What is the Achilles tendon?
The Achilles tendon (tendo calcaneus) is the largest and strongest tendon in the human body, measuring about 15 centimeters in length. It is made up of dense connective tissue that is extremely resistant to stress, yet it is still prone to injury due to the significant forces it endures. This tendon connects the calf muscles — the gastrocnemius (the two-headed calf muscle) and the soleus (the flat muscle) which together form the triceps surae — to the heel bone (the calcaneus), allowing for efficient force transmission during foot movements.
Its key function is plantar flexion of the foot, which means it helps push us off the ground when walking, running, and jumping. When the calf muscles contract, the Achilles tendon pulls on the heel bone, lifting the heel and propelling the body forward. This function is essential for athletes and physically active individuals, as it enables explosive movements such as sprinting and jumping.
Without a functional Achilles tendon, basic movements like standing on tiptoes, climbing stairs, or pointing the foot downward would be significantly more difficult or nearly impossible. The tendon absorbs and transmits substantial loads, often greater than a person’s body weight, especially during jumping and sudden changes in direction. Therefore, proper stretching, strengthening of the lower leg muscles, and gradual increase of workload are crucial for preventing Achilles tendon injuries.
Achilles tendon injuries
The Achilles tendon is subjected to significant stress during everyday activities such as walking, running, and jumping, which makes it prone to various types of injuries. These injuries can range from mild inflammation to severe damage, such as a complete rupture (tear) of the tendon. Factors that increase the risk of injury include excessive loading, sudden changes in the intensity of physical activity, improper footwear, poor movement biomechanics, and insufficient stretching and warm-up before activity.
The most common Achilles tendon injuries are:
Tendinitis (inflammation of the tendon)
Achilles tendon tendinitis is an acute inflammation of the tendon tissue, most commonly caused by overuse or improper movement technique. The main symptoms include:
Pain and stiffness in the lower calf, especially in the morning or after physical activity
Tenderness and swelling along the Achilles tendon
Popping or creaking sensations during movement (crepitus)
Treatment for tendinitis includes rest, ice, physical therapy, and stretching and strengthening exercises to reduce tension in the calf muscles.
Tendinosis (degenerative changes in the tendon)
Tendinosis is a chronic degenerative condition of the Achilles tendon that develops due to prolonged overuse and micro-injuries. Unlike tendinitis, it does not involve active inflammation but rather the degeneration of the tendon’s collagen fibers, making it weaker and less elastic.
Symptoms of tendinosis include:
Chronic pain that develops gradually
Thickening of the tendon and reduced flexibility
Decreased ability to perform explosive movements (running, jumping)
Partial rupture (partial tear of the tendon)
A partial rupture of the Achilles tendon refers to a partial tear of the tendon fibers, which can occur due to sudden overload, direct trauma, or chronic tendinosis.
Symptoms include:
Sudden pain in the lower calf, often described as a sharp stabbing sensation
Difficulty walking and standing on tiptoes
Tenderness and swelling along the tendon
Treatment depends on the severity of the injury — milder cases can be managed non-surgically with immobilization, physical therapy, and gradual muscle strengthening, while more severe cases may require surgical intervention.
Complete rupture (full tear of the tendon)
A complete rupture of the Achilles tendon is the most severe injury and usually occurs during a sudden movement, such as jumping or rapid acceleration. It most commonly affects athletes and physically active middle-aged individuals who are unprepared for intense exertion.
Symptoms include:
Sudden, severe pain in the lower calf, often accompanied by a sensation as if someone has “hit” the person from behind
An audible popping sound at the moment of injury
Inability to stand on the toes of the injured leg
A noticeable gap or indentation at the site where the tendon ruptured
The appearance of calcifications on the Achilles tendon
Symptoms of Achilles tendon injury
Achilles tendon injuries can manifest with various symptoms depending on the type and severity of the damage. Symptoms may develop gradually, as in tendinitis and tendinosis, or suddenly, as with partial or complete tendon rupture. Timely recognition of these symptoms is crucial for proper treatment and to prevent further complications.
Pain and stiffness along the tendon, especially in the morning
One of the first signs of Achilles tendon problems is pain along the tendon, particularly in the morning after waking up. This pain often results from reduced circulation and stiffness in the tendon overnight. When a person gets out of bed and takes the first steps, the pain may be more intense but usually decreases after a few minutes of movement as the tendon warms up and becomes more flexible.
