The Achilles tendon is a band of tissue that attaches your calf muscle to your heel bone, and aids in the pushing off during the gait cycle (e.g. when walking). Rupturing your Achilles tendon can be painful and disruptive to your lifestyle and worst of all can linger for years. The Achilles tendon can suffer a partial rupture or a complete rupture. Athletes can suffer a partial rupture during running, jumping, throwing or racket sports. A total rupture is common in older men and may be the result of degeneration, but more likely from pushing off too hard or bending the foot upwards.
Symptoms of a partially ruptured tendon:
- A sudden sharp pain, although this is not always felt at the time of the tear. It may be felt later after you have cooled down.
- Pain returns with exercise then disappear when warmed down only to be felt again when the exercise is stopped.
- Stiffness in the area of the tendon upon awaking.
- Slight swelling in the tendon
Symptoms of a total rupture:
- A sudden sharp pain as if you were struck with something in the back of the leg, followed by a loud crack or bang.
- Difficulty walking or standing on tiptoe.
- There may be a gap in the tendon.
- A lot of swelling in the area.
Treatment of partial Achilles rupture:
- Use the RICE protocol for the first three days – Rest, Ice, Compress, Elevate.
- See your doctor or physiotherapist to determine whether it is a partial or total rupture.
- Use anti-inflammatory medications
- You may be placed in a plaster cast for eight weeks, at the end of which time the tendon is healed.
- Following removal of the cast, your physiotherapist will carry out a program of stretching, strengthening and massage.
Treatment of total Achilles rupture:
- Use ice initially
- Get to your doctor as quickly as possible.
- If tests confirm a total rupture, surgery is indicated.
- Following surgery, the leg will be placed in a plaster cast for 8 weeks to allow the tendon to heal.
- Physiotherapy begins after the 8 weeks with gentle active stretching and massage, followed by strengthening exercises. Great care must be taken to avoid re-injury of the tendon.
- Heat is applied before exercise to aid blood flow and reduce pain. Following exercise, ice is used to keep inflammation down.
An athlete may not be able to return to training for several months following a rupture. During this time, it is important to follow the advice of your doctor and physiotherapist. No training should be attempted if you are still in pain. Once the pain subsides, you may gradually begin walking and jogging a few minutes at a time. Most athletes can expect to be out of training for 6 to 9 months.