Achilles Tendon Rupture

There is a familiar phrase among athletes that when the going gets tough, the tough get going. True grit and discipline are wanted qualities in an athlete, but the cost can be high, particularly when it comes to your foot and ankle health. Professionals and amateurs alike are vulnerable to overuse injuries.

The Achilles tendon is one area that is crucial in allowing the lower extremity to perform necessary functions. It can also develop tendinitis over time and/or completely rupture. NBA superstar Kobe Bryant has first-hand experience when an injury forced him to undergo surgery for a ruptured Achilles tendon in 2013.

What is an Achilles tendon rupture?

The Achilles tendon is the strongest and longest in the body, and it connects the muscles in your calf to your heel bone. Under repeated stress, it can be overstretched and microscopic tears can develop in the tissue of the tendon. Lack of treatment and further deterioration can then lead to a partial or complete tearing (rupture) of the tendon. A rupture is a serious, traumatic event that is typically very painful and requires immediate medical treatment.

How does this injury occur?

The Achilles is vulnerable to wear and tear, and both athletes and non-athletes are susceptible. Even household tasks can add enough stress to weaken the tendon over time and put you at risk for a rupture. There are several common factors that can cause this type of injury to occur:

• When the foot is forced into an upward position, causing an extreme stretching of the Achilles
• A direct blow
• Overuse
• Falling from a height
• Increasing your level of physical activity too quickly
• Having flat feet
• Tight leg muscles and tendons
• Sports with a lot of running, jumping, starting, and stopping

Diagnosis and Treatment

The symptoms for an Achilles rupture will vary depending on the severity of your injury. At the time of incident, you will typically feel sudden and severe pain near your heel, along with swelling. You may hear an actual popping or snapping sound and may not be able to stand up on your toes, bend your foot downward, or put any weight on the injured leg at all.

The presence of these symptoms helps to diagnose between Achilles tendinitis and a rupture. Dr. Tejas Pandya will look for tenderness, swelling, and a possible gap in the tendon where the rupture occurred. A simple test of squeezing the calf muscle also indicates a rupture when the foot fails to be moved downward. Sometimes an X-ray or MRI is needed to fully determine the extent of the rupture.

It is imperative that treatment is applied promptly, and we will be able to tailor a plan according to your age, activity level, and extent of your injury. Non-surgical treatment usually begins with ice, elevation, and full mobilization in a cast or boot to allow the torn tendon to heal. Pain medication and anti-inflammatory medication may be advised (always check before taking). The casting process can take 6-8 weeks, and it is usually followed by a period of physical therapy and gentle introduction into activity.

A complete rupture often requires surgical intervention to repair the tendon. This may involve a simple stitching together of the torn ends or grafting to lengthen the tendon. A period of immobilization will also be required post-surgery.

The best way to avoid this type of injury is to properly warm up before activity, gradually increase your intensity level, thoroughly stretch and strengthen your calf muscles, and routinely wear well-fitting athletic shoes. If you are experiencing pain or strain in your Achilles, or if you have sustained a painful rupture, contact our office immediately for evaluation and treatment. Call our Troy, NY office at (518) 273-0053 to make an appointment with Dr. Tejas Pandya today.