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Achilles Tendon Rupture

What Is the Achilles Tendon?  

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 prior to the push-off phase of gait.

What Is an Achilles Tendon Rupture?

An Achilles tendon rupture is a partial or complete tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping, falling, pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. 

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

Signs & Symptoms 

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

  • Sudden pain (which feels like a kick, shot, or stab) in the back of the ankle or calf
  • A popping or snapping sensation
  • Swelling on the back of the leg between the heel and the calf. In some cases, there is a noticeable divot or deficit where the tear occurred.
  • 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 employed:

  • Rest. Stay off the injured foot and ankle, since walking can cause more pain, swelling, 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 (ACE type) to prevent further swelling.
  • Elevation. Keep the leg elevated to reduce the swelling. It should be even with or slightly above heart level. 

Diagnosis

In diagnosing an Achilles tendon rupture, your doctor will ask questions about how and when the injury occurred and whether you’ve previously injured the tendon or experienced similar symptoms. Your doctor 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 and compared to the uninjured foot and ankle. If the Achilles tendon is ruptured, the patient 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, your doctor may order an MRI or Sonogram (Ultrasound). It’s important to note that MRI is the gold standard imaging technique to help assess the magnitude of this injury.

Treatment

Treatment options for an Achilles tendon rupture include surgical and nonsurgical approaches. The decision of whether to proceed with surgery or nonsurgical treatment is based on the severity of the rupture and the patient’s 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 use of a cast, walking boot, or posterior splint/ brace to restrict motion and allow the torn tendon to heal.  

Surgery

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. The surgeon will select the procedure best suited to the patient.

Following surgery, the foot and ankle are initially immobilized in a cast or walking boot. The surgeon will determine when the patient can begin weightbearing. 

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

Physical Therapy

Whether an Achilles tendon rupture is treated with or without surgery, physical therapy is an important component of the healing process. Physical therapy involves exercises that strengthen the muscles and tendon, improves range of motion in the foot and ankle, and helps re-establish balance.  


If you have suffered a rupture of the Achilles tendon, do not hesitate to call us at (949) 833-3406 or request an appointment online.  Our doctors are well-versed in this condition and can develop an effective treatment course to get you back in action as soon as possible.