Achilles Tendon Rupture

Achilles Tendon Rupture

Article by John Miller

Achilles Tendon Rupture

What is an Achilles Tendon Rupture?

Achilles tendon rupture

What Causes an Achilles Tendon Rupture?

When your Achilles tendon snaps or pops, it is known as Achilles tendon rupture. Often an Achilles tendon rupture can occur spontaneously without any prodromal symptoms. Unfortunately, the first “pop” or “snap” that you experience your Achilles tendon rupture.

Achilles tendon rupture most commonly occurs in the middle-aged male athlete (the weekend warrior who is engaging in a basketball pickup game, 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 the powerful thigh muscles straighten your knee. 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 overstretching the tendon.
  • You fall from a significant height.

The most significant risk factor for Achilles tendon rupture is tendon cell death resulting from poorly managed tendinopathy.

Higher Risk of Achilles Tendonitis History

It does appear that any previous history of Achilles tendinopathy 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 Achilles tendon rupture’s risk.

Achilles Tendon Diagnosis

Achilles tendon ruptures misdiagnosis is a staggering 20%-30%. Yet, they shouldn’t be if your healthcare practitioner is methodical and thorough in their assessment. Thompson (calf squeeze) test is 96% sensitive and 93% sensitive. Unfortunately, some health practitioners fail to perform this simple clinical test. An ultrasound examination or an MRI can confirm an Achilles tendon rupture. A palpable “gap” in the Achilles tendon is another positive sign of at least partial rupture.

Please consult your trusted physiotherapist or a sports doctor for a thorough Achilles assessment.

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. Your decision should involve a conversation with your ankle surgeon.  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. Surgical intervention has a higher risk of infection.

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

Post-Achilles Repair Physiotherapy

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

Ruptured Achilles Tendon Prognosis

You will typically 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 considering any graduated return to sport program. This timing is, of course, at the discretion of your Achilles surgeon. However, some Achilles tendon repairs can take six to 12 months to rehabilitate successfully and return to sport if there are complications.

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.

Common Treatments For Foot Pain

With accurate assessment and early treatment, most foot pain responds extremely quickly to physiotherapy allowing you to quickly resume pain-free and normal activities of daily living. Please ask your physiotherapist for their professional treatment advice.

Acute Treatment

Subacute Treatment Options

Other Treatment Options

Balance Improvement