Achilles Tendon Rupture


A tear or rupture occurs when the tendon is stretched beyond its capacity. Common causes for this tear include running, jumping, falling, or tripping. Achilles tendinitis refers to the inflammation of the Achilles tendon. However, this is not the cause of the pain associated with Achilles problems such as a tear or rupture of the Achilles tendon.

Signs and Symptoms
*Note:These symptoms require prompt medical attention to prevent further damage.
- Sudden kicking or stabbing pain in the back of the calf or ankle – often this pain subsides into a dull aching pain.
- A popping or snapping sensation.
- Swelling of the back of the leg, between the heel and calf.
- Difficulty walking - especially on stairs or walking uphill - and difficulty standing on your toes.

In diagnosing an Achilles tendon rupture, the foot and ankle surgeon will ask questions  about how and when the injury occurred and whether the patient has previously injured  the tendon or experienced similar symptoms. The surgeon will examine the foot and ankle, feeling for a defect in the tendon that suggests a tear. Range of motion and muscle strength will be evaluated and compared to the uninjured foot and ankle.

If the Achilles tendon is ruptured, you will have less strength in pushing down (as on a gas pedal) and will have difficulty rising on the toes. The diagnosis of an Achilles tendon rupture is typically straightforward and can be made through this type of examination. In some cases, however, the surgeon may order an MRI or other advanced imaging tests.

Based on the severity of the tear/rupture, treatment options include either surgical or non-surgical treatment.

Non-Surgical Treatment
For minor ruptures, non-surgical treatment may be the best option - especially for those who are less active or have medical illnesses that keep them from undergoing surgery. Non-surgical treatment can include the use of a cast, walking boot, or brace to restrict motion and allow the torn tendon to heal.

Surgery decreases the likelihood of re-rupturing the Achilles tendon. Surgery often increases the your push-off strength and improves muscle function and movement of the ankle. Since there are various surgical options for treating a torn Achilles tendon, the surgeon will have to select the best procedure for you.
Following surgery, your foot and ankle are typically in a cast or walking boot. The surgeon will determine when you can put weight on it again. In rare cases, complications such as incision-healing difficulties, re-rupture of the tendon, or nerve pain can arise after surgery.

Physical Therapy
Whether a ruptured tendon is treated surgically or non-surgically, physical therapy is an important part of the recovery and healing process. Physical therapy includes exercises that strengthen the muscles and improve the range of motion of your foot and ankle.

Until you are able to see a doctor, practice the "R.I.C.E." method. This means:

- Rest. Avoid causing further damage by staying off the injured foot and ankle.
- Ice. Apply an ice-pack covered with a towel to reduce the swelling and numb the pain. *Note: Do not put ice directly against the skin.
- Compression. Use a bandage to wrap your foot and ankle to keep the swelling from getting worse.
- Elevation. Keep your leg slightly above your heart. You can prop it up on a pillow or couch cushion to help reduce the swelling.