The Achilles tendon connects your heel bone to the powerful calf muscles in your lower leg. This tendon, named for the almost invulnerable Greek god, is the largest tendon in the human body. Tendons are made of a durable woven protein connective tissue. This resilient, rope-like material is elastic enough to handle tremendous stress yet flexible enough to stretch as bone pulls against muscle.
Risks of Rupture
Like the Greek god Achilles, this heel cord has proven liable to many weekend warriors, aging athletes and others. With age and disuse, the tendon becomes weaker. Diabetes, types of arthritis, use of corticosteroids and some antibiotics may also put you in greater jeopardy.
The two main reasons for rupture are either the tendon has weakened or strain and overuse on the tendon has finally thinned and worn it to tear. If you have ever stretched and sawed away at a rubber band, only to have it suddenly snap apart at your fingers, then you can imagine the sudden force rupture involves.
Symptoms Vs. Signs
Understand the difference between symptoms and signs. This article reviews the signs of Achilles rupture, not the symptoms. "Signs" are findings observed by a doctor during an exam. "Symptoms" are what a patient feels such as pain, or stiffness. The most common symptoms patients report with Achilles rupture is that it felt like someone hit them with a rock in the back of the leg, they felt pain in the same location and they were then unable to walk normally.
Sometimes signs and symptoms overlap. Both you and your doctor will note bruising, swelling and redness. The following are the signs your health care provider will look for.
Stand on Tiptoe
Normally, as your calf muscles (gastrocnemius) tighten, they pull on the Achilles tendon, which in turn tenses, pulling on the heel (calcaneus). Such motion allows you to point your toe and stand on tiptoe. However, since the calf muscle is now detached from the heel, you cannot get on up your toes on the injured side.
Feel the Gap
Sometimes the doctor can actually feel the breach in the tendon; this space is usually at the most common rupture site, two inches above the heel bone.
Thompson's Test
The doctor will have you rest face down on a table and squeeze your calf muscles. If the connection from calf muscle to Achilles tendon to heel bone is intact, your toes will point out. With a ruptured connection, your toes just stay still.
X-Rays
When your doctor orders X-rays, he is looking to see any bone flecks from the heel bone that were torn off during Achilles rupture. If surgery is needed and parts of the heel bone have been torn off, this may alter the type of surgery required.
Ultrasound and MRI
This is to confirm whether this is a complete or partial tear. Because Achilles tendon rupture often requires surgical repair, so your doctor will want as much information as possible.
