Condition: Achilles Tendon Rupture

An Achilles Tendon Rupture is a common, usually spontaneous rupture in the Achilles Tendon, often observed in people aged between 24-45 years. In most cases, the rupture occurs between 3-6 cm above where the tendon meets the heel bone. Ruptures in the Achilles Tendon usually happen when there is a forceful movement of the foot against resistance (typically heel facing downwards). An example of this happening would be someone pushing their feet with great force to jump, or from using gym equipment improperly.

Most people who have ruptured their Achilles Tendon display symptoms of severe or moderate pain near their heel, often accompanied by swelling. If the pain is severe, it is possible that you may not be able to stand on your toes of the injured leg, or bend your foot downwards. On some occasions, there is a popping sound in the heel area when the tendon is ruptured.

Being proactive about preventing a rupture is easier than having to manage one. If you are going to be putting any moderate amount of pressure on your Achilles Tendon, consider the following. Firstly, stretch for 15-30 seconds on each heel one to three times a day. It could also be a good idea to strengthen the muscle through exercises such as seated calf raises. Be sure to increase your exercise intensity slowly however, because increasing exercise intensity rapidly is a common way to incur an Achilles injury. If you run often, consider avoiding hard or slippery surfaces to decrease risk of rupture.

Achilles Tendon rupture risk factors include things such as age, with the majority of incidents happening to patients over 30 due to decreased blood supply making them more prone to injury. Another factor is obesity, which puts an added weight pressure on the tendon. Excessive or abnormal training is another key risk factor, causing repeated micro-traumas that can subsequently result in injuries. Certain anti-biotics can also increase risk of a rupture.

The Achilles tendon is the strong, fibrous cord in the lower leg connecting the muscles of your calf to your heel which helps you to walk, run and jump. When this tendon tears or ruptures, surgery is needed to fix the damaged tendon.

The Achilles tendon can also degenerate, also known as tendinitis or tendinopathy which can cause pain and stiffness along your Achilles tendon and near your heel. Having short calf muscles can also increase the risk of tendinopathy.

Surgery on the Achilles tendon can be performed as a minimally invasive procedure with a small scope with small camera, whereby an incision is made at the back of the calf and the ruptured tendon stitched back together or if degenerated, the damaged part may be removed and repaired with stiches.

If there is severe damage to parts of the tendon, the damaged parts may be replaced with tendon taken from another place in your foot. Other treatment for a ruptured Achilles tendon may be advised including rest, using ice and pain medicines, a device to stop movement of the foot or physical therapy.

With every surgery there are risks. With Achilles tendon repair surgery these include:

• Excess bleeding
• Nerve damage
• An infection
• A blood clot
• Problems with the wound healing process
• Weakness of the calf
• Anaesthesia complications
• Continued pain in the foot or ankle

Risks, as with any surgery may vary with age, the shape of the muscles and tendons in your foot and leg, your general health and wellbeing, and the type of surgery. Our leading expert orthopaedic consultants will be able to help with any concerns you may have.

Your consultant will provide you with all the relevant information before your procedure along with any preparation you may need to do in the days leading up to your surgery. It is important to tell your consultant about any medicines you may be taking, including any over the counter pain medicines such as paracetamol or aspirin.

You may need imaging tests before your surgery, including ultrasound, X-ray or an MRI.

Do not eat or drink 6 hours before you are due to have surgery otherwise your surgery may be delayed.

Please ensure you have a companion available to take you home after you leave OneWelbeck Orthopaedics.

Your consultant orthopaedic surgeon will make a small incision through the skin and muscle of your calf and then through the sheath that surrounds the tendon. The damaged tendon will be removed, or if ripped, will repair this part of the tendon with the strongest possible sutures so it can heal well. If there are any other repairs, the surgeon will ensure these are done at the same time before closing the layers of muscle and skin around your calf with sutures.

You will be sedated throughout your surgery, so you don’t feel anything. Whilst with all surgery there are complications, having surgery to fix a ruptured Achilles tendon means the tendon is less likely to rupture again. Your consultant will explain every option to you so you can decide what is best for you.

After your operation, you will be watched by your dedicated nurse at OneWelbeck Orthopaedics for the few hours after your surgery. To stop your leg from moving, you will need to wear a cast or brace on your leg which will help the tendon to heal. Once you have seen your Consultant you will be able to go home the same day. You can start to do gentle exercise, and slowly start to get around which will help aid your recovery process and give you the best chance to recover fully.

Make sure you follow any advice given to you by your consultant orthopaedic surgeon including any advice on pain relief and wound dressing.

Is surgery the only option for repairing a torn Achilles tendon?

Surgery is the most popular method for patients hoping to get back to peak physical ability in the shortest amount of time possible. Non-surgical options are available but may leave heightened risk of further rupture in the future.

How long does it take to recover?

Typically, it’s about 10 months to a year before patients are back to doing what they were doing before tearing their Achilles. But improvements can be seen along the way.

Are there other common kinds of Achilles injuries?

It is possible to have an Achilles tendon that is working too hard but hasn’t torn. This is called tendinopathy. Common signs include tenderness where the Achilles meets the heel bone.

Surgery is the most common treatment for an Achilles Tendon Rupture. This offers the best chances of a full recovery in the shortest amount of time.

You can find out more about Achilles Tendon Repair surgery on our dedicated treatment page.