A total tear in the Achilles tendon can happen in any part of its length. It is a sudden, traumatic injury. When the tendon snaps, it leaves two broken ends which may stay close together or spring apart, leaving a visible dent. There may also be bruising.

Achilles Tendon Rupture

Rupture is very rare in children, uncommon in teenagers, and happens most often to people in early and later middle age.

What you Feel When you Have Achilles Tendon Rupture

You feel as if something has hit you hard in the back of the leg. If you try to walk, you stumble or fall over. Your foot feel floppy: you can draw the foot upwards into dorsiflexion, but while toes can still move downwards into flexion, you cannot point the foot down at the ankle. If you lie on your stomach, the foot falls to a right angle. If the gastrocnemius muscle is squeezed, the foot does not move as it normally would: this is a standard test for Achilles tendon rupture, and does not cause pain.

Causes for Achilles Tendon Rupture

Although the rupture can be caused by a direct blow to the back of the leg when the calf is under tension, more often it is intrinsic, with no obvious cause. It usually happens late in an exercise session or competition, and is associated with fatigue and circulatory problems rather than being cold or not warmed up properly. You may have had previous warning signs, such as tightness, cramping or involuntary twitching in the calf. You may have been stressed, overtired or suffering from an infection. The tendon may have been weakened by previous injury or injection, or overworked by compensating for a previous thigh or foot injury.

Treatment for Achilles Tendon Rupture

The foot must be supported immediately with bandaging or taping in the plantarflexed position, pointing down from the ankle. Avoid putting weight through it: hop using crutches. If you have to put the foot down, keep the leg away from your body turned out sideways, and try to keep your weight on the heel.

Seek specialist advice as quickly as possible. You have the choice of an operation or non-intervention. Surgery can be done through a scar as open surgery.

Non-intervention is a choice between either immobilisation in a plaster cast for several weeks, or support in a removable walking boot which allows weight-bearing, remedial therapies, exercises and alternative training to commence immediately. You should decide with your doctor which approach you want to use, and then follow all instructions to the letter.

Read more about Achilles Tendon Injury: Should I go for Surgery?.

Rehabilitation Phases

In all cases the foot is held pointing downwards in plantarflexion for the first phase, as the tendon has to be prevented from lengthening as it heals. If it is not in plaster, the leg can be taped to hold the position. Crutches are used as directed by the specialist. In the case of the walking boot they may not be needed for long, but should be used when exercises are done without boot on.

Rehabilitation starts with calf strengthening holding the Achilles tendon in a shortened position. Progression through the rehabilitation phases should generally be pain-free. However, sometimes following open surgery there is a moment when some movement causes a tearing sensation around the scar, almost as if the injury has happened again. This is usually due to adhesions round the scar breaking, and does not interfere with your progress to fitness. If in doubt, refer back to your doctor.

Call +65 64712674 for to treat Achilles Tendon Rupture today.

The tendon can become sore, thickened and tender to touch at the back of the ankle or just above, on one or both legs. The condition is called Achilles tendinitis, meaning inflammation in the paratenon. It is an overuse problem which happens mainly to teenagers and adults, but can happen to very young children.

Achilles Tendinitis

What you Feel When you Have Achilles Tendon Injury

Symptoms may appear gradually or suddenly. vFirst thing in the morning there is stiffness in the tendon, which wears off as you move around. There is no pain at rest. The tendon might hurt if you go up and down on your toes barefoot, but in the early stages this pain eases with repetitions. Going up and down on your toes wearing shoes usually causes pain. In the later stages, the tendon hurts when you walk and when there is any kind of pressure against it, for instance if you sit with your ankles crossed.

What are the Causes for Achilles Tendon Injury

If you feel the pain when you wear certain shoes, but not barefoot, the cause is friction from the back of the shoe. Most sports shoes have raised backs, known as heel tabs, as do many normal shoes. It may look low, but if the tab is any higher than the level of the ankle it puts pressure on the Achilles tendon. Boots with stiff seams do the same. Once the problem starts, any shoes which touch the Achilles tendon make it worse.

Other causes or aggravating factors of this type of pain include overtraining; faulty foot mechanics, especially overpronation; pain referred from the hip; poor circulation caused by sitting too long in tight clothing or with your ankles crossed; and hormonal changes in females.

Treatment for Achilles tendon Injury

Any faulty shoes must be discarded or modified by cutting the heel tabs back to the right level. In some cases this solves the problem immediately.

Some specialists offer injections into the painful tendon: if you choose this option, make sure your specialist is an expert, otherwise there is a strong risk of tendon rupture a few weeks later. A more drastic option in chronic cases is surgery to strip the tendon clean of inflammatory material.

Call +65 64712674 for to treat Achilles Tendon Injury today.