The Achilles tendon runs down the back of the leg and connects the calf muscle to the heel bone. It is important for push-off during walking, running, and jumping.
An Achilles tendon rupture can be complete or partial. When the tendon ruptures, a loud pop may be heard along with immediate pain, swelling, and bruising. Early diagnosis and treatment are important for a good outcome.
What Is an Achilles Tendon Rupture?
An Achilles tendon rupture is a partial or complete tear of the tendon that connects the calf muscle to the heel bone.
Because the Achilles tendon is important for push-off, a rupture can interfere with walking, running, jumping, and standing on the toes.
Causes and Risk Factors
Causes may include:
- Forceful push-off with the foot while the knee is straight
- Direct trauma
- Degenerative tendon conditions
Risk factors include:
- Sports such as tennis, diving, soccer, basketball, and track
- Poor conditioning before exercise or overexertion
- Use of corticosteroids or fluoroquinolone antibiotics
- Limited calf flexibility and strength
- Male sex
- Age 30 to 50
Symptoms
Common signs and symptoms include:
- Sudden and severe pain
- A sensation that something hit the back of the ankle
- Swelling, bruising, or stiffness
- Inability to walk on the toes or push off normally
- A loud pop at the time of injury
Treatment
There are two treatment options for Achilles tendon rupture: conservative treatment and surgical repair.
Conservative treatment may be recommended for older patients who are less active and have lower physical demands. This treatment uses a short leg cast with the foot pointed downward to bring the torn tendon ends closer together. The cast is generally used for six to 10 weeks. Conservative treatment is associated with an increased risk of later re-rupture.
Surgical repair is generally recommended for younger, active, healthy individuals. Dr. Chudik prefers to repair the torn tendon ends by sewing them together through a limited incision.
Following surgery, protected weight bearing and immobilization are required for up to six weeks. After approximately six weeks, the patient transitions to a regular shoe with a heel lift, and physical therapy is used to restore strength and motion.
Pain relievers may be prescribed as necessary following surgery.
Cold may be used to relieve pain and reduce inflammation.
Recovery and Outcomes
When the torn Achilles tendon ends are brought back together, the tendon can heal and allow a return to normal function.
Following surgical repair, the estimated time to full recovery is approximately 16 weeks.
If an Achilles tendon rupture is not diagnosed and treated, the tendon may heal with scar tissue and the muscle may remain in a shortened, nonfunctional position. This can result in permanent weakness, difficulty walking, and loss of power for pushing off, running, or jumping.
Potential complications include:
- Decreased range of motion
- Scarring
- Muscle weakness
- Re-rupture
- Functional limitations with walking and running
When to See Dr. Chudik
If you experience sudden severe pain in the back of the ankle, hear a loud pop, or are unable to push off or walk on your toes, schedule an evaluation with Dr. Chudik.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.