In acute inflammation (tendinitis), pain may persist throughout the day, while in chronic conditions (tendinosis), it usually occurs after activity or during rest following physical exertion.
Swelling and tenderness to touch
Inflammation or injury to the Achilles tendon can cause swelling in the area where the tendon attaches to the heel bone or along the tendon itself. The swelling may be constant or appear after physical activity.
In addition to swelling, increased tenderness is present — even light pressure on the tendon can cause discomfort or pain. This symptom is especially pronounced in tendinitis and partial ruptures, while complete rupture may present with significant bruising and a visible indentation at the tear site.
Sensation of creaking or snapping during movement
People with Achilles tendon injuries often describe sensations of creaking, popping, or friction during movement. This symptom, known as crepitus, may be felt or heard when bending the foot or trying to lift the heel off the ground.
This occurs due to the uneven tendon surface damaged by inflammation or degenerative changes. In tendinosis, this symptom is more pronounced because of the disrupted structure of the collagen fibers in the tendon.
In complete rupture, patients often report feeling as if they were hit from behind, accompanied by a popping sound, followed by immediate loss of tendon function.
Reduced strength in the leg
Since the Achilles tendon plays a key role in foot and lower leg movements, damage to it leads to reduced strength and stability in the affected leg. Patients may notice difficulty with:
Standing on one foot’s toes
Pushing the foot downward (plantar flexion)
Running or jumping on the injured leg
Reduced strength may also be present in milder injuries like tendinitis and tendinosis, while in complete rupture, a person almost entirely loses the ability to bear weight on the injured leg.
Difficulty walking, running, or jumping
Depending on the severity of the injury, performing basic movements such as walking, climbing stairs, running, or jumping may become difficult or impossible. In milder injuries, these activities may cause discomfort, while in severe injuries like complete rupture, they can be impossible.
Patients with partial ruptures often limp to avoid putting weight on the injured leg. In cases of complete rupture, walking is extremely difficult, and the person cannot lift the heel off the ground during steps.
Risk groups – Who should pay special attention?
Achilles tendon injuries can happen to anyone, but certain groups of people are at higher risk due to their lifestyle, physical activities, or predispositions. Timely prevention and adjustment of training or daily activities can significantly reduce the risk of these injuries.
Athletes
Athletes are among the most vulnerable groups when it comes to Achilles tendon injuries, especially those involved in sports that include sudden movements, running, and jumping. These include:
Track and field athletes (sprinters, long-distance runners, jumpers)
Football (soccer) players
Basketball players
Tennis players
Handball and volleyball players
Athletes are prone to tendinitis and partial ruptures due to frequent overloading of the Achilles tendon. Injuries often occur in those who do not perform proper warm-up and stretching before training, or who do not allow enough recovery time between intense activities.
Middle-aged and older adults
As we age, the elasticity of tendons and ligaments decreases, and the collagen fibers in the Achilles tendon become more brittle. In people over 40, the tendon gradually weakens, making it more susceptible to micro-injuries and degenerative changes.
Because of this, physically active middle-aged and older individuals (whether through sports or recreation) often experience sudden Achilles tendon injuries without prior warning symptoms. This is especially true for those who suddenly increase their physical activity level after a long period of inactivity.
People with excessive body weight
Excess body weight places additional stress on the Achilles tendon because it has to bear more load with every step, jump, or other physical activity. This can increase the strain on the tendon, raising the risk of inflammation (tendinitis) and gradual weakening of its structure.
People who are overweight often have weaker calf muscles, which further strains the Achilles tendon. Additionally, obesity can contribute to systemic inflammation, which weakens tendon structures and increases injury risk.
People who suddenly increase physical activity intensity
A sudden increase in the intensity of physical training or a quick return to sports after a long break can significantly raise the risk of Achilles tendon injury. This is a common issue among:
People starting running or intense workouts without gradual adaptation
Recreational athletes who dramatically increase effort on weekends (so-called “weekend warriors”)
Individuals who try to quickly regain previous fitness levels after inactivity
The Achilles tendon cannot rapidly adapt to sudden changes in load, which can lead to micro-injuries, inflammation, and even complete rupture if the strain continues without proper recovery.
