Achilles tendon ruptures seem to be the most common injury along with ACL tears for professional athletes these days. The Achilles tendon goes down the back of your leg to your heel. It is formed by three separate muscles from your calf that come together and attach to the heel bone. When you jump, climb or even push off for your next run, you’re activating your Achilles. We discussed how to treat and prevent Achilles tendon injuries with Dr. Andrew Wohler, foot and ankle surgeon in Carmel and Greenwood.
What is an Achilles rupture?
- An Achilles rupture occurs when the tendon that connects the calf muscle to the heel tears (ruptures). Tears most commonly occur in the mid portion of the tendon or, occasionally, the tendon can pull away from the bone, insertional rupture.
How does an Achilles rupture happen?
- Achilles tendon ruptures happen when the load placed on the tendon exceeds the material strength that the tendon can handle. The excess force causes the tendon to fail/rupture.
What are the signs and symptoms of an Achilles injury?
- Signs and symptoms of an Achilles tendon rupture include weakness with push off, a palpable gap in the Achilles and calf pain. Often patients will describe feeling as if they are hit or kicked in the back of the ankle but no one or nothing was there.
How are Achilles tendon ruptures treated?
- Achilles tendon ruptures can be managed surgically and non-surgically. Studies have shown good outcomes with both treatment strategies, though there are certain risks that accompany each treatment that should be discussed with your surgeon when choosing a treatment method.
What is the process with surgery?
- When treating Achilles tendon ruptures surgically, your surgeon will repair the tendon, effectively “resetting” the tension on the Achilles to try to regain optimal function. A lot of research has been done on different surgical techniques (open, mini-open, minimally invasive, *PARS to speedbridge). All surgical techniques are effective and sometimes there are reasons your surgeon may choose one technique over another. What research has consistently shown is that operative management decreases risk for re-rupture compared to non-operative management, though surgical risks, most commonly wound issues are increased.
Are there any risk factors with surgery?
- Yes, surgery always has some degree of associated risk. The greatest risks for Achilles repair are for wound healing complications, nerve injury (slightly higher with percutaneous techniques), DVT/PE (with both operative and non-operative treatment) and a re-rupture risk of 1-2% when managed surgically and 7-10% without surgery.
How long is the recovery period?
- Tendon healing usually takes about 12 weeks, but the strength loss and muscle atrophy associated with the injury and repair means that full recovery is close to 9-12 months.
Are men more likely to tear their Achilles versus women?
- Yes, men are at a slightly higher risk of Achilles tear though numbers in women have increased recently with the rise in women's sports and increase in recreational activities among women. Achilles ruptures tend to follow a bimodal distribution with peaks in mid-20s to early 30s and again in 60s-70s.
Do you see more Achilles injuries in basketball vs football?
- Overall, more Achilles injuries tend to occur in basketball and volleyball due to planting and jumping with load.
How can you prevent an Achilles injury?
- In some ways, Achilles injuries can be difficult to completely "prevent" but warming up appropriately and stretching prior to activity can help to minimize risk.
If you’re struggling with calf or Achilles pain, our Forté Sports Medicine and Orthopedics foot and ankle team in Carmel, Greenwood or Noblesville are here to help. Contact us today! Our experts will create a treatment plan tailored to your needs so you can get back on your feet pain-free!
* PARS Achilles Midsubstance SpeedBridge™ Implant System with Arthrex
