The Achilles tendon is the thickest and strongest tendon in the human body, located at the back of the lower leg. This robust cord connects the calf muscles to the heel bone (calcaneus), transmitting force to the foot for movements like walking, running, jumping, and standing on tiptoes. Recognizing the signs of a potential tear is important due to its role in mobility.
Recognizing Potential Symptoms
A torn Achilles tendon often presents with distinct and immediate symptoms. Many individuals report hearing or feeling a sudden “pop” or “snap” at the back of the heel or ankle at the moment of injury. This sensation can sometimes be so pronounced that it feels like being kicked or hit in the back of the leg. Following this initial event, sharp and sudden pain typically develops in the back of the ankle near the heel.
The injury can lead to immediate weakness in the affected foot and ankle, often manifesting as difficulty pushing off when walking. Swelling and bruising are also common in the heel and calf area, and the tendon itself may feel thickened or tender at the point of injury. In some cases, a noticeable gap or indentation might be felt above the heel bone where the tendon has ruptured.
Simple Self-Assessment Methods
While a medical professional should always confirm a diagnosis, several simple self-assessment methods can provide an initial indication of an Achilles tendon tear. The most widely recognized is the Thompson Test, sometimes called the calf squeeze test. To perform this test, lie face down with your feet hanging freely off the edge of a bed or table.
Next, gently but firmly squeeze the calf muscle of the affected leg. In a healthy Achilles tendon, this action causes the foot to point downward (plantarflexion). If the Achilles tendon is completely torn, the foot will not move when the calf is squeezed, indicating a positive Thompson Test.
Other simple checks include attempting to stand on tiptoes on the affected side; an inability to do so can suggest a tear. Additionally, carefully running your fingers along the back of the ankle, just above the heel, might reveal a noticeable dip or indentation in the tendon’s continuity, which suggests a rupture.
Professional Diagnostic Procedures
Upon suspecting an Achilles tendon tear, a medical professional, such as an orthopedic specialist, will perform a thorough physical examination. This examination often begins with palpation, where the doctor gently feels along the Achilles tendon to identify any gaps or discontinuities. The Thompson Test is also a standard part of this clinical assessment, with a lack of foot movement during the squeeze strongly suggesting a complete rupture.
Beyond the physical examination, imaging techniques provide definitive confirmation and detailed information about the tear. Ultrasound is a common initial imaging choice. It allows medical professionals to visualize the tendon, assess the presence and extent of a tear, and measure the gap between the torn ends. Ultrasound is particularly effective in diagnosing full-thickness tears and can also show fluid or hemorrhage around the tendon.
Magnetic Resonance Imaging (MRI) offers a more detailed view of the Achilles tendon and surrounding tissues. MRI provides high-quality images that are particularly useful for assessing partial tears. MRI can also help evaluate the overall condition of the tendon, identify any associated injuries, and assist in planning the most appropriate treatment, whether surgical or non-surgical.
Immediate Actions After Suspecting a Tear
If you suspect you have torn your Achilles tendon, seeking immediate medical attention is important. Timely diagnosis can prevent further complications. A delay in treatment can lead to improper healing and potential loss of strength and function in the ankle and foot.
While awaiting professional medical evaluation, you can manage pain and swelling. The RICE method—Rest, Ice, Compression, and Elevation—is recommended. Rest involves avoiding any weight-bearing activity on the injured leg to protect the tendon from further damage. Applying ice to the affected area for 15-20 minutes every few hours can help reduce pain and inflammation.
Compression, using an elastic bandage wrapped snugly around the ankle, can help minimize swelling. Elevating the injured leg above the level of your heart assists in reducing swelling. These initial steps can provide comfort and help prepare the area for medical assessment and subsequent treatment.