The Achilles tendon is the largest and thickest tendon in the human body. It is located at the back of the lower leg, connecting the calf muscles to the heel bone. This robust fibrous tissue transmits the force generated by the calf muscles to the foot, enabling important movements. The Achilles tendon allows for plantarflexion, the action of pointing the foot downward, which is necessary for walking, running, jumping, and standing on tiptoes.
Understanding Achilles Tendon Tears
An Achilles tendon tear occurs when this strong tendon stretches beyond its capacity, resulting in a partial or complete disruption of its fibers. A partial tear involves damage to some fibers, but the tendon largely remains intact. A complete rupture signifies that the tendon has fully severed.
These tears often happen due to sudden, forceful movements that place extreme stress on the tendon. Activities like sprinting, jumping, or sudden stops and pivots, commonly seen in sports such as basketball, soccer, and tennis, are frequent causes. Less commonly, direct trauma or certain medications, including some antibiotics and steroid injections, can weaken the tendon and increase the risk of a tear.
The Reality of Walking with a Tear
Walking with a torn Achilles tendon is generally difficult, painful, and often discouraged due to the risk of exacerbating the injury. For a complete rupture, the connection between the calf muscles and the heel bone is lost, making it nearly impossible to push off the ground effectively. This loss of function means individuals often cannot stand on their tiptoes or walk without a noticeable limp or assistance.
While some limited weight-bearing might be possible with a partial tear, it will likely be accompanied by significant pain and instability. Attempting to walk on a partially torn Achilles tendon can worsen the damage, potentially turning a partial tear into a complete rupture. Continuing to put weight on the injured tendon can also delay the healing process and lead to further complications.
Recognizing a Torn Achilles Tendon
An Achilles tendon tear is recognized by distinct sensations and physical signs. Many individuals report hearing or feeling a sudden “pop” or “snap” at the back of their ankle at the moment of injury, often described as feeling like they were kicked or hit in the calf. This immediate sensation is usually followed by sharp, sudden pain in the back of the ankle or near the heel.
Following the injury, swelling and bruising often develop in the back of the ankle and lower leg. A noticeable gap or indentation may be felt or even visible above the heel where the tendon has torn. Individuals typically experience difficulty bearing weight on the affected leg, particularly when trying to push off the ground, climb stairs, or stand on their tiptoes.
Immediate Steps After Injury
If an Achilles tendon tear is suspected, immediate action can help manage symptoms and prevent further damage. Applying the R.I.C.E. protocol—Rest, Ice, Compression, and Elevation—is a recommended first aid measure.
Rest involves avoiding any activity that stresses the injured area and refraining from putting weight on the affected leg. Applying ice to the back of the ankle for 15-20 minutes at a time, several times a day, helps reduce pain and swelling. Compression, using an elastic bandage wrapped snugly around the ankle, can help minimize swelling and provide support. Elevating the injured leg above heart level, especially when resting, further aids in reducing swelling. It is important to seek immediate medical attention for proper diagnosis and to determine the best course of treatment.