Ruptured Achilles tendon

A ruptured Achilles tendon is a complete tear of the tendon that connects the calf muscle to the heel bone. When that happens, the muscle is no longer joined to the bone. That makes it impossible to raise your heel off the ground.

It tends to happen with extra stress on the Achilles tendon due to

• intense effort during sports
• falling

stepping into a hole

Symptoms

If your Achilles tendon ruptures, you

• will probably feel pain and swelling near your heel
• may hear a popping or snapping sound when the injury occurs
• will have trouble bending your foot downward or pushing off the affected leg when walking
• can't stand to stand on your toes on the injured leg

Sometimes the break in the tendon is visible under the skin.

Diagnosis

To diagnose a ruptured Achilles tendon, your doctor will ask about your symptoms and what brought them on. He or she will examine your Achilles tendon. If it has ruptured, your doctor will be able to feel a gap. He or she may also squeeze your calf muscle to see if your foot will automatically flex.

It the physical exam raises questions, your doctor may order an ultrasound or MRI scan to better see what has happened to the Achilles tendon.

Treatment

If you suspect that you have ruptured your Achilles tendon, get medical help immediately.

Different treatment options are available depending on your age, the severity of the rupture, and how active you are.

Nonsurgical treatment. This involves wearing a cast or walking boot to let your torn tendon heal. The advantage of this method is that it avoids surgery-associated risks. But a second rupture may be more likely with a nonsurgical approach, and recovery may also take longer.

Surgery. Fixing a ruptured Achilles tendon usually involves making an incision in the back of your lower leg and stitching the torn tendon together. Sometimes an extra piece of tendon taken from another muscle in the calf is stitched around the reattached ends to reinforce them. The incision is stitched closed and the leg is immobilized in a cast that extends from foot to knee, with your foot positioned so that it points downward to facilitate healing of the tendon. Complete recovery takes at least three months, including an exercise rehabilitation program to help you regain full range of movement and to reduce stiffness.