The Achilles tendon connects the calf muscle to the heel bone.

Achilles tendon ruptureAchilles tendon ruptures occur most commonly in 30-50 year olds. It is common in the recreational athlete.

The reason for rupture is when the tendon is rapidly loaded when it is already under tension. Common mechanisms include jumping from a height, pushing off for a tennis shot, or tripping on a curb.

The diagnosis is made by clinical examination.

There are 2 methods of treatment, operative and non operative.

Both techniques require 8 weeks of immobilisation followed by protected activities and diligent physiotherapy to regain range of motion and strength over a 4-6 month period.

In some cases non operative treatment is preferred because of the risks of surgery.
 
 

Operative treatment

Advantages

  • Lower risk of rerupture 3-4%
  • Possibly better strength
  • No difference in the long term

Disadvantages

  • Infection and wound healing issues
  • Nerve injury
  • Anaesthetic problems

Non operative treatment

Advantages

  • No surgical risk
  • No difference in the long term

Disadvantages

  • Higher rerupture rate 8-10%
  • Slower initial mobilisation

Mr Curry’s preferred treatment is surgical repair.

This results in a lower rate of re-rupture than non operative treatment and more confidence in the first 3 months to allow the progression of rehabilitation, return to work and recreational activities.