Achilles Tendon Rupture

What is an Achilles tendon rupture?

An Achilles tendon rupture is when there is a partial or complete tear of the tendon. Your Achilles tendon connects the calf muscle in your lower leg to your heel bone. Your Achilles tendon allows you to point your foot down and to rise on your toes. This allows you to push your foot toward the ground, such as when you walk, run, or jump.

What causes an Achilles tendon rupture?

Your Achilles tendon can rupture if you put too much pressure on it or it is directly injured. A rupture can happen when you play sports or fall down stairs.

What are the signs and symptoms of an Achilles tendon rupture?

• A sudden pop, snap, or crack at the back of your leg or heel
  
  
• Severe pain in your leg or ankle
  
  
• Swelling, stiffness, or weakness in your leg or foot
  
  
• A bruise on the back of your leg or foot
  
  
• Difficulty moving, balancing, or putting weight on your leg
  
  
• Trouble going up and down stairs

What increases my risk of an Achilles tendon rupture?

The following may make your Achilles tendon weak or stiff, and more likely to tear:

• Bone structure: Abnormal bone structure in your foot can put pressure on your Achilles tendon.
  
  
• Past rupture: A rupture weakens the tendon and makes it more likely to tear again, even after treatment.
  
  
• Being overweight: Extra body weight will put more pressure on your Achilles tendon.
  
  
• Medical conditions: You may have other medical conditions that increase inflammation in your body. Inflammation can increase the risk of an Achilles tendon rupture.
  
  
• Activity: If you are not usually physically active, your Achilles tendon may become too weak for activity.
  
  
• Age: As you get older, your Achilles tendon may become stiffer and less flexible.
  
  
• Medicines: Steroids and antibiotics may make your Achilles tendon weak.

How is an Achilles tendon rupture diagnosed?

Your caregiver will ask about your symptoms and your recent physical activities. He will also ask what you were doing at the time of your injury. Tell your caregiver about your past medical conditions and what medicines you take.

• Calf-squeeze test: Your caregiver will ask you to lie on your stomach on a table or bed. Your feet will hang over the edge. Your caregiver will squeeze the lower part of your calves. He may then repeat the test on your other leg to compare them.
  
  
• Heel raise test: This is also called a tiptoe test. You may be asked to stand on your toes so your caregiver can see how high your heels are raised off the ground.
  
  
• Knee flexion test: Your caregiver will ask you to lie on your stomach on a table or bed. You will be asked to bend your knees until your lower leg is straight up. If your injured foot points down during the test, your Achilles tendon may have a rupture.
  
  
• Needle test: Your caregiver will insert a needle a few inches above your heel into the skin of your calf. He will move your foot down and then up. He will see if the needle moves while your foot is pointing up.
  
  
• Sphygmomanometer test: A sphygmomanometer is the cuff put around your arm when your caregiver takes your blood pressure. You will be asked to lie on your stomach on a table or bed. The cuff will be wrapped around the middle of your calf and filled with air. Your caregiver moves your foot towards your body. If the pressure in your calf does not increase, then you may have an Achilles tendon rupture.
  
  
• X-ray: X-ray pictures will help your caregiver see swelling in your tendons or muscles, or any broken bones.
  
  
• Ultrasound: An ultrasound uses sound waves to show pictures of your Achilles tendon. The pictures help your caregiver see if your Achilles tendon is torn.
  
  
• MRI: Your caregiver will use this image to see how much tendon damage you have. This image may show if you have swelling and bleeding around the torn tendon. You will need to lie still during an MRI. Never enter the MRI room with any metal objects. Metal can cause serious injury.

How is an Achilles tendon rupture treated?

Your treatment will depend on your health, age, level of activity, and type of rupture.

• Cast: You may have a cast on your leg for 2 months or more. Your foot will be positioned in the cast with your toes pointing slightly down. Your caregiver will change your cast and your foot position several times during the time you are healing. Do not move or put weight on your foot until your caregiver tells you it is okay.
  
  
• Leg brace: You may be asked to wear a leg brace or splint to prevent you from moving your foot. A leg brace will allow you to move your leg and walk when your caregiver says it is okay.
  
  
• Heel lifts: Heel lifts are wedges put into your shoe or cast. Heel lifts help keep your foot in the best position for healing.
  
  
• Surgery: You may need surgery if other treatments are not successful. Surgery is used to sew the edges of the tendon back together. You may need pieces of another tendon or artificial material called a graft to patch the tear if it is wide. The cut is closed with stitches, and a cast is put on your leg.

What are the risks of an Achilles tendon rupture?

• Your Achilles tendon may rupture again. If your Achilles tendon ruptures, you may get an infection or a tear in your skin. If you have surgery, you may develop scars, skin problems, or numbness in your ankle or foot.
  
  
• Without treatment, you may always have trouble walking or moving your foot. One or more of your bones may break. The nerves in your leg may be injured. This may cause leg numbness, tingling, or burning.

When should I contact my caregiver?

Contact your caregiver if:

• You have a fever.
  
  
• You have swelling in your ankle, heel, or leg.
  
  
• You have pain in your ankle or heel area.
  
  
• The muscles in your legs become weak.
  
  
• The skin on any part of your legs or hips turns purple.
  
  
• You have questions or concerns about your condition, treatment, or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

• You have trouble standing up or walking.
  
  
• You cannot move your leg or foot.
  
  
• You feel like you may have broken a bone.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Achilles Tendon Rupture