Achilles Rupture

What is it: The Achilles tendon is the most commonly injured tendon. Rupture can occur while performing actions requiring explosive acceleration, such as pushing off or jumping.

Important Facts: The Achilles tendon is the strongest and thickest tendon in the body, connecting the gastrocnemius and soleus to the calcaneus. It is approximately 15 centimeters (5.9 inches) long and begins near the middle portion of the calf.

Statistics: Most cases of Achilles tendon rupture are traumatic sports injuries. The average age of patients is 30–40 years with a male-to-female ratio of nearly 20:1. Those who suffer this injury are typically “weekend warriors” who are active intermittently.

Between 75% and 85 % of ruptures have been associated with athletic activities or racquet and ball sports.

Treatment Duration: The length of time to allow full activity after Achilles tendon repair is generally thought to be four to six months. Currently, it’s thought that operative treatment yields the best functional outcome for active patients. Intra-operatively, the appropriate resting tension of the tendon should be restored. Unfortunately, this is difficult to assess because there is no objective way to predict the actual resting tension of the tendon. The treatment of acute Achilles tendon ruptures varies, and there is no uniformly accepted algorithm of care. Management ranges from nonsurgical to percutaneous, mini-open, and formal open repair methods. In general, studies show lower re-rupture rates and better functional outcomes with surgical repair than nonsurgical management.

Do’s/Don’ts: Runners are often advised to rest from exercise for varying periods when Achilles problems strike. As inflammation needs time to develop after the stressful activity has occurred, typically the pain will often not be felt for several hours after the activity, classically on getting up the following morning. If inflammation is the problem, a few days rest will settle symptoms but the pain is likely to recur if the training is not modified.

Common Myths: Take a look at Christian Olsson, the Swedish triple jumper. His ability to translate speed on the runway to the jumps seems more likely to be due to fantastic elasticity in his tendons than massive strength from his fairly skinny legs. The secret may well lie in the elastic fibers contained within the tendon. After all, the kangaroo’s secret is not extreme power coming from its muscles but rather relates to the elasticity of its tendons.