The Achilles tendon is the strongest tendon in our body. It links the heel bone to the calf muscles, enabling activities like walking, running, and jumping. Achilles tendon injuries are common, especially in athletes and physically active individuals. The most frequent injury is Achilles tendinitis, where the tendon becomes inflamed due to overuse, sudden increases in activity, or improper technique. This condition often causes pain, stiffness, and swelling in the back of the leg or above the heel. But, what about an even worse injury to the Achilles?
What Is an Achilles Rupture?
An Achilles rupture means your tendon is torn. You may hear a pop and then a very sharp pain in the back of your ankle that moves up your lower leg. It can happen due to age, overuse, and other underlying problems like arthritis. There may be swelling and bruising at the back of the ankle, pain especially when going up stairs or up a hill, and tenderness where the tendon is torn.
To confirm the diagnosis, Anderson Orthopaedic Clinic will do imaging tests like an MRI or an ultrasound. Your specialist will examine the area, check if you can move it in different directions as well as how much pressure you can put on your ankle. For confirmation, they will feel for a gap where the tendon is torn.
If the tear is serious, Achilles repair surgery may be recommended.
What Are Treatment Options for an Achilles Tendon Rupture?
Non-invasive treatments are used first with Achilles injuries. If non-surgical treatments do not alleviate the pain, your orthopaedic specialist may utilize a combination of non-surgical and surgical techniques.
For less active patients, non-surgical treatments may be satisfactory, but for someone more active or an athlete, surgical repair is the best option. Most of these surgeries are performed as an outpatient.
Surgical Treatment for Achilles Ruptures
The objective of surgery for repairing an Achilles tendon rupture is to reattach the calf muscle to the heel bone, thereby restoring the strength needed for effective push-off during movement. This must occur in order to walk without pain. Blood supply to a rupture is limited so repair must progress quickly after a torn tendon.
Surgical treatment options include:
- An open repair in which a board-certified orthopaedic surgeon at Anderson Orthopaedic Clinic makes an incision on the posterior of the lower leg. The surgeon then ties together the ends of the tendon using sutures and closes the incision.
- A minimally invasive technique. Only one small incision is made and instruments with sutures connected are passed through to tie the ends together.
Recovery and What to Expect
Most patients are fitted in a splint or cast and no weight should be put on the leg. Crutches, a walker, or a knee scooter is used to get around. The cast or splint can be removed in two weeks, and you may be given a walking boot.
You can begin to put weight on the leg within six weeks and also begin physical therapy. Most patients are fully recovered by six months and able to get back to full activity, but it may take a full year for full recovery.
Patients should be aware that even after a successful repair, you may never regain the same strength as before. You may possibly suffer a re-rupture but it is rare and less than 5%.
Contact Anderson Orthopaedic Clinic for a diagnosis and timely treatment if you suspect you have ruptured your Achilles tendon. Give us a call at (703) 892-6500 or request an appointment through our secure online form.
Sources:
Chronic Achilles Tendon Pain: Diagnosis & Treatment | HSS
Achilles tendon rupture – Diagnosis and treatment – Mayo Clinic