The Achilles tendon connects the muscles in the back of your calf to your heel bone. There are two basic variations of Achilles injuries: Achilles tendonitis, and a complete tear. It’s important to know whether the Achilles is torn or not, because the treatment is very different: a torn Achilles may require surgery; Achilles tendonitis probably means rehab and rest. While tendonitis is a gradual onset of pain that tends to get worse with more activity, an Achilles tear is a sudden injury, and it feels as if you were hit or kicked in the back of the ankle. A tear usually affects your ability to walk properly.
Because an Achilles tendon rupture can impair your ability to walk, it’s common to seek immediate treatment. You may also need to consult with doctors specializing in sports medicine or orthopaedic surgery.
Tests and Diagnosis
During the physical exam, your doctor will inspect your lower leg for tenderness and swelling. In many cases, doctors can feel a gap in your tendon if a complete rupture has occurred. Achilles tendon rupture can be diagnosed reliably with clinical examination, but if there’s a question about the extent of your Achilles tendon injury then your doctor may order a magnetic resonance imaging (MRI) scan.
The best treatment for a ruptured Achilles tendon in an active individual is typically surgery. While an Achilles rupture can sometimes be treated with a cast, splint, brace, or other device that will keep your lower leg from moving, surgery provides less chance that the tendon will rupture again and offers more strength and a shorter recovery period. Surgery may be delayed for a period of a week after the rupture, to let the swelling go down.
There are two types of surgery to repair a ruptured Achilles tendon and both involve the surgeon sewing the tendon back together through the incision(s):
- Open surgery – the surgeon makes a single large incision in the back of the leg.
- Percutaneous surgery – the surgeon makes a number of small incisions rather than one large incision.
Depending on the condition of the torn tissue, the repair may be reinforced with other tendons.
After treatment, whether surgical or nonsurgical, you’ll go through a rehabilitation program involving physical therapy exercises to strengthen your leg muscles and Achilles tendon. Most people return to daily activity within four to six months, though high-impact athletes may take up to a year to return to sport.
About Dr. Labib
Sam Labib, MD, is a sports medicine fellowship-trained surgeon and director of the foot and ankle service at Emory. Dr. Labib started practicing at Emory in 1999. He is an Associate Professor of Orthopedic Surgery.
He has lectured both nationally and internationally at many orthopedic meetings. His research has been published in several journals, including the JBJS, Arthroscopy, Foot and Ankle International and the American Journal of Orthopedics as well as numerous video presentations and book chapters. Dr. Labib is Board Certified in orthopedic surgery with additional subspecialty certification in Sports Medicine Surgery.
For the past 5 years, Dr. Labib has been nominated by his peers as one of “America’s Top Doctors” as tracked by CastleConnelly.com. Dr. Labib has a particular interest in problems and procedures of the knee, ankle, and foot. He is the head team physician for the athletic programs at Oglethorpe University and Spelman College, and an orthopaedic consultant to the Atlanta Falcons, Georgia Tech and Emory University.