Achilles Tendon Rupture

What is the Achilles tendon?

Tendons join muscles to bones. The Achilles tendon joins the calf muscles onto the heel bone. It is the firm rope-like structure you can feel on the back of your ankle, just above your heel bone.

How do Achilles tendons rupture?

As we get older our tendons generally get weaker. If we exercise regularly our tendons stay strong and healthy, but if we don’t then our tendons can get weaker. If we suddenly put extra force through the achilles tendon by stumbling over, jumping off something or playing a new sport, we can overload the tendon and it can snap (rupture). This feels like you have been kicked in the back of the heel and sometimes a “snap” can be heard.

Certain medicines such as some antibiotics (ciprofloxacin and ofloxacin) and steroids can also weaken the tendon and make it more likely to rupture.

 

What problems does it cause?

Patients with a ruptured Achilles tendon can often still stand on the foot, they just can’t walk normally or stand on their tip-toes.

Non-surgical treatment:

Achilles tendons can heal without surgery. It is important for you to discuss treatment options with your doctor to see if this method is right for you.

There are many ways to do this but below is a rough guide to give you an idea of one way of treating Achilles tendon ruptures without surgery. It is important that you follow your doctors advice, below is for reference only.

The leg is placed into a cast with the toes pointing down for 2 weeks.

Pointing the toes down brings the heel bone up which pushes the torn tendon ends together to allow them to heal back together.

For the first 2 weeks you will not be able to put any weight through the foot and you will need to take blood-thinning injections to avoid getting a blood clot in the leg.

After this you can go into a removable boot with wedges under your heel to keep the tendon relaxed. For 4 weeks you will be putting 50% of your weight through the foot and you will remove wedges as time goes on. After this 4 week period you can put your full weight through the boot for 2 weeks, then start physiotherapy. This treatment takes around 8 weeks in total, then a period of physiotherapy depending on how active you are.

Surgery

If you are sporty or active you may benefit from surgery. Although there are many different ways of performing the surgery, it generally involves sewing the tendon ends back together. This brings the tendon back to its original length, which gives you back more of the strength in your calf muscle after the tendon has healed, allowing you to run and jump more normally, so that you are more likely to go back to sports. If surgery is to be performed it is best to perform this within 2 weeks.

It is important that you have a frank discussion with your doctor about your lifestyle so that they can inform you of whether you would benefit from surgery or if it would be suitable to treat you without an operation. An orthopaedic surgeon is the best person to discuss this with.

After surgery

It is important that you follow your doctor’s advice, below is for reference only.

After surgery you should be comfortable and nearly all patients go home on the same day.

For the first 2 weeks you will need to keep your foot elevated above your heart at home day and night to keep the swelling down. This reduces pain and helps the wound to heal. You will not be able to put any weight through the foot and you will need to take blood-thinning injections to avoid getting a blood clot in the leg.

After 2 weeks your cast will come off and the stitches will be removed.

After this you can go into a removable boot with wedges under the heal.

For 4 weeks you will be putting 50% of your weight through the foot with the boot on and wedges will be removed at set time points.

After this you can put your full weight through the boot for 2 weeks, then start physiotherapy.

This treatment takes around 8 weeks in total after the surgery followed by a period of physiotherapy depending on how active you are.

The main benefits of surgery are to restore the strength of the calf muscle closer to how it was before the rupture.

 

It is crucial you don’t smoke (including e-cigarettes) or take anti-inflammatories for 8 weeks after the surgery.

Achilles tendon rupture

This website is designed and run by Mr Edward Gee, a Consultant Orthopaedic Surgeon specialising in Foot and Ankle Surgery, as an educational resource for Patients and Professionals.

View More Videos

Achilles Tendon Rupture FAQs

    Your Achilles tendon is an incredibly important structure that attaches your calf muscles to your heel bone. When your calf muscles contract they pull up on your heel, propelling you forwards onto your toes, allowing you to walk, run and jump. Sometimes an Achilles tendon can snap or rupture and this commonly happens to active people during sports.

    An Achilles tendon can rupture without warning and is often felt as a “snap” in your calf or heel after a trip or when trying to set off running. You will have swelling and bruising over your Achilles tendon on the back of your heel. You may still be able walk to some degree, but you would feel like there is something “not quite right” and you won’t be able to walk quickly, run, jump or stand on your tip toes.

    As a foot and ankle specialist, I will be able to assess your Achilles tendon to see if it is ruptured. This is confirmed using an ultrasound scan or MRI scan to assess the position and severity of your rupture and the distance between the ends of the snapped tendon. This information helps us to decide how best to treat your Achilles tendon rupture.

    If you are less active you can be treated without surgery. This involves splinting your ankle with the toes pointing down to bring your heel up, bringing your tendon ends together. This is done using a plastercast for 2 weeks, then placing your foot into a specially designed boot to protect your healing tendon whilst slowly bring your foot back up to 90 degrees over the next few weeks. Your tendon will become slightly longer when treated without an operation and this is likely to weaken your calf permanently. If you are treated without surgery, you should be able to walk well, but walking quickly up a hill will be more difficult, and running and jumping may not be possible. If you are active or sporty, you are likely to require an operation to repair your tendon back to its original length to allow you to return to your previous level of activity.

Book face to face or remote consultations

Email admin@footandankleexpert.co.uk to book your face to face or remote consultations.

Book consultation

 

 

Facebook Twitter Youtube Quote Linkedin instagram