Achilles Rupture

The Achilles tendon is found on the rear of the heel, extending into the calf muscles. It assists greatly with downward ankle movement (plantar flexion). Sportspeople, particularly older male athletes, are often struck by a full or partial rupture of the tendon, which can be caused through a long term degenerative process or, most commonly, due to a single trauma. This is a serious injury and always requires swift medical attention.

Symptoms of Achilles Rupture

Severe pain in the back of the leg that feels like a significant blow to the area, usually during physical activity. At the moment the pain commences, a loud bang, snap or similar noise can sometimes be heard. The initial pain should soon become a lesser ache, but walking will become very painful and difficult; regular walking patterns will be impossible and standing on tiptoes can be unachievable. Walking flat footed is a typical gait after the injury strikes, characterised by an inability to push off the floor on the injured leg. The area around the back of the heel will become inflamed and possibly reddened, and when touching the area you are often liable to feel a gap in the Achilles tendon, though this can be obscured by bruising.

Causes of Achilles Rupture

Generally the acute pain caused by the tendon tearing will be preceded by an obvious trauma during activity. This can be due to fatigued muscles, a failure to stretch or warm up properly, or can simply arise spontaneously with a stressful motion. The most common movement that provokes such ruptures is pushing powerfully off the ground using the foot, the toes hitting the surface with force (e.g. in running or any fast paced sport). Another damaging movement can be bending the foot upwards, which can be caused through falling. These movements put great pressure on the Achilles tendon by rapidly contracting the calf muscles.

Sometimes the tendon has been weakened over time, due to factors including age (particularly in the over 60s), a cut close to the tendon, corticosteroid or antibiotic treatments, particular conditions like gout or Cushing's, or pre-existing Achilles tendinitis (please see our corresponding article).

Medical Treatment for Achilles Rupture

See a doctor as soon as possible; the earlier the treatment begins, the better the chance of full recovery. (It is not recommended to wait for longer than two days.) The doctor will assess the severity of the rupture and then recommend suitable treatment, which occasionally includes wearing a cast and leaving the tendon to heal, but most often necessitates surgery. Surgery involves reattaching the broken ends of the tendon, and will also require a leg cast after the operation.

Following surgery or other treatment, a program of physical rehabilitation will be crucial in building up strength in the leg and its muscles. The full process of treatment and rehab can be protracted, regularly lasting between 8 and 12 months. This is essential for total recovery, and surgery can reduce the risk of eventually sustaining the same injury again.