Achilles Tendon Rupture (cont.)
Diagnosis of Achilles Tendon Rupture
- A physician usually can make this diagnosis with a good physical examination and history. X-rays usually are not taken.
- A simple test of squeezing the calf muscles while lying on your stomach should indicate if the tendon is still connected (the foot should point). This test isolates the connection between the calf muscle and tendon and eliminates other tendons that may still allow weak movement.
- A word of caution: Achilles tendon rupture is often misdiagnosed as a strain or minor tendon injury. Swelling and the continuing ability to weakly point your toes can confuse the diagnosis.
- Ultrasound and MRI are tests that can assist in difficult diagnosis. Depending on the degree of injury, these tests can also assist in determining which treatment may be best.
Achilles Tendon Rupture Treatment
The objective of treatment is to restore normal length and tension to the tendon and allow you to do what you could do before the injury. Treatment reflects a balance between protection and early motion.
- Protection is necessary to allow time for healing and to prevent reinjury.
- Moving your foot and ankle is needed to prevent stiffness and loss of muscle tone.
- Treatment options are surgical or nonsurgical. The choice is controversial.
- Both surgical and nonsurgical treatment will require an initial period of about six weeks of casting or special braces. The cast may be changed at two- to four-week intervals to slowly stretch the tendon back to its normal length. Casting may be combined with early movement (one to three weeks) to improve overall strength and flexibility.
- A heel lift device and, regardless of the choice of treatment, regular physical therapy follow for the remainder of treatment.
- Consultation with an orthopedic surgeon will determine the treatment and follow-up that is right for you.
Self-Care at Home for Achilles Tendon Rupture
Initial treatment for sprains and strains should occur as soon as possible. Remember RICE!
- Rest the injured part. Pain is the body's signal to not move an injury.
- Ice the injury. This will limit the swelling and help with the spasm.
- Compress the injured area. This again, limits the swelling. Be careful not to apply a wrap so tightly that it might act as a tourniquet and cut off the blood supply.
- Elevate the injured part. This lets gravity help reduce the swelling by allowing fluid and blood to drain downhill to the heart.
Over-the-counter pain medication is an option. Acetaminophen (Tylenol) is helpful for pain, but ibuprofen (Motrin, Advil, Nuprin) might be better, because these medications relieve both pain and inflammation. Remember to follow the guidelines on the bottle for appropriate amounts of medicine, especially for children and teens.
Medically Reviewed by a Doctor on 3/25/2016
Christopher C Nannini, MD
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