Achilles Injuries / Repair
The Achilles tendon is the strongest, thickest and largest tendon in the body. It attaches the calf muscles to the heel bone, and is critical for walking, climbing, jumping and running. The Achilles tendon’s function is to bend the foot downward at the ankle. A rupture of the Achilles tendon is a debilitating injury that requires a long, and sometimes incomplete recovery. Middle-aged men suffer a torn Achilles tendon more often than women, and the rates increase with age.
What is an Achilles tendon rupture?
A rupture is when the tendon tears, either partially or completely.
What are the symptoms?
- A sudden sharp pain in the heel
- A snapping sound when the tendon breaks
- Difficulty walking, and inability to bear weight
- An inability to walk on tiptoes
What causes an Achilles tendon rupture?
The majority of Achilles tendon ruptures are the result of traumatic sports injuries in middle aged, healthy, active men. A sudden strong force on the foot or ankle as found in football, running, basketball, diving and tennis can rupture this tendon. Weekend warriors frequently experience a rupture. Any sport that requires the foot to push off causing the calf muscles to contract can stress the tendon.
Other causes include a fall that forces the foot into an upward pointing position, or a deep cut to the back of the ankle. Importantly, a rupture can result in older men who have chronic degeneration of the tendon and repetitive stress, without a physical blow.
Potential predisposing factors that increase the risk of rupture include:
- Corticosteroid medications
- Corticosteroid injections near the ankle
- Certain medical conditions like Rheumatoid Arthrits, Gout, and some rare diseases
- Some antibiotics
- Long-standing tendinitis or tendinosis. Tendinosis is when the tendon degenerates, swells and inflames. Tendinitis is inflammation that irritates the tendon, that results from repetitive stress, overuse and age-related degeneration of the tendon.
How is it diagnosed?
Achilles tendon ruptures can be detected with physical exam. Often the injury is visible but can’t be felt. Dr. Stark will conduct a physical exam and use specific clinical tests to identify a rupture. However, studies report that up to 20% of ruptures can be missed with clinical assessment. Thus, Dr. Stark will order diagnostic imaging tests to confirm a suspected rupture, including an MRI which is the gold standard for diagnosis of Achilles tendon rupture with 100% accuracy.