When the Achilles tendon ruptures. it gets completely torn by a sudden movement of the ankle/leg. It usually occurs in a tendon that is worn out and has weakened over time and then suddenly tears
when there is enough force. It typically occurs during recreational sports that involve running, jumping, and pivoting, such as basketball, soccer or racquet sports. It is most often seen in men in
their 30s and 40s. Some medications and medical problems can predispose to having an Achilles rupture.
The Achilles tendon usually ruptures as a result of a sudden forceful contraction of the calf muscles. Activities such as jumping, lunging, or sprinting can cause undue stress on the Achilles tendon
and cause it to rupture. Often there is a background of Achilles tendinitis. Direct trauma to the area, poor flexibility or weakness of the calf muscles or of the Achilles tendon and increasing age
are some of the other factors that are associated with an Achilles tendon rupture.
Symptoms usually come on gradually. Depending on the severity of the injury, they can include Achilles pain, which increases with specific activity, with local tenderness to touch. A sensation that
the tendon is grating or cracking when moved. Swelling, heat or redness around the area. The affected tendon area may appear thicker in comparison to the unaffected side. There may be weakness when
trying to push up on to the toes. The tendon can feel very stiff first thing in the morning (care should be taken when getting out of bed and when making the first few steps around the house). A
distinct gap in the line of the tendon (partial tear).
It is usually possible to detect a complete rupture of the Achilles tendon on the history and examination. A gap may be felt in the tendon, usually 4-5cm above the heel bone. This is the normal site
of injury and is called an intra-substance tear. The tear can occur higher up about 10cm above the insertion into the heel at the site where the muscles join the tendon, this is known as a
musculo-tendinous tear. A special test will be performed which involves squeezing the calf. Normally if the Achilles tendon is intact this causes the foot to point downwards but if it is ruptured it
causes no movement. To confirm the diagnosis and the exact site of the rupture it may be necessary to perform an Ultra-sound or MRI scan.
Non Surgical Treatment
Non-surgical treatment of Achilles tendon rupture is usually reserved for patients who are relatively sedentary or may be at higher risk for complications with surgical intervention (due to other
associated medical problems). This involves a period of immobilization, followed by range of motion and strengthening exercises; unfortunately, it is associated with a higher risk of re-rupture of
the tendon, and possibly a less optimal functional outcome.
Surgery is recommended to those who are young to middle-aged and active. The ruptured tendon is sewn together during surgery. This is an outpatient procedure. Afterward the leg is put into a splint
cast or walking boot. Physical therapy will be recommended. In about 4 to 6 months, healing is nearly complete. However, it can take up to a year to return to sports fully.