If you’re ever moving along and you feel a sudden snap on the back of your heel, or if you feel like somebody has hit the back of your leg with a stick, you may have experienced the unpleasantness that is an Achilles tendon rupture. (Of course, someone may have really hit you with a stick, but that has its own set of problems.)
The Achilles tendon is a long, thick cord of tissue connecting the bottom of the calf muscle to the back of the heel bone. It’s basically what enables you to lift the back of your heel. You may not be aware of it, but you use your Achilles tendon almost every time you move your foot.
When it’s stretched beyond its ability to extend, the Achilles tendon may rupture, either completely breaking or partially tearing across the width of the tendon. This is not a pretty injury, folks. Such ruptures may occur as a result of sudden jumping, running, pivoting, stepping into a hole, or falling. Although athletes are at risk for ruptures of the Achilles tendon (simply because they do things like running and jumping so much), this injury is most often seen in individuals whose activities are limited to weekends or other recreational periods. (Yes, weekend warriors, you are very much in the at-risk group.) Because they’re not conditioned for bursts of activity, the sudden increase of stress these individuals put on the tendon may result in a rupture. Obesity, gender (males are more likely to experience ruptures) and age (those between 30 and 40) may also make a rupture more likely for some people.
When the rupture happens, it’s likely to feel like someone kicked, stabbed or hit you really hard in the back of your heel. You may also actually hear or feel a popping sensation. After the initial ruckus though, the pain will likely die down to a dull ache. But don’t let this fool you into thinking this is a minor injury, folks. See your podiatrist right away if this happens to you, especially if your leg is weak afterward while you walk or try to stand on your tiptoes. If you’re being perceptive, you may also notice that the region between the bottom of your calf and the back of your foot has gotten swollen and painful.
When you go in to see your podiatrist after experiencing the symptoms of a ruptured tendon (sooner rather than later, right?), your doctor will probably ask you about the circumstances surrounding the injury, such as how long ago it occurred, what it felt like, and so on. He or she will probably test and compare the strength of one foot versus the other, and will feel the area to see if signs of a ruptured tendon are noticeable (like swelling, or a sometimes a gap if there’s been a complete rupture). Podiatrists are often able to diagnose a ruptured Achilles tendon based on these observations, but they may decide to order an MRI of the area if there’s any lingering questions.
Surgery is a pretty common treatment for a rupture of the Achilles tendon, and is often the most effective. However, if medical conditions keep you from surgery, or if the rupture is only a minor one, non-surgical treatments may enable your tendon to heal. However, you should be aware that the possibility of experiencing a rupture again with non-surgical treatment is more likely than with surgery.
Non-surgical treatment usually involves wearing a cast or boot to keep the tendon immobilized while it tries to stitch itself back together. (Casts and boots are also pretty effective ways of showing off to the world that you’ve got an injury, thus increasing the likelihood that you’ll get some nice get-well cards, and maybe even flowers, if you’re lucky.) Healing with non-surgical treatment can actually take longer than surgical treatment, and it may be difficult for you to ever fully regain the strength in the tendon.
Surgery, if possible, is really the best way to treat this injury, since it provides a way for the tendon to regain its original strength, and significantly decreases the chance that your tendon will rupture again. Basically, using different techniques, your surgeon will stitch the two ends of the broken tendon back together.
Whatever the treatment method you and your podiatrist decide on, you’ll likely need to undergo some physical therapy afterwards in order to regain strength in the Achilles tendon and your leg muscles, and prevent further injury. Then, if all goes well, your Achilles tendon will be your Achilles Heel no more.