Achilles Tendon Rupture Introduction

Achilles tendon rupture is a serious injury which needs to be diagnosed and treated as soon as possible.

The Achilles tendon is located just behind and above the heel. Its role is to help the foot to bend downwards at the ankle.

Achilles Tendon Symptoms

When the tendon ruptures a snap is felt and often heard. It is initially very painful but not for long. Swelling and bruising appear within hours.

Causes of Achilles Tendon

Classically, rupture of the Achilles occurs with a sudden and “violent” contraction of the calf muscle and is most commonly associated with racquet sports (tennis, badminton and squash) but can occur as a result of a stumble, fall or even just missing a step. Rarely, it can occur spontaneously.

Diagnosis for Achilles Tendon

Unfortunately the condition is often misdiagnosed as a sprain. However, an experienced foot and ankle specialist will make a diagnosis on the basis of symptoms, the history of the injury and an examination.

The doctor may observe you as you walk and assess whether you can stand on tiptoe. A method known as the ‘Thompson’s test’ (also known as the ‘calf squeeze test’) may be used. In this test, you will be asked to lie face down on the examination bench and to bend your knee. The doctor will gently squeeze the calf muscles at the back of your leg, and observe how the ankle moves. If the Achilles tendon is functional, the calf squeeze will make the foot point briefly away from the leg (a movement called ‘plantar flexion’). This is quite an accurate test for Achilles tendon rupture.

If the diagnosis is uncertain, an ultrasound or MRI scan may be used.

Achilles Tendon Treatment

Non-surgical treatment

A ruptured tendon can be treated non-operatively with Plaster of Paris and then “functional” bracing or with surgery. Each method has its advantages and disadvantages. Non-operative treatment is associated with a much higher re-rupture rate, but surgery can be complicated by infection.

Surgical treatment

Using minimally invasive surgery, many of the problems encountered with older techniques are totally avoidable. However, the period of immobilisation in a brace is about eight weeks and it takes approximately six months to return to normal activity.

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