People with congenital or acquired foot deformities
Foot deformities can cause improper distribution of forces acting on the Achilles tendon, increasing injury risk. Common problems include:
Flat feet (pes planus) – cause abnormal foot positioning and extra load on the Achilles tendon during walking and running
High arches (pes cavus) – reduce shock absorption ability, increasing stress on the tendon
Improper gait biomechanics – if a person walks or runs incorrectly (e.g., putting too much weight on one side), it leads to excessive tension in the Achilles tendon
People with these issues often suffer from recurring tendon inflammation and long-lasting pain. If the deformity is not corrected with appropriate orthopedic insoles or therapy, serious injuries can develop.
Treatment of Achilles Tendon Injuries at the In Locco Center
Achilles tendon injuries, although common, can have a serious impact on everyday functionality. This tendon is essential for movements such as walking, running, and jumping, which is why injuries can significantly disrupt your activity. At the In Locco Physio & Aesthetic Center, we approach each patient with special care, using modern therapeutic methods to ensure the fastest possible recovery and return to normal activities. Our team of experts is dedicated to your health and providing effective treatment tailored to your individual needs.
Therapy for Achilles tendon injuries
Shockwave Therapy
Shockwave therapy is an effective treatment used for both acute and chronic Achilles tendon pain, as well as calcifications that form on the tendon. This treatment uses high-intensity acoustic waves that penetrate deep into the tissue and stimulate healing. It accelerates the regeneration of damaged cells and reduces pain, helping patients return to physical activities faster and with less discomfort. Shockwave therapy is especially beneficial for tendinitis and chronic tendon injuries, as well as for calcification issues.
Laser Therapy
Laser therapy uses high-frequency light waves to penetrate deeper skin layers, helping reduce inflammation and accelerate tendon regeneration. This therapy not only reduces pain but also improves blood circulation in the injured area, speeding up the healing process. Laser therapy is effective for both acute and chronic injuries and is often used as a complementary treatment to enhance recovery.
Electrotherapy
Electrotherapy employs mild electrical impulses to stimulate muscles and tendons, aiding in pain relief and muscle relaxation. It also improves circulation, facilitating faster delivery of nutrients to the injured area and speeding up recovery. Electrotherapy is commonly combined with other treatments to achieve the best results in the shortest time.
Magnetic Therapy
Magnetic therapy uses pulsing magnets to enhance circulation and reduce inflammation. This treatment stimulates the body’s natural regenerative processes, helping combat inflammation and speeding recovery. Magnetic therapy is particularly useful for patients experiencing swelling (edema) or inflammation, as well as those seeking improved circulation in the injured region.
Ultrasound Therapy
Ultrasound therapy utilizes sound waves to improve circulation and stimulate tissue healing. For Achilles tendon injuries, it helps reduce pain and accelerates recovery. The therapy can also decrease inflammation and promote tendon regeneration.
Kinesiotherapy
Kinesiotherapy includes therapeutic exercises designed to improve the strength, flexibility, and stability of the Achilles tendon and calf muscles. Our expert team works closely with patients to guide them through specific exercises that help prevent further injuries and enhance the functional capacity of the Achilles tendon.
Kinesio taping, which involves applying elastic tapes to the skin, provides additional support to the tendon and helps reduce stress on the injured area. This method also improves circulation and aids in faster recovery.
Our rehabilitation program includes:
Postoperative therapies that reduce swelling, relieve pain, and speed up the initial recovery phase.
An exercise program aimed at strengthening the tendon and calf muscles while restoring mobility.
Continuous monitoring of progress to ensure the right balance between recovery and return to physical activities.
Rehabilitation at our center is based on an individualized approach and constant progress tracking, ensuring that each patient achieves the best possible results.
Why Choose the In Locco Physio & Aesthetic Center?
Expertise and Experience – Our team consists of experienced physiotherapists who have many years of practice in treating Achilles tendon injuries.
Modern Equipment – By using the latest technologies and treatments, we achieve the best results in the shortest possible time.
Individual Approach – Every patient is unique, so we tailor therapy to your specific needs and goals.
Fast Results – Our treatments are effective, with visible improvements in a short period.
Don’t ignore pain and early symptoms of injury!
If you experience pain, stiffness, or difficulty moving, don’t wait. Contact us today and schedule an appointment at the In Locco Physio & Aesthetic Center. Our team is here to help you return to normal activities and ensure your full health and mobility.