How do you diagnose an Achilles tendon rupture?
If you're experiencing pain and other symptoms of a ruptured Achilles tendon, you should be seen by a doctor. They'll be able to test for a ruptured Achilles tendon and recommend treatment based on the severity of your injury. Ruptured Achilles tendon treatments may be surgical or nonsurgical, depending on how badly you've damaged the tendon.
Diagnosing an Achilles tendon rupture usually starts with a physical examination that includes:
- Questions about the injury and extent of pain in the lower leg
- Movement testing to evaluate pain, range of motion, and stability
- Special tests to measure the automatic flex of the foot
Through a physical exam, your doctor will determine the severity of your Achilles tendon tear. They may also decide to use imaging technology to evaluate the Achilles tendon. An X-ray can show the health of bones, including bone spurs, and may reveal if the tendon has hardened and calcified. A magnetic resonance imaging (MRI) scan can show the extent of the tendon damage.
Once your doctor has performed any necessary exams and imaging, they'll assign your Achilles tendon rupture a grade from 1 to 3:
- Grade 1: A mild injury that brings minimal torn tendon fibers, known as a partially torn Achilles
- Grade 2: A moderate injury with less than half the Achilles tendon fibers tearing
- Grade 3: The most severe form of Achilles tendon injury, a rupture in which the majority or all the fibers tear
Call 617-726-0500 or request an appointment with a Mass General Brigham sports medicine specialist to discuss your symptoms and have your Achilles tendon evaluated.
How do you know if your Achilles is torn?
The red flags for Achilles tendon rupture are:
- A popping sound at the moment of injury
- A feeling like you've been kicked in the calf
- Swelling, bruising, and pain at the back of the ankle, especially during athletic activities like walking, running, and jumping
- Swelling and thickening of the tendon
- Instability and difficulty walking, especially on an incline or decline
Treatment for a ruptured Achilles tendon
Depending on the details of your case, your medical history, and the severity of your Achilles injury, recovery can range from rest and immobilization to surgery.
Non-surgical Achilles tendon treatment
A non-surgical approach allows the Achilles tendon to heal naturally. Non-surgical Achilles tendon repair usually requires a period of rest and immobilization of the foot and ankle. Following immobilization, athletes must strengthen the muscles around the Achilles tendon and engage in physical therapy and low-impact exercise to rebuild strength and range of motion.
Achilles tendon repair surgery
Surgery is a common treatment for Achilles tendon rupture. Surgery may be open (the surgeon uses a larger incision to reveal the damaged tendon) or percutaneous (the surgeon makes a few small incisions to enter with minimally invasive tools). In either case, the surgeon stitches the torn tendon fibers together during the procedure before immobilizing the foot and ankle following the Achilles heel surgery to expedite recovery. If the rupture is extreme, the surgeon may need to use tissue from elsewhere in the body to assist in the procedure.
Can a ruptured Achilles tendon heal itself?
In milder cases of Achilles tendon tear, recovery may be possible with rest and immobilization of the foot, but surgery is more common. Your doctor and sports medicine specialist will advise you on the best method of ruptured Achilles tendon recovery based on the specifics of your case.
Achilles tendon rupture recovery time
Connective tissue, like tendons, can take a long time to fully recover. Expect the recovery time for your ruptured Achilles tendon to be four to six months. A complete return to sports or athletic activity may take a year or more.
Improving strength and mobility through physical therapy exercises improves the prognosis for Achilles tendon recovery. Athletes often need to modify their exercise routines in the early phases of recovery. Swimming and other low-impact exercises can help with conditioning while gradually adding more weight-bearing activities to the lower leg improves strength as athletes recover.
How long does it take to walk after a ruptured Achilles tendon?
Connective tissue (like tendons) heals slowly. After your surgery, you can expect to spend four months to a year progressing towards full recovery and return-to-sport. Most people can walk normally again within six months.
Will I limp after Achilles tendon surgery?
People who have Achilles tendon surgery are generally able to return to walking normally, without a limp, if they allow sufficient time to heal and follow recovery and physical therapy recommendations. Most people can return to sports, but full recovery can take six months to a year.
