Definition
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. Treatment depends on the severity of the rupture.
Causes
Achilles tendon rupture can be caused by:
- Overuse
- Overstretching
- Overworking an inflamed tendon
- Injury from an accident or fall
Risk Factors
Factors that 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, scleroderma
Symptoms
Symptoms may include:
- Popping or snapping noise when injury occurs
- Sudden, extreme pain at back of heel
- Swelling near your heel
- Inability to push off from ball of foot
- Inability to walk on affected leg
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
- MRI
- Ultrasound
- X-ray
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. Don’t wrap the bandage too tight. It may cut off circulation.
- Elevate your foot above your heart.
Medication
To help manage pain, your doctor may recommend:
- 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. The doctor makes an incision in the lower leg and sews the tendon 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 very 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:
- Begin with range-of-motion exercise. Often these will focus on the body as a whole.
- Progress to weight-bearing exercises using support devices, such as a walker or crutches.
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. Cool down with ice to the area.
- Wear proper footwear. Consider heel lifts.
- Maintain a healthy weight.
- Rest if you feel pain during an activity. Avoid activities that cause pain.
- Change your routine. Switch between high-impact activities and low-impact activities.
- Strengthen your calf muscle with exercises.
These steps can also reduce your chance of repeat injury.
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