The Achilles tendon connects the calf muscles to the heel bone. A rupture occurs when there is a tearing or separation of the tendon fibers. An Achilles heel rupture leads to loss of normal function.

Achilles Tendon Rupture

Achilles Tendon Rupture

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Causes

Achilles tendon rupture can be caused by:

  • Overuse
  • Overstretching
  • Overworking an inflamed tendon
  • Injury from an accident or fall
Risk Factors

Factors that may increase your chance of getting Achilles tendon rupture include:

  • Achilles tendinopathy
  • Recent increase in activity level
  • Weak or inflexible calf muscles
  • Previous Achilles tendon rupture
  • Involvement in sports that involve running, jumping, twisting, or lunging
  • Improper footwear
  • Obesity
  • Certain medications, such as quinolone antibiotics or corticosteroids, which weaken the tendon
  • Collagen vascular diseases, such as rheumatoid arthritis, lupus, and scleroderma
Symptoms

Symptoms may include:

  • Popping or snapping noise when injury occurs
  • Sudden, extreme pain at the back of the heel
  • Swelling near your heel
  • Inability to push off from the ball of the foot
  • Inability to walk on the affected leg
Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Images may be taken of the affected area. This can be done with:

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options may include the one or more of the following:

First Aid

When you are injured, apply these steps right away and seek medical help:

  • Stop your activity and stay off the injured foot.
  • Apply an ice pack. Place a towel between the ice pack and your skin.
  • Wrap your injured foot and ankle in elastic bandaging. Do not wrap the bandage too tight. It may cut off circulation.
  • Elevate your foot above the level of your heart.
Medication

To help manage pain, your doctor may advise:

  • Over-the-counter pain relievers, such as acetaminophen or non-steroidal anti-inflammatory medication (NSAIDs)
  • Prescription pain relievers
Surgery

Surgery is the most common treatment for this condition. An incision is made in the lower leg and the tendon is sewn back together. A cast, splint, walking boot, or brace is worn for 6-8 weeks. One of the benefits of surgery is that it lowers the risk of re-rupturing the tendon. Surgery may also be a better option if you are athletic.

Non-Surgical Care

The other option is to allow your tendon to heal without surgery. In this case, you also need to wear a cast, splint, walking boot, or brace for 6-8 weeks. You also may have different exercises to do. If you are less active or have a chronic illness that prevents surgery, this option may be better for you.

Rehabilitation

During rehabilitation, you will:

  • Complete range-of-motion exercises for the legs. Ankle motion will begin when healing allows.
  • Progress to strengthening and balance exercises as your condition improves
  • Use crutches or a walker to protect the healing tendon
  • Be advised of other exercises and activities that are safe for you

Most people can return to normal activity in 4-6 months.

Prevention

To help reduce your chance of getting Achilles tendon rupture, take the following steps:

  • Do warm-up exercises before an activity and cool down exercises after an activity.
  • Wear proper footwear.
  • Maintain a healthy weight.
  • Rest if you feel pain during an activity.
  • Change your routine. Switch between high-impact activities and low-impact activities.
  • Strengthen your calf muscle with exercises.