Achilles Tendon Tear (Partial Tear)

Injuries > Achilles & Heel > Achilles Tendon Tear

(Also known as Achilles Tendon Partial Tear, Achilles Tendon Strain)

What is a partially torn Achilles tendon?

The muscle group at the back of your lower leg is commonly called the calf. The calf comprises of 2 major muscles one of which originates from above the knee joint (gastrocnemius) the other of which originates from below the knee joint (soleus). Both of these muscles insert into the heel bone via the Achilles tendon (figure 1). 

During contraction of the calf, tension is placed through the Achilles tendon. When this tension is excessive due to too much repetition or high force, the Achilles tendon can be torn. Tears to the Achilles tendon can range from a small partial tear whereby there is minimal pain and minimal loss of function, to a complete rupture which may require surgical reconstruction.

Cause of a partially torn Achilles tendon

Achilles tendon tears most commonly occur when a patient attempts to accelerate from a stationary position or when lunging forwards such as while playing tennis or squash. Occasionally they may occur due to repetitive strain associated with overuse (e.g. walking or running excessively).

Signs and symptoms of a partially torn Achilles tendon

Patients with a partially torn Achilles tendon typically experience a sudden onset of achilles pain during the causative activity. Symptoms may increase during activities placing strain on the achilles tendon such as walking (especially uphill), going up and down stairs, running, jumping or hopping. It is also common for patients to experience pain after these activities with rest especially upon waking in the morning. Swelling and tenderness may also be present in the Achilles region.

Diagnosis of a partially torn Achilles tendon

A thorough subjective and objective examination from a physiotherapist may be sufficient to diagnose a partially torn Achilles tendon. Diagnosis may be confirmed with MRI scan or Ultrasound investigation.

Treatment for a partially torn Achilles tendon

Most patients with a partially torn Achilles tendon heal well with an appropriate physiotherapy program. The success rate of this program is largely dictated by patient compliance with the program. One of the key components of the program is that the patient rests sufficiently from ANY activity that increases their pain until they are symptom free (crutches are often required). This allows the body to begin the healing process in the absence of further tissue damage. Once the patient can perform these activities pain free, a gradual return to these activities is indicated provided there is no increase in symptoms.

Patients with this condition should follow the R.I.C.E. regime in the initial phase of injury. The R.I.C.E regime is beneficial in the first 72 hours following injury or when inflammatory signes are present (i.e. morning pain or pain with rest). The R.I.C.E. regime involves rest from aggravating activities (crutches are often required), regular icing, the use of a compression bandage and keeping the leg elevated. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. 

A graduated and pain-free flexibility, strength and return to activity program under direction from a physiotherapist is vital to ensure an optimal outcome.  

Prognosis of a partially torn Achilles tendon

With appropriate management, patients with minor Achilles tendon tears can usually recover in one to three weeks. With larger tears, recovery may take four to eight weeks or longer depending on the severity.

Contributing factors to the development of a partially torn Achilles tendon

There are several factors which can predispose patients to developing an Achilles tendon tear. These need to be assessed and corrected with direction from your physiotherapist. Some of the factors which contribute to the development of this condition include:

• poor flexibility
• inappropriate training
• poor biomechanics
• poor foot posture
• inadequate warm up
• muscle weakness
• inadequate rehabilitation following a previous ankle, calf or achilles tendon injury

Physiotherapy for a partially torn Achilles tendon

Physiotherapy is vital to hasten the healing process and ensure an optimal outcome in all patients with this condition. Treatment may comprise:

• soft tissue massage
• electrotherapy (e.g. ultrasound)
• anti-inflammatory advice
• the use of crutches
• the use of heel wedges
• stretches
• joint mobilization
• ice or heat treatment
• exercises to improve strength, flexibility or balance
• education
• activity modification advice
• biomechanical correction

Further intervention for a partially torn Achilles tendon

Despite appropriate physiotherapy management, some patients with a partially torn Achilles tendon do not improve. When this occurs the treating physiotherapist or doctor will advise on the best course of management. This may include pharmaceutical intervention, corticosteroid injection, autologous blood injection or referral to appropriate medical authorities who will advise on any interventions that may be appropriate to improve the condition.

Exercises for a partially torn Achilles tendon

The following exercises are commonly prescribed to patients with a partially torn Achilles tendon. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 1 - 3 times daily and only provided they do not cause or increase symptoms.

Lunge Stretch

Begin this exercise with your hands against the wall. Place the leg to be stretched in front of you as demonstrated. Keep your heel down. Gently move your knee forward over your toes until you feel a stretch in the back of your calf or Achilles tendon (figure 2). Hold for 15 seconds and repeat 4 times at a mild to moderate stretch pain-free.

Figure 2 – Lunge Stretch (right leg)

Calf Stretch

Begin this exercise with your hands against the wall. Place the leg to be stretched behind you as demonstrated. Keep your heel down, knee straight and feet pointing forwards. Gently lunge forwards until you feel a stretch in the back of your calf, knee or Achilles tendon (figure 3). Hold for 15 seconds and repeat 4 times at a mild to moderate stretch pain-free.

Figure 3 – Calf Stretch (left leg)

Calf Raises

Begin this exercise standing at a bench or chair for balance. Keep your feet shoulder width apart and facing forwards. Slowly move up onto your toes, raising your heels as far as possible and comfortable without pain. Then very slowly lower your heels to the floor (figure 4). Perform 10 - 20 repetitions.

Figure 4 – Calf Raises

Find a Physio for a partially torn Achilles tendon

Find a physiotherapist in your local area who can treat a partially torn Achilles tendon.

Other Exercises

View more calf flexibility exercises.

View more calf strengthening exercises.

Physiotherapy products for a partially torn Achilles tendon

Some of the most commonly recommended products by physiotherapists for patients with a a partially torn Achilles tendon are:

1. Ice Packs or Heat Packs
2. Heel Wedges
3. Foam Rollers (for self massage)
4. Crutches

To purchase physiotherapy products for a partially torn Achilles tendon click on one of the above links or visit the PhysioAdvisor Shop.

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