The Achilles tendon connects the calf muscles with the heel bone. It begins in the middle of the lower leg and becomes narrower as it progresses to the heel bone, where it ends. It serves to transfer power from the calf muscles to the heel bone. This makes it possible to stretch the foot and thus walk.
Pain can occur due to overloading or incorrect loading - for example, due to too much sport. Causes can be shortened, tense or fatigued calf muscles, insufficient warm-up or a rapid increase in the training load. The irritation can cause the tendon to become inflamed.
This is noticeable by the pain. Due to the swollen tendon, the affected person reacts sensitively to stress, for example. He or she may also experience a diffuse, sometimes stabbing pain in various places, as well as limited mobility of the ankle joint.
In the case of a chronic course or strong acute stresses, the Achilles tendon can also tear. This often becomes noticeable by a tearing or popping sound. The affected person suddenly feels severe pain in the area of the Achilles tendon or the lower calf. A limping gait with a twisted foot is also one of the typical symptoms.
When making a diagnosis, it is important for the attending physician to know what action triggered the pain, for example, sports, an illness or exercise habits. Usually, after the first few hours after the tear has happened, a strong swelling and redness forms and the area turns blue. During the subsequent physical examination, the doctor checks whether the patient can walk on tiptoe or stand on one leg. The ankle joint is tested for pain sensitivity. If there is a ruptured Achilles tendon, the doctor may also notice a dent a few centimeters above the heel when palpating the tendon.
Another method to detect a rupture of the Achilles tendon is the so-called calf pinch test. In this test, the doctor squeezes the calf muscles. If the foot does not move reflexively with the tip of the foot downward as usual, there is probably an Achilles tendon tear. In an ultrasound examination, the physician can also identify the structures of the Achilles tendon. In the case of a tear, the ends of the tendon and the gap between them can be easily visualized.
In the case of a fresh tear, the Achilles tendon can be sutured in most cases during surgery. Older and larger tears are often reconstructed by our specialists with a replacement plastic. It is important that the surgery is performed promptly after the accident to regain the greatest possible functionality. If there is no tendon left, a donor tendon can be used. For undisturbed healing after the treatment, stress should be avoided for the time being.