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The Achilles tendon, the strongest and largest tendon in the body, connects your calf muscles to your heel bone and plays a vital role in walking, running, and jumping. Unfortunately, it’s also highly susceptible to injuries, particularly in active individuals. One of the most severe injuries that can occur is an Achilles tendon rupture, a complete tear of the tendon that can bring a sudden halt to mobility. Recognising the early signs of an Achilles rupture and understanding the path to recovery is essential for a successful return to activity.
What is an Achilles Rupture?
An Achilles rupture occurs when the tendon experiences a sudden, forceful strain, leading to a complete tear. This injury often happens during activities that involve sudden starts, stops, or pivots, such as basketball, tennis, or football. When the Achilles tendon ruptures, it loses its ability to function properly, making it difficult or even impossible to push off the ground, stand on tiptoe, or walk normally.
Achilles ruptures are more common in men and typically occur between the ages of 30 and 50. However, anyone participating in high-impact sports or activities is at risk, especially if they have a history of Achilles tendinitis or other calf-related issues.
Early Signs of an Achilles Rupture
An Achilles rupture often occurs suddenly and may be mistaken for a less severe injury if the symptoms aren’t fully recognised. Here are some of the early signs to watch for:
1. A Sudden “Pop” Sound or Sensation
Many people report hearing or feeling a “pop” or snapping sensation in the back of the ankle when the Achilles ruptures. This sensation often feels as if someone or something hit the back of your leg.
2. Immediate Pain and Swelling
A rupture is usually accompanied by immediate, sharp pain in the heel or lower calf. Swelling may develop quickly, making it difficult to move the foot or ankle.
3. Difficulty Walking or Pushing Off
After an Achilles rupture, you may find it difficult or impossible to push off the injured leg when walking, running, or jumping. This loss of power and function is a key indicator of a possible rupture.
4. Inability to Stand on Tiptoe
The Achilles tendon plays a crucial role in allowing you to rise onto your toes. After a rupture, standing on tiptoe on the injured leg will likely be impossible.
5. Bruising Around the Heel and Calf
As the injury progresses, bruising may appear around the lower leg and ankle, indicating internal bleeding in the area of the rupture.
If you experience any of these symptoms, it’s essential to seek medical attention immediately. Early diagnosis and treatment play a critical role in the outcome of the injury and your ability to regain full function.
Diagnosing an Achilles Rupture
At HealthStride Orthopaedics, diagnosing an Achilles rupture involves a physical examination and, often, imaging tests for confirmation. During the examination, the orthopaedic specialist may perform the Thompson test, in which they squeeze the calf muscle to see if the foot moves. Lack of movement in the foot when the calf is squeezed is a strong indicator of a complete rupture.
In addition to a physical exam, an MRI or ultrasound may be used to assess the extent of the injury. These imaging tests allow the specialist to determine whether the tendon is fully or partially ruptured, which will inform the treatment approach.
Treatment Options for Achilles Rupture
Achilles rupture treatment generally falls into two categories: non-surgical and surgical. The right choice depends on factors such as the patient’s age, activity level, and the extent of the rupture.
1. Non-Surgical Treatment
For patients who are less active or have a partial tear, non-surgical treatment may be an option. This approach typically involves wearing a cast or boot to immobilise the foot, allowing the tendon to heal naturally. Non-surgical treatment may take several months, with the boot adjusted over time to gradually bring the foot back into its natural position.
While non-surgical treatment avoids surgical risks, it may increase the chance of re-rupture, particularly in athletes or highly active individuals. A thorough consultation with an orthopaedic specialist is essential to determine if this option is suitable.
2. Surgical Treatment
For those who are active or who have experienced a complete rupture, surgery is often recommended to repair the tendon. The procedure typically involves stitching the torn ends of the Achilles tendon back together, sometimes with reinforcement to promote strength and reduce the risk of re-rupture.
Surgery is followed by a period of immobilisation in a cast or boot to protect the repair, with the foot positioned in slight plantar flexion (pointed downward). This allows the tendon to heal in a shortened position, which helps prevent lengthening of the tendon—a common complication that can reduce strength.
The Road to Recovery
Recovering from an Achilles rupture is a gradual process that requires patience, dedication, and a structured rehabilitation program. Here’s what you can expect on the road to recovery:
1. Initial Healing Phase (0-6 Weeks Post-Injury)
After surgery or immobilisation, the initial phase involves protecting the tendon as it begins to heal. You will likely wear a cast or boot, keeping weight off the affected leg with the help of crutches. This phase is crucial for giving the tendon a strong foundation to heal.
2. Gradual Weight-Bearing and Mobility (6-12 Weeks)
Around six weeks post-injury, under the guidance of your orthopaedic specialist, you’ll gradually start bearing weight on the injured leg. At this stage, physical therapy becomes a key component of recovery, focusing on gentle stretching and strengthening exercises to restore mobility.
3. Strengthening and Conditioning (3-6 Months)
As you progress in physical therapy, exercises will intensify to build strength in the calf, ankle, and surrounding muscles. This phase focuses on regaining power and stability in the leg, preparing you for a return to normal activities.
4. Return to Activity (6-12 Months)
Returning to high-impact activities or sports typically takes six to twelve months, depending on the severity of the rupture and the patient’s commitment to rehabilitation. It’s essential to work closely with your orthopaedic team to avoid rushing this phase, as returning too soon could risk re-injury.
Tips for a Successful Recovery
1. Commit to Physical Therapy
Physical therapy is crucial in restoring mobility and strength, reducing the risk of re-rupture. Work with your therapist and follow your prescribed exercises to ensure steady progress.
2. Gradually Increase Activity Levels
Resist the urge to jump back into high-impact activities too soon. Follow your orthopaedic specialist’s advice on when and how to increase your activity level safely.
3. Focus on Calf Strengthening
Rebuilding calf strength is essential after an Achilles rupture. Your physical therapist will guide you through exercises that target the calf muscles without overstraining the tendon.
4. Wear Supportive Footwear
Proper footwear can provide support and help prevent additional strain on the healing tendon. Avoid high heels or any footwear that forces the tendon into an overly stretched position.
5. Listen to Your Body
Recovery is different for everyone, and listening to your body is key. If you experience pain or discomfort, take a break and communicate any concerns with your care team.
HealthStride’s Expertise in Achilles Injury Recovery
At HealthStride Orthopaedics, we are committed to helping patients navigate the challenges of an Achilles rupture with comprehensive, personalised care. From accurate diagnosis and tailored treatment options to a structured rehabilitation plan, our team of orthopaedic specialists and physiotherapists work together to guide you through every phase of recovery.
If you suspect an Achilles rupture or are seeking expert care for tendon-related issues, contact us today to schedule a consultation. Our goal is to support you on the path to a full recovery, helping you return to the activities you love with confidence.
An Achilles rupture can be a life-altering injury, but with the right care and dedication, full recovery is achievable. By recognising the early signs and committing to a thorough rehabilitation process, you can regain strength, mobility, and resilience.
