An Achilles tendon rupture is a complete tear of the fibrous tissue that connects the heel to the calf muscle. This is often caused by a sudden movement that overextends the tendon and usually occurs while running or playing sports such as basketball or racquetball. Achilles tendon rupture can affect anyone, but occurs most often in middle-aged men.

Causes of Achilles tendon rupture

An Achilles tendon rupture is often caused by overstretching the tendon. This typically occurs during intense physical activity, such as running or playing basketball. Pushing off from the foot while the knee is straight, pivoting, jumping, and running are all movements that can overstretch the Achilles tendon and cause it to rupture.

A rupture can also occur as the result of trauma that causes an over-stretching of the tendon, such as suddenly tripping or falling from a significant height.

The Achilles tendon is particularly susceptible to injury if it is already weak. Therefore, individuals who have a history of tendinitis or tendinosis are more prone to a tendon rupture. Similarly, individuals who have arthritis and overcompensate for their joint pain by putting more stress on the Achilles tendon may also be more susceptible to an Achilles tendon rupture.

Achilles tendon rupture symptoms

Symptoms of an Achilles tendon rupture include: 

• A popping sound that accompanies the sudden pain when the injury occurs. 
• Inability to stand on tip-toes or push off when walking. 
• Pain, swelling, and bruising near the heel. 
• Stiffness. 
• Sudden and severe pain in the back of the ankle or calf when the injury occurs, as if struck by a hard object. 
• Visible gap in the tendon above the heel bone. 
• Weakness.

One way to confirm the injury is to squeeze the calf muscles while lying on your stomach. If the foot does not point or move when the calf muscles are squeezed, then the tendon is likely torn.

An MRI or ultrasound can also confirm that the Achilles tendon is in fact torn.

Treatment of Achilles tendon rupture

A ruptured Achilles tendon can be treated with or without surgery.

Non-surgical

Non-surgical treatment typically involves wearing a brace or cast for the first six weeks following the injury to allow time for the ends of the torn tendon to reattach on their own. Over-the-counter medications, such as ibuprofen or aspirin, may be taken during this time to reduce pain and swelling. Once the tendon has reattached, physical therapy will be needed to strengthen the muscles and tendon. A full recovery is usually made within four to six months.

Surgical

During surgery, the ends of the tendon are stitched back together. Following the surgery, a brace or cast must be worn for about six weeks to allow the tendon time to heal. Physical therapy will then be needed to help maintain strength and flexibility of the muscles and tendon.

Contact your doctor to determine which treatment would be best for you.

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