Ankle Conditions

Achilles Tendon Rupture

An Achilles tendon rupture is a tear of the Achilles tendon. The Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to heel bone. The Achilles tendon is the largest tendon in the body and is used when you walk, run, climb stairs, jump, and stand on your tip toes.When the Achilles tendon becomes thin, weak, or if it is not used, it may be susceptible to injury or damage.

Causes

Achilles tendon ruptures can happen to anyone but occur most often in middle-aged athletes participating in sports that involve running, pivoting, and jumping. A direct injury or fall can also cause an Achilles tendon rupture. The rupture can be complete or a partial tear of the tendon. Factors that may increase the risk of an Achilles rupture include:

  • Increased age
  • Sports that require sudden running or jumping such as basketball, tennis, soccer, and tennis.
  • Obesity
  • Steroid injections- repeated injections near the tendon or ankle can weaken the tendon over time and have been associated with tendon rupture
  • Fluoroquinolone antibiotics have been associated with achilles tendon ruptures

Symptoms

Although it’s possible to injure your achilles and have no symptoms, most people generally notice a “pop” when they tear their achilles. Other symptoms include:

  • Swelling and deformity- you may notice that you’re no longer to visibly identify the tendon as compared to the other leg
  • Inability to press the foot downward or to push off with the foot when walking
  • Inability to stand on your toes
  • Swelling and bruising

Diagnosis

Dr. Faucett diagnoses the rupture based on symptoms, history of the injury and physical examination. Dr. Faucett will gently squeeze the calf muscles, if the Achilles tendon is intact, there will be flexion movement of the foot, if it is ruptured, there will be no movement observed. This is called Thompson’s Test. Ultrasound or MRI may be used to confirm the diagnosis.

Treatment

Achilles tendon ruptures can be treated conservatively or with surgery depending on the severity of the tear. Non surgical treatment involves wearing a cast or special brace which is changed after some period of time to bring the tendon back to its normal length. Along with cast or brace, physical therapy may be recommended to improve the strength and flexibility of leg muscles and Achilles tendon.

Surgical repair of the Achilles tendon generally involves making an incision along the back of the leg involves suturing the torn tendon together. Surgery helps to decrease the recurrence of the Achilles tendon in comparison to the non-surgical treatment. You will be placed in a splint in the operating room with your toes pointed down to help take stress of the tendon and the repair. Eventually, you will transition to a boot. Initially you will need crutches to avoid putting weight on the leg.

Physical therapy is necessary following surgery to help regain range of motion and strength. Participating in physical therapy can help you to get back to your regular activities and achieve the best outcome following surgery.

To help prevent an Achilles tendon injury, it is a good practice to perform stretching and warm-up exercises before participating in any activities. Gradually increase the intensity and length of time of activity.


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