Diagnosis
To diagnose Achilles tendon rupture, a healthcare professional checks the lower leg for tenderness and swelling. There may be a gap in the tendon if it has torn all the way.
The healthcare professional might ask you to kneel on a chair or lie face down with your feet hanging over the end of the exam table. The healthcare professional might then squeeze your calf muscle to see if your foot flexes. If it doesn't, you likely have ruptured your Achilles tendon.
An ultrasound or MRI can show whether the tendon is torn partly or all the way. These painless procedures take pictures of the tissues inside the body.
Treatment
Treatment for a ruptured Achilles tendon often depends on your age, how active you are and how bad the injury is. Younger and more active people, especially athletes, tend to choose surgery to repair an Achilles tendon that's torn all the way. Older people and those not active in sports are more likely to opt for nonsurgical treatment.
Recent studies suggest that both types of treatment work equally well.
Treatment without surgery
This approach most often involves:
- Keeping the ankle still for a few weeks. This often involves wearing a walking boot with a heel wedge to bring the torn edges closer together or a cast with the foot flexed down for a few weeks.
- Resting the tendon and keeping weight off it by using crutches.
- Putting ice on the area.
- Taking pain relievers you can get without a prescription.
Treatment without surgery doesn't have the risks linked with surgery, such as infection. But it might increase the chances of another rupture. And recovery can take longer. But recent studies suggest that rehabilitation that involves moving and bearing weight early may help healing.
Surgery
The procedure most often involves a surgeon making a cut, called an incision, in the back of the lower leg. The surgeon then stitches the torn tendon together. Depending on the condition of the torn tissue, the surgeon might use donated tissue to make the repair.
Complications can include infection and nerve damage. Minimally invasive procedures have lower infection rates over those of open procedures.
Rehabilitation
After either treatment, physical therapy exercises can strengthen the leg muscles and the Achilles tendon. Most people return to their former level of activity within 18 to 24 months after the injury.
A type of rehabilitation known as functional rehabilitation starts earlier and moves faster than other types of physical therapy. Functional rehabilitation focuses on the whole body rather than just the injury. The purpose is to get people back to where they were before the tear, as an athlete, as a worker or in everyday life.
Some studies suggest that minimally invasive surgical repair with functional rehabilitation may offer the best results. This includes lower risk of infection and of the tendon tearing again. Study in this area is ongoing.
Preparing for your appointment
People with an Achilles tendon rupture often seek treatment right away at a hospital's emergency department. You also might want to talk with doctors who specialize in sports medicine or orthopedic surgery.
What you can do
Write a list that includes:
- Detailed descriptions of the symptoms and how and when the injury happened.
- Information about past medical conditions.
- All the medications, vitamins and dietary supplements you take, including doses.
- Questions to ask your healthcare professional.
What to expect from your doctor
Your healthcare professional may ask you some questions, including:
- How did this injury happen?
- Did you feel or hear a popping or snapping sound when the injury happened?
- Can you stand on tiptoe on that foot?