Achilles Tendon Injury and Physical Therapy

By Deborah Holmes, PT

An Achilles tendon injury is one of the most common causes of pain felt behind the heel and up the back of the ankle when walking or running. While Achilles tendon rupture affects both active and inactive individuals, it is most common in active individuals; 24% of athletes develop the condition. Males experience 89% of all Achilles tendon injuries, and an estimated 50% of runners will experience Achilles pain in their running careers. In all individuals, Achilles tendon injury can result in a limited ability to walk, climb stairs, or participate in recreational activities.

If your Achilles tendon ruptures, you might feel a pop or snap, followed by an immediate sharp pain in the back of your ankle and lower leg that is likely to immediately affect your ability to walk properly. Surgery may be an option to repair an Achilles tendon rupture. For many people, however, non-surgical treatment works just as well.

Common Causes of Achilles Tendon Injury

Your Achilles tendon helps you point your foot downward, rise on your toes and push off your foot as you walk. You rely on it virtually every time you move your foot. Ruptures often are caused by a sudden increase in the amount of stress on your Achilles tendon. Most often, Achilles tendon pain is the result of repetitive trauma to the tendon. This could be a repetitive strain and a gradual breakdown of the tissue. This is most often treated with physical therapy.

Common causes include

Increasing the intensity of sports participation, especially in sports that involve jumping

Falling from a height

Stepping into a hole

Age. The peak age for Achilles tendon rupture is 30-40.

Sex. Achilles tendon rupture is up to five times more likely to occur in men than in women.

Recreational sports. Achilles tendon injuries occur more often during sports that involve running, jumping, and sudden starts and stops such as soccer, basketball and tennis.

Steroid injections. Doctors sometimes inject steroids into an ankle joint to reduce pain and inflammation. However, this medication can weaken nearby tendons and has been associated with Achilles tendon ruptures.

Certain medications.

Treatment For Achilles Tendon Injury

The non-surgical treatment approach typically involves wearing a cast or walking boot with wedges to elevate your heel, which allows your torn tendon to heal. This method avoids the risks associated with surgery, such as infection. Whether surgical or non-surgical, you'll go through a rehabilitation program involving physical therapy exercises to strengthen your leg muscles and Achilles tendon.

Physical therapy promotes recovery from Achilles tendon injuries by addressing issues such as pain or swelling of the affected area, and any lack of strength, flexibility, or body control. Most people return to their former level of activity within 4-6 months.