Causes

The Achilles tendon is the connection of the powerful calf muscle to the back of the heel bone. It is essential for pushing up off the floor. The blood supply in middle age makes it vulnerable to injury. If a complete tear occurs, you would probably feel a sudden pain in your heel or calf. Some people describe it as though someone had kicked, or hit them with a squash racquet on the calf. Usually the heel becomes painful, swollen and bruised, and it becomes difficult to walk.

Diagnosis

It is essential to recognise a new complete rupture quickly.  If in doubt the ankle should be rested in a plaster or a walking boot with the toes pointing down until an expert clarifies the diagnosis and you have chosen a treatment.  There is a choice between treatments with and without surgery.

Treatment

A good outcome can be achieved by treating the torn tendon in a walking boot for eight weeks.  This avoids the risks of wound problems after surgery.  However the tendon may be a little slack and slightly less powerful after surgery.

Surgery

For younger or more active people with a more sporty lifestyle surgical repair is likely to give a better final result. We use a mini-incision technique to minimise the risks of wound problems. Surgery is not an emergency and can be fitted into your busy schedule, within the next ten days.

An accelerated functional rehabilitation programme of early walking and exercises co-ordinated with the local physiotherapists is followed after both treatment methods.
Unfortunately an Achilles tendon tear can sometimes be subtle and making the diagnosis difficult, such that it is not detected until weeks after surgery. In this case with a delay in presentation to the surgeon the tendon must be repaired by surgery, which is a little more complicated requiring a tendon transfer.