Achilles Tendon Rupture

Injuries commonly occur in sports, strenuous activities, or accidents. When the foot is brought upward, the Achilles Tendon is placed on stretch and is at its most vulnerable position for injury. If too much force is applied, the tendons may tear or become ruptured. The separation may be classified as a partial or total rupture, depending on the severity of the injury.

Signs and symptoms include a pain and stiffness in the back of the tendon while walking that doesn’t go away. A thorough clinical exam is needed to differentiate tendonitis from a rupture. There is usually a palpable mass in the tendon about 2 cm above the point where the tendon inserts into the heel bone. When a partial rupture occurs, one is able to still walk around with mild to moderate discomfort. If a total rupture occurs, it becomes more difficult to bear weight and walking is labored. We recommend an MRI to evaluate the integrity of the tendon, to determine partial vs. total ruptures, and to help decide on the best treatment plan.

Treatment usually consists or ice, immobilization, oral anti-inflammatory medicines, and rest. Immobilization is best accomplished with a soft cast, walking boot, or fiberglass cast. If the injury is serious enough, we perform surgery to repair the broken tendon and reapproximate the separated tendons.

If the injury is not diagnosed correctly, untreated, or treated inadequately, a condition occurs where the split tendon hardens within the central aspect of the tendon, called Tendinosis.

Achilles Tendonitis
Achilles tendonitis is a common overuse injury and inflammation of the tendon. Events that can cause Achilles tendonitis may include tightness or shortness of the Achilles tendon, hill running or stair climbing, increasing mileage or speed in a training program, starting up too quickly from a crouched position, and trauma.

Achilles tendonitis often begins with mild pain after exercise or running that gradually worsens. Other symptoms include recurring localized pain along the tendon during or after exercise, pain at the area where the tendon attaches to the Calcaneus, or heel bone, mild or severe swelling, stiffness the generally diminishes as the tendon warms up with use or stiffness that occurs the next morning after a hard workout.

Treatment normally includes immobilization, either soft cast and splint or walking boot, anti-inflammatories, ice, rest, gradual stretching, and a rehab program. Orthotics work well to realign the leg and ankle and prevent further abnormal motion.