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HealthInfo West Coast-Te Tai Poutini

Ruptured Achilles tendon

On the left, a gap shows where an Achilles tendon has ruptured. On the right a normal tendon shows no gapThe Achilles tendon attaches your calf muscle to the back of your heel bone.

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.

If the tendon is completely torn, you may feel a gap just above the back of your heel.

Your doctor will diagnose a ruptured Achilles tendon by listening to your explanation of what happened and examining you. You probably won't need scans or X-rays.

Treatment

An orthopaedic surgeon will talk to you about your treatment options. You might have surgery to stitch the tendon back together, or you might not have surgery – this is called conservative treatment. In both cases you will spend some time in a plaster cast and have three months of rehabilitation.

You will probably need to raise your leg for a couple of days after your injury to help the swelling to go down.

Plaster cast

You will get a plaster cast on your leg, either in the Orthopaedics Department (OOPD) or straight after surgery. The cast will keep your toes pointing down – this is called the equinus position. While the cast is on, you won't be able to put any weight on this leg.

A nurse will let you know how to care for your cast and use your crutches, and you may see a physiotherapist to check how well you can move. Outpatient staff will let you know when you need to come in for a follow-up appointment.

If you are at all worried about your cast, phone the Emergency Department on (03) 769‑7400.

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.

Moonboot

If you will be using a hinged moonboot, you will get a prescription for this when you get your plaster cast. You will need to make an appointment at the Orthotics Department (see below for details) to get a boot fitted, using your good leg as a guide for size.

Remember to bring your moonboot when you come in to have your plaster cast taken off, so it can be fitted correctly.

You should not walk in the moonboot, but you can take it off for a shower (taking care not to put weight on your injured leg). You will need to wear the moonboot at night.

Splint or orthosis

If you are being treated with a splint you need to go to the Orthotics Department (see below for details) when your cast is taken off. The department will make you a custom-fitted splint.

You will not be able to put weight on your leg while you are in the splint but you will be able to take it off to shower. You will need to wear the splint in bed at night.

Heel raises (orthotics)

No matter how you are treated, you will spend some time with heel raises in your normal shoes. This is to remove tension from the tendon so it doesn't tear again.

You will need to take two pairs of shoes to the Orthotics Centre to have the heel raises fitted. This will take up to five working days.

Choose shoes that are supportive and don't have a high heel. It is usually a good idea to bring in a pair of work shoes and a pair of casual or dress shoes. They should not be new shoes, as your injured leg can swell. Some people choose to have a raise only on the injured side. There is no cost for the heel raises, and you can take them out once you no longer need them, without damaging the shoe.

Remember to bring the shoes with the heel raise to your outpatient appointment.

You will be able to start walking once the heel raises are fitted. At first you will need crutches. Take care when going upstairs to put your whole foot on the step so you don't 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 are in the shower or the bath.

You may need physiotherapy to help you to learn to walk again, as you don't want to stretch your tendon too quickly. It will slowly stretch back to normal as you walk. Your doctor will let you know at your next appointment if you need physiotherapy.

Some swelling is normal, but you will get a Tubigrip bandage to help control this. Make sure you take the bandage off at night.

Orthotic Department

Grey Base Hospital

High St

Greymouth

phone: (03) 769‑7400 ext 2866

fax: (03) 769‑7695

Information provided by the Canterbury DHB. Adapted by the West Coast DHB.Last reviewed September 2016.

See also:

Achilles tendon rupture: first aid

Living with an injury

Sources

Page reference: 261652

Review key: HIAAF-225274