The Achilles tendon is the strongest tendon in the human body, but can also be one of the most problematic. It is prone to degenerative and inflammatory disorders, as well as rupture.

Degeneration of the Achilles tendon is known as tendinosis. Patients with this condition suffer with pain on activity, such as running, sport or climbing stairs, and may be quite disabled during flare-ups. There is often a tender swelling in the tendon, above the heel-bone, which when severe, may indicate inflammation of the tendon sheath (peritendonitis). These conditions are collectively known as non-insertional tendinopathy, as distinct from insertional tendinopathy, when the pain and swelling occur near the heelbone.

These Achilles tendon problems are sometimes referred to as “injuries”, but strictly are “overuse” or “chronic” conditions. However, in certain circumstances, the tendon may rupture, either partially or completely. Although bruising, swelling, pain and loss of function are usually present, rupture of the Achilles tendon is sometimes missed, and passed of as a sprain of the ankle.

If you think you have ruptured your Achilles tendon, you must seek medical advice immediately, as urgent treatment is essential (whether non-operative or surgical repair). If treatment is started within a few days of rupture, the outcome is usually good, but a delay of even a few weeks can lead to a less favourable result.