Achilles Tendon Rupture: Symptoms, Causes, Treatment

What are the symptoms of an Achilles tendon rupture?

An Achilles tendon rupture is a serious injury that typically causes sudden and severe pain in the back of the ankle or calf. The symptoms of an Achilles tendon rupture may include:

1. Sudden, sharp pain: A rupture is often described as feeling like a sudden, sharp pain or snap in the back of the ankle or calf. Some people compare the sensation to being kicked or hit in the leg.
2. Swelling: Swelling in the area of the rupture may occur rapidly, making it difficult to walk or put weight on the affected leg.
3. Difficulty walking: After a rupture, it may be difficult or impossible to push off with the affected foot or walk normally. Some people experience a feeling of weakness or instability in the ankle.
4. Calf stiffness: The calf muscles may feel tight or stiff, and you may have difficulty pointing your toes downward.
5. A gap in the tendon: In some cases, a gap or indentation may be visible or palpable in the area where the tendon has ruptured.
6. Bruising: Bruising may occur around the ankle and heel area, although this is more common in complete ruptures than partial ruptures.

It’s important to seek medical attention immediately if you suspect you have ruptured your Achilles tendon, as early treatment can help prevent further damage and improve outcomes. A healthcare provider can perform a physical examination and imaging tests, such as an ultrasound or MRI, to diagnose the extent of the injury and recommend the most appropriate treatment.

What are the causes of an Achilles tendon rupture?

An Achilles tendon rupture is often caused by a sudden forceful movement or excessive stress on the tendon. Some common causes and risk factors for Achilles tendon rupture include:

1. Sudden increase in physical activity: A sudden increase in the intensity or duration of physical activity, such as running or jumping, can put excessive stress on the Achilles tendon and increase the risk of rupture.
2. Age: The risk of Achilles tendon rupture increases with age, as the tendon tends to weaken and lose elasticity over time.
3. Gender: Men are more likely than women to experience an Achilles tendon rupture, possibly due to differences in muscle strength and activity levels.
4. Sports injuries: Achilles tendon ruptures are common in sports that involve running, jumping, or sudden changes in direction, such as basketball, soccer, or tennis.
5. Tight calf muscles: Tight calf muscles can increase the strain on the Achilles tendon and make it more prone to injury.
6. Poor footwear: Wearing shoes that do not provide adequate support or cushioning for the foot and ankle can increase the risk of Achilles tendon rupture.
7. Previous tendon injuries: A history of Achilles tendon injuries or conditions such as Achilles tendinitis can weaken the tendon and increase the risk of rupture.
8. Certain medications: Some medications, such as fluoroquinolone antibiotics or corticosteroids, can weaken tendons and increase the risk of rupture.
9. Medical conditions: Certain medical conditions, such as rheumatoid arthritis or diabetes, can weaken the Achilles tendon and increase the risk of rupture.
10. Steroid injections: Injections of corticosteroids into the Achilles tendon can weaken the tendon and increase the risk of rupture.

It’s important to address risk factors and take preventive measures to reduce the risk of Achilles tendon rupture, such as maintaining a healthy weight, wearing proper footwear, and gradually increasing the intensity of physical activity.

What is the treatment for an Achilles tendon rupture?

The treatment for an Achilles tendon rupture depends on the extent of the injury, the individual’s activity level and health, and other factors. Treatment options may include:

1. Non-surgical treatment: For partial tears or in patients who are not good candidates for surgery, non-surgical treatment may be recommended. This typically involves wearing a cast or walking boot with the foot pointed downward to allow the tendon to heal in the stretched position. Physical therapy may also be recommended to strengthen the calf muscles and improve range of motion.
2. Surgical treatment: For complete Achilles tendon ruptures or in active individuals, surgery may be recommended to repair the tendon. The two main surgical techniques are open surgery, where an incision is made in the back of the leg to repair the tendon, and percutaneous surgery, where the tendon is repaired through small incisions using specialized instruments. Surgery is often followed by a period of immobilization and physical therapy to regain strength and range of motion.
3. Rehabilitation: Whether treated surgically or non-surgically, rehabilitation plays a crucial role in recovery from an Achilles tendon rupture. Physical therapy exercises are typically prescribed to improve strength, flexibility, and function of the calf muscles and Achilles tendon. Gradual return to activity is important to prevent re-injury.
4. Orthotic devices: After healing, orthotic devices such as heel lifts or custom shoe inserts may be recommended to reduce stress on the Achilles tendon and prevent future injury.

The choice of treatment depends on several factors, including the extent of the rupture, the individual’s activity level and health, and the preferences of the healthcare provider and patient. It’s important to follow the recommendations of your healthcare provider to ensure proper healing and reduce the risk of re-injury.

Can you still walk with an Achilles tendon rupture?

Yes, it is possible to walk with an Achilles tendon rupture, but it is not recommended. Walking with an Achilles tendon rupture can worsen the injury and increase the risk of complications.

When the Achilles tendon ruptures, it can cause significant pain and weakness in the calf and ankle. Some people may still be able to bear weight and walk a few steps after a rupture, especially if the rupture is partial or if the other leg is compensating for the injured leg. However, walking with a ruptured Achilles tendon can cause further damage to the tendon and surrounding tissues, making it more difficult to heal and increasing the risk of a larger tear.

If you suspect you have ruptured your Achilles tendon, it is important to seek medical attention immediately. A healthcare provider can perform a physical examination and imaging tests to diagnose the extent of the injury and recommend appropriate treatment. Treatment may include rest, immobilization, physical therapy, or surgery, depending on the severity of the rupture.

How long does it take to recover from an Achilles tendon rupture?

The recovery time for an Achilles tendon rupture can vary depending on the extent of the injury, the type of treatment, and individual factors such as age and overall health. In general, recovery from an Achilles tendon rupture can take several months. Here is a general timeline for recovery:

1. Immediate post-injury phase (0-2 weeks): Immediately after the injury, the ankle may be immobilized in a cast or walking boot to allow the tendon to heal. During this time, weight-bearing is usually restricted, and crutches may be used for mobility.
2. Early rehabilitation phase (2-6 weeks): After the initial immobilization period, physical therapy exercises are typically started to improve range of motion and strength in the ankle and calf muscles. The goal is to gradually reintroduce weight-bearing activities.
3. Mid-rehabilitation phase (6-12 weeks): During this phase, physical therapy focuses on strengthening the calf muscles and improving balance and coordination. Activities may include calf raises, heel drops, and balance exercises.
4. Late rehabilitation phase (12 weeks and beyond): As strength and range of motion improve, the focus shifts to functional activities and gradually returning to normal activities. Orthotic devices or shoe inserts may be used to support the foot and reduce stress on the Achilles tendon.
5. Return to activity (4-6 months): Most people can return to light activities, such as walking and swimming, within 4-6 months after an Achilles tendon rupture. However, it may take up to a year or more to fully recover and return to sports or other high-impact activities.

It’s important to follow the recommendations of your healthcare provider and physical therapist during the recovery process to ensure proper healing and reduce the risk of re-injury. It’s also important to gradually increase activity levels and listen to your body to avoid overloading the healing tendon.