Although an Achilles tendon rupture mainly occurs in people playing recreational sports, it can happen to anyone. Because the Achilles tendon is essential for walking, running, and jumping, it is prone to wear and tear. Injuries to this tendon tend to be uncomfortable and can seriously restrict a person’s movement. While not everyone experiences severe pain, it is essential to seek immediate medical attention as an Achilles tendon rupture can worsen if untreated. At Advanced Orthopedic in Denver, Parker, and Aurora, Colorado, their foot and ankle specialists can be trusted to assess and determine if you have an Achilles tendon rupture and, if so, recommend the best treatment.
THE ACHILLES TENDON
The Achilles tendon is the largest in the body. It 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. It allows someone to climb stairs, jump and even rise up on their tiptoes. It also allows the foot to point downward and push-off, making activities such as running and jumping possible. It is strong, durable, and experiences a load of up to 10 times a person’s body weight during physical activity.
WHAT IS AN ACHILLES TENDON RUPTURE?
An Achilles tendon rupture is a full or partial tear of the Achilles tendon. This acute (sudden) injury occurs when the tendon stretches to its breaking point. Rupture usually occurs in the section of the tendon situated within 2 ½ inches of the point where it attaches to the heel bone. Achilles tendon ruptures occur most frequently in people ages 25-45 and are more common in men than women.
POSSIBLE CAUSES AND RISK FACTORS
There are multiple and varied instances that can cause an Achilles tendon rupture. Any sudden movement that puts stress on the Achilles tendon can lead to a rupture. People who are “weekend warriors” (usually adults who don’t train regularly, then exercise at a high intensity) are more likely to rupture an Achilles tendon than younger, well-trained athletes. Sports with sudden stops, starts, and pivots—such as soccer, football, basketball, tennis, and squash put one at higher risk. A rupture can also happen by tripping, missing a step when going down stairs, or accidentally stepping into a hole and twisting the ankle. Other risk factors are bone spurs, wearing high heels, wearing the wrong shoes when exercising, and exercising on an uneven surface. Less commonly, medications such as certain steroids or antibiotics, or illnesses like rheumatoid arthritis or diabetes that can weaken the tendon can contribute to ruptures.
Symptoms of an Achilles tendon rupture include the following:
- A pop or snap when the tendon tears
- Severe pain down the back of the leg or near the heel
- Pain in the back of the ankle, making it difficult to walk
- Swelling and discoloration
- Inability to rise on the toes
- Difficulty flexing the affected foot
- Pain in the tendon that gets worse with activity during the day
WHEN TO SEE A DOCTOR
These symptoms require prompt medical attention to prevent further damage. Until the patient can see a doctor for evaluation, the RICE method should be used. This involves Rest (staying off the injured foot), Ice (ice up to 20 minutes at a time as needed), Compression (wrapping the foot and ankle in an elastic bandage to prevent swelling), and Elevation (propping the leg on a pillow when sitting or lying down). Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can be taken for pain.
Treatment for an Achilles tendon rupture includes surgical and non-surgical approaches. Non-surgical 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. Non-surgical treatment involves use of a cast, walking boot, or brace to restrict motion and allow the torn tendon to heal.
WHEN IS SURGERY INDICATED?
Surgery offers important potential benefits. Besides decreasing the likelihood of re-rupturing the Achilles tendon, it can improve push-off strength and improve muscle function and movement of the ankle. During surgery, an incision is made in the back of the calf. If the tendon is ruptured, the surgeon will stitch the tendon back together. If there is severe damage to a lot of the tendon, the surgeon might replace part or all of the Achilles tendon. This is done with a tendon from another place in the foot. In some cases, the Achilles tendon rupture surgery can be done as a minimally invasive procedure. This is done with several small incisions and may use a special scope with a tiny camera and light to help do the repair. Following surgery, the foot and ankle are initially immobilized in a cast or walking boot.
GETTING THE RIGHT DIAGNOSIS
Achilles tendon ruptures are common, but research has shown that about one-quarter of all Achilles tendon ruptures are misdiagnosed during an initial examination. This results in delayed therapeutic treatment and increases the risk of long-term problems. This is why it is critical to seek out a highly trained and experienced foot and ankle specialists like those at Advanced Orthopedic in Denver, Parker, and Aurora, Colorado. In the right skilled hands, a physical exam alone is often enough to diagnose an Achilles tendon rupture. The surgeon will ask questions about how and when the injury occurred and whether the patient has previously injured the tendon or experienced similar symptoms. They will examine the foot and ankle, feeling for a defect in the tendon that suggests a tear. Range of motion and muscle strength will be evaluated. In some cases, the surgeon may order an MRI or other advanced imaging tests. With the right treatment at Advanced Orthopedic, an Achilles tendon rupture doesn’t have to knock you off your feet.