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Achilles tendon

The Achilles tendon, or Achilles tendon, is the body's strongest tendon and plays a crucial role in walking, running, and jumping. It connects the calf muscles to the heel bone.

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Quick version

What is the Achilles tendon?

The Achilles tendon, also known as the Achilles tendon, is a strong tendon that runs from the two large muscles of the calf – the gastrocnemius and soleus – down to the heel bone (calcaneus). It enables movements such as standing on tiptoe, running and jumping, making it particularly vulnerable to overuse injuries, especially in athletes.

Anatomy and location

The Achilles tendon is located on the back of the lower leg and is approximately 15 cm long. It lies superficially, making it easy to feel with the hand. The Achilles tendon lacks a protective sheath, making it susceptible to friction and irritation.

Function

The main function of the Achilles tendon is to transfer force from the calf muscles to the foot, which allows you to extend the foot downward (plantar flexion). This is important when walking, running and jumping.

Common Achilles tendon problems

The Achilles tendon can suffer from several common problems that are often due to overexertion, aging or sports injuries.

Typical Achilles tendon conditions
  • Achilles tendonitis: Inflammation of the tendon, often caused by overload.
  • Achilles tendonitis: Chronic degenerative change in the tendon without obvious inflammation.
  • Achilles tendon rupture: A complete rupture of the tendon, common during quick start/stop movements in sports.
  • Achilles peritendinitis: Inflammation of the tissue around the tendon.
  • Bursitis: Inflammation of the mucous sacs at the tendon attachment, especially at heel.

Examination and diagnosis

If a problem with the Achilles tendon is suspected, a clinical examination is performed in which the doctor assesses swelling, pain, mobility and any lumps along the tendon. Tests such as Thompson's test can be used to check whether the tendon is torn or weakened. If necessary, the examination is supplemented with imaging diagnostics.

Common diagnostic methods

  • Ultrasound: Used to see the structure of the tendon, any ruptures or inflammation.
  • Magnetic resonance imaging, MR of the Achilles tendon: Detailed imaging diagnostics to map injuries, especially in cases of chronic problems or before surgery.
  • Clinical tests: E.g. Thompson's test, where you squeeze the calf to see if the foot moves - lack of movement indicates a torn tendon.

Risk factors

Sports with a lot of running and jumping, flat shoes, short calf muscles, overpronation, increasing age and previous injuries increase the risk of Achilles tendon problems.

Treatment and rehabilitation

For mild problems, rest, eccentric training and unloading are used. In case of rupture, surgery or orthopedic treatment may be required. Rehabilitation is often long, up to 6–12 months.

Relevant symptoms

  • Pain in the back of the heel or lower leg
  • Stiffness in the Achilles tendon in the morning
  • Swelling or thickening of the tendon
  • Cracking sensation when moving
  • Inability to stand on tiptoe if ruptured

Related conditions and diagnoses

  • Achilles tendonitis (Achilles tendinopathy)
  • Achilles tendon bursitis (inflammation of the bursa)
  • Achilles tendon rupture (rupture)
  • Haglund's deformity
  • Achillodynia (chronic Achilles tendon pain)

Questions and answers

The Achilles tendon is the body's strongest tendon and runs from the calf muscles to the heel bone. It enables movements such as standing on tiptoe and running.

Achilles tendon pain can be caused by overuse, inflammation (tendinopathy), shoe wear, poor warm-up, and sudden movements that cause microtrauma.

Treatment for Achilles tendonitis includes rest, eccentric exercise, anti-inflammatory medications, physiotherapy and, in some cases, shockwave therapy or orthopedic assistance.

There are some typical signs that the Achilles tendon is damaged, these are pain, swelling, stiffness and sometimes a cracking sensation when moving. When ruptured, there is often a pop and you cannot stand on your toes.

It's different, a mild strain can heal in just a few weeks, while a rupture or chronic tendinopathy can take up to 6–12 months of rehabilitation.

Yes, a customized workout works for mild pain, but for persistent pain, you should rest, seek medical attention, and follow a physiotherapy plan.

Achilles tendonitis is an overuse injury that involves pain and swelling. A ruptured Achilles tendon is an acute injury where the tendon tears completely or partially.

If you have problems with your Achilles tendon where the pain does not go away after rest, if you cannot walk normally or suspect a rupture, you should contact healthcare immediately.

Yes, you can prevent problems with the Achilles tendon by stretching your calf muscles, using good shoes, gradually increasing your training intensity and avoiding overload.