Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The most common initial symptom of Achilles tendon rupture is a sudden snap
at the back of the heels with intense pain. Immediately after the rupture, the
majority of individuals will have difficult walking.
Some individuals may have had previous complains of calf or heel pain,
suggesting prior tendon inflammation or irritation.
Immediately after an Achilles tendon rupture, most individuals will develop a
limp. In addition, when the ankle is moved, the patient will complain of pain.
In all cases, the affected ankle will have no strength.
Once the Achilles tendon is ruptured, the individual will not be able to
run, climb up the stairs, or stand on his toes. The ruptured Achilles tendon
prevents the power from the calf muscles to move the heel.
Whenever the diagnosis is missed, the recovery is often prolonged.
Bruising and swelling around the calf and ankle occur.
Achilles tendon rupture is frequent in elderly individuals who have a
sedentary lifestyle and suddenly become active. In these individuals, the tendon
is not strong and the muscles are deconditioned, making recovery more
Achilles tendon rupture has been reported after injection of
corticosteroids around the heel bone or attachment of the tendon. The
fluoroquinolone class of antibiotics (such as ciprofloxacin [Cipro]) is also
known to cause Achilles tendon weakness and rupture, especially in young
Some individuals have had a prior tendon rupture that was managed
conservatively. In such cases, recurrence of rupture is very high.
Function of Achilles tendon
The Achilles tendon is the largest and strongest tendon in the human body.
The Achilles tendon connects the heel bone (calcaneus) to the muscles at the
back of the calf (using gastrocnemius and soleus muscles). The synchronous
function of the tendon and calf muscles is critical for activities like jumping,
running, standing on the toe, and climbing stairs.
When climbing stairs or running, the forces within the tendon have been
measured and indicate that the structure is able to withstand at least 10 times
the body weight of the individual. (See picture 1.)
The function of the Achilles tendon is to help raise your heel as you walk.
The tendon also assists in pushing up the toes and lifting the rear of the heel.
Without an intact Achilles tendon, almost any motion with the ankle (for
walking or running) is difficult.
Picture 1 shows the Achilles tendon and its attachment to the heel bone.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 9/10/2013
Sports injuries refer to the kinds of injury that occur during sports or exercise. While it is possible to injure any part of the body when playing sports, the term sports injuries is commonly used to refer to injuries of the musculoskeletal system.
While the patient's history and physical examination are the building blocks
of making a medical diagnosis, the ability to peer inside the body can be a
powerful tool. Ultrasound is an imaging technique that provides th"...