What is an Achilles tendon tear?
The Achilles tendon is a thick band that connects the calf to the heel bone. The Achilles tendon is the strongest and largest tendon in the body. The Achilles tendon can partially or fully tear when it stretches to the breaking point. This most commonly occurs during sports but can happen if you fall, trip or twist your ankle.
What causes an Achilles tendon tear?
A sudden movement that puts stress on the tendon can lead to a tear. Any sudden stops or pivots can lead to a tear. The most common sports include basketball, soccer, football, and tennis. Missing a step on the stairs or tripping may also lead to a tear. Steroid injections in the area can weaken the tendon and increase the risk for a tear.
What are symptoms of an Achilles tendon tear?
A common symptom is feeling and/or hearing a pop or snap in the back of your ankle. People may think that someone kicked the back of their ankle, but it is actually the tendon snapping. Other common symptoms include: sharp sudden pain at the back of the ankle, swelling and bruising, pain with walking and tenderness to the area that is torn.
What is nonsurgical treatment?
Nonsurgical treatment of a torn Achilles tendon requires immobilizing the injured ankle and foot. The calf, ankle and foot will be placed in a brace or walking cast with the foot flexed downwards, so the Achilles tendon can heal. Early diagnosis and treatment are important for good results with nonsurgical treatment. Crutches, a cane or walker may be used in the beginning to remove body weight from the injured leg during walking. Physical therapy is important to improve mobility and strength. The patient will slowly progress from non-weightbearing to walking in a boot with wedges, to walking in a shoe with wedges.
What is surgical treatment?
Surgical repair is typically recommended by providers to patients who are active and middle-aged or younger. The surgeon will stitch the two ends of the torn tendon back together. The patient will be in a splint or cast after surgery to immobilize the leg so the tendon can heal. After surgery the patient will be non-weightbearing with crutches and a splint or boot. Physical therapy is important to improve strength and range of motion while protecting the Achilles repair.
What are advantages and disadvantages?
Advantages of nonsurgical treatment include avoiding risks of surgery such as infection, nerve injury and wound care. If a patient has medical problems such as vascular conditions or diabetes, risk of complications can increase. Disadvantages of nonsurgical treatment include higher re-rupture rate and increased weakness.
Advantages of surgical treatment include lower Achilles tendon re-rupture rate. Disadvantages of surgical treatment include risk of nerve damage, infection, blood clot, wound healing problems, excess bleeding, and calf weakness.
-Dr. Leanne Komoda, PT, DPT
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