Achilles Tendon Rupture
Foot & Ankle Care of Colorado
Achilles Tendon Rupture Symptoms
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 RICE 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.
Achilles Tendon Rupture Diagnoses
In diagnosing an Achilles tendon rupture, the foot and ankle surgeon will ask questions about how and when the injury occurred and whether the patient has previously injured the tendon or experienced similar symptoms. The surgeon 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, the surgeon may order an MRI or other advanced imaging tests.
Nonsurgical Treatments
Nonsurgical treatment, which is generally associated with a higher rate of 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 brace to restrict motion and allow the torn tendon to heal.
When Is Surgery Needed?
Surgery offers important potential benefits. Besides decreasing the likelihood of rerupturing 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, rupture of the tendon or nerve pain can arise after surgery.
