1. It Feels Like You've Been Shot
The Achilles tendon is the largest tendon of your body; it connects your calf muscles to the heel bone. If you pinch right above your heel bone, you can almost put your fingers right on the tendon. According to Greek mythology, Thetis dipped her infant son, Achilles, into the underworld river Styx, which made him invincible except for the small area where her fingers held the child.
This injury typically occurs in "weekend warriors." As people age, the tendon gets weaker. During sudden, forceful contractions of the calf muscles (gastrocnemius and soleus), the tendon is stretched. If it reaches the breaking point, the tendon fibers tear. These motions can happen while running, jumping, cutting or having your foot forcefully dorsiflexed (same motion as stepping off the gas pedal in a car). Some examples of this are making a quick move in basketball, coming down with a rebound, landing from a jump with a BMX bike or coming off the starting blocks in a sprint. The injuries often happen with an audible pop or snap. With the noise and the sudden pain, people can feel as if they've been shot.
2. Weakness and Pain While Walking
You may or may not be able to walk after the injury. If you are able to walk, you won't be able to "push off" very well. While seated, you may still be able to actively move your ankle down (plantarflexion), but it will be weaker. A doctor may perform a Thompson test to check the integrity of the tendon. While prone (face down), the feet are slid off the end of the table and both calves are squeezed. This should cause the foot to flex towards the sole of the foot. If one side has less movement, the Achilles is probably torn. Another way of checking is with palpation, as there will often be a palpable divot or gap at the rupture site.
3. Antibiotics Can Put You at Risk
Fluoroquinolones are a class of antibiotics that can weaken tendons. Taking these antibiotics can cause Achilles tendonitis or even ruptures. Of course, the risks must be balanced out with the dangers of the infections that the antibiotics are meant to treat. Ask your doctor about this to avoid any problems.
4. Some Will Heal Without Surgery
Non-surgical treatment options for an Achilles tendon rupture are controversial. The main risk of non-surgical treatments is a higher re-rupture rate. One big risk of surgical treatment is wound healing problems and a higher chance of infection. Remember how thin the skin that overlies the Achilles tendon is? This thinness can cause many wound healing problems, such as dehisence (rupture of wound) or chronic irritation with underlying sutures. This can lead to infections in the area, which can be difficult to treat.
5. Surgical Options
Because of the higher re-rupture rate associated with non-surgical treatments, the tendency for younger, more active patients is to undergo surgery, which can be open or percutaneous. During surgery, the ends of the tendon are sewed back together, and you are usually in a cast for about six weeks. The cast may be changed every few weeks to gradually allow your ankle to bend upward as the tendon heals.
