Achilles Tendon Rupture (Part Two)

How common is an Achilles tendon rupture?

It affects about 1 in 5,000 people at any time. It can occur at any age, but is most common in people between the ages of 30 and 50.

What are the symptoms of an Achilles tendon rupture?

You may notice that symptoms come on suddenly during a sporting activity or injury. You may hear a snap or feel a sharp pain when the tendon suddenly tears. The sharp pain usually resolves or goes away quickly, although you may have mild pain in the back part of the leg, namely the calf. After the injury, common symptoms include:

• A type of flat-footed walking. You may walk and bear weight on the foot, but cannot push the foot off the ground.
• Inability to rise on the toes.
• If the tendon is completely torn, you may feel a gap or discontinuity - a gap in its continuity on the back of the ankle. However, if it is swollen or bruised then the gap might be hidden.

If you suspect an Achilles tendon rupture, it is good to visit a doctor urgently, as the tendon heals better if treated as soon as possible.

How is an Achilles tendon rupture diagnosed?

The diagnosis is usually based on symptoms, the history of the injury, and the doctor's examination.

The doctor may look at your walk and observe if you can stand on your toes. He/she may test the tendon using a method called the Thompson Test (also known as the calf squeeze test). In this test, you will be asked to lie face down on the bed and bend your knee. The doctor will gently squeeze the calf muscles on the back of your leg and observe how the ankle moves. If the Achilles tendon is intact, squeezing the calf will move the foot away from the leg (a movement called plantar flexion) if it is torn the foot will not move. This is a quite accurate test for the rupture of the Achilles tendon.

Thompson Test

If the diagnosis is uncertain, an ultrasound (echo) or MRI scan may help.

Note: Achilles tendon rupture is sometimes difficult to diagnose and may not be detected on the first evaluation. It is important for both the doctor and the patient to be aware of this and to carefully look for an Achilles tendon rupture if it is suspected.

What else could it be?

Similar symptoms may be caused by Achilles tendonitis (inflammation of the Achilles tendon), a strain or tear of the calf muscles, deep vein thrombosis in the calf, and arthritis of the ankle joint

What is the treatment for an Achilles tendon rupture?

This condition should be diagnosed and treated as soon as possible, as immediate treatment perhaps improves healing. You may need to be sent urgently to a doctor in an orthopedic department or the emergency department. Meanwhile, if an Achilles tendon rupture is suspected, you should not bear weight on that leg, so you should not walk on that leg.