Achilles Tendon Rupture: Causes, Symptoms, and Treatments

What is Achilles tendon rupture?

The Achilles tendon is a strong, thick band of tissue that connects your calf muscles to your heel bone. It is the hard, thick cord you feel at the back of your ankle. This flexible connective tissue is what allows us to walk, run, or jump.

An Achilles tendon rupture occurs when the Achilles tendon that connects your calf muscles to your heel bone experiences a partial tear or is fully torn. When the Achilles tendon ruptures, you may experience pain, swelling, and weakness in the injured foot, making it difficult to walk normally.

Causes of Achilles tendon rupture

Achilles tendon rupture often occurs when the Achilles tendon experiences a sudden increase in stress or is overextended. That’s why this type of injury is common in athletes or individuals engaging in intense physical activities.

There are a few other causes of Achilles tendon ruptures, such as:

• Sports activities:

  • High-intensity or fast-paced sports involving sudden movements and quick changes in direction, such as basketball or tennis, can strain the Achilles tendon.

• Age: 

  • As the body ages, the Achilles tendon becomes less flexible, making it more prone to injury, especially in older adults aged 30 to 50.

• Previous injuries: 

  • A history of Achilles tendinitis or previous Achilles tendon tears can weaken the tendon, making it more prone to tearing.

• Improper footwear: 

  • Shoes that lack proper support can contribute to Achilles tendon tears, especially during high-intensity activities or exercising on uneven surfaces.

  • Shoes should keep your foot in a neutral position and provide enough arch support and cushioning to evenly distribute pressure across your foot, reducing strain on the tendon. 

• Skipping warm-up:

  • Sudden increases in physical activity or training intensity without proper warm-up can overload the tendon, leading to a rupture.

• Medical conditions: 

  • Conditions such as diabetes, obesity, and consumption of certain medications, like fluoroquinolone antibiotics, can weaken the tendon and increase the risk of injury.

Symptoms of Achilles tendon rupture

An Achilles tendon rupture is a traumatic injury that needs medical care. Therefore, it's important to identify the signs of an Achilles tendon rupture in order to receive appropriate medical care.

Here are common symptoms of Achilles tendon ruptures, including:

• Pain: 

  • A sharp pain at the back of the ankle, often feeling like someone has forcefully kicked your heel.

• A popping sound: 

  • When the tendon ruptures, you might hear a distinct popping sound, similar to a rubber band snapping.

• Swelling: 

  • Immediate swelling around the Achilles tendon, which can extend from the heel up through the ankle and into the lower calf.

• Difficulty walking: 

  • This type of tendon injury can cause difficulty in walking, as the Achilles tendon's function is essential for our mobility.

• Limited range of motion: 

  • There may be noticeable difficulty in moving the foot or toes, particularly if the rupture is severe.

• Tenderness: 

  • The area surrounding the tendon can become tender to the touch, making movement painful.

Suspect that your Achilles tendon has ruptured? Are your symptoms worsening? don’t hesitate to request an appointment with our specialists at Thomson Medical for an accurate diagnosis and personalised treatment plan.

How is an Achilles tendon rupture diagnosed?

A healthcare provider will review your medical history and enquire about any symptoms you may be experiencing to diagnose an Achilles tendon rupture. The doctor will also assess whether you are experiencing any difficulty moving your foot.

Next, healthcare providers usually give a physical exam to assess the area for swelling, tenderness, and movement limitations. A doctor can also do specific tests, such as  the Thompson test, which involves squeezing the calves to see how the foot moves.

In addition to that, to get a better diagnosis, imaging diagnoses like ultrasound or magnetic resonance imaging (MRI) scans may be used to evaluate the extent of the injury, particularly if there is uncertainty about the diagnosis.

Treatment options for Achilles tendon rupture

The degree of the injury, the patient's age, and their activity level determine the treatment for Achilles tendon rupture. Treatment is essential to ensure that Achilles tendon ruptures to heal properly

Treatment options include both non-surgical and surgical methods.

Non-surgical treatments

Patients with minor symptoms, such as those experiencing partial ruptures, may not require surgical intervention. Here are some examples of nonsurgical treatment, such as:

• R.I.C.E. method

  • Rest: Avoid using the affected foot to prevent further strain.

  • Ice: Apply ice to the injured area to reduce swelling and pain. Do this for 15-20 minutes at a time, several times a day.

  • Compression: Use an elastic bandage or brace to compress the area and reduce swelling.

