Is my Achilles Ruptured?

Is my Achilles Ruptured?

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Written by .
Achilles rupture expert and orthopedic surgeon.


Is my Achilles ruptured?

If you get sudden sharp pain in the back of the heel, sometimes with an audible snapping sound, then you may have torn the Achilles tendon. You should assume that is the case until you are sure it is a less serious injury. You may be tempted think you have just sprained your ankle. There are several myths about what is and is not possible to do with your leg after you have suffered a tear to the Achilles tendon, and sometimes this leads to a delayed diagnosis. Even with a torn Achilles you can move the foot (other tendons help to do this) and you can still walk (albeit awkwardly). Sometimes people seek help after a delay, having initially hoped that the injury was something more minor and would recover quickly.

What happens when you tear your Achilles?

The Achilles tendon joins the calf muscles to the heel bone. It is important for standing up on tip toes and pushing off when you walk. If it tears, then the muscle is no longer connected to the heel and so the ankle movement is weak.

How to tell if your Achilles tendon is about to tear?

Most ruptures of the Achilles happen suddenly with no warning at all. The reasons for this are not well understood, but susceptibility to rupture may relate to poor blood supply to the tendon. Most patients with a rupture report that they have never had any previous Achilles trouble (such as tendinitis / tendinopathy).

How do you tear your Achilles?

Pushing off with your foot causes a strong and sudden contraction of the calf muscle which proves to be too much for the tendon. The tendon is made of millions of hairs that run like a horse’s tail from the calf muscle to the heel bone. Why the tendon should suddenly fail is not well understood. Each fibre tears at a different point, so the tear is not clean but results in two ragged ends.

How do Achilles tears happen?

The type of injury can be any sudden push-off using the ankle. The classical stereotype is of a middle-aged person returning to sport. Pushing a heavy object or (particularly in older individuals) just an awkward stumble can be enough.

What else it could be?

A torn calf muscle (tennis leg) is a different injury where sudden pain develops, but in the middle of the calf rather than low down by the heel. Like a torn Achilles this can be suddenly very painful. A tearing or snapping feeling is common. This injury is much less severe than an Achilles rupture.

What does it feel like when you tear your Achilles tendon?

Usually, you experience a sudden pain in the back of your leg. You might hear a snap. Sometimes other people hear it too. Often the rupture happens during sport. You might think that an opponent has kicked you or your tennis partner hit you with their racquet.

How painful is a torn Achilles?

The pain is instantaneously quite severe but settles down quickly. The absence of lasting pain makes some people believe (hope) that nothing too serious has happened.

How do you know if you tore your Achilles?

Sudden pain in the back of the heel, often with an accompanying snapping sound. The pain subsides quickly. You can still move your toes and ankle. You can still stand and walk/limp. You cannot stand onto tip toes on just the injured leg.

Should I go to hospital?

If you are in doubt, seek medical advice and have the injury checked. Limping around hoping it will get better means a delay in diagnosis and a greater chance that surgical repair will be needed.

How bad is an Achilles tear?

Properly treated Achilles tendon ruptures heal well, but recovery is lengthy. You can expect to be in a boot or similar support for your leg for about 10 weeks. After this it takes months to regain the muscle strength. If you ask someone who has been through this they will say that they were limited in activities for at least 6 months and that full recovery takes about a year.

How common is an Achilles tendon rupture?

Between 0.01% and 0.02% of the population tear their Achilles every year. In the UK it is estimated that there are 11,000 confirmed cases per year. In the US the estimate is 59 000.


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