Overview
Achilles tendon rupture is an injury that affects the back of your lower leg, typically occurring in the strong fibrous cord that connects the muscles in the calf to the heel bone. When the Achilles tendon is overstretched, it can tear either partially or completely, resulting in a sudden pop, severe pain, and swelling near the heel. Symptoms may include difficulty bending the foot downward, an inability to stand on the toes, and a popping or snapping sound during the injury. Achilles tendon ruptures often result from a sudden increase in stress on the tendon, which can occur in sports that involve running, jumping, or sudden starts and stops.
Understanding the disease
Symptoms
The symptoms of an Achilles tendon rupture may include:
- A feeling of having been kicked in the calf
- Pain, possibly severe, and swelling near the heel
- An inability to bend the foot downward or "push off" the injured leg when walking
- An inability to stand on the toes on the injured leg
- A popping or snapping sound when the injury occurs If you experience these symptoms after hearing a pop in your heel, it's important to seek medical advice immediately.
Risk Factors
Risk factors for developing Achilles tendon rupture include:
- Age: The peak age for Achilles tendon rupture is 30 to 40.
- Sex: Achilles tendon rupture is up to five times more likely to occur in men than in women.
- Recreational sports: Achilles tendon injuries occur more often during sports that involve running, jumping, and sudden starts and stops - such as soccer, basketball, and tennis.
- Steroid injections: Doctors sometimes inject steroids into an ankle joint to reduce pain and inflammation, but this medication can weaken nearby tendons and has been associated with Achilles tendon ruptures.
- Certain antibiotics: Fluoroquinolone antibiotics, such as ciprofloxacin (Cipro) or levofloxacin (Levaquin), increase the risk of Achilles tendon rupture.
- Obesity: Excess weight puts more strain on the tendon.
Development
Achilles tendon ruptures can develop due to a sudden increase in stress on the tendon or a traumatic incident, such as falling from a height, stepping into a hole, or engaging in sports that involve jumping and sudden starts and stops. The rupture occurs when the tendon is overstretched, causing it to tear either partially or completely. The risk of Achilles tendon rupture is higher among individuals who engage in recreational sports, especially those in the age group of 30 to 40, and men are more likely to experience this injury than women.
Assessment and Diagnosis
Triage
You should see a doctor immediately if you suspect an Achilles tendon rupture. The symptoms include hearing a pop in your heel, experiencing severe pain and swelling near the heel, and having difficulty walking or bending your foot downward.
Diagnosis
To diagnose an Achilles tendon rupture, your doctor will typically conduct a physical exam. During the exam, they will inspect your lower leg for tenderness and swelling, and they might feel a gap in your tendon if it has ruptured completely. They may also ask you to kneel or lie in a specific position to test your ankle's flexibility and mobility. If there's uncertainty about the extent of the injury, your doctor might order an ultrasound or MRI scan to create images of your tissues.
Management and Treatment
Prevention
Achilles tendon rupture can be prevented to some extent by following certain precautions. Some preventive measures include:
- Stretching and strengthening exercises: Regularly stretch and strengthen your calf muscles. Stretch your calf until you feel a noticeable pull but not pain. Calf-strengthening exercises can also help the muscle and tendon absorb more force and prevent injury.
- Varying your exercises: Alternate high-impact sports with low-impact sports. Avoid activities that place excessive stress on your Achilles tendons, such as hill running and jumping activities.
- Choosing running surfaces carefully: Avoid or limit running on hard or slippery surfaces. Dress properly for cold-weather training and wear well-fitting athletic shoes with proper cushioning in the heels.
- Increasing training intensity slowly: Gradually increase the distance, duration, and frequency of your training by no more than 10% weekly to avoid sudden stress on your Achilles tendon. By following these precautions, you can reduce your risk of developing Achilles tendon problems and potentially prevent tendon ruptures. However, it is important to note that some cases may still occur due to factors like genetics or sudden accidents.
Home Remedies
It is important to consult a healthcare professional for proper diagnosis and treatment of an Achilles tendon rupture.
Treatment
There are generally two main treatments for an Achilles tendon rupture: nonsurgical treatment and surgical treatment. Nonsurgical treatment typically involves immobilizing the injured ankle with a cast or a brace to allow the tendon to heal. Physical therapy may also be recommended to regain strength and flexibility in the affected area. This approach is often suitable for less severe ruptures or for people with certain medical conditions that may increase the risk of complications from surgery. Surgical treatment involves repairing the torn tendon by sewing the ruptured ends together. This procedure is often recommended for more severe ruptures or for people with a high level of physical activity. After surgery, a cast or brace will be used to immobilize the ankle, followed by physical therapy to regain strength and flexibility. The choice between nonsurgical and surgical treatment depends on the severity of the injury, the patient's overall health, and their intended level of activity after recovery. It is important to consult with a medical professional to determine the most appropriate treatment plan for your specific case.
Preparing for medical consultation
To prepare for an appointment for an Achilles tendon rupture, you can follow these steps:
- Gather information: Make a list of your symptoms, including when and how the injury occurred. Also, include any past medical problems, current medications, and dietary supplements you are taking.
- Write down questions: Prepare a list of questions to ask your doctor during the appointment. Some questions could include how the injury occurred, treatment options, recovery time, and any lifestyle changes you should consider.
- Inform your doctor about your activities: Mention the sports or activities you participate in, as well as the level of physical activity you engage in regularly. This will help your doctor understand your specific needs and recommend appropriate treatment.
- Be prepared for the physical exam: Wear comfortable clothing and footwear that allows your doctor to inspect your lower leg easily. Be ready to describe your symptoms and provide any additional information that may help with the diagnosis.
- Seek a specialist referral: If necessary, ask your family doctor for a referral to a specialist in sports medicine or orthopedic surgery. These specialists have more experience in treating Achilles tendon injuries and can provide a more comprehensive evaluation and treatment plan. Remember to arrive on time for your appointment and bring your list of symptoms, questions, and any relevant medical information. This will ensure you make the most of your appointment and get the information and care you need for your Achilles tendon rupture.