Achilles rupture

An Achilles rupture is the partial or complete tearing of your Achilles tendon, which connects your heel bone with your calf muscle. It usually occurs during sports that involve jumping, but anyone can accidentally overstretch the Achilles tendon, resulting in a rupture. Surgery is required to repair a completely ruptured Achilles tendon, but nonsurgical treatment can often heal a partial tear quite well.

Woman dribbling basketballWoman dribbling basketball

Causes and symptoms of Achilles tendon ruptures

Achilles ruptures are caused by a sudden increase in the stress on your Achilles tendon, usually during sports and intense physical activities that increase the risk. A rupture typically occurs in the section of the tendon situated within 2.5 inches of where it attaches to the heel bone, a spot where blood flow is poor.

A rupture most commonly occurs from:

  • Intense sports activity, especially from jumping.
  • Falling from a height.
  • Stepping into a hole.

Although it’s possible to have no signs or symptoms with an Achilles tendon rupture, most people experience these symptoms:

  • A feeling of being kicked in the calf.
  • Sharp pain and swelling near the heel.
  • An inability to bend the foot downward or push off when walking.
  • An inability to stand on the toes.
  • A popping sound at the time of injury.

Treatment options at UCHealth

We’ll treat your ruptured Achilles tendon based on the severity of the tear, your age and your activity level. Depending on the injury, both surgical and nonsurgical repair can be equally effective in healing.

Nonsurgical treatment typically involves:

  • Resting the tendon by using crutches.
  • Applying ice to the area.
  • Taking over-the-counter pain relievers.
  • Keeping the ankle from moving for the first few weeks, usually with a walking boot with heel wedges or a cast, with the foot flexed down.

Surgery involves stitching the torn tendon together, and we might reinforce the repair with other tendons. We do this through one of two procedures:

  • Open surgery. We make an incision in the skin to repair the tendon.
  • Percutaneous surgery. We use needles to access the tendon.

Studies that compare nonsurgical vs. nonsurgical repair (a review of overlapping meta analyses) show that surgical treatments reduce the chance of re-rupture, and percutaneous repair has a lower chance of wound infection. Your orthopedic specialists will discuss the best treatment plan for your case.

Getting you back on your feet

After treatment, you’ll need physical therapy exercises to strengthen your leg muscles and Achilles tendon.

You can expect return to your former level of activity within four to six months, but you should still continue your prescribed strength and stability training because some problems can persist for up to a year.

Ice climber on crevice wall

References

Orthoinfo: American Academy of Orthopaedic Surgeons. Achilles Tendon Tear (https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendon-rupture-tear-video/)

National Library of Medicine. Achilles Tendon Rupture (https://www.ncbi.nlm.nih.gov/books/NBK430844/)