The Achilles tendon most often ruptures as a result of a sports injury. When it ruptures, it may feel like a pop or snap followed by immediate pain in the back of the ankle and lower leg making it difficult to walk.
If the Achilles only partially ruptures, nonsurgical treatments may be able to treat the tendon; however, if it ruptures completely, surgery is required to repair it in almost all instances.
What is the Achilles Tendon and How Can it Rupture?
The Achilles tendon is the largest tendon in the body. It is a strong, fibrous cord that connects the calf muscles to the heel bone. It affects how a person runs, walks and jumps.
If the Achilles tendon becomes overstretched, it can partially or completely rupture (tear). A rupture most often occurs at the point where the tendon attaches to the bone. This section may be predisposed to rupture because it gets less blood flow, making it harder to heal.
A rupture is typically caused by a sudden increase in the amount of stress on the Achilles tendon. This may happen when a person:
- Steps into a hole
- Falls from a significant height
- Rapidly increases the intensity of sports participation
- Has a high velocity impact to the area
Several risk factors increase one’s chances of rupturing the Achilles tendon. Men are more likely to experience a ruptured Achilles tendon and certain antibiotics increase the risk of a rupture.
When an Achilles tendon ruptures, patients most often report symptoms including:
- A popping or snapping sound when the injury occurs
- Pain, possibly severe
- Swelling near the heel
- Inability to bend the foot downward
- Inability to stand on the toes
What Nonsurgical Treatments Exist for Achilles Tendon Repair?
The treatment plan a patient receives will depend on their age, activity level and severity of the injury. Younger, more active patients are more likely to opt for surgery while older individuals are more likely to opt for nonsurgical treatments.
Nonsurgical treatments typically involve wearing a cast or walking boot with wedges that elevate the heel. This allows the torn tendon to heal and avoids the risks associated with surgery. However, it may increase the likelihood of re-rupture and the recovery process may take longer. After treatment, a patient will go through physical therapy to strengthen the leg muscles and the Achilles tendon.
What Happens with Achilles Tendon Repair Surgery?
If surgery is required for treatment, it will involve making an incision in the back of the lower leg and stitching the torn tendon together. If the tear is severe, a tendon graft may be used to replace the torn Achilles.
What is the Recovery Process Like for Achilles Tendon Repair Surgery?
A full recovery typically takes anywhere from six months to a year. A patient will go through physical therapy to regain strength in their leg muscles and the Achilles tendon. Within six months, a patient can typically return to jogging and non-competitive sporting activities. Within nine months, they can typically return to physically demanding sports and work.
What Are the Results of Achilles Tendon Repair?
Most patients return to their former activity level once they have fully recovered from either a surgical or nonsurgical Achilles tendon repair. Recent studies show that there is fairly equal effectiveness for surgical and nonsurgical repair depending on the severity of the tear.