Bodyworks: Achilles Rupture - Partial

How to recognise it, how to overcome it


Posted: 28 May 2002
by Patrick Milroy

Symptoms
You’ll feel pain of course, particularly as you take off from the injured leg, and also after sleep when you first stretch the slightly-healed scar tissue that has formed overnight (a ‘drop-foot splint’ can keep the Achilles stretched overnight and reduce this tightness). The initial pain may be sudden, and soon becomes chronic with further use.

Signs
If you carefully feel along the tendon you can often discover one or more small, tender nicks at the side of the tendon where there is a healing area of torn tissue.

Medical investigations
Again, X-ray or ultrasound will confirm your diagnosis, but can also exclude other causes.

What else could it be?
Because your TA is so poorly supplied with blood, it is possible for parts of it to die off, leaving areas of focal degeneration. In this case, the onset of pain may be more insidious and you may notice a swollen area of tendon 1-2in long, tapering at each end. Surgery may well be required.

Self-treatment
You can do a lot to both prevent and treat all minor TA problems. Prevention should include: 1 A Sorbothane-type heel raise, lessening the strain on the tendon and softening the landing forces; 2 Ensuring that the heel tabs on your shoes don’t press on your TA when your toes are pointed, and cutting them off horizontally if they do; 3 Using orthoses if you overpronate. Pronation twists and untwists the TA with every stride. To treat it use:

  1. RICE – particularly the ‘ice’ part, massaging the tendon with a cube upwards and downwards frequently;
  2. Stretching – even more frequently! Try facing a wall, placing your forearms against it, feet 1.5-2ft away and slightly turned in, then, with knees held straight, push your hips towards the wall and hold still with the TA feeling merely uncomfortable for 30 seconds. A little bending of your knees can alter the site of the stretch. Repeat again and again.

Medical treatment
Although severe and recurrent partial TA ruptures may deserve surgery, operations leave scars, which also have to be rehabilitated, so doctors are increasingly reluctant to apply scalpel to skin. Some electronic treatments such as ultrasound put energy into your tendon, but as the blood supply is so poor, this can technically ‘fry’ it, so it must be used very carefully. Laser is preferable for physio use, but the majority of treatment shouldn’t be electrically based – rather add careful local massage to free scarred areas to the self-treatment outlined above.

Can you run through it?
Yes, but you’re probably foolish and simply worsening what can be a very long, drawn-out and chronic injury. Spend your time cycling instead. This will exercise your heart and stretch scar tissue more gently and regularly.

Recovery time
There is a high risk of reinjury if treatment is overenthusiastic, so length of recovery time is rather like that of the proverbial piece of string.


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Discuss this article

Can anyone offer any help, I went over on my ankle while out on a training run about a month ago, thinking it was only a slight sprain i was able to complete my run and continue to train for the next week and race a 1/2 marathon as a bluid up to my marathon training for london, over the next few days the pain developed till i saw a physio who said that i had a partilly ruptured achillies, has anyone else had this before, any advice would be appreciated and how soon can i get back to training.
Posted: 02/01/2003 at 10:25

Whoh! A partial rupture could lead to full rupture and bang (literally) goes London. I think you need a precise diagnosis. Hop along to GP or sports injury clinic and discuss the possibilities. An ultrasound scan can be helpful in diagnosing Achilles tears.

Good luck with it.

Posted: 02/01/2003 at 10:34

Chris,

Get to your doctor asap - if it goes bang you will find yourself in plaster for 3 months so you really need to look after this one.

Lindi
Posted: 02/01/2003 at 11:53

As Eamonn says dont mess around ! get an answer ASAP and dont train til you do !
Posted: 02/01/2003 at 15:09

I have started to get an ache in the achillies area whilst running, I have rested it this week but am unsure what it is and wether or not it will develop into something major, training for New York so can't really afford any injuries. Anybody any suggestions as to what can cause this ???
Posted: 11/07/2003 at 13:42

I have got a ruptured achillies and am in plaster for a minimum of 6 weeks, probably longer. Dont try running, I knew i had an injury but carried on any way. Dont do it!! Now i am fed up!!
Posted: 22/10/2003 at 12:18

Am currently suffering a torn medial calf muscle in my left leg, the tear being at the junction with my Achilles tendon - a very very painful experience which happened in 3 quick sequences of a loud Pop from my calf followed by a searing pain from heel to back of knee followed by feeling as if somweone had struck the back of my leg with an iron bar. It occurred last Thursday 28/7/05 during a gym training session (calf strengthening) on a rotary calf machine. Am now out of action for 4 to 6 weeks for full rehabilitation and recovery. If I may suggest for an excellent insight to the injury and superb advice insert into your internet Google Search 'Calf Muscle Injury' and you will find a number of websites that explain all. Good luck. Eric.
Posted: 04/08/2005 at 20:11

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