Achilles Tendon Rupture
Usually ruptures or tears in the Achilles tendon occur from sudden contraction of your calf muscles from pushing off and is most commonly seen in racquet sports such as tennis or squash. However they can occur from a simple stumble or even awkward step. The tendon usually tears in an area of poor blood supply where the tendon weakens slightly in middle age. A rupture is usually suddenly painful and we are often told that it feels like somebody has hit you from behind. Following this bruising and swelling will occur.
The diagnosis is normally made based on what happened to you and on the findings on examining your leg. This includes the “squeeze test” where we gently squeeze your calf and look for foot movement. It is important that the diagnosis is made promptly and the leg rested in a plaster or removable boot. Although not usually required for our surgeons to diagnose a rupture, an ultrasound is often arranged to see how big a gap exists between the ends of the tendon. This is especially true if we are considering not operating.
Good results from an Achilles tendon rupture can be achieved with or without surgery and we will help you choose which option is right for you. Modern non-operative techniques using a functional brace and early weight bearing usually give a good outcome without the complications of surgery. However there is a risk of the tendon healing too long, resulting in some loss of power in the calf. Our surgeons will often obtain an ultrasound to assess the likelihood of the tendon healing too long to help you make the right decision for you. Surgery will ensure the correct length of tendon is achieved and for the younger or more active patient this may be beneficial. Surgery does have a risk of wound problems but we can reduce these by using a mini-incision technique.
Both options require you to be in a removable boot for about 8 weeks, followed by an accelerated functional rehabilitation programme of early walking and exercises co-ordinated with the local physiotherapists.
Unfortunately an Achilles tendon tear can sometimes be subtle and the initial diagnosis missed. In such cases with a delay in seeing our surgeons we are far more likely to suggest surgery. Surgery for delayed diagnosis is usually more extensive and often requires transfer of a tendon.
There are many ways to book an appointment at the Cotswold Foot & Ankle Clinic. This may be a referral from either your GP, Hospital Consultant, Chartered Physiotherapist or Podiatrist.
For insured patients you will need to contact your insurance provider. If self-funding you may make a direct referral, but we prefer if you contact your GP, so they can inform us of your medical background.
OUR CONSULTANTS MR BROWN AND MR CLINT ARE MEMBERS OF
Cheltenham Hospital, Nuffield Health
Cheltenham GL51 6SY
The Manor Hospital, Nuffield Health
Oxford OX3 7RP
01242 246 559