The Achilles tendon is the largest and strongest tendon in the human body. It connects the calf muscles to the heel bone, allowing movements such as walking, running, jumping, and standing on tiptoes. Recognizing the signs of an Achilles tear is important for prompt action and better outcomes.
Immediate Physical Indicators
An Achilles tendon tear presents with several physical signs. Rapid swelling around the ankle and heel is a common indicator, often developing within minutes or hours. Bruising may also appear shortly after the injury in the heel and lower leg.
A distinct physical sign is a visible or palpable gap or indentation in the tendon. This gap is typically located a few inches above the heel bone, where the tendon often tears. Gently feeling along the back of the lower leg can help identify this dip or space. This indentation occurs because the torn ends of the tendon recoil, creating a void where the tendon should be continuous.
Sensory Experiences and Functional Impairment
An Achilles tear also involves distinct sensory experiences. Many report hearing or feeling a sudden “pop” or “snap” at the back of the ankle at the moment of injury. This sensation is often described as feeling like being kicked or hit in the calf, even without external force. Immediate, sharp pain typically follows in the back of the ankle or heel.
While initial sharp pain might lessen to a dull ache, the injury significantly impacts function. There is often difficulty pushing off the foot when walking or attempting to stand. Individuals commonly find themselves unable to stand on tiptoes on the injured leg. This functional impairment can lead to a noticeable limp or a complete inability to bear weight on the affected leg. Weakness or instability in the ankle is also frequently reported.
Differentiating Tear Severity
Achilles tears range in severity, from partial to complete, with subtle differences in presentation. A partial tear involves damage to only a portion of the tendon, where some fibers are frayed but the tendon remains connected. Symptoms might be less pronounced, with less severe pain and swelling. An individual with a partial tear might still retain some ability to bear weight or move the foot, though usually with significant discomfort.
A complete tear signifies that the tendon has fully ruptured, detaching from the heel bone or tearing completely in its middle section. For a complete tear, the “pop” sensation at the time of injury is more distinct. The functional impairment is more profound, resulting in a near-total inability to push off the foot or stand on tiptoes. The gap in the tendon is also more apparent with a complete tear compared to a partial one.
Initial Steps After Injury
If an Achilles tear is suspected, seeking immediate medical attention is important. A healthcare professional can accurately diagnose the injury and recommend an appropriate course of action for recovery.
While awaiting medical assessment, certain immediate first aid steps can help manage symptoms. The RICE method—Rest, Ice, Compression, and Elevation—can be applied.
Resting the injured leg helps prevent further strain on the tendon. Applying ice to the affected area for 15-20 minutes at a time can help reduce swelling and discomfort. Compression, such as wrapping the ankle with an elastic bandage, can also help limit swelling. Elevating the injured leg above heart level may further assist in reducing swelling. These measures are temporary and do not replace professional medical diagnosis and treatment.