According to "Ramamurti's Orthopaedics in Primary Care," rupture of the Achilles tendon, or the band of fibrous tissue that joins the calf muscles to the heel bone, usually occurs when a sudden external force pushes the foot from a pointed toe to a flexed position. People who have experienced an Achilles tendon rupture often compare the sensation to being struck just above the heel with a stick. The American Academy of Family Physicians explains that Achilles tendon ruptures occur most frequently in males between the ages of 30 and 50, and that the Thompson Test is the best method of diagnosing a rupture.
Step 1
Have the patient lie on his stomach on an exam table or other flat surface to perform the Thompson Test. Both of the patient's knees should be bent at 90 degrees.
Step 2
Squeeze the calf of the uninjured leg while watching the foot. The toes should point, or plantar flex, in response, which indicates an intact Achilles tendon.
Step 3
Squeeze the calf of the injured leg while watching the foot. If no plantar flexion occurs, this indicates a positive Thompson Test and rupture of the Achilles tendon, explains the American Academy of Family Physicians.
Step 4
Wrap a sphygmomanometer, or blood pressure cuff, around the affected calf to double-check for an Achilles rupture, suggests the American Academy of Family Physicians. Inflate it to 100 mm Hg, then flex the affected foot. If the pressure only flickers briefly instead of rising to 140 mm Hg, it's indicative of an Achilles rupture.
Step 5
Palpate and observe the back of the calf for a visible defect in the Achilles. According to "Ramamurti's Orthopaedics in Primary Care," such a defect can often be found 1 to 6 cm above the heel bone.
Tips and Warnings
- If uncertainty remains over whether or not the Achilles is ruptured, an MRI can make a positive diagnosis.
Things You'll Need
- Exam table
- Sphygmomanometer
References
- "Ramamurti's Orthopaedics in Primary Care," by Gerald C. Steinberg, Carlton M. Akins, and Daniel T. Baran; 1999
- American Academy of Family Physicians: Common Conditions of the Achilles Tendon
