Achilles Tendon Rupture

New York Jets quarterback Aaron Rodgers injured his left Achilles tendon in Monday night’s victory over the Buffalo Bills, an injury that ended his season. It was a sight no Jets fans wanted to see, and it happened within the first four minutes of their season opener.

Here’s a closer look at the Achilles Tendon Rupture and what Rodgers’ injury could mean:

What is your Achilles tendon?

The Achilles tendon is a strong fibrous cord in the lower leg. It connects the muscles of your calf to your heel. It is the largest tendon in your body. It helps you walk, run, and jump.

What is a ruptured Achilles Tendon?

It is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping, pivoting, or sudden accelerations of running can overstretch the tendon and cause a tear.

The Achilles tendon can also degenerate over time. This is also known as tendinitis or tendinopathy. This may cause symptoms like pain and stiffness along your tendon and back of your heel. This happens often through overuse and repeated stress to the tendon.

Most tendon ruptures we see in private practice are in “weekend warriors”—typically, middle-aged people participating in sports in their spare time.

Signs and Symptoms

  • Sudden pain in the back of the ankle of the calf
  • A popping or snapping sensation.
  • Swelling on the back of the leg between the heel and the calf
  • Difficulty walking

Diagnosis

Range of motion and muscle strength is evaluated and compared to the uninjured foot and ankle. If the Achilles tendon is ruptured, the patient will have less strength in pushing down and will have difficulty rising on the toes. MRI/ Ultrasound usually confirms our diagnosis and is a helpful test for surgical planning.

Treatment

It includes surgical and nonsurgical approaches. The decision is based on the severity of the rupture and the patient’s health status and activity level.

Nonsurgical treatment is generally associated with a higher rate of re-rupture and is mostly selected for partial tears, less active patients, and those with medical conditions that prevent them from undergoing surgery. Treatment involves the use of a cast, walking boot, or brace to restrict motion and allow the torn tendon to heal.

Surgery decreases the likelihood of re-rupture of the tendon. It increases the patient’s push-off strength and improves muscle functions and movement of the ankle.

There are various surgical techniques available.

During the surgery, an incision is made in the back of the calf. If the tendon ruptured, we would stitch the tendon end to end back together. If the tendon is degenerated, we may have to remove the damaged part of the tendon and repair the rest of the tendon with stitches. If there is severe damage to a lot of the tendon, we will replace part or all of your Achilles tendon. This is done with a tendon taken from another place in your foot.

In some cases, Achilles tendon repair surgery can be done as a minimally invasive procedure. This is done with several small incisions instead of one large one. It may use a special scope with a tiny camera and a light to help do the repair.

Complications

  • Incision healing difficulties
  • Re-rupture of the tendon
  • Nerve pain
  • Infection
  • Blood clot
  • Calf weakness

Physical Therapy

Physical therapy is an important component of the healing process. It involved exercises that strengthen the muscles and improve the range of motion in the foot and ankle.

How long is the recovery?

It can be six to nine months until the patient can return to full activities.

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