Achilles Tendon Rupture
Introduction
The Achilles tendon, a robust band of tissue connecting the calf muscles to the heel bone, is essential for various movements, from walking to jumping. However, this resilient tendon is vulnerable to injury, with Achilles tendon ruptures being a common occurrence, particularly among athletes and active individuals.
Signs and Symptoms:
1. Sudden Sharp Pain:
An Achilles tendon rupture often manifests as a sudden, sharp pain in the back of the ankle or calf region, typically described as a "popping" or "snapping" sensation. This acute onset of pain is frequently accompanied by a feeling of being struck or kicked in the back of the leg.
2. Swelling and Tenderness:
Following the injury, swelling and tenderness may develop around the site of the rupture. The area may feel warm to the touch, and there may be visible bruising or discoloration due to bleeding within the tissues.
3. Difficulty Walking:
Individuals with an Achilles tendon rupture often experience difficulty walking, particularly when attempting to push off the affected foot or rise onto tiptoes. Walking may be accompanied by a noticeable limp or altered gait pattern.
4. Weakness and Instability:
The affected leg may feel weak and unstable, with a sensation of "giving way" or buckling under pressure, especially during weight-bearing activities such as standing or walking.
5. Palpable Gap or Defect:
In cases of complete tendon rupture, a palpable gap or indentation may be felt along the back of the ankle where the tendon has torn. This gap may be evident upon physical examination by a healthcare professional.
Conservative Treatment Options:
1. Immobilisation:
For partial tears or mild ruptures, conservative treatment may involve immobilisation of the ankle joint using a cast, walking boot, or brace to allow the tendon to heal in the correct position. Crutches may be used to offload weight from the affected leg during the initial phase of recovery.
2. Rehabilitation
Following the immobilisation period, a structured physiotherapy and exercise program is initiated to gradually restore strength, flexibility, and function to the Achilles tendon and surrounding muscles. Therapeutic exercises focus on gentle stretching, progressive strengthening, and proprioceptive training to promote optimal healing and prevent re-injury.
3. Manual therapy
Throughout the recovery, manual therapy techniques such as massage, dry needling and joint mobilisations/manipulations may be utilised to help promote function and reduce stiffness at the ankle and surrounding joints.
3. Orthotic Devices:
Custom orthotic devices, such as heel lifts or wedges, may be prescribed to provide additional support and alignment to the foot and ankle, reducing strain on the healing tendon and promoting proper biomechanics during walking and other activities.
Surgical Intervention:
1. Surgical Repair:
In cases of complete Achilles tendon ruptures or partial tears with significant functional impairment, surgical intervention may be recommended. Surgery typically involves making an incision in the back of the ankle and suturing the torn ends of the tendon back together. Depending on the extent of the injury, additional procedures such as tendon transfer or augmentation may be performed to reinforce the repair.
2. Postoperative Rehabilitation:
Following surgery, a period of immobilisation in a cast or walking boot is usually prescribed to protect the repaired tendon. Physiotherapy is initiated early in the recovery process to promote healing, prevent stiffness, and gradually restore strength and function to the ankle joint. Rehabilitation protocols are tailored to the individual's specific needs and may involve a combination of manual therapy, therapeutic exercises, and gait training.
Conclusion:
Achilles tendon rupture can be a debilitating injury, but with prompt diagnosis and appropriate treatment, the majority of individuals can expect to achieve a full recovery and return to their previous level of function and activity. Whether opting for conservative management or surgical intervention, come see our team at Brisbane Physiotherapy for a thorough rehabilitation programme tailored to you and your needs.
