About Achilles Tendon

Achilles tendon structure and Achilles tendinitis treatment
The Achilles tendon is a long tendon that connects the heel with calf muscles. The function of the Achilles tendon is simple but crucial: it allows you to the floor.

Common Causes of Achilles Tendon Injury

  • Repetitive stress caused by overuse
  • Not increasing physical activity slowly – quick and tremendous stress
  • Not enough stretching and warming up before exercise
  • Wearing high heels
  • Feet problems like flat feet. It leads to disposition of pressure on the foot.
  • Too tight muscles/tendons in the foot.

Leg muscles

Muscles of the right leg, posterior view

m. gastrocnemius caput mediale
m. gastrocnemius caput laterale
m. soleus (calf muscle)

Achilles tendon

Do you know that the Achilles tendon is the thickest and strongest one in the body?

Do you know that during walking the Achilles tendon can withstand a stress load 3.9 times exceeding your body weight?

Calcaneal tendon (Achilles)

Achilles injuries

Here’s the list of the most common injuries of the Achilles tendon:


Tendon’s tissue sheath becomes inflamed, swollen, and hot

Tendon rupture

It occurs when the Achilles tendon is completely or partially torn. Also, tendon rupture may be caused by medication side effects, laceration or crushing.

Tendinosis (tendonitis)

Degeneration and inflammation of the Achilles lead to its partial breakdown or even tears (in chronic cases).

How to Treat Achilles Tendon Conditions

In case of tendonitis or tendinosis

  • Sto ache. Get some rest.
  • Gentle stretches are a daily must
  • Be proactive and strengthen your Achilles tendon with calf raises
  • Try physical therapy
  • Keep your Achilles tendon cold with ice. Apply a pack of ice every time after exercising or physical therapy.

In case of tendon rupture or laceration

  • Do not do anything that causes pain. Get some rest and forget about stretching and exercising – it will have a negative impact on the tendon.
  • Surgery. If you have a complete rupture of the tendon, surgery is needed.

In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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