Achilles Tendon Rupture

Achilles tendon rupture is a relatively common injury that occurs when the tendon connecting the calf muscles to the heel bone tears or ruptures. It is most commonly seen in middle-aged individuals who participate in sports such as basketball, tennis, and soccer, although it can occur in anyone at any age. In this article, we will discuss the pathophysiology, signs and symptoms, investigation, treatment, and advice for Achilles tendon rupture.

Pathophysiology:
The Achilles tendon is the thickest and strongest tendon in the body, connecting the calf muscles to the heel bone. The primary function of the Achilles tendon is to allow the foot to move up and down. The injury occurs when there is a sudden and forceful contraction of the calf muscle, which puts too much stress on the Achilles tendon. This stress can cause the tendon to tear or rupture, resulting in a range of symptoms.

Signs and Symptoms:
Achilles tendon rupture typically presents with a sudden onset of pain in the back of the ankle, which is often described as feeling like a “pop” or “snap.” Other common symptoms include:

Swelling and bruising around the ankle
Difficulty walking or standing on tiptoe
Stiffness or tightness in the calf muscles
A noticeable gap or indentation in the Achilles tendon
Investigation:
The diagnosis of Achilles tendon rupture is usually made through a combination of a physical examination and imaging studies such as an ultrasound or MRI. These tests can confirm the diagnosis and assess the severity of the rupture.

Treatment:
The treatment of Achilles tendon rupture depends on the severity of the injury. In cases where the rupture is partial, conservative management such as immobilization with a cast or brace, physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) may be sufficient to allow the tendon to heal on its own. However, in cases of complete rupture or if the tendon fails to heal with conservative management, surgery may be required.

After treatment, it is important to follow the dos and don’ts for Achilles tendon rupture:

Dos:

Follow the treatment plan prescribed by your doctor, including rest, physical therapy, and any medications prescribed.
Gradually reintroduce physical activity and exercise under the guidance of your healthcare provider.
Wear appropriate footwear and avoid high-impact activities that could place excessive strain on the Achilles tendon.
Strengthen your calf muscles through exercise to help prevent future injuries.
Don’ts:

Don’t ignore the signs and symptoms of Achilles tendon rupture, as delaying treatment can lead to a more severe injury.
Don’t return to physical activity too quickly or without clearance from your healthcare provider.
Don’t wear shoes with high heels or poor arch support, which can increase the risk of re-injury.
Reference:

Khan, R. J., Fick, D., Keogh, A., & Crawford, J. (2005). Surgical management of Achilles tendon rupture: clinical and economic analysis. Australian and New Zealand Journal of Surgery, 75(9), 677-682. doi: 10.1111/j.1445-2197.2005.03500.x