Achilles Tendon Rupture

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Article by John Miller

What is an Achilles Tendon Rupture?

achilles tendon rupture

When your Achilles tendon snaps it is known as Achilles tendon rupture.

What Causes an Achilles Tendon Rupture?

Often an Achilles rupture can occur spontaneously without any prodromal symptoms. Unfortunately the first "pop" or "snap" that you experience is your Achilles tendon rupture.

Achilles tendon rupture most commonly occurs in the middle-aged male athlete (the weekend warrior who is engaging in a pickup game of basketball, for example). Injury often occurs during recreational sports that require bursts of jumping, pivoting, and running. Most often these are tennis, racquetball, squash, basketball, soccer, softball and badminton. 

Achilles rupture can happen in these situations:

  • You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping.
  • You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully over stretching the tendon.
  • You fall from a significant height.

The biggest risk factor to Achilles tendon rupture is tendon cell death which occurs as a result of poorly managed tendinopathy.

  • What is a Tendinopathy?

  • Higher Risk with Achilles Tendonitis History

    It does appear that previous history of Achilles tendonitis results in a degenerative tendon, which can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Certain illnesses (such as arthritis and diabetes) and medications (such as corticosteroids and some antibiotics) can also increase the risk of rupture.

    Achilles Tendon Diagnosis

    A staggering 20%-30% of Achilles tendon ruptures are missed. Thompson (calf squeeze) test is 96% sensitive and 93% sensitive. Unfortunately, some health practitioners fail to perform this simple clinical test.

    Ultrasound examination or an MRI can confirm an Achilles tendon rupture.

    Totally Ruptured Achilles Tendon Treatment

    Treatment of a ruptured Achilles tendon is usually conservative (non-operative) in a Controlled Motion Ankle (CAM) Boot or it may require surgery.

    The current consensus based on research is to treat them conservatively since the functional outcome and chance of re-rupture is similar (7% to 15%) using both approaches but surgical intervention has a higher risk of infection.

    Achilles tendon surgery is usually considered if your Achilles has re-ruptured or there is delay of two weeks between the rupture and the diagnosis and commencement of conservative bracing and treatment.

    Post-Surgical Physiotherapy

    Most surgeons will recommend that you commence physiotherapy about one week post-op. It is important to not over-stress your Achilles tendon repair. Professional guidance of a physiotherapist experienced in Achilles tendon rupture rehabilitation is strongly recommended for your best outcome.

    Ruptured Achilles Tendon Prognosis

    You will normally be in your CAM brace for between 6 to 12 weeks. If everything goes perfectly during your rehabilitation it takes at least 12 weeks before a return to sport is possible. However, if there are complications, some Achilles tendon repairs can take six months to rehabilitate successfully and return to sport.

    Seek Professional Advice

    The best advice is to seek early advice from your physiotherapist, doctor or orthopaedic surgeon. Delay does result in a poorer prognosis.

    If you are lucky, you may avoid surgery but require a walking boot or similar with a graduated rehabilitation program to strengthen your injured tendon and prevent a further injury.

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    Common Achilles Tendon Rupture Treatments

    While everyone's treatment can vary depending on your individual assessment and rehabilitation goals, here's a few common Achilles Tendon Rupture Treatment Options.

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • Sub-Acute Soft Tissue Injury Treatment
  • Active Foot Posture Correction Exercises
  • Gait Analysis
  • Biomechanical Analysis
  • Eccentric Strengthening
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Agility & Sport-Specific Exercises
  • Medications?
  • Heel Cups
  • Orthotics
  • Soft Tissue Massage
  • Walking Boot
  • Brace or Support
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Kinesiology Tape
  • Neurodynamics
  • Prehabilitation
  • Running Analysis
  • Strength Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • Yoga
  • Helpful Achilles Tendon Products

    Achilles Tendon Rupture

    FAQs about Achilles Tendon Rupture

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • How Does Kinesiology Tape Reduce Swelling?
  • What Causes Post-Exercise Muscular Pain?
  • Barefoot Running: Your MUST READ Guide to the Pro's and Con's.
  • How Can You Prevent a Future Leg Injury?
  • How Do You Improve Your Balance?
  • How Much Treatment Will You Need?
  • Post-Run Soreness: Should You Be Concerned?
  • What are the Early Warning Signs of an Injury?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
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    Related Injuries

    General Information

    Achilles Injuries

    Calf Pain

    Shin Pain

    Muscle Injuries

    Systemic Conditions

    Neurological Conditions


    References

    • Cary DV. (2009) How to diagnose and manage an acute Achilles tendon rupture.JAAPA; 22(8):39-43
    • Dressendorfer R, Lombara A. (2014) Achilles Tendon Rupture. CINAHL Clinical Review. Website: http://search.ebscohost.com/login.aspx?direct=true&db=rrc&AN=T708413&site=rrc-live Published May 16, 2014. Accessed May 4, 2015.
    • Elias DA, McKinnon E. (2011) The role of ultrasound imaging in acute rupture of the Achilles tendon. Ultrasound. vol. 19 no. 2. 70-75
    • Gulati V, Jaggard M, Al-Nammari SS, Uzoigwe C, Ismail N, Gibbons C, Gupte C (2015) Management of achilles tendon injury: A current concepts systematic review.World J Orthop. 18;6(4):380-6
    • Maffulli N. (1998) The clinical diagnosis of subcutaneous tear of the Achilles tendon. A prospective study in 174 patients. Am J Sports Med. 1998 Mar-Apr;26(2):266-70.
    • Sode J, Obel N, Hallas J, Lassen A. (2007) Use of fluroquinolone and risk of Achilles tendon rupture: a population-based cohort study. Eur J Clin Pharmacol. May;63(5):499-503
    • Soroceanu A, Sidhwa F, Aarabi S, Kaufman A, Glazebrook M. (2012)Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a meta-analysis of randomized trials. J Bone Joint Surg Am;94(23):2136-43
    • van der Linden PD, Sturkenboom MC, Herings RM, Leufkens HM, Rowlands S, Stricker BH (2003) Increased risk of achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids. Arch Intern Med. 11-25;163(15):1801-7
    • Wallace RG, Traynor IE, Kernohan WG, Eames MH. (2004) Combined conservative and orthotic management of acute ruptures of the Achilles tendon. J Bone Joint Surg Am. Jun;86-A(6):1198-202
    • Weatherall JM, Mroczek K, Tejwani N.(2010) Acute achilles tendon ruptures. Orthopedics. 33(10):758-64

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    Last updated 21-Jun-2017 04:36 PM

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