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