Achilles tendon rupture 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.
Causes of Achilles tendon rupture
Most Achilles tendon 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.
Things that may increase the risk of Achilles tendon rupture include:
- having frequent episodes of Achilles tendinopathy (a condition that can cause pain, stiffness and swelling of the Achilles tendon)
- 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.
Symptoms of Achilles tendon rupture
If you rupture your tendon, you are 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 your injured 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.
Diagnosing a ruptured Achilles tendon
Your healthcare provider 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.
If the diagnosis is unclear, your healthcare provider 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.
The orthopaedic team 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 after a ruptured Achilles tendon
Recovery takes months, whether you have surgery or conservative treatment. In both cases your treatment will include being in a plaster cast or moonboot. This is usually for the first 8 to 10 weeks.
At first, your foot will be pointed down to let the ends of the tendon heal together. Over the next few weeks your foot will be repositioned in the plaster cast or moonboot to gradually return your foot to a more neutral position.
You will be told what to do by your orthopaedic team, including:
- how much weight you can put on your injured leg
- if there are any simple exercises you can start doing.
When the tendon has healed your orthopaedic team will let you know when you can stop wearing the moonboot and start using your own shoes. At this stage, the team will outline the rehabilitation part of your recovery, usually from about 10 to 12 weeks after the injury.
Rehabilitation is generally done in your local community with the support of a physiotherapist. It will take several months. Rehabilitation strengthens the newly healed tendon and prepares it for getting back to full activity.
You will either get a plaster cast or a moonboot on your leg. Casts or moon boots 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 2 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 or a walking frame to move around.
If you are at all worried about your cast, contact the place where it was put on or your primary healthcare provider.
If you need any other mobility aids or help at home, the orthopaedics team or your healthcare provider can let you know how to get this. ACC might be able to help.
To keep your foot from moving you will be fitted with a 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 can take it off for a shower (taking care not to put weight on your injured leg). You will need to wear the moonboot day and night.
You will be able to start putting weight through your leg once your orthopaedic team says this is okay. At first, you will 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.
Be careful not to slip when you are 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 healthcare provider will tell you 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.
If you have any concerns during your treatment, contact your healthcare provider.
Accident cover
The Accident Compensation Corporation (ACC) is a government agency that helps pay for treatment if you are injured in an accident.
The ACC provides comprehensive, no-fault personal injury cover for all residents and visitors to Aotearoa New Zealand. This means if you are hurt in an accident, ACC can help no matter who caused the accident.
If you have an accident and need emergency care in a hospital, it will be covered by ACC.
ACC usually pays some of the other medical costs if you have an accident, like surgery, physiotherapy and medicines. ACC may also be able to cover some loss of earnings resulting from an accident.