Sometimes the phrase “your “Achilles’ heel” is not just a metaphor. It may be that your area of weakness, at least for a time, is actually located in that particular body part. When stretched beyond its normal limits, the Achilles tendon may tear or rupture, an extremely painful injury. Whether or not the injury occurs, as it most frequently does, during a sports activity, the resulting combination of swelling and pain will make you unable to walk or bend the affected foot. While sometimes confused with Achilles tendonitis, which is also painful, an Achilles rupture is a much more severe injury, requiring the intervention of an experienced, knowledgeable foot and ankle orthopedist.
What is the Achilles Tendon?
Tendons are bands of fibrous tissue that connect muscles and bones, enabling mobility. The Achilles tendon is the largest tendon in the body, something like a rope, located in the back of the ankle. It connects the heel to the calf muscles, and is essential for walking.
Symptoms of Achilles tendon ruptures
There are many ways an Achilles tendon rupture may make its presence known, none of them pleasant. Some patients hear a popping sound at the moment of impact; all patients feel immediate sharp pain in the back of the ankle and calf and are unable to walk normally, if at all. Other symptoms commonly reported are pain and swelling near the heel, the inability to bend the foot downward or “push off” the affected foot. Of course, as with other orthopedic injuries, diagnosing is not a do-it-yourself project. You must have a thorough physical examination by a trustworthy foot and ankle orthopedist who may also order one or more diagnostic imaging tests, such as an MRI or ultrasound, to observe the actual damage to the region.
Causes of Achilles Tendon Ruptures
Ruptures of your Achilles tendon often occur when you suddenly increase the intensity of your participation in a sports activity, especially one that includes: running on difficult terrain, jumping or falling.You are far more likely to suffer an Achilles tendon rupture if you:
- Are male
- Over 30 years of age
- Engaging in games such as soccer, football, tennis and basketball — especially when first beginning, or after taking a break from, such strenuous activity
- Have had steroid injections for treatment of a previous ankle injury
- Have taken certain antibiotics (e.g. Cipro or Levaquin)
- Are obese
- Haven’t prepared by stretching before exercising
Will I have to have surgery for an Achilles Tendon Rupture?
Although most Achilles tendon ruptures do require surgical repair, some patients are able to recover with alternative treatments. In some cases, trying alternative treatments first to see how helpful they are is a good idea before deciding that a surgical procedure is necessary.
The decision about whether to operate or not will depend on your orthopedic surgeon’s assessment of the extent of the injury, your age, your general health, and whether you have a pre-existing condition that makes surgery riskier, such as diabetes or neuropathy of the legs and/or feet. It should be remembered that whatever decision you and your doctor make, there are now less invasive surgical procedures available as well as improved methods to accelerate recovery.