Achilles Tendon Rupture

An Achilles tendon rupture is a serious injury that occurs when the Achilles tendon, which connects the calf muscles to the heel bone, partially or completely tears. This tendon is crucial for movements such as walking, running, and jumping.

Causes and Risk Factors

The causes of an Achilles tendon rupture can vary but often involve a sudden contraction of the calf muscles, which can happen during sports activities or even simple movements like stepping off a curb. Risk factors include age (with most ruptures occurring in people between 30 and 50 years old), gender (males are more commonly affected than females), and previous Achilles tendon problems.

Symptoms

The symptoms of an Achilles tendon rupture can be quite dramatic and may include a sudden, severe pain in the back of the ankle, a loud "pop" or snap at the time of injury, swelling and bruising around the ankle, and difficulty walking or standing on the affected leg. Patients often report feeling as though they have been kicked or hit in the back of the ankle.

Diagnosis

Diagnosing an Achilles tendon rupture typically involves a physical examination by a healthcare provider. The provider may perform a Thompson test (also known as the calf squeeze test), where the patient lies on their stomach with their feet hanging off the end of the table, and the doctor squeezes the calf muscle to check for movement of the foot. If the Achilles tendon is ruptured, the foot will not move or will move very little. Imaging tests like ultrasound or MRI may also be used to confirm the diagnosis.

Treatment

Treatment options for an Achilles tendon rupture can vary depending on the severity of the injury and the patient's overall health status. Non-surgical treatment involves immobilizing the ankle in a cast or walking boot, followed by physical therapy to strengthen the calf muscles and improve ankle function. Surgical repair is often recommended for younger, more active patients or those with a complete rupture. Surgery involves stitching the tendon back together, which can provide a faster recovery and lower risk of re-rupture compared to non-surgical treatment.

Recovery

Recovery from an Achilles tendon rupture is a lengthy process that requires patience and adherence to a rehabilitation program. For non-surgical treatment, it can take about 6-12 months for the tendon to heal fully. Surgical repair typically offers a faster recovery time but still requires several months of physical therapy and rehabilitation to regain strength and function in the ankle.

Prevention

While not all Achilles tendon ruptures can be prevented, certain measures may reduce the risk. These include warming up before exercise, stretching after activity, avoiding sudden increases in exercise intensity or duration, wearing proper footwear, and maintaining a healthy weight to reduce stress on the tendons.