Is it possible to tear your achilles tendon and not have any swelling?

Question

I accidentally stepped in a hole earlier today, I guess those things normally do happen on accident right. :) I did hear a pop and think I may have torn my achilles however I am not sure because there is no swelling only severe pain. Is it possible to tear a tendon and have no swelling?

Answer 1

Yes it is very possible, but you should be in  alot of pain and have difficulty walking.  

Answer 2

I have achilles tendinitis and at first thought I had just torn my tendon but my podiatrist said that if you can go up on your tippy toes, then it is not torn because there is no way you would be able to do that with a torn one, so try doing that and see. Other than that ice ice ice it.

Answer 3

tendons are made of a cartilage like material so they have little blood & nerve connections, thus making it a little hard for your body to realize that there is something wrong. don't let that fool you. wrap your ankle for support but readjust the bandage or brace daily as to not develop "edema" wich is swelling that is made worse by bandages.-blurey

Answer 4

I had the same thing happen to me.  You need to pay real close attention to what I'm about to tell you because I spend alot of time every day wishing that I could go back to the point in time during my injury that you are in now.  

I had that same small pop in my achilles tendon and there was alot of pain afterwards but no swelling.  The tendon looked and felt normal to the touch but I was walking with quite a limp.  I thought that it might clear itself up and just kept walking on it, although I did no exercising whatsoever, only walking.  Well, it's almost 2 years later and the injury is still extremely bad.  It is very weak, very inflexible and I can't walk or stand for too long without making it worse.  

I'm so glad that I looked at this question today because now I have a chance to relay some very important information to you that is coming from direct experience and from the same situation.  I would honestly give a million dollars to go back the stage of my injury that you are in now, knowing what I know now.  My injury was the result of overuse and finally a quick movement led to what felt like a small pop or a light-to-moderate finger flick on the back of my achilles.  

What you have suffered is most likely a partial tear.  Your symptoms and the fact that there is no swelling and that a pop was felt really make me believe that you have an injury that is very similar to what I had.  If you had a complete rupture (torn in half) I think that there would be a lot of swelling and you would be able to feel an impression or hole where the tear was.  A way to test for a rupture is to use the Thompson Test.  You can give this to yourself or someone else can do it for you, look it up on line and here's a video of it being performed. http://www.youtube.com/watch?v=AmDi08rlR...  

I strongly believe that I had a small tear and I still suffer to this day because I didn't do the proper things that would have allowed it to heal properly.  I just kept walking on it, although I really cut down on the amount of walking that I did.  The fact that I kept using it and walking on it prevented the injury from being able to heal properly due to the constant stress and pulling apart during each step.  When muscles or tendons tear, the way that they are repaired is by the small vessels and capillaries bleeding and this blood solidifies and becomes scar tissue.   Over time, this scar tissue matures and if let to heal properly can become almost as strong and elastic as the original tendon.  If this scar tissue is repeatedly disrupted and pulled apart, more and more scar tissue will be built up and the orientation of the fibers in the tissue will become gnarled and disoriented.  The proper orientation of the fibers is really important to strength and elasticity.  Fibers are stacked in a straight pattern which gives them strength and the ability to stretch.  When they are disoriented, they are nowhere near as strong and stretching them causes the gnarled mass to be pulled apart easily due to the inferior design of its structure.  

Here are some pictures of what I'm talking about along with short articles:

http://www.athleticadvisor.com/Injuries/...

http://eccentric-exercises.blogspot.com/

The condition that I've developed is called tendinosis and it is the same one that you will develop if you don't treat the injury like I should have.  Tendinosis is a result of improperly healed tissues and built up scar tissue as well as disrupted blood flow to the tissue from the damaged capillaries.  The result is a "failed" healing and the tissue that is in place of the injury is nothing like the original healthy tissue.  This improperly healed tissue is very weak and can't be stretched much at all or it becomes irritated or causes further injury.  I can't stretch my calves very hard at all and not really hard enough to make much of a stretch in order to elongate them and I can't extend my foot upwards at much more that a 90 degree angle and this makes it really difficult to walk.  The tendons eventually shorten as a result of not being able to stretch them which causes reinjury.  If you let the tissue heal properly it will be strong however, strong enough to be stretched and brought back to normal length in order to make regular walking possible and allowing the injury to eventually heal back to normal strength.  Here's the best site that I've been able to find on tendinosis: http://www.tendinosis.org/  

First off, I think that it's of paramount importance that you go and see a doctor and ASAP.  I truly, truly believe that the best treatment for you is going to be to certainly at the minimum to be put on crutches and possibly to be put into a cast.  Let me tell you from direct experience that if you don't use crutches, your injury will heal like c**p.  If I had the chance to go back, I know for a fact that this would have been the proper treatment for me, and I strongly believe that it will be what's best for you.  If you felt a pop and are having severe pain, then you most likely have a small tear.  This is serious business and is a very dangerous situation without the proper care; and without the right knowledge on what's happening and which steps to take, it's almost certain disaster.  Lucky for you, someone who has been in your exact situation just happened to view your question so take what I'm saying very seriously.  

Go see a doctor ASAP and see if he recommends casting.  I'm telling you right now, that you should absolutely use crutches from this moment on, no matter what anyone says.  It's great that your injury is still very fresh and you have a really good chance to clear this up if you treat it properly.  If you don't you will be in psychological misery like I am due to the debilitating aftermath of what comes from the neglect of this injury.  My life is literally 50% as good as it was before and I don't want to see this happen to someone else.  

In the mean time you need to be icing it.  Ice for 15-20 min. every 2 hours.  Take 800mg ibuprofen 3 times a day also, both of these will help reduce the inflammation which will aid in healing.  These are both very standard treatments for this injury or any muscle or tendon injury and were prescribed to me by every doctor I've ever seen for a muscle or tendon injury.

My neighbor had this happen to him too.  He hyperextended his foot upwards (just like you) by putting his foot down hard while riding a four-wheeler.  He went to the doctor and ended up with a partial tear and was put into a cast for 2 or three months, I can't remember which, I think 2.  He said that it took a year until it was back to normal and now he's doing fine.  I think that he had an MRI done to diagnose his injury and if you don't have insurance, they cost over $1000.  If you do have insurance, tell them that you want one done and if you don't have insurance, they should be able to assume by your symptoms what kind of treatment you should have.  Let them know about these storys and that you're willing to be put on crutches and casted if necessary.  If they want to send you to a specialist, then use crutches form this point on until you get the yes or no on crutches or casting.  I'm telling you that you most likely will need them by what you describe and they certainly can't hurt in any way.   Even if the injury is minor (which if you felt a pop is not considered minor) crutches will definitely help regardless and if the injury is what I believe that it is, then crutches will prevent a disaster.

I've read stories from others who had the same thing I had happen to them also, it's very real and could happen to you too.  Take care of this now and don't let this ruin your life like it's ruined the h**l out of mine.  Email me by all means if you want at [e-mail] and good luck.