Achilles Rupture

The achilles tendon connects the calf muscles to the heel bone and has a role in transferring forces that allow us to walk, run and jump.


  • An Achilles rupture is a complete or partial tear of the achilles tendon from your heel bone (calcaneus)

Causes

  • Achilles tendon rupture is commonly caused by sudden increase in stretch of the tendon when jumping, taking off into a sprint or pivoting

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Signs & Symptoms

  • Severe pain at the heel, likened to being kicked or stabbed

  • A popping/snapping sensation

  • Difficulty walking and rising onto toes

  • Swelling at the back of the heel

Differential Diagnosis

  • Calf strain/tear

  • Achilles Tendinopathy

How to Manage

  • Achilles ruptures/tears can be managed both conservatively with immobilisation in a moon boot and gradual reintroduction to an exercise program, and non-conservatively with surgery

  • The decision between conservative and non-conservative management is made from a number of factors including the size of the tear, patients age, activity and functional demands, and patients health status.

  • Following assessment by a physio, you may be referred onto a sports doctor or orthopaedic specialist for consideration of management options

  • Whether managed conservatively or non-conservatively physiotherapy is important to help restore ankle range of movement, muscle strength and functional movements.

References

  1. Wertz J., Galli M., Borchers J.R. (2013). Achilles tendon rupture: risk assessment for aerial and ground athletes. Sports Health; 5(5).

  2. Yang X., Meng H., Quan Q., Peng J., Lu S., Wang A. (2018). Management of acute achilles tendon ruptures: a review. Bone Joint Res; 7(10).

PROmotion Assessment and Outcomes Measures

  • Subjective examination including mechanism of injury, aggravating and easing factors, past history of injury, rehabilitations goals and return to sport timelines

  • Assessment of ability to weight bear and walk

  • Specific orthopaedic tests of the achilles tendon

  • Palpation of heel and foot region

  • Assessment of lower limb strength, control and flexibility