It’s a moment sports fans and weekend athletes alike dread — a pop in the back of the leg, pain and an abrupt inability to walk. At The Ohio State University Wexner Medical Center in Columbus, Ohio, we’ll treat your Achilles tendon rupture like your season is on the line. Using a combination of treatment and rapid rehabilitation, our orthopedic foot and ankle surgeons will work to return you to life and play as quickly as possible.
What is an Achilles tendon rupture?
The Achilles tendon, the largest, strongest and most powerful “spring” in the body, connects the muscles of your calf to the back of your heel bone. You use it every time you run and jump. The tendon ruptures when its fibers partially or completely tear, usually during intense athletic activity, such as pushing off your feet, breaking into a run or making a sudden stop-and-start move.
A rupture is different from Achilles tendonitis, an injury whose symptoms build up over time. Some differences between an Achilles tendon tear and tendonitis are that people with tendonitis:
- Feel pain that is longer, drawn out and covers several centimeters
- Still have strength in the injured leg and can push off and walk, though often with pain
How we repair Achilles tendon ruptures today
Kevin Martin, DO, a leader in Achilles tendon reconstruction and surgical techniques, describes how repairing Achilles tendon ruptures has changed. He’s at the forefront of developing innovative ways to treat Achilles tendon injuries as the chief foot and ankle consultant to Ohio State athletes.
How do I know when I should see a foot and ankle specialist for an Achilles tendon rupture?
People who have torn their Achilles tendon say it feels like a sudden kick, pop or stab in the back of the leg. Signs you may want to see a doctor are:
- Difficulty walking or placing weight on the injured leg
- Bruising or swelling
- A gap you can feel in the tendon once swelling has gone down, about five to seven days after the injury
How does a doctor diagnose an Achilles tendon rupture?
When you see an orthopedic foot and ankle surgeon or a sports medicine doctor at one of our Ohio State Wexner Medical Center clinics, you’ll be physically examined, and imaging will be taken of your Achilles tendon.
Physical exam
The doctor may examine your tendon to find a gap. The provider will also perform the Thompson test, which involves the physician squeezing the calf muscle while you lie in a prone position. When the tendon is attached and healthy, the squeeze should cause the foot to move. If the foot doesn’t move, that’s an indication the tendon might be partially or completely torn. Finally, the doctor may ask you to attempt hopping on the injured foot.
Imaging
Your provider may order an ultrasound or X-ray images of your Achilles tendon to help with diagnosis. Each of these methods has benefits and strengths, and your doctor will choose the one(s) best for your situation.
What can make someone prone to an Achilles tendon rupture?
About 70% of Achilles tendon tears happen during athletic play, and no one is exempt from risk. Even elite athletes tear their Achilles tendons. This injury does seem to be more common in some people. Risk factors for an Achilles injury include:
- Men, particularly between 20 and 59 years old
- People playing “explosive” sports that involve intense running, jumping, pivoting and quick weight-shifting.
- Someone who already has Achilles tendonitis, which can be a precursor to a tear. Overuse and previous injury are also risk factors.
- People with certain pre-existing conditions, such as diabetes (especially when not well controlled), rheumatoid arthritis and obesity.
What sports are most associated with Achilles tendon tears?
Rupture commonly occurs in explosive sports, such as basketball, football, gymnastics and in paddle sports, such as pickleball. All these sports involve body mechanics that leave the Achilles tendon at risk for injury, including:
- Landing hard on your feet
- Rapid foot push-off, especially when your knee and hip are extended
- Sudden starting and stopping
- Overextension
Regardless of the activity type, exercising too much, training too much, conditioning too little or abruptly increasing the volume or intensity of exercise can all leave you prone to injury.
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How can you treat a ruptured Achilles tendon?
Depending on the severity of your injury, your activity level, your overall health and other factors, you and your doctor will decide the best way to treat your Achilles tendon tear. Ohio State doctors offer nonsurgical and surgical treatments. With any treatment, the Ohio State Wexner Medical Center gets you moving again as quickly and safely as possible through early rehabilitation and weight-bearing.
Surgical treatments
People who have an active lifestyle and participate in sports or recreational hobbies or those who have physically demanding jobs should consider surgery. We offer leading-edge surgical treatment options, including minimally invasive surgery that may reduce pain, recovery time and risk of complications.
In Achilles rupture surgery, the surgeon reattaches the tendon. The size and placement of the incision, the type of sutures and the use of anchors all differ with surgical technique and your specific injury. Each person with an Achilles tendon injury will have a detailed plan of care established for their needs and expectations, and your surgeon will review options with you.
Surgery is typically paired with early physical therapy to begin rebuilding strength, mobility and range of motion.
Nonsurgical treatments
Your injured foot will be placed in a cast or walking boot to immobilize the tendon and promote healing. You’ll be in this boot or brace until you’ve healed enough to walk without it. A heel lift or brace might also be used. You’ll be given specific instructions for caring for your injury. You’ll gradually be introduced to movement and weight-bearing through physical therapy. A therapist will work with you to restore strength, flexibility and range of motion.
How long does it take to recover from a ruptured Achilles tendon?
Our greatest priority in treating you for an Achilles tendon tear is returning you quickly and safely to the activities you love, whether that’s running after your kids or running a 10K. You can start rehabilitating your injury as soon as possible after either surgical or nonsurgical treatment.
Your rehabilitation will be progressive, or step-by-step. Carefully, you’ll add weight and exercises that increase your range of motion. You’ll pass therapeutic milestones along the way and gain clearance for more movement, starting with everyday activities. Return to sports often begins around 24 weeks post-repair, but some people will get back on the road or court sooner.
More than 80% of people who have Achilles tendon surgery can return to preinjury activities, including sports. Factors like rehabilitation and physical therapy can make a big difference in the speed and success of healing.
Why choose Ohio State for Achilles tendon rupture treatment?
Ohio State orthopedic foot and ankle surgeons offer comprehensive treatment that repairs your injury and returns you to full activity faster than ever before. Achilles tendon ruptures would sideline athletes for a year, if not an entire career. That’s no longer the case. Our orthopedic foot and ankle surgeons have pioneered methods that reduce the time between injury and return to activity. In the hands of our highly trained experts, you can expect better, faster results thanks to minimally invasive surgeries and rapid implementation of rehabilitation.