• Diagnosis
  • Treatment
  • Rehabilitation

Achilles Rupture

An Achilles tendon rupture is a serious injury which needs to be diagnosed and treated as soon as possible.

The Achilles tendon is located just behind and above the heel and its role is to help the foot bend downwards at the ankle. The most common cause of a rupture is through a sudden and violent contraction of the calf muscle, racquet sports players are most prone to suffering, but it can also occur by itself.

Symptoms

Sometimes a snap can be heard and felt when the tendon ruptures.

Initially it will be very painful but this extreme pain will not persist. However, swelling and bruising will appear within hours.

Investigation

It is easy for the condition to be misdiagnosed as a sprain, thus it is imperative for a patient to see an experienced foot and ankle specialist who will be able to make a diagnosis on the basis of symptoms, the history of the injury and an examination.

The most common test is the ‘Thompson’s Test’. In this test the patient will be asked to lie face down on the examination bench and to bend the knee. The doctor will gently squeeze the calf muscles at the back of the leg, and observe how the ankle moves. If the Achilles tendon is functional, the calf squeeze will make the foot point briefly away from the leg. This is the most accurate test for Achilles tendon rupture.

Achilles Rupture

Treatment will depend on the severity of the injury, and will fall under the category of surgical or non surgical.

Non-surgical Treatment

A ruptured tendon can be treated non-operatively with plaster of Paris and then functional bracing. It is associated with a much higher re-rupture rate than surgery, but has no risk of infection.

Surgical Treatment

Minimally invasive surgery is used, and future problems are totally avoidable. However, the period of immobilisation in a brace is about eight weeks and it takes approximately six months to return to normal activity.

Achilles Rupture

Post Surgery: After surgical repair of the Achilles Tendon, the patient will be on crutches and in a brace. Early post operative rehabilitation is required and will continue for 6 to 12 months. Patients will be advised to continue with a maintenance programme of physiotherapist-prescribed rehabilitation exercises even after having returned to full activity.