ACHILLES TENDON TEAR OR RUPTURE

QUESTIONS AND ANSWERS

Symptoms 

When the Achilles tendon ruptures, you may hear a snapping or popping sound at the back of your ankle. You may also experience sharp pain in that region. Many people describe it as a kick or hit in the calf. Typically, people with a torn Achilles tendon find it hard to walk properly. Other common symptoms include swelling and bruising near the heel, tenderness at the back of the lower leg, an inability to stand on the toes, etc.

Complications

An Achilles tendon tear or rupture requires medical attention. Without proper treatment, the injury may not heal perfectly. As a result, the tendon may rupture again in the future.

Diagnosis

If you hear a snap or pop near your heel or ankle and you feel immediate pain when walking afterward, you should see your doctor. First, your healthcare provider will perform a thorough physical examination of the area around your ankle and heel. He will look for signs of pain when he presses or moves the tendon. He may ask you to move your foot and ankle in different directions to see how you react to it. What’s more, he will examine your lower leg for any knots on the back of your leg, small bumps, and swelling or tenderness near the heel.

Your doctor may use various tests to diagnose an Achilles tendon sprain or rupture. These include:

• MRI (Magnetic Resonance Imaging) – It is a medical imaging technique that produces detailed images of the leg and ankle using a magnetic field and computer-generated radio waves. The images help the doctor determine the best option to treat the injury.
• Ultrasound – It is an imaging technique that uses sound waves to produce images of the Achilles tendon.
• X-rays – Your healthcare provider may also take X-rays of your lower leg and foot to find bone spurs or hardening of the tendon’s lower part.

Other tests used to diagnose Achilles tendon injuries include the Thompson test and the Matles test.

Treatment and Management

Treatment options for a torn or ruptured Achilles tendon include conservative treatment and surgery. In most cases, the healthcare provider first recommends non-surgical treatment methods to treat the ruptured Achilles tendon. The doctor may also recommend surgery depending on the extent of injury you have and your circumstance.

Non-Surgical Treatment and Pain Management: Your doctor will advise you to follow the RICE to reduce pain and swelling. It includes:

• Rest – You need to avoid all physical activities that put stress on the Achilles tendon. These include running, jumping, etc. However, you may do low-impact activities such as swimming. But before that, you must consult with your healthcare provider.
• Ice – Apply ice to the area around the injured tendon for 15-20 minutes every two to three hours throughout the day. Ice is a great tool for alleviating pain and swelling. Nonetheless, make sure you wrap the ice in a light, absorbent towel before applying it to the skin to avoid frostbite.
• Compression – You need to wrap your ankle and heel with an elastic medical bandage to prevent swelling. However, make sure the bandage is not too tight. Otherwise, it will interrupt the blood flow in that region.
• Elevation – It is another effective way to reduce pain, swelling, and throbbing. You need to keep your foot and ankle raised above the level of your heart as long as you can.

If the pain is severe, your healthcare provider may place your leg in a walking cast or brace. You may also need physical therapy to regain strength and mobility in the tendon. Also, your doctor will give you nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain.

With non-surgical treatment methods, it may take about four to six months for the torn Achilles tendon to heal completely.

Surgery: The surgical repair involves stitching the two ends of the torn or ruptured Achilles tendon back together. The surgeon will make a small incision in the back of your lower leg and reattach the ends of the torn tendon. You will need to use a walking cast after surgery to immobilize the tendon.

Risk Factors 

Here are some factors that increase the chances of an Achilles tendon sprain or rupture:

• Tendon ruptures usually occur in people between the ages of 30 to 40. Nevertheless, it can also occur in kids who participate in sports like soccer, tennis, etc.
• Men are up to five times more likely to rupture their tendons than women.
• Steroid injections at the ankle joint can weaken nearby tendons and increase the risk of tendon ruptures.
• People who play recreational sports like basketball, tennis, and soccer are at a higher risk of rupturing their tendons. It’s because these sports involve sudden starts, stops, and pivots which are a major cause of Achilles tendon injury.
• Since excess weight places more stress on the tendon, people who are overweight or obese are more likely to experience Achilles tendon injuries.

How to Prevent Achilles Tendon Injuries?

Here are some ways to reduce the risk of Achilles tendon injuries:

• Do calf-stretching and calf-strengthening exercises on a regular basis.
• Avoid physical activities that put extreme stress on the Achilles tendon.
• Mix high-impact sports with low-impact sports and activities such as walking or swimming.
• Increase the intensity of training in a slow and gradual manner.
• Avoid running or jumping on hard or slippery surfaces.

Final Thoughts

Always consult with your doctor if your child has pain and swelling near the ankle or heel, especially if your child heard a snap or pop at the back of the lower leg. If you come to one of our Medical City Children’s Orthopedics & Spine Specialists offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, Texas, our pediatric orthopedic doctors will examine your child’s leg and recommend the best treatment option to repair the problem and get your child back playing. We specialize in Children and treat them for minor conditions and the most complex ones as well.

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Footnote:

American Academy of Orthopedic Surgeons: Achilles Tendon Rupture