Achilles Tