Achilles Tendon Rupture

Are you a weekend warrior? If so, then you or someone you know has likely suffered from an Achilles Tendon Rupture.

Achilles Tendon Rupture: What is it?

The Achilles tendon is the large cord behind your ankle that allows you to point your toes. It is attached to the calf muscles. This injury typically occurs in people playing sports, but can also happen during daily actives. A rupture or tear of the Achilles can result from overstretching. Tears can be complete or partial and can also occur where the muscle attaches to the tendon. Surgical and nonsurgical options are available for treatment.

Symptoms: What does Achilles Tendon Rupture feel like?

You may hear or feel a pop, followed by pain in the back of the leg
Your ability to walk may be affected
Crampy pain in the calf muscles
Difficulty with pointing toes or pushing off with walking
No signs or symptoms, although rare
Classic presentation is a 45 year old man playing basketball. He comes down with a rebound tries to run down the floor but falls down and is sure that someone kicked him in the back of his ankle.

Causes

Ruptures are often caused by a sudden increase in stress on the Achilles tendon. This usually occurs when the calf muscle fires strongly or the foot forcefully extends (opposite of pointing the toes).

Anatomic Factors

The lower section of the Achilles tendon has poorer blood supply about 2 ½ inches above the heel bone. This is typically where we see tendon ruptures.

Risk Factors

Age: Peak age for Achilles rupture is 30-40
Sex: 5 times more common in men than women
Recreational sports: More common in sports with running, jumping, and quick sudden starts and stops.
Steroid injection: Injections into and around the Achilles tendon have been associated with ruptures.
Obesity: Excess weight places additional strain on the tendon
Certain antibiotics: Fluoroquinolone antibiotics can increase the risk of Achilles tendon rupture.

Evaluation: How is Achilles Tendon Rupture diagnosed?

History and physical examination: Feeling a defect in the tendon and no foot movement with squeezing the calf are usually diagnostic

Imaging: If there is a question about the extent or location of your injury, MRI, ultrasound or X-ray can be used to aid in diagnosis.

Treatment

Treatment of an Achilles tendon rupture can vary based on age, activity level, injury severity or other additional medical conditions. Good results can be obtained with surgical and nonsurgical treatment.

Nonsurgical treatment

Immobilization with a walking boot with a wedge or casting
Ice
Anti inflammatory medications
Physical therapy

Avoids the risks associated with surgery, but can take longer to recover. There is also an increased risk of re-rupture.

Surgery

The procedure usually involves an incision on the back of the lower leg and stitching the tendon together. Adjacent tendons may also be used to aid the repair
Immobilization with a splint, then wedge walking boot
Progressive weight bearing
Physical therapy

Risks include infection, nerve injury and blood clots.

Rehabilitation

Prescribed with either type of treatment
Goal is to regain as much function as possible

Recovery: What Can Be Expected?

Person recovery from Achilles Tendon Rupture

Frequently asked questions about Achilles Tendon Rupture

Can this happen again?

The rate for re-rupture is around 5% for surgical repair and 10% for nonsurgical treatment. There is a higher likelihood of tearing your other Achilles tendon after this injury.

How long am I non-weight bearing?

Non-weightbearing is usually for two weeks with gradual progression of weight with the wedge boot.

Will I be able to play sports again?

Generally, people make a full recovery and return to their prior level of activity. You will likely notice some lack of spring from the affected side with jumping.

When can I return to sports?

It will likely be about 6 months until return to sports. Especially cutting and jumping types of activity.

Physicians

The following physicians specialize in the treatment of Achilles Tendon Rupture:

Gregory M. Neely, MD

Gregory F. Alvine, MD

Eric S. Watson, MD

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Testimonials

I went to Dr. Watson with a lot of foot pain. He guided me through the process of healing. His office is connected with great physical therapists that were able to assist me in buying the correct shoes and orthotics. They made a great team in helping me walk comfortably again. I was happy to avoid surgery.

I had similar surgery on my other ankle several years ago with another doctor so I was hesitant going into this surgery but this went a 100 times better. Very pleased so far with the results and he and his whole staff are outstanding.

I broke my lower leg bone in my ankle on Saturday, Dr. Watson was able to see me on the following Monday. I had my surgery the next day. I have been more than happy with Dr. Watson and his staff. I was able to have open discussions about what to expect and how the treatment will go. I have nothing but positive testimonials for the service I’ve received. I highly recommend Dr. Watson and his staff. Top notch!

Achilles Tendon Rupture