How to treat an achilles tendon rupture?

A tear of the Achilles tendon is not an uncommon injury in sports activity and can be very dramatic if it happens, because the calf muscles and the attached Achilles tendon play such an necessary function. It is more likely to occur in explosive activities such as tennis. The real issue is that the achilles tendon and the two muscles connected to it cross two joints (the knee as well as the ankle) and if both joints are moving in contrary directions simultaneously, especially if instantly (as might happen in tennis), then the probability of something failing is pretty high.

The management of an achilles tendon rupture is a bit controversial because there are two options that almost all the research shows have got quite similar outcomes. One option is conservative and the other is operative. The conservative option is commonly putting the lower limb in cast that supports the foot pointing downwards a little. Usually it takes approximately six weeks to get better and after the cast is removed, there should be a slow and gentle resumption of physical activity. Physiotherapy is normally used to assist with this. The surgical choice is to surgically stitch the two ends of the tendon together again, this is followed by a period in a cast that is shorter compared to the conservative choice, and is followed by a similar steady and slow return to sport. If longer term results are compared the final outcome is generally about the same, but the surgical procedure has the additional risk of surgical or anaesthetic complications that the conservative approach does not have. The choice as to which approach is better is going to have to be one based on the experiences of the surgeon and the preferences of the individual with the rupture. There is a tendency for competitive athletes to go down the operative pathway because it is thought that this does give a improved short term outcome and get them back to the sports field a lot quicker. It is alsways important to head to the emergency department if you think you might have an achilles tendon rupture.