Achilles Tendon Rupture

An Achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the “heel cord,” the Achilles tendon facilitates walking by helping to raise the heel off the ground. 

Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.

Achilles tendon ruptures are most often seen in “weekend warriors” – typically, middle-aged people participating in sports in their spare time. Less commonly, illness or medications, such as steroids or certain antibiotics, may weaken the tendon and contribute to ruptures.

What are the symptoms of an Achilles tendon rupture?

A person with a ruptured Achilles tendon may experience one or more of the following:

  • Sudden pain (which feels like a kick or a stab) in the back of the ankle or calf – often subsiding into a dull ache
  • A popping or snapping sensation
  • Swelling on the back of the leg between the heel and the calf
  • Difficulty walking (especially upstairs or uphill) and difficulty rising up on the toes

These symptoms require prompt medical attention to prevent further damage. Until the patient is able to see a doctor, the “R.I.C.E.” method should be used. This involves:

  • Rest. Stay off the injured foot and ankle, since walking can cause pain or further damage.
  • Ice. Apply a bag of ice covered with a thin towel to reduce swelling and pain. Do not put ice directly against the skin.
  • Compression. Wrap the foot and ankle in an elastic bandage to prevent further swelling.
  • Elevation. Keep the leg elevated to reduce the swelling. It should be even with or slightly above heart level.

How is an Achilles tendon rupture diagnosed?

In diagnosing an Achilles tendon rupture, Dr. Neitzel will ask questions about how and when the injury occurred and whether you have previously injured the tendon or experienced similar symptoms. Dr. Neitzel will also examine the foot and ankle, feeling for a defect in the tendon that suggests a tear. The range of motion and muscle strength will be evaluated and compared to the uninjured foot and ankle. If the Achilles tendon is ruptured, you will have less strength in pushing down (as on a gas pedal) and will have difficulty rising on the toes.

The diagnosis of an Achilles tendon rupture is typically straightforward and can be made through this type of examination. In some cases, however, Dr. Neitzel may order an MRI or other advanced imaging tests.

What is the treatment for an Achilles tendon rupture?

Treatment options for an Achilles tendon rupture include nonsurgical and surgical approaches. The decision of whether to proceed with nonsurgical or surgical treatment is based on the severity of the rupture and your health status and activity level.

Nonsurgical Treatment

Nonsurgical treatment, which is generally associated with a higher rate of re-rupture, is selected for minor ruptures, less active patients, and those with medical conditions that prevent them from undergoing surgery. Nonsurgical treatment involves the use of a cast, walking boot, or brace to restrict motion and allow the torn tendon to heal.

Surgical Treatment

Surgery offers important potential benefits. Besides decreasing the likelihood of re-rupturing the Achilles tendon, surgery often increases the patient’s push-off strength and improves muscle function and movement of the ankle.

Various surgical techniques are available to repair the rupture. Dr. Neitzel will select the procedure best suited for you.

Following surgery, your foot and ankle are initially immobilized in a cast or walking boot. Dr. Neitzel will determine when you can begin weight-bearing.

Complications such as incision-healing difficulties, re-rupture of the tendon, or nerve pain can arise after surgery.

Physical Therapy

Whether an Achilles tendon rupture is treated nonsurgically or surgically, physical therapy is an important component of the healing process. Physical therapy involves exercises that strengthen the muscles and improve the range of motion of the foot and ankle.

Contact Us

If you suspect you may have ruptured your Achilles tendon, please give us a call at (360) 286-0404 to schedule an appointment with Dr. Neitzel for evaluation and treatment recommendations.