Achilles Tendon Rupture

(Rupture, Achilles Tendon; Severely Torn Achilles Tendon)

Definition

The Achilles tendon connects the calf muscles to the heel bone. A rupture occurs when there is a tearing or separation of the tendon fibers.
Achilles Tendon Rupture
Achilles Tendon Rupture
Copyright © Nucleus Medical Media, Inc.

Causes

Achilles tendon rupture can be caused by:
  • Overuse
  • Overstretching
  • Overworking an inflamed tendon
  • Injury from an accident or fall

Risk Factors

Factors that may increase your chance of getting Achilles tendon rupture include:
  • Achilles tendonopathy
  • Recent increase in activity level
  • Weak or inflexible calf muscles
  • Previous Achilles tendon rupture
  • Involvement in sports that involve running, jumping, twisting, or lunging
  • Improper footwear
  • Obesity
  • Certain medications, such as quinolone antibiotics or corticosteroids, which weaken the tendon
  • Collagen vascular diseases, such as rheumatoid arthritis, lupus, and scleroderma

Symptoms

Symptoms may include:
  • Popping or snapping noise when the injury occurs
  • Sudden, extreme pain at the back of the heel
  • Swelling near your heel
  • Inability to push off from the ball of the foot
  • Inability to walk on the affected leg

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Images may be taken of the affected area. This can be done with:

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options may include the one or more of the following:

Supportive Care

You will need time to heal. RICE and immediate medical care are often the pain part of treatment:
  • Rest—Activities will need to be restricted.
  • Ice—Ice therapy may help relieve swelling.
  • Compression—Used for a limited time, compression bandages can provide gentle pressure to help move fluids out of the area.
  • Elevation—Keeping the area elevated can help fluids drain out or prevent fluids from building up.
Crutches or a walker may be advised to protect the healing tendon. Prescription or over-the-counter medication may be advised to reduce pain.

Surgery

Surgery is the most common treatment for this condition. An incision is made in the lower leg and the tendon is sewn back together. A cast, splint, walking boot, or brace is worn for 6-8 weeks. One of the benefits of surgery is that it lowers the risk of re-rupturing the tendon. Surgery may also be a better option if you are physically active. The other option is to allow your tendon to heal without surgery. In this case, you also need to wear a cast, splint, walking boot, or brace for 6-8 weeks. You also may have different exercises to do. If you are less active or have a chronic illness that prevents surgery, this option may be better for you.

Physical Therapy

A physical therapist will assess the tendon. An exercise program will be created to help recovery and to stregthen the muscles.

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Prevention

To help reduce your chance of getting Achilles tendon rupture, take the following steps:
  • Do warm-up exercises before an activity and cool down exercises after an activity.
  • Wear proper footwear.
  • Maintain a healthy weight.
  • Rest if you feel pain during an activity.
  • Change your routine. Switch between high-impact activities and low-impact activities.
  • Strengthen your calf muscle with exercises.

RESOURCES

American Podiatric Medical Association
http://www.apma.org

OrthoInfo—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES

Canadian Orthopaedic Foundation
http://www.canorth.org

Canadian Physiotherapy Association
http://www.physiotherapy.ca

References

Achilles tendon rupture. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=AV0003. Updated February 2009. Accessed March 9, 2015.

Achilles tendon rupture. American College of Foot and Ankle Surgeons Foot Health Facts website. Available at: http://www.foothealthfacts.org/Content.aspx?id=1363&terms=achilles%20tendon%20rupture. Accessed February 28, 2014.

Achilles tendon rupture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 15, 2015. Accessed March 9, 2015.

Maffulli, N. Current concepts review—rupture of the Achilles tendon. JBJS. 1999;81:1019-1036.

van der Linden P, Sturkenboom C, Herings R, et al. Increased risk of Achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids. Arch Intern Med. 2003;163:1801-1807.

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