What Is an Achilles Tendon Rupture?
Achilles tendon ruptures can be devastating injuries. These frequently result from an acute eccentric load to the Achilles tendon, often during sports or work activities. They can even occur with a simple step off of a curb. After suspected Achilles tendon injury, patients may experience severe pain, mild discomfort or even no pain at all. Significant weakness, however, is universal with these injuries. Prompt evaluation with a foot and ankle specialist is critical for a successful recovery.
How Achilles Ruptures Are Diagnosed
At an initial visit for Achilles tendon rupture, a thorough physical examination will be performed. Most specifically, a Thompson test will be done to assess the Achilles tendon. This test involves squeezing the calf and assessing for plantarflexion of the foot. If the foot moves appropriately when the calf is squeezed, it is unlikely for the Achilles to have been ruptured. However, if the foot does not move appropriately, a diagnosis of Achilles tendon rupture can be made with a high degree of certainty.
Treatment Options: Surgical vs. Non-Surgical
Achilles tendon ruptures may be treated both surgically and non-surgically. A careful discussion with the patient, including their past medical history, occupation and desired physical activities, is necessary to arrive at the correct decision for an individual patient. Sometimes, further imaging such as an MRI may be useful in ultimately deciding on a course of management.
What to Expect During Recovery
Regardless of treatment chosen, patients typically need to remain non-weightbearing for at least 4 weeks following an Achilles tendon rupture. Immobilization in plantarflexion is crucial for a successful outcome. Progressive weightbearing in a boot with wedges is indicated after the initial non-weightbearing phase, to slowly allow a patient’s foot to normalize. Physical therapy is also critical to achieve a successful outcome. Return to full activity including sports may take 6 to 12 months. Maximal recovery may even take up to 18 months following injury.
