Q&A Topic: Achilles Tendon Ruptures: Getting You Back on Your Feet

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Kurt Voellmicke, MD, FAAOS

Q. What is your Achilles tendon responsible for?

A. Your Achilles tendon is the largest and strongest tendon in your body – receiving a load stress 3.9 times your body weight during walking and 7.7 times your body weight while running. This tendon connects your calf muscles to the heels of your feet. Whether you’re running, jumping or just pointing your toes, your Achilles tendon is in play. When your calf muscles contract, your Achilles tendon is tensioned, allowing movement.

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Q. If it’s the strongest tendon in my body, how do injuries occur? Can I prevent injuries?

A. Though it’s a strong tendon, your Achilles tendon is also inherently vulnerable as changes to the mechanical properties of the tendon and poor blood supply occur as we age. A simple, sudden movement or abrupt action can result in a painful rupture and inability to move your heel. Think about your Achilles tendon like silly putty – pull it slowly and it elongates and stays intact, but if you pull it fast it may snap. Your forties and fifties are usually the sweet spot for Achilles ruptures. You’re young enough to play sports that involve running and jumping, but your parts are just not the same. You can make lifestyle changes to decrease your vulnerability to both tears and complete ruptures. Warm up before exercising and drink plenty of water to hydrate your muscles and tendons. Also, be aware of the temperature outside. Strenuous activities in cooler temperatures put you at a higher risk. Your tendons become less elastic, less malleable and more prone to injury.

Q. What are symptoms of a ruptured Achilles tendon?

A. If you’ve ruptured your Achilles tendon, it’s likely you’ll experience one or more of the following symptoms: the feeling of having been kicked in the back of the leg or heel; a popping sound when the injury occurs; pain – possibly severe with swelling near the heel, at least at the moment of rupture; an inability to bend the foot downward or push off the injured leg when walking; or, an inability to stand on the toes of the injured leg.

Q. If I think I’ve ruptured my Achilles tendon, what should I do?

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A. It’s important to elevate and ice the leg to minimize swelling. If you’re unable to bear weight you should go to the emergency room. If you can bear weight, you can make an appointment with orthopedic surgeon for a diagnosis.

Q. If I’m diagnosed with a rupture, will I need surgery? How long is recovery?

A. While ruptures can be managed successfully without surgery, there is a general consensus that non-operative management is associated with a higher risk of re-rupture and decreased strength. The goal of surgical treatment is to pull the frayed tendons together at the right length for optimal long-term function. This will allow early motion and gentle tension to facilitate faster, more efficient tendon healing. Regardless of the type of treatment, the recovery process after an Achilles tendon rupture is a long one, requiring a year or more for full recovery. Consistent physical therapy will help strengthen your calf muscles and your Achilles tendon so you’re able to resume all the activities they were doing before the rupture, without pain.

Learn More About Dr. Voellmicke
Director, Foot and Ankle Section
Orthopedic and Spine Institute
Northern Westchester Hospital

Northern Westchester Hospital is a proud member of Northwell Health.

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Read Past Topics from Dr. Voellmicke:
Ankle Sprains
Feet That Go Flat
Plantar Fasciitis
Don’t Let Bunions Interfere with Your Life

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