  • Elevation: Elevate the injured limb to reduce swelling, ideally above the level of your heart.

• Immobilisation: 

  • To prevent further damage, you can also immobilise the injured foot using a cast or a walking boot.

• Physiotherapy: 

  • Once the initial swelling and pain subside, physical therapy may be recommended to strengthen the muscles around the injured joint and restore mobility and function.

  • Exercises to improve flexibility, strength, and coordination are key to preventing further injuries and restoring full use of the joint.

• Medications: 

  • Over-the-counter pain relief medications, such as ibuprofen or paracetamol, can help manage pain and reduce inflammation.

However, if your condition worsens with persistent swelling and discomfort after non-surgical treatment, you should consult a doctor. Request for an appointment with our specialists at Thomson Medical. .

Surgical treatments

For severe Achilles tendon injuries, particularly complete ruptures, surgical treatment is often recommended. This is especially true for younger patients, athletes, and active individuals who want to return to their previous level of activity.

Here are two main surgical approaches that are commonly used:

• Open repair: 

  • This traditional surgical method involves a larger incision to directly stitch the torn tendon back together.

• Percutaneous repair: 

  • This minimally invasive technique uses smaller incisions, reducing recovery time and minimising scarring while effectively repairing the tendon.

A well-structured rehabilitation programme is essential for proper recovery and restoring foot functionality after Achilles tendon rupture surgery. Recovery typically takes several months and requires an intensive rehabilitation programme.

How long does it take to recover from an Achilles tendon rupture? 

Recovery time for an Achilles tendon rupture varies based on the severity of the injury and treatment method used. Generally, it can take anywhere from 4 to 12 months to fully recover.

After the tendon heals, a thorough rehabilitation programme is required to restore the Achilles tendon's strength, flexibility, and functionality. Recovery programs for Achilles tendon rupture include:

• Exercises: 

  • To help regain Achilles tendon strength, your physiotherapist may recommend exercise such as ankle pumps, toe curls, towel calf stretch, and calf raises. 

• Functional training: 

  • Functional training is introduced to prepare individuals for their normal routines and sports, ensuring a safe return to activity. This may include activity-specific drills that simulate the movements needed in the real-world application.

• Gradual return to sports: 

  • A well-structured plan helps athletes transition back to their sports safely, often involving gradual increases in intensity and complexity of movements. 

How to prevent an Achilles tendon rupture

Achilles tendon rupture is not entirely preventable, especially if it results from a health condition or an activity you cannot avoid. Here are a few steps you can do to reduce your chance of developing Achilles tendon problems, such as:

• Warm-up:

  • To prepare the tendon from the strain of exercising, perform a calf stretch or warm-up beforehand.

• Strengthen calf muscles:

  • Increasing the strength of the calves muscles can enhance their ability to support the Achilles tendon, enabling it to absorb more force and reducing the risk of injury.

  • Jump rope and squats are some easy exercises that can help strengthen your calf muscles.

• Wear comfortable shoes:

  • Wear well-fitting and comfortable shoes before exercising or doing sports to protect your calf and heel. Comfortable shoes could also help stabilise you when exercising on uneven surfaces.

• Gradual progression when exercising:

  • An abrupt increase in training intensity often leads to Achilles tendon injuries. You can increase the distance, duration, and frequency of your training gradually. 

FAQ

Can you still walk with an Achilles tendon rupture?

Severe pain often accompanies an Achilles tendon rupture, so walking is painful and challenging. It's crucial to seek medical attention and avoid putting weight on the affected foot until a healthcare provider assesses the injury.

Can a ruptured Achilles tendon heal itself?

Mild cases of Achilles tendon rupture may resolve on their own with rest and self-care. However, persistent or severe cases may require medical treatment to prevent the condition from worsening and to heal properly.

How long is the recovery for a ruptured Achilles tendon?

Recovery times can vary significantly. Non-surgical treatment normally lasts 4 to 6 months, however, recovery from surgery can take up to 6 to 12 months, depending on individual circumstances and rehabilitation commitment.

Early diagnosis and proper treatment can effectively manage Achilles tendon rupture. If you suspect you have this condition, seek medical advice to prevent complications and ensure proper healing.

The information provided is intended for general guidance only and should not be considered medical advice. For a personalised treatment plan and tailored advice, please consult a specialist at Thomson Medical. Book an appointment with Thomson Medical today.