Achilles Tendinitis and Tear

Introduction

The Achilles tendon is the most powerful tendon in the human body.  Tendons are strong cords of tissue that bind muscle to bone.  The Achilles tendon is located in the lower back part of the leg, above the heel and back of the ankle. It works with the calf muscles to produce forceful foot movements like kicking, jumping, or lunging. For this reason, Achilles tendon ruptures most often occur as a result of sports injuries from activities such as basketball, football, or tennis.  Ruptures of this tendon can also result from a condition called Achilles tendonitis. Individuals with Achilles tendonitis have tendons that are susceptible to injury, due to weakness and inflammation in the tissue.

Anatomy

The Achilles tendon is a fibrous cord that connects the calf muscles in the back of the leg to the back of the calcaneus, more commonly known as the heel bone. The Achilles tendon works with the calf muscles to allow the foot to raise upwards and point downwards. This motion enables you to walk, jump, stand on their toes, and climb stairs. People engage their Achilles tendon nearly every time they use their feet. Individuals with Achilles tendon ruptures will most likely not be able to perform such movements.

Achilles Tendon Tear Causes

Achilles tendon ruptures are most common in men between the ages of 30 and 50 years old that participate in sports.  Sports like basketball, football, tennis, and fencing require quick forward and backward leg movements, jumping, and cutting. This can create imbalanced stress on the leg and foot. The Achilles tendon can potentially rupture when the flexed foot sustains a sudden strong impact and the calf muscles shorten powerfully.  Achilles tendon rupture can also result from tendons weakened over time by chronic inflammation of the tendon, a condition known as Achilles tendonitis.

Achilles Tendon Tear Symptoms

You may hear a loud “pop” if your Achilles tendon ruptures.  Most individuals will feel a sudden and painful “snap” in the back of the calf or lower leg followed by sharp severe pain. Swelling and skin discoloration in the back of the calf are common due to bleeding under the skin. Individuals will be unable to point their feet downward or raise their heels upward, which will make it difficult to walk, jump, stand on their toes, or climb stairs.

Achilles Tendon Tear Diagnosis

In order to diagnose a possible Achilles tendon rupture, your doctor will need to perform an examination and review your medical history.  The Thompson Test is the most reliable and commonly used physical examination to confirm a suspected Achilles tendon rupture.  The test is simple to perform. The individual will lie face down with the injured leg held straight out. The physician will squeeze the calf muscles.  If the foot does not point, the Achilles tendon could be ruptured. The foot will not be able to point because the tendon connecting the calf muscles to the heel, and thus to the foot, is torn.  Some physicians may want to order medical imaging tests, such as ultrasound or an MRI, to confirm the tear and determine its exact location. An ultrasound uses sound waves to create an image when a device is gently placed on the skin.  An MRI provides a detailed view of specific body structures. In some cases, x-rays are ordered to assess if the leg or heel bone was injured when the Achilles tendon rupture.

Achilles Tendon Tear Treatment

Treatment for Achilles tendon rupture is highly individualized. It is important to discuss with your doctor the most appropriate treatment based on the location and severity of your rupture.  Treatment for Achilles tendon ruptures can be nonsurgical or surgical.

Surgery is not recommended for individuals who engage in low levels of activity or anyone prone to complications who may have difficulty tolerating the surgery.  Treatment for individuals not eligible for surgery includes approximately six weeks of casting to hold the leg and foot still and allow the tendons to heal, followed by a period of physical therapy. This method can be effective, and it avoids the risks associated with surgery, such as infection.

Achilles Tendon Tear Surgery

For individuals with active lifestyles and who want to return to strenuous recreational activities quickly, physicians recommend surgery that will reattach the torn Achilles tendon.  Surgery has a high chance of success and a low risk of complications. The surgery will require anesthesia but can be performed on an out-patient basis. The surgeon makes a three to a four-inch opening behind the ankle and reattaches the ends of the ruptured tendon to each other or to the calcaneus.  The foot is stabilized in a pointed position in a splint or short leg cast to prevent movement that might irritate the area. The splint or cast will be worn for four to six weeks. The individual participates in physical therapy when the healing is complete.

Achilles Tendon Tear Recovery

Individuals with surgical and non-surgical repair generally have good to excellent rates of recovery with proper treatment and rehabilitation.  The length of time for healing is variable. Typically, individuals with surgical repair can return to walking and swimming regularly after six weeks, and gradually return to sports several months after the surgery.  They have a lower risk of repeated tendon rupture and a much better chance of regaining full strength and range of motion in the leg. Individuals with non-surgical repair will likely need to participate in rehabilitation for a longer period of time, as they have a higher risk of repeated tendon rupture and loss of strength.

At SPORT, we will identify the source of your pain and then utilize state-of-the-art therapeutic techniques that focus on restoring your range of motion.

Depending on the specific condition and its severity, these treatment options may include physical therapy, over-the-counter anti-inflammatory medication, slings and supports, cortisone shots, or surgery.

If you have an acute or chronic foot or ankle injury that needs medical attention, call SPORT at (469) 200-2832 to arrange a consultation or you can request one online. Hurt today? We can arrange a same-day urgent care visit to ensure you get fast, effective relief.

Call Now Button