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Achilles Tendon Tears

By Danielle Campagne, MD , University of San Francisco - Fresno

Achilles tendon tears (ruptures) occur when the tendon that attaches the calf muscle to the heel bone tears.

Achilles tendon tears are common. They occur most often in athletes and middle-aged sedentary men, particularly those who are out of shape and start an intense activity or sport without gradually building up to it. The tendon is more likely to be completely torn in middle-aged men than in athletes. These injuries can occur when people do not warm up or stretch enough before intense activity. Typically, the injury occurs while running or jumping, especially if the sport requires quick changes in directions. The tendon tears when a movement pushes the toes upward, toward the shin, too forcefully and too far.

Rarely, the Achilles tendon tears with no apparent cause in people who take fluoroquinolone antibiotics or corticosteroids.

The tendon may be partially or completely torn.

Symptoms

When the Achilles tendon tears, people feel as if they have been kicked behind the ankle. The calf is very painful and walking is difficult, particularly when the tear is complete. The calf may be swollen and bruised.

Diagnosis

  • A doctor's evaluation

  • Sometimes ultrasonography or magnetic resonance imaging

Doctors can usually diagnosis this tear based on the physical examination. If the tear is complete, they can often feel it.

If results of the physical examination are normal but doctors still suspect a tear, ultrasonography is done to confirm the diagnosis. If it is not available, magnetic resonance imaging (MRI) is done.

Treatment

  • Referral to an orthopedic surgeon

  • For partial and some complete tears, a splint or boot

  • For some complete tears, surgery

People with an Achilles tendon tear are usually referred to an orthopedic surgeon.

For partial tears and some complete tears, an ankle splint or a removable boot is applied. It is worn for 4 weeks.

Some complete tears are surgically repaired.

If partial tears continue to cause symptoms for 3 months or more, these tears may also be surgically repaired.

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* This is the Consumer Version. *