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Treatment. Achilles tendon rupture

By Editorial Team (Y)
March 10, 2022


When the physician exams you, if a ruptured Achilles tendon diagnosis is suspected, your leg will be examined for swelling and tenderness. If the Achilles tendon rupture is complete, there may be a gap in the tendon.
The doctor may ask you to lie down on your abdomen or knee facing forward in a chair with your feet dangling. The doctor will then put pressure on the muscle in the back of your calf to check the flexion in your lower leg. If this pressure does not cause an automatic reflex, an Achilles tendon rupture has probably occurred.
To check the extent of an Achilles tendon rupture diagnosis, an MRI scan or ultrasound may be ordered by your doctor. This can provide information about the tissues to tell whether the Achilles tendon rupture is partial or completely ruptured. These procedures are non-invasive and painless.


Certain factors may make it more likely that an Achilles tendon rupture will occur. These include:

  • Age. In most cases of Achilles tendon rupture, the person affected is between the ages of 30 and 40 years old.
  • Sex. Men are more likely to experience an Achilles tendon rupture than women.
  • Recreational sports. Achilles tendon rupture happens more frequently in sporting activities that include sudden stops and starts, jumping, and running, such as tennis, basketball, and soccer. 
  • Steroid injections. If you have had an injection of steroid medication into the joint of your ankle to relieve inflammation and pain, you may be at increased risk for Achilles tendon rupture. Steroids can cause the Achilles tendon to lose strength and be more at risk for tears.
  • Certain antibiotics. Levofloxacin and ciprofloxacin, which are fluoroquinolone antibiotics, are associated with increased occurrence of Achilles tendon rupture.


What kind of Achilles tendon rupture treatment is recommended most often is dependent on the severity of the rupture, the activity level of the patient, and their age. Typically, people who are more active and younger have surgery for an Achilles tendon rupture that is completely ruptured. Older patients more often choose non-surgical treatment. Research has shown that both methods of treatment are almost equally effective.


Non-surgical treatment of a ruptured Achilles tendon generally includes immobilization of the affected tendon to allow it to heal. Patients wear a walking boot or a cast with the heel elevated, so the tendon does not have to work. Avoiding surgery reduces risks like infection, but the chance of re-rupture might be higher with non-surgical treatment. If the tendon ruptures again, surgery to repair the second Achilles tendon rupture might be more complicated.


Achilles tendon rupture surgery typically involves surgically opening the calf of the leg and sewing the tendon back together where it’s torn. The torn tendon may need to be reinforced using other tendons. Potential surgical complications include nerve damage and infection. Using smaller incisions reduces the risk of infection.


In either surgical or non-surgical treatment of Achilles tendon rupture, rehabilitation will be needed. This usually includes physical therapy to strengthen the Achilles tendon the muscles of the leg. Most patients have resumed their prior level of activity within six months after injury.


To reduce your risk of problems associated with the Achilles tendon problems, follow these suggestions:

  • Strengthen and stretch your lower leg muscles. Stretch your lower leg muscles so you can feel a slight pull, but not pain. Never bounce while you are stretching. Strengthening your calf muscles can help the Achilles tendon, and your muscles absorb more force. This may help prevent Achilles tendon rupture and other injuries. 
  • Vary your exercise routine: Alternate high-impact activities like running with low-impact activities, such as biking, swimming, or walking. Avoid sports activities that increase stress on the Achilles tendon, like jumping and hill running. 
  • Choose surfaces carefully. Avoid running on slick or hard surfaces. Make sure you’ve dressed adequately, training in cold temperatures. Wear athletic shoes that have cushioned heels and make sure your shoes fit well. This may help prevent Achilles tendon rupture and other injuries.
  • Slowly increase your intensity. Achilles tendon rupture often occurs when people abruptly increase their training intensity. Limit the increase of your frequency, distance, and duration of your training to no more than 10 percent weekly.

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