Achilles Tendon Rupture – Diagnosis and Treatment
Diagnosis
Doctors use a physical exam to check for signs of an Achilles tendon tear. Common steps include looking for tenderness, swelling, or a gap in the area of the Achilles tendon.
They may ask the patient to lie face down with feet hanging off the table or to kneel, then gently squeeze the calf muscle.
Table: Key Signs During Exam
| Test | What Doctor Looks For |
|---|---|
| Inspection | Swelling, bruising, or a visible gap |
| Calf Squeeze Test | Foot movement in response to squeeze |
| Observation | Difficulty standing on tiptoe, sharp pain |
Doctors look for symptoms such as severe or sharp pain near the heel bone, trouble standing on tiptoe, or hearing a pop at the time of injury. Sometimes, doctors use ultrasound or MRI to show whether the tendon is fully or partly torn.
Treatment
Options Without Surgery
Many people with a ruptured Achilles tendon start with non-surgical steps. These often include resting the leg and keeping weight off it with crutches. Applying ice can help reduce swelling and discomfort. Over-the-counter medicines can control any pain.
Doctors usually place the injured leg in a boot or cast with the foot pointed downward. This keeps the tendon still as it heals. The boot may contain heel wedges that lift the heel slightly to ease tension.
Immobilization can last for several weeks, and patients must limit movement. This path avoids surgical risks like infection, but the tendon may tear again.
Possible Benefits of Going Without Surgery:
- Avoids operational risks like infection.
- Often preferred for older adults or those less active.
- Effective when paired with early rehab.
Possible Drawbacks:
- Slightly higher re-rupture risk.
- Recovery period could take longer.
Operative Procedures
Surgeons often repair the tendon for younger or more active people, especially athletes. In this approach, a doctor makes a cut in the back of the lower leg and sews the torn ends of the tendon back together.
Sometimes the surgeon uses extra tissue to support weak areas.
There are two main types of procedures:
- Open surgery (a larger incision)
- Minimally invasive surgery (smaller cuts, lower infection risk)
Risks include infection or nerve issues, but newer methods have improved safety. Many people choose surgery to lower the chance of re-injury and allow for earlier, more aggressive rehabilitation.
Surgical treatment can:
- Reduce re-rupture risk.
- Allow for more controlled healing.
- Be paired with quicker rehab protocols.
Regaining Movement and Strength
A carefully planned rehabilitation program helps patients regain movement and strength. This often starts with gentle exercises to increase range of motion. Gradually, strengthening exercises for the calf muscles and leg are included as healing progresses.
Physical therapists restore movement, balance, and strength. Functional rehabilitation adds training that focuses on coordinated movement during daily activity or sports. Most people can return to regular activities within 4 to 6 months.
A typical rehab plan might include:
| Stage | Focus |
|---|---|
| Early weeks | Immobilization, light motion |
| Mid-phase | Range of motion exercises |
| Late phase | Strengthening, balance drills |
Continuing exercises and training after recovery helps prevent stiffness and lowers the risk of future injuries.
Getting Ready for Your Visit
Steps to Take Beforehand
- Write down the symptoms, when they started, and how the injury happened, such as during walking, running, or playing sports like tennis or basketball.
- List any previous health conditions. This helps the doctor understand your health history.
- Make a note of all medicines and supplements you use. Include doses.
- Prepare a list of questions about the injury, treatment, prevention, and ways to return to safe activities.
What the Doctor Might Ask
| Possible Questions | Purpose |
|---|---|
| How did the injury happen? | To understand the event and mechanism. |
| Did you notice a popping or snapping sound? | To help diagnose a rupture. |
| Can you stand on tiptoe on the hurt foot? | To check tendon function. |
Prepare for your visit to make it smoother and to support education and prevention planning for future activities.
