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The Difference Between Achilles Tendon Strains & Tears

Your Achilles tendon attaches the muscles in your calf to your heel bone, and they work in conjunction to help you flex your foot during walking/running. It is susceptible to injury from overuse and accidents, and also from sudden increases in physical activity. The most common injuries being strains (tendonitis) and tears (also called ruptures). 

The treatment required varies based upon the severity of the strain (or in the case of rupture), so it’s important to be able to distinguish between the symptoms of each so you know how to proceed. 

man squatting down holding ankle

Symptoms of Achilles Tendon Strains & Tears

In cases of strain, the achilles tendon is experiencing minor tearing on a small scale. Common symptoms include:

  • Mild to severe pain in the achilles tendon or the back of the calf

  • Inflammation and swelling

  • Stiffness, particularly in the morning before the tendon has been “warmed up” through regular activity

  • Feelings of weakness in/near the heel

In instances of complete rupture of the achilles tendon, sufferers often report feeling (and hearing) a pop, or a sensation like being struck in the back of the leg. Pain accompanying a rupture is sharp, and it can cause significant trouble with walking. 

How Physical Therapy Can Help You Recover

For mild injuries to your achilles tendon, a physical therapist can lead you through eccentric calf strengthening exercises (for example, heel and calf raises). These targeted exercises are designed to reduce how much stress your tendon experiences during exertion by strengthening complementary muscles. Your PT can also recommend whether orthotics, splinting, or taping can be beneficial to your recovery. As you recover they can help you determine which activities you can safely resume without aggravating your injury. 

The RICE (Rest, Ice, Compression, Elevation) protocol as well as over-the-counter drugs to help reduce pain and inflammation may also be used in conjunction with these other methods to help alleviate discomfort while you heal. 

When you’re recovered, your PT can recommend stretches and exercises which can help prevent future injury to the affected tendon (or to the other!) to help keep you in peak form.

Treatment for More Severe Injury

If a severe injury is suspected your healthcare provider may do diagnostic imaging to confirm their diagnosis and judge what is required to treat it. For the most severe injuries, surgical repair of the ruptured tendon may be necessary. This can include transplanting tendons from another part of your foot to help replace the damaged Achilles tendon. Physical therapy will become a vital part of recovering from surgery to help you regain strength and mobility in the affected leg. 


For both mild achilles tendon injuries, you can expect to gradually return to your normal activities as you heal. The recovery from more severe injuries (and the surgery they may possibly require) takes more time, and your healthcare providers and PT can help identify activities you can safely resume.


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