Achilles Tendon Ruptures

Achilles tendon ruptures commonly occur in individuals playing sports that require running, forceful jumping, and cutting/pivoting movements such as basketball, soccer, and tennis. What occurs is that the tendon becomes overstretched and tears just above the heel bone. 

Patients will report that they felt as if someone kicked them in the back of their lower leg accompanied by a loud pop. The Achilles tendon is the largest tendon in our body and it attaches the calf muscle to the heel or calcaneal bone. 

Signs and Symptoms:

• Sudden pain – that feels like a kick in the back of the leg
• Inability to point the toes
• Audible loud pop
• Swelling
• Difficulty walking
• Inability to perform a heel raise

Surgery is considered the best option for a fully ruptured tendon, but the person’s age, general health, and activity level will be weighed when considering surgery.

For the surgical option, the orthopedist will re-attach the tendon with sutures and you will be put in a cast or walking boot anywhere from 8-12 weeks. Once out of the boot, heel lifts are used in the shoes until full range of motion is achieved.  

Non-surgical treatment is for patients with a partially ruptured tendon or for those patients who are not a good candidate for surgery due to age or activity level. Patients will initially be casted/immobilized and then put in a walking boot with the ankle in a plantarflexed position (pointed downwards) to allow the tendon to approximate and heal.  

Whether surgical or non-surgical, it can take up to 12 months for a full return to sports.

Physical therapy is mandatory for patients with Achilles tendon ruptures, whether surgical or non-surgical. 

Your physician will give you instructions about when you can start physical therapy. Be sure to follow your physician’s and physical therapist’s instructions about medicines, wound care, and exercises. This will help make sure the surgery and recovery are a success for you.