Achilles Tendon Injures Are Rising - Here's How to Spot Them

Achilles tendon injuries have skyrocketed in the United States this year, researchers report.

Physicians at Michigan Medicine-University of Michigan diagnosed more Achilles ruptures during June 2021 than in all of 2020.

Injuries to the body's strongest, thickest tendon account for about 30% of all sports-related injuries, and are most common among active, middle-aged men, they added.

Experts say the spike in Achilles tendon injuries is the result of many people returning to physical activity after a year of inactivity during the pandemic, said Adam Abraham, a research investigator in the Department of Orthopedic Surgery at Michigan Medicine.

"Getting back into the summer with people getting back outside, a lot of people wanted to get back in shape and get their 'pre-COVID bodies,'" Abraham said in a Michigan Medicine news release. "Soft tissues don't respond to exercise as fast as muscle and bone, and they struggle to adapt on the return."

Some experts say stretching can prevent Achilles injuries, but that's a controversial opinion. The best prevention is regular exercise and strength training catered to the individual, according to Abraham.

"There are very few studies that have investigated the effects of specific prevention strategies," he said.

Knowing your limitations, the signs of Achilles damage and when to seek medical attention are important, said Dr. James Holmes, service chief of foot and ankle and associate professor of orthopedic surgery at Michigan Medicine.

The most common injury is tendinitis, which occurs when the sheath of the Achilles becomes inflamed, often through overuse.

"These may happen as a result of a training error when someone is doing too much too fast," Holmes said in the release. "It's occasionally associated with walking up the step of a steep incline, but overuse is often the major issue for young-to-middle-aged people."

People with tendinitis will have pain when moving the ankle, and may also have tenderness and some swelling.

Another injury is tendinosis, a degenerative condition in which the tendon's collagen deteriorates. It's more common than tendinitis in middle-aged people.

"I tell patients: tendinosis is to tendons what arthritis is to joints," Holmes said.

In cases of tendinosis and tendinitis, continued aggravation and prolonged pain means it's time to see a doctor.

An Achilles rupture or tear is another type of injury that causes a "pop" or "chop" feeling in the back of the leg.

Patients often "look behind to see who hit them because it may feel like a chop to the back of the leg," Holmes said. "This tear classically occurs in middle-aged weekend warriors. You see it in athletes, for sure, but it's typically a mid-40s guy who plays court sports."

A tear may not cause a lot of pain, but requires medical attention.

"People try to walk them off; it doesn't hurt that much, and you can walk on it," Holmes said. "That's a big concern though because if you continue to walk on it and do not get treatment after a day or two, the muscle will often pull unopposed and create more of a gap between the two ends of the tendon."