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Overview

An Achilles tendon rupture is when part or all of your tendon is torn. The Achilles tendon connects the calf muscle in your lower leg to your heel bone. It allows you to point your foot down and to rise on your toes. A tear is caused by an injury or increased pressure, such as during sports or a fall. The following may make your Achilles tendon weak or stiff, and more likely to tear. A past tendon tear. Lack of physical activity. Abnormal bone structure in your foot. Obesity. Older age. Medicines, such as steroids and antibiotics.

Causes
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.

Symptoms
Symptoms of an Achilles tendon rupture usually directly follow a traumatic event where the foot is forced in an upward position at the ankle, causing a sudden tight stretch of the Achilles tendon. There can also be a direct blow to the tendon causing a rupture. There is typically a popping feeling or even a popping sound described during the occurance of the rupture. Typically there is pain with swelling in the region. Often the patient is unable to put weight on this foot as there is too much pain.

Diagnosis
A staggering 20%-30% of Achilles tendon ruptures are missed. Thompson (calf squeeze) test is 96% sensitive and 93% sensitive. Unfortunately, some health practitioners fail to perform this simple clinical test. Ultrasound examination or an MRI can confirm an Achilles tendon rupture.

Non Surgical Treatment
Non-surgical treatment of Achilles tendon rupture is usually reserved for patients who are relatively sedentary or may be at higher risk for complications with surgical intervention (due to other associated medical problems). This involves a period of immobilization, followed by range of motion and strengthening exercises; unfortunately, it is associated with a higher risk of re-rupture of the tendon, and possibly a less optimal functional outcome.


Surgical Treatment
Your doctor may recommend surgery if you?re young and active, or an athlete. However, this will depend on where your tendon is ruptured. If the rupture is at, or above, the point at which your tendon merges with your calf muscle, for example, surgery may not be possible. There are three main types of surgery to repair a ruptured Achilles tendon. Open surgery. Your surgeon will make one long cut in your leg to reach the tendon and repair it. Limited open surgery. Your surgeon will still make a single cut but it will be shorter. Percutaneous surgery. Your surgeon will make a number of small cuts to reach the tendon and repair it. In all types of surgery, your surgeon will stitch the tendon together so it can heal. Each type of surgery has different risks. Open surgery is less likely to injure one of the nerves in your leg for example, but has a higher risk of infection. Ask your surgeon to explain the risks in more detail. After your operation, you will need to wear a series of casts or an adjustable brace on your leg to help your Achilles tendon heal. This will usually be for between four and eight weeks. There is a chance that your tendon will rupture again after the operation.