achilles

Achilles Rupture

Helping you with Achilles tendon

 

Do you need help with your Achilles tendon? Call us for free, professional advice or make an appointment – we can see you in clinic or home.

 

How do you know if you have ruptured Achilles tendon?

 

Did you hear a pop followed by a sudden, sharp pain in the back of your leg when you ran, played football or rugby? Did you feel like someone kicked you in the leg from behind? If yes, it is likely that you have ruptured your Achilles. Do not think you just have a tear.Think you have ruptured Achilles unless proven otherwise.  Get help!

Swelling around your heel, calf and foot is normal after rupture .You may notice some bruising too (very likely).

You may still move your foot up and down as there is another muscle – plantaris, helping you move the foot. Also, you may have a few fibres in the Achilles left and intact tendon sheath

 

Where is the most  common place of rupture in Achilles?

 

In most cases we see a rupture roughly 5-6 cm above calcaneus ( the heel bone)

 

Is rupture worse than a tear?

 

Well, rupure is a rupture – it is a serious injury with the diruption  of the tendon. It means you will not be able to continue with sport for some time.  WIth partial tear only some of the tendon fibres are disrupted.

 

Is tendon injury worse than broken bone?

 

In a way it is – tendons do not heal so quickly and getting back to full health is tricky with various ups and downs in the process. Fracture takes 6-8 weeks to heal. With tendons it may take long months to get better Remember, everybody is different so it is best to get some professional advice.

 

What does the ruptures tendon look like?

 

In tendon rupture most of the tendon fibres ( if not all) get torn and you end up with a hole filled with blood. This is why it is important to get help ASAP as this blood will change its consistency and this part of the tendon wil not be as strong and functional as before.

Achillles tendon runs in the tendon sheath that often remains intact after injury it is a little like a sausage with a casing outside, that protective material  is often intact with most of  the damge occuring inside the sausage.

 

What should you do immediately after Achilles rupture?

 

Get help right away. It is important that you receive help within 48 hours of your injury. A health professional will be able to examine your Achilles and calf. After speaking to you, he will recommend the best course of action.

Before you see a specialist –  it is important to keep your foot in equinus position so two stumps of the tendon can be as close to each other as possible. Otherwise you are risking more damage to the tendon long term and the loss of function in your foot and ankle.

 

Is operation necessary?

 

No, not really. But this will depend on what type of sport you want to do, and level of activity.Do you want to continue with  horse riding, playing football, rugby? Then  I would advise you to have an operation. For most people, however a conservative approach will be a better option.In the NHS we see a trend where less and less patients have a surgery

The key message is this – the outcome of surgery and conservative (no-surgery) treatment is pretty much the same; it is worth discussing this with your physiotherapist or surgeon.

 

How do you treat tendon conservatively (without operation)?

 

We will ask you to wear a boot (Vacoped boot is designed to support your foot after Achilles injury) for around 10 weeks, so your foot and ankle are in the right position to facilitate healing of the injury. The foot should be at the 30 degrees plantar flexion.  We will ask you to wear the boot in bed too.

With time, we will ask you to do more and more advanced exercises and load the tendon. Loading the tendon as early as it is only possible is important. The whole process  does take time so you have to be patient.

 

Can you walk on a ruptured Achilles?

 

You will be able to walk as soon as possible; understandably you will be using crutches.It may be difficult to walk with your flexed foot in the boot.

 

What is the risk of operation?

 

The main problem that may arise is with the wound post-operation and infection. If you take a look at the Achilles tendon, it lays right under the skin. Bacteria do not have far from the wound to affect the tendon.

 

Is Achilles healing easily?

 

Unfortunately not. The blood supply that is important for soft tissue to heal is very limited in the tendon. This is why probably it gets easily injured in first place

 

Can a ruptured Achilles tendon heal on its own?

 

Well, the pain is likely to go away and so the swelling and bruising.The question that you should be asking is this: will my Achilles be fit for purpose after it has healed up? Physiotherapy and rehabilitation will help you get your Achilles stronger and get back to what you did before injury. Otherwise you are risking another injury and your Achilles, with plenty of scarring tissue, will be very prone to another injury.  

 

How long does it take to recover from a ruptured Achilles?

 

It all depends. Everybody is different and it also depend what sport and level of activity you want to get back to. Getting back to walking without the boot will take around 2-3 months.  On average 9 months is required toget back to sport but it all depends –  some people need less time,others much more.

 

 Would you like more information? Here are some useful resources:

 

https://www.evidencesportandspinal.com/Injuries-Conditions/Ankle/Research-Articles/Cast-and-Walking-Boot-Used-to-Treat-Achilles-Tendon-Tear/a~625/article.html

 

https://www.fracturecare.co.uk/care-plans/ankle/achilles-tendon-ta/achilles-tendon-conservative-mamagment-weightbaring-white-wedges/

 

https://www.cuh.nhs.uk/patient-information/achilles-tendon-rupture/

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