HealthInfo Waitaha Canterbury
Ruptured Achilles tendon
Whatianga iohere punga
Your Achilles tendon attaches your calf muscle to your heel.
When some or all of the tendon's fibres tear, we call this a rupture. This often happens after a sudden force on the foot or ankle, such as suddenly breaking into a sprint while playing sport. It makes it difficult or impossible to stand on tiptoes.
Symptoms of a ruptured Achilles tendon
If you rupture your tendon, you're likely to have a sudden, sharp and severe pain in the back of your leg. People often describe it as feeling like someone has hit them on the back of the heel. The pain usually settles down into a dull ache.
Symptoms may also include:
- swelling in your calf
- difficulty walking and not being able to put your full weight on the affected leg or stand on tiptoe
- bruising on your lower leg.
If your tendon is completely torn, you may feel a gap just above the back of your heel.
Causes of a ruptured Achilles tendon
Most ruptures are sports related and often happen after a quick movement such as suddenly jumping and sprinting. This most often happens in sports that involve a lot of stopping and starting such as tennis, basketball, netball, football and squash.
Factors that may increase the risk of Achilles tendon rupture include:
- having frequent episodes of Achilles tendinopathy
- being between 30 and 50 years old – Achilles tendon ruptures are more common in this age group
- being male
- starting a new sport or increasing the amount of exercise you do too quickly
- having a poor running technique
- being overweight – extra weight puts more strain on the tendon
- taking some medications. For example, steroids or some antibiotics such as ciprofloxacin
- having a medical condition that can weaken the tendons such as rheumatoid arthritis or diabetes.
Diagnosing a ruptured Achilles tendon
Your doctor will diagnose a ruptured Achilles tendon by listening to your explanation of what happened and examining you. You usually will not need scans or X-rays.
But if the diagnosis is unclear, your doctor may advise you to have an ultrasound or MRI scan.
Treating a ruptured Achilles tendon
Surgery to stitch the tendon back together or non-surgical measures (conservative treatment) are both used to treat ruptured Achilles tendons.
An orthopaedic surgeon will talk to you about your treatment options. Your treatment will depend on several factors including your age, your general health and how active you are.
Recovery takes three months whether you have surgery or conservative treatment. In both cases you'll spend about two weeks in a plaster cast followed by a moonboot for four weeks, then physiotherapy.
Plaster cast
You'll get a plaster cast on your leg, either in the Orthopaedics Outpatient Department (OOPD) or straight after surgery. Casts for ruptured Achilles tendons usually go from your knee downwards and keep your toes pointing down – this is called the equinus position. This brings the two ends of the torn tendon together allowing it to heal.
While the cast is on, you will not be able to put any weight on this leg and will need crutches to move around.
If you're at all worried about your cast, contact the Orthopaedics Outpatient Department.
If you need any other mobility aids or help at home, the orthopaedics team or your GP can let you know how to get this. ACC might be able to help.
Moonboot
To keep your foot from moving when the plaster is removed, you'll be fitted with a special hinged splint known as a moonboot. A moonboot is a rigid type of boot with Velcro straps to adjust it. It usually fits from your knee downwards.
You'll get a prescription for a hinged moonboot when you get your plaster cast. You'll need to make an appointment at the Orthotics Centre to get the boot fitted, using your good leg as a guide for size.
You shouldn't put your weight on the moonboot when walking so you'll still need to use crutches. You can take it off for a shower (taking care not to put weight on your injured leg). You'll need to wear the moonboot day and night.
Splint or orthosis
If you're being treated with a splint, you'll need to go to the Orthotics Centre when your cast is taken off. The centre will make you a custom-fitted splint.
You will not be able to put your weight on your leg while you're in the splint, but you'll be able to take it off to shower. You will need to wear the splint day and night.
Heel raises (orthotics)
No matter how you're treated, you'll spend some time with heel raises in your normal shoes. This is to remove strain from the tendon, so it doesn't tear again. These are usually fitted to two pairs of shoes by the Orthotics Centre.
Getting moving
You'll be able to start walking once the heel raises are fitted. At first, you'll need crutches. When going upstairs, take care to put your whole foot on the step so you do not put extra stress on your tendon.
When you get up at night to go to the toilet, make sure you put your shoe on or use your crutches. Be careful not to slip when you're in the shower or bath.
You may need physiotherapy to help you to learn to walk again, as you do not want to stretch your tendon too quickly. It will slowly stretch back to normal as you walk. Your doctor will tell you at your next appointment if you need physiotherapy.
Some swelling is normal, but you'll get a Tubigrip bandage to help control this. Make sure you take the bandage off at night.
Getting help with a ruptured Achilles tendon
If you have any concerns during your treatment, contact the Orthopaedics Outpatient Department.
On the next page: Recovery after a ruptured Achilles tendon
Written by HealthInfo clinical advisers. Last reviewed May 2022.
Sources
Review key: HIAAF-225274
