The Achilles tendon is the largest and strongest tendon in the human body, connecting the calf muscles to the heel bone. This tendon is essential for nearly all foot movements, playing a significant role in walking, running, and jumping. It enables the foot to push off the ground and allows an individual to stand on their tiptoes. A ruptured Achilles tendon involves a complete or partial tear of this structure, representing a substantial injury that warrants immediate medical attention.
The Immediate Sensation
At the moment of an Achilles tendon rupture, many individuals report a distinct sensation. It is commonly described as a sudden, loud “pop” or “snap” from the back of the ankle or lower calf. This event can be so pronounced that others nearby may even hear it. Following this sound, sharp, immediate pain manifests in the affected area, often likened to being kicked or hit forcefully from behind.
The pain can be severe and is concentrated near the heel or in the lower calf. Simultaneously, there is an immediate feeling of weakness or instability in the injured foot. Individuals often find themselves suddenly unable to push off the foot, as if the connection between the calf muscle and heel bone has been severed. This combination of sound, sharp pain, and functional loss is characteristic of an Achilles rupture.
Accompanying Physical Signs
Beyond the acute sensation of rupture, several physical signs and functional limitations emerge after the injury. Swelling and bruising commonly develop around the ankle and extending up the lower calf. This discoloration and puffiness become noticeable as blood accumulates in the damaged tissues.
A significant functional impairment is the inability to stand on tiptoes on the injured leg. The ruptured tendon can no longer transmit the force from the calf muscles needed for this action. A noticeable gap or depression can also be felt in the tendon approximately 2 to 6 centimeters above the heel bone, where the tear has occurred. Walking becomes difficult, often resulting in a flat-footed gait, and bearing weight on the affected foot is painful or impossible.
Common Causes of Rupture
An Achilles tendon rupture occurs during activities involving sudden, forceful movements that place extreme stress on the tendon. One common mechanism is a rapid push-off with the foot while the knee is extended, such as during sprinting, jumping, or sudden acceleration. Another scenario involves abrupt dorsiflexion of the ankle, where the foot is suddenly forced upward, as might happen when falling from a height or stepping into a hole.
The injury is common in sports that demand quick stops, starts, and changes in direction, including basketball, soccer, tennis, and badminton. Middle-aged recreational athletes, often referred to as “weekend warriors,” are often affected. Certain factors can increase susceptibility, such as the use of specific antibiotics (like fluoroquinolones) or steroid injections, which can weaken the tendon. Pre-existing tendon degeneration, often from chronic overuse, can also make the Achilles more prone to tearing.
Immediate Steps After Suspecting a Rupture
If an Achilles tendon rupture is suspected, seeking professional medical attention without delay is important. Prompt diagnosis is important for effective treatment. It is advisable to go to an emergency room, urgent care clinic, or contact an orthopedic specialist as soon as possible.
While awaiting medical evaluation, avoid putting any weight on the injured leg to prevent further damage. Using crutches or other supportive devices can help with mobility. Applying ice to the back of the ankle and lower calf can help reduce swelling and discomfort. Elevating the injured leg above heart level, if possible, also assists in minimizing swelling.