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Achilles Tendon Rupture - Causes, Symptoms, Diagnosis and Treatment

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When the Achilles tendon (tendon above the heel) is partially or fully disrupted, it is known as Achilles tendon rupture. Read the article to know more.

Medically reviewed byDr. Suman Saurabh

Published At March 22, 2022
Reviewed AtMarch 6, 2023

What Is Achilles Tendon Rupture?

The Achilles tendon is a thin, strong material that is present inside the leg, which connects the muscles present in the back of the foot to the muscles in the lower rear part of the calf. Hence a rupture of this material is referred to as the Achilles tendon rupture, which causes pain to the rear part of the lower leg. This injury can happen to anyone, but it is common in people who are involved mostly in recreational sports such as baseball or basketball.

The robust material that connects the heel bone and the calf muscles is a strong fibrous cord. It can be ruptured completely or partially if it is overextended. Any injury that causes the Achilles tendon to rupture is presented by a pop sound, which is followed by an immediate extreme pain around the ankles and the lower part of the leg. This pain can be very severe, and it is highly impossible to walk properly without any aid or support.

The main function of the Achilles tendon is to help in the foot movement as it guides us to point our foot downwards, stand on our toes, and push back the floor while walking. Hence this part of our body is extremely important for our mobility, and we tend to rely on it basically every time we put our feet on the ground.

What Are the Causes of Achilles Tendon Rupture?

The Achilles tendon usually gets damaged or ruptured at around six centimeters above the point where it is joined to the heel bone (present in the foot). This is because the level of blood circulation to this area is comparatively poor, making it slightly weak and also affecting the ability to heal quickly if damaged.

As discussed earlier, the Achilles tendon becomes ruptured if there is excessive stress on the tendon. This is observed very commonly in people who rely more on their feet during their daily life such as professional sportspersons, athletes, mountain climbers, etc. Some of the common categories of people who are most affected by Achilles tendon rupture are:

  1. Those who play sports that require jumping and landing on feet.

  2. Those who have fallen from height.

  3. Those who have mistakenly stepped into a hole.

What Are the Symptoms Associated With Achilles Tendon Rupture?

This injury can happen to anyone, so immediately seek medical attention if you hear a pop sound and find it hard to walk afterward. There are no specific signs and symptoms for Achilles tendon rupture. In the majority of the cases, it is possible to be asymptomatic as well. But in a study, it has been identified that people who have suffered from Achilles tendon rupture have experienced the following:

  • Very sharp pain around the ankles.

  • Possible swelling around the ankles and lower part of the calf.

  • The popping sound or napping sound at the time of injury.

  • Not able to stretch the leg and foot downwards.

  • Not able to apply pressure on the injured foot while walking.

How Is Achilles Tendon Rupture Diagnosed?

Once the doctor collects a detailed history of your pain and symptoms, he or she will check the lower part of the leg for tenderness and swelling. During this physical examination, the doctor may diagnose a small gap in the tendon, right below the calf muscle, indicating a complete rupture of the Achilles tendon.

Since the tendon connects the feet and the calf muscle, there will be automatic flex between these two. Hence in order to diagnose the rupture of the Achilles tendon, the doctor will instruct you to lie flat on your stomach while hanging the foot over the other end of the examination table. While in this position, the doctor will squeeze your calf muscle to check for the automatic flex. If there is no flex during this procedure, then the rupture is confirmed.

To know more about the rupture, like the extent or whether it is ruptured completely or not, the doctors might go for imaging tests, such as magnetic resonance imaging (MRI) or an ultrasound. With the help of this imaging, further treatment will be instructed accordingly.

How Is the Rupture of Achilles Tendon Treated?

In order to treat a ruptured Achilles tendon, it is important to consider the factors like the age of the person, the level of activity, and also the severity of the injury. If the injury is caused in a younger and more active set of people, then they would opt for surgical treatment as they require comfortable mobility and complete foot movement. Otherwise, in the case of elderly people who tend to move less and have limited use of their feet, surgical procedures will not be recommended.

Surgical Treatment:

The surgical treatment for repairing the tendons involves an incision on the lower back of the leg and stitching the ruptured tendons back together. This procedure might also require additional reinforcement from other tendons based on the severity and the tearing of the tissue. Similar to other surgical procedures, there are chances of infection and damage to nerves, but they are very rare. Also, the possibility of getting an infection is very low in the case of minimally invasive procedures when compared to open procedures.

Nonsurgical Treatments:

For elderly people who do not prefer surgery, nonsurgical treatments are given, which involves:

  • Avoid pressure on the tendons by using clutches during movement.

  • Constantly apply ice over the area to manage swelling and pain.

  • Make use of over-the-counter pain relievers.

  • Use a walking boot to isolate the ankle and avoid any movement of the feet.

  • In certain rare cases, a cast might also help.

The downside of the nonsurgical procedure is that the time taken to heal is comparatively more, and there is also a possibility of re-rupturing of the tendon.

Rehabilitation:

Since the Achilles tendon is one of the major body parts that we make use of in our daily routine, proper healing and strengthening are required irrespective of the treatment method. It is important to have physical therapy and exercise to get back to full movement and strength. This might take at least four to six months, but for some people, it might take more than a year to gain the old stability and strength back. One such type of rehabilitation that has been found to be efficient for both surgical and nonsurgical treatment is “functional rehabilitation,” which focuses on improving mind and body coordination.

Conclusion:

Achilles tendon rupture is not a very severe condition, but it is required to immediately reach out to your doctor so that no further damage is done to the injury. There are several studies happening nowadays that are focused on improving the recovery rate and minimizing the invasion of the surgery. Hence with the help of proper medical help and physical exercise, the rupture can be reversed, and the full functionality of the tendon can be gained back.

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Frequently Asked Questions

A sharp, sudden rise in stress at the site of the Achilles tendon can lead to Achilles tendon rupture. This can happen during intense workouts or can happen during an intense fall.
Yes, a person with a ruptured Achilles tendon can walk.
A person can take from two to three weeks up to six weeks to completely recover from Achilles tendon rupture with the help of physical therapy.
Yes, Achilles tendon ruptures are more severe than a tear, as ruptures can take a longer time to heal completely.
Yes, most commonly, people with Achilles tendon rupture seek emergency treatments, and they require an orthopedic surgeon for treatment.
Achilles tendonitis requires proper treatment. And if untreated, they can lead to a series of tendon tears which might complicate the treatment by causing Achilles tendon rupture.
Some people might not experience any signs or symptoms; however, many other people with Achilles tears will experience intense pain and may feel like their calves are being kicked, and they will have difficulties in moving the injured foot forward while walking.
Usually, your doctor might advise other treatments like casting your leg to prevent movements. In some cases, with serious injuries with Achilles tendon rupture, your doctor might advise surgical intervention.
Achilles tendon ruptures can require surgical intervention where the torn tendons are sutured together to help in recovery. This is a straightforward surgery.
You might need to have your leg cast for about 6 to 12 weeks after surgery. At first, you might have to keep your foot facing forward to help in recovery. But, it might take several months to completely recover.
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