Achilles tendon rupture is a complete or partial tear caused by overstretching the tendon. Performing actions requiring explosive acceleration such as sprinting, forceful jumping or pivoting can stretch the tendon beyond its capacity and result in a tear. Falling or tripping may also cause tendon rupture.
These tendon ruptures are more common in "weekend warriors" -- middle-aged people staying active in their spare time. Illness or medications, including steroids and some antibiotics might weaken the tendon and less commonly lead to ruptures.
Achilles tendon rupture may be accompanied by one or more of the following symptoms:
Patients should seek immediate medical attention when experiencing these symptoms to prevent further damage. Until a doctor can be seen, the patient should follow the "R.I.C.E." method of treatment as follows:
Rest. Relieve pressure from the injured foot and ankle, as walking can cause pain and worsen damage.
Ice. Apply an ice bag covered with a thin cloth to reduce swelling and pain. Avoid putting ice directly on the skin to prevent skin damage.
Compression. Wrap a bandage around the foot and ankle to prevent further swelling.
Elevation. Keeping the leg elevated at or slightly above heart level reduces swelling.
To diagnose an Achilles tendon rupture, Dr. Radovic will ask how and when the injury occurred, and whether the tendon has been previously injured or if similar symptoms have been experienced. Dr. Radovic will evaluate the foot and ankle, feeling for a gap in the tendon that signifies a likely rupture. Muscle strength and range of motion will be tested in comparison to the uninjured foot and ankle. In the case of rupture, the patient will have difficulty pointing the foot downward, as on a gas pedal; and standing on the toes of the affected leg.
An Achilles tendon rupture is most often diagnosed with this type of examination. But in some cases, Dr. Radovic might order an MRI or other imaging study to confirm diagnosis.
Achilles tendon rupture may be treated with surgical and non-surgical approaches. The patient's health status, activity level and the extent of rupture are all factors to consider when deciding whether to proceed with surgical or non-surgical treatment.
Non-surgical treatment is most suitable for patients who are less active, have minor ruptures or medical conditions that prevent them from being surgically treated. Usually associated with a higher rate of re-rupture, non-surgical treatment includes wearing a cast, walking boot or brace to immobilize the foot and ankle, and allow the torn tendon to heal.
Surgery is a beneficial option for several reasons. Patients are less likely to re-rupture the Achilles tendon after surgery; and often experience increased push-off strength, improved muscle function and improved ankle movement.
There are a number of surgical techniques to repair tendon rupture. Dr. Radovic will decide on the most suitable procedure for the particular patient.
Patients are instructed to immobilize the foot and ankle after surgery by wearing a cast or walking boot. Dr. Radovic will determine when the patient may resume weight bearing activities.
Post operative complications may arise such as nerve pain, incision-healing difficulties or re-rupture of the tendon.
Achilles tendon rupture may be treated surgically or non-surgically, but physical therapy remains an important factor in recovery. Physical therapy includes muscle strengthening exercises and improved range of motion in the foot and ankle.