achilles tendon
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 physiotherapist. Some of the factors which contribute to the development of this condition include:
- poor flexibility (particularly in the calf and ankle)
- inappropriate or excessive training
- poor biomechanics
- poor foot posture (i.e.. flat feet or high arches)
- inappropriate footwear
- inadequate warm up
- muscle weakness
- poor proprioception or core stability
- lack of fitness or sport specific conditioning
- inadequate rehabilitation following a previous ankle, calf or Achilles tendon injury
- age and bodyweight
Physiotherapy for a partially torn Achilles tendon
Physiotherapy is vital to hasten the healing process and ensure an optimal outcome in all patients with a partial Achilles tendon tear. Treatment may comprise:
- soft tissue massage
- electrotherapy (e.g. ultrasound)
- anti-inflammatory advice
- the use of crutches
- the use of heel wedges
- the use of a protective boot
- joint mobilization
- ice or heat treatment
- Achilles tendon taping
- exercises to improve strength, flexibility, core stability, balance or fitness
- activity modification advice
- biomechanical correction (e.g. the use of orthotics)
- footwear advice
- a gradual return to activity program
- a gradual return to running program
Further intervention for a partially torn Achilles tendon
Despite appropriate physiotherapy management, some patients with a partially torn Achilles tendon do not improve. When this occurs the treating physiotherapist 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.
Exercises for a partially torn Achilles tendon
The following exercises are commonly prescribed to patients with a partially torn Achilles tendon. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 2 – 3 times daily and only provided they do not cause or increase symptoms.
Your physiotherapist can advise when it is appropriate to begin the initial exercises and eventually progress to the intermediate and advanced exercises. As a general rule, addition of exercises or progression to more advanced exercises should take place provided there is no increase in symptoms.
Calf Stretch with Towel
Begin this stretch in long sitting with your leg to be stretched in front of you. Your knee and back should be straight and a towel or rigid band placed around your foot as demonstrated (figure 2). Using your foot, ankle and the towel, bring your toes towards your head until you feel a stretch in the back of your calf, Achilles tendon or leg. Hold for 5 seconds and repeat 10 times at a mild to moderate stretch provided the exercise is pain free.
Resistance Band Calf Strengthening
Begin this exercise with a resistance band around your foot as demonstrated and your foot and ankle held up towards your head (figure 3). Slowly move your foot and ankle down against the resistance band as far as possible and comfortable without pain, tightening your calf muscle. Very slowly return back to the starting position. Repeat 10 – 20 times provided the exercise is pain free.
Rehabilitation Protocol for a partially torn Achilles tendon
Find a Physio for a partially torn Achilles tendon
Find a physiotherapist in your local area who can treat a partially torn Achilles tendon.
- Calf Flexibility Exercises.
- Calf Strengthening Exercises
- Balance Exercises.
- View detailed information on How to use Crutches.
- Learn when to use Ice or Heat ?.
- Learn how to perform Achilles tendon taping.
- Read about essential initial injury management and the R.I.C.E. Regime.
- View our Return to Running Program.
- Do i need Orthotics?.
- Read our Achilles & Heel Diagnostic Guide.
Physiotherapy products for a partially torn Achilles tendon
Some of the most commonly recommended products by physiotherapists for patients with a partially torn Achilles tendon are:
Heel Lifts (Elevators – Talar Made) (Pack of 5 Pairs)
Forearm Crutches Adjustable – Standard Grip
AllCare Wobble Board (Red – ACWOBRD)
AllCare Ortho Night Splint
AllCare Spikey Massage Ball
Heat Wheat Handy Pack
Medipak Hot & Cold Pack (15 x 22cm)
AllCare Foam Roller Round
AllCare Ortho Standard Walker (Cam Boot)
To purchase physiotherapy products for an Achilles tendon tear click on one of the above links or visit the PhysioAdvisor Shop.
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