The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture). The tendon can rupture completely or just partially.
If you have an Achilles tendon rupture, you might feel a pop or snap, followed by an immediate sharp pain in the back of your ankle and lower leg that usually affects your ability to walk properly. Surgery is often the best treatment option to repair an Achilles tendon rupture. For many people, however, nonsurgical treatment works just as well.
Symptoms of Achilles Tendon Rupture
Although it's possible to have no signs or symptoms with an Achilles tendon rupture, most people experience:
- Pain, possibly severe, and swelling near your heel
- An inability to bend your foot downward or "push off" the injured leg when you walk
- An inability to stand up on your toes on the injured leg
- A popping or snapping sound when the injury occurs
Causes of Achilles Tendon Rupture
Your Achilles tendon helps you point your foot downward, rise on your toes and push off your foot as you walk. You rely on it virtually every time you move your foot.
Rupture usually occurs in the section of the tendon located within 2.5 inches (6 centimeters) of the point where it attaches to the heel bone. This section may be predisposed to rupture because it gets less blood flow, which may impair its ability to heal.
Ruptures often are caused by a sudden increase in the amount of stress on your Achilles tendon. Common examples include:
- Increasing the intensity of sports participation
- Falling from a height
- Stepping into a hole
Treatment and Medication
The best treatment for a ruptured Achilles tendon often depends on your age, activity level and the severity of your injury. In general, younger and more active people often choose surgery to repair a completely ruptured Achilles tendon while older people are more likely to opt for nonsurgical treatment. Recent studies, however, have shown fairly equal effectiveness of both operative and nonoperative management.
Nonsurgical treatment
This approach typically involves wearing a cast or walking boot with wedges to elevate your heel; this allows the ends of your torn tendon to heal. This method can be effective, and it avoids the risks, such as infection, associated with surgery. However, the likelihood of re-rupture may be higher with a nonsurgical approach, and recovery can take longer. If re-rupture occurs, surgical repair may be more difficult.
Surgery
Surgery is a common treatment for a complete rupture of the Achilles tendon. The procedure generally involves making an incision in the back of your lower leg and stitching the torn tendon together. Depending on the condition of the torn tissue, the repair may be reinforced with other tendons. Surgical complications can include infection and nerve damage. Infection rates are reduced in surgeries that employ smaller incisions.
Rehabilitation
After treatment, whether surgical or nonsurgical, you'll go through a rehabilitation program involving physical therapy exercises to strengthen your leg muscles and Achilles tendon. Most people return to their former level of activity within four to six months.
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