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Achilles tendon rupture Acute Rupture: A common scenario for Achilles rupture occurs in the middle age male who undertakes explosive activity such as a game of squash. By this age the tendon often has undergone some degenerative change and may fail to sustain a sudden strong resisted muscle contraction. This injury however, can occur in anyone. The feeling is of being hit in the back of the calf by a cricket bat. When diagnosed early a mid substance Achilles rupture can be treated without an operation. Ideally, if the two ends of the ruptured tendon

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Page 1: Achilles tendon rupture - orthoam.com.au · Achilles tendon rupture Acute Rupture: A common scenario for Achilles rupture occurs in the middle age male who undertakes explosive activity

AchillestendonruptureAcuteRupture:AcommonscenarioforAchillesruptureoccursinthemiddleagemalewhoundertakesexplosiveactivitysuchasagameofsquash.Bythisagethetendonoftenhasundergonesomedegenerativechangeandmayfailtosustainasuddenstrongresistedmusclecontraction.Thisinjuryhowever,canoccurinanyone.Thefeelingisofbeinghitinthebackofthecalfbyacricketbat.

WhendiagnosedearlyamidsubstanceAchillesrupturecanbetreatedwithoutanoperation.Ideally,ifthetwoendsoftherupturedtendon

Page 2: Achilles tendon rupture - orthoam.com.au · Achilles tendon rupture Acute Rupture: A common scenario for Achilles rupture occurs in the middle age male who undertakes explosive activity

canbebroughtintocontactbyplacingtheankleinplantarflexion(pointingthetoe)thenitshouldheal.Theinjurycanalsooccurlowerdownattheinsertionintothecalcaneus(heelbone)orhigheratthemusculotendinousjunctioninwhichcasetheimplicationsmightbedifferentandwillbediscussedatyourconsult.ThesurgicaloptionistohaveanAchillesrepair.Itreducesslightlytheriskofre-ruptureinthefutureandgivesaslightedgeinmaximumsportsperformance.Thisoptioninvolvestheriskofsurgerysuchasinfection,woundbreakdownandnerveinjury.Thesurgerytakesapproximately30minutesandcanbedonethroughanapproximately5cmincision,sometimessmaller.Anacceleratedrehabilitationprogramisusuallyrecommendedregardlessofthechoicebetweensurgeryvsnosurgeryandmustbecloselyadheredtoandbesupervisedbyaphysiotherapist.Aplantarflexioncast(withthetoepointed)isusedinitiallybeforea2weekwoundassessmentandtransitioningtoabootwithaheelraise.ThePhysiotherapistcanthensuperviseyourrehabandyoucanexpecttostartsportspecifictrainingat3monthsbutitisgenerallyrecommendedtotake12monthsofffromseriousrunningandexplosive“pushoff”typesports.ChronicAchillestendonrupture.TherearesituationswhereanAchillesrupturemaynotbediagnosedandtreatedinthefirstfewweeks.Atthisstagethegapbetweentheendsofthetendoncannotbeclosedwithasimplerepair.Thismayinvolveareconstructiveprocedurewhereextralengthtobridgethegapisgainedfromfurtherupthecalf.ThisinvolvesalargerincisionandbecomesasimilarscenariotothatseeninNonInsertionaltendinopathywhichisexplainedearlierinthisinformationsheet.


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