Achilles Tendon Tear & Repair

The Achilles tendon is a thick, fibrous band connecting the calf muscles to the heel bone (calcaneus). It plays a critical role in movements like pointing the foot downward and lifting the heel. This function is essential for actions such as walking, jumping, standing on tiptoes, and climbing stairs. When the Achilles tendon is ruptured, performing these movements becomes extremely difficult or impossible.

Achilles tendon ruptures are most common in men aged 30 to 50 who engage in sports like basketball, football, or tennis. These activities often involve sudden, forceful movements that place excessive stress on the leg and foot. The tendon may tear if the foot is suddenly forced into a flexed position while the calf muscles contract powerfully. Additionally, Achilles tendon ruptures can occur in individuals with Achilles tendonitis, where chronic inflammation weakens the tendon over time.

A loud "pop" is often heard when the Achilles tendon ruptures, followed by a sharp, intense pain in the back of the calf or lower leg. Swelling and bruising typically develop due to internal bleeding. Those affected will struggle to point their foot downward or raise their heel, making activities like walking, jumping, or standing on tiptoes very challenging.

To diagnose an Achilles tendon rupture, a doctor will perform a physical examination and review the patient’s medical history. The most reliable test is the Thompson Test, where the doctor squeezes the calf muscles while the patient lies face down. If the foot does not move, it indicates a potential Achilles tendon tear. Imaging tests such as ultrasound or MRI may be used to further assess the tear’s severity. In some cases, x-rays are ordered to rule out bone injuries.

Each case of Achilles tendon rupture is unique, and treatment decisions are made based on the individual’s activity level and preferences. Both surgical and non-surgical options are available.
For individuals who are less active or have health risks that complicate surgery, a non-surgical approach is recommended. This usually involves immobilization in a cast for about six weeks, followed by physical therapy to restore muscle strength, flexibility, and balance. While effective, non-surgical treatment carries a higher risk of re-rupture compared to surgery.

Surgery is typically recommended for more active individuals who wish to resume high-impact activities. The procedure, performed under anesthesia, involves making an incision behind the ankle and reattaching the torn tendon. After surgery, the foot is immobilized in a splint or cast for four to six weeks, and physical therapy begins once healing has progressed. Surgery offers a lower risk of re-rupture and better outcomes for regaining leg strength.