The Achilles tendon is the strongest of all 1,000 present in the human body. Although it can handle tremendous force, it is the one which is most commonly ruptured.
What are tendons?
Tendons are situated throughout the human body, are made up of tough connective tissue fibres and are found at the end of muscles, forming the connection between muscle and bone.
The Achilles tendon is found at the end of the Gastrocnemius and Soleus muscles in our calf and its function is to allow contractions in these muscles so that we can walk and run.
How do you rupture your Archilles tendon?
Almost half of the Achilles tendon ruptures treated occur during sporting activities and most commonly involve a sudden, excessive load being placed on the tendon, which is more than the tendon is able to manage. One example of this is at the start of a sprint. This is, of course, not the only reason for this kind of injury. Others include:
- Direct/indirect trauma to the tendon
- Chronic tendinopathies
- Inflammatory or auto immune conditions
- Steroid or certain antibiotic use
- Poor vascularity
- Poor biomechanics
All of the above can alter the integrity of the tendon and cause it to weaken. Injury to the tendon causes a disruption of the fibres and in a rupture the fibres have been completely disrupted.
Could you have ruptured your Achilles tendon?
In most cases, when you rupture your Achilles tendon, you will recall a specific event and the following symptoms:
- Sharp pain – like someone has kicked you in the back of the ankle
- Popping sound
- Difficulty walking
You will likely have or be experiencing a lot of pain, so if you are ignoring this, don’t!
Physiotherapy management of Achilles tendon ruptures
A thorough assessment by a Physiotherapist will help you determine whether you may have ruptured your Achilles tendon. The best way to manage an Achilles tendon rupture is constant supervision. A specialist orthopaedic surgeon will determine if you need a surgical correction or a non-surgical approach – your Physiotherapist will refer you for this kind of assessment.
Once the best solution has been determined, the specialist, you need to work closely with your Physio to ensure optimal recovery.
The physiotherapy treatment for both conservative or surgical management will be fairly similar. Although each Orthopedic surgeon generally has their own protocol, research has shown that you need to be mildly active, do early weight-bearing movements and supervised exercises in order to have a successful and complete recovery.
During the healing process, you will be given an orthotic boot to limit movement. A heel lift will be in place to protect your tendon. Your physio will assist in gradually weaning you off the boot and assist you with heel raise exercises over a period of usually 8-12 weeks. You can start to put weight on your foot as soon as the surgeon allows.
Your physio will remove the boot during treatments to work on:
- Regaining full ankle movement
- Preventing stiffness
- Improving strength
- Training you to revert to normal walking patterns
- Being more aware of the position and movement of your ankle
- Returning to sport
The above will depend on the time frames outlined by your doctor.
- Bistolfi A, Zanovello J, Lioce E, Morino L, Cerlon R, Aprato A, Massazza G 2017 Achilles Tendon Injuries: Comparison of different Conservative and Surgical Treatment and Rehabilitation. Heighpubs J Nov Physiotherapy Rehabilitation 1:39-53.
- Kearney RS, Parsons N, Underwood M, Costa ML 2015 Achilles tendon rupture rehabilitation. Bone Joint Res 4(4):65-69.
- Kearney RS, McGuinness KR, Achten J, Costa ML 2012 A systematic review of early rehabilitation methods following a rupture of the Achilles tendon. Physiotherapy 24-32.
- Neumayer F, Mouhsine E, Arlettaz Y, Gremion G, Wettstein M, Crevoisier X 2010 A new conservative-dynamic treatment for the acute ruptured Achilles tendon. Arthroscopy and Sports Medicine 130:363-368.