The Achilles tendon is the body’s largest and strongest tendon, connecting the calf muscles to the heel bone. This robust cord plays a direct role in movements like walking, running, and jumping by enabling the foot to push off the ground and rise onto the toes. When this tendon experiences a significant tear or rupture, the ability to bear weight or walk becomes severely compromised.
Understanding Achilles Tendon Tears
An Achilles tendon tear involves a rupture or partial tearing of the thick, fibrous cord that links the calf muscles to the heel bone. This injury can manifest with a distinct sensation, often described as a sudden “pop” or “snap” at the back of the ankle. Individuals experience sharp, immediate pain in the Achilles area, accompanied by swelling and bruising.
The inability to walk or push off the foot stems from the tendon’s compromised integrity. The Achilles tendon is responsible for plantarflexion, the motion of pointing the foot downward and raising the heel. When it tears, this mechanical linkage is broken, preventing the calf muscles from effectively transmitting force to the heel, making tasks like standing on tiptoes or pushing off the ground difficult.
Achilles tendon tears often occur due to sudden, forceful movements that overstretch the tendon. Common scenarios include sports that involve abrupt stops, starts, or pivots, such as basketball, soccer, tennis, or football. The injury can also result from incidents like tripping, falling from a height, or stepping into a hole. Age and certain medications like some antibiotics or steroid injections, can increase susceptibility to a tear.
Immediate Steps and Diagnosis
Upon suspecting an Achilles tendon tear, immediate action is important. Stop any activity, avoid putting weight on the injured leg, and apply ice to the affected area to reduce swelling. Elevating the leg can also minimize swelling.
Seeking prompt medical attention is important following a suspected tear. A healthcare provider will typically perform a physical examination to assess the injury. This includes specific tests like the Thompson Test, where the calf muscle is squeezed to observe if the foot points downward; a lack of movement can indicate a complete tear. The doctor may also feel for a gap in the tendon, which indicates a rupture.
To confirm the diagnosis and determine the extent of the tear, imaging tests are commonly used. An ultrasound can provide a real-time view of the tendon and identify the presence and size of a tear. Magnetic Resonance Imaging (MRI) offers detailed images of soft tissues, which show the location and severity of the rupture.
Treatment and Rehabilitation
Treatment for an Achilles tendon tear typically involves either surgical repair or non-surgical management, with the choice depending on the patient’s age, activity level, and the tear’s severity. Surgical options include open repair, where an incision is made to stitch the torn ends of the tendon together, or percutaneous repair, a less invasive method using smaller incisions. Surgical intervention is often considered for younger, more active individuals to reduce the risk of re-rupture.
Non-surgical management usually involves immobilizing the ankle and foot to allow the tendon to heal naturally. This approach includes wearing a cast, brace, or walking boot for several weeks to prevent movement and protect the healing tendon. While non-surgical methods may carry a higher risk of re-rupture compared to surgery, they avoid surgical complications such as infection.
Regardless of the chosen treatment, rehabilitation is a lengthy process that spans several months for a return to former activity levels. The initial phase involves immobilization, followed by a gradual progression to weight-bearing as directed by a healthcare professional. Physical therapy plays an important role, incorporating exercises to restore range of motion, strengthen the calf muscles and Achilles tendon, and improve balance and coordination. Adherence to the prescribed rehabilitation program and patience are important for regaining full function.