A total rupture of the achilles tendon is a complete tear of the tendon and typically affects men over the age of 40 involved in recreational sport. A complete rupture of the achilles tendon is not always recognized at the time of injury, however it is very important it is treated properly as soon as possible to increase the chances of a good recovery.
A rupture occurs when a patient overstretches the Achilles tendon, an act which causes it to tear partially or completely. Achilles tendon ruptures can occur during athletic play or any time the tendon is stretched in an unexpected way.
The classic sign of an Achilles' tendon rupture is a short sharp pain in the Achilles' area, which is sometimes accompanied by a snapping sound as the tendon ruptures. The pain usually subsides relatively quickly into an aching sensation. Other signs that are likely to be present subsequent to a rupture are the inability to stand on tiptoe, inability to push the foot off the ground properly resulting in a flat footed walk. With complete tears it may be possible to feel the two ends of tendon where it has snapped, however swelling to the area may mean this is impossible.
Your caregiver will ask what you were doing at the time of your injury. You may need any of the following. A calf-squeeze test is used to check for movement. You will lie on your stomach on a table or bed with your feet hanging over the edge. Your caregiver will squeeze the lower part of each calf. If your foot or ankle do not move, the tendon is torn. An x-ray will show swelling or any broken bones. An ultrasound uses sound waves to show pictures of your tendon on a monitor. An ultrasound may show a tear in the tendon. An MRI takes pictures of your tendon to show damage. You may be given dye to help the tendon show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.
Non Surgical Treatment
Initial treatment for sprains and strains should occur as soon as possible. Remember RICE! Rest the injured part. Pain is the body's signal to not move an injury. Ice the injury. This will limit the swelling and help with the spasm. Compress the injured area. This again, limits the swelling. Be careful not to apply a wrap so tightly that it might act as a tourniquet and cut off the blood supply. Elevate the injured part. This lets gravity help reduce the swelling by allowing fluid and blood to drain downhill to the heart. Over-the-counter pain medication is an option. Acetaminophen (Tylenol) is helpful for pain, but ibuprofen (Motrin, Advil, Nuprin) might be better, because these medications relieve both pain and inflammation. Remember to follow the guidelines on the bottle for appropriate amounts of medicine, especially for children and teens.
Surgery is recommended to those who are young to middle-aged and active. The ruptured tendon is sewn together during surgery. This is an outpatient procedure. Afterward the leg is put into a splint cast or walking boot. Physical therapy will be recommended. In about 4 to 6 months, healing is nearly complete. However, it can take up to a year to return to sports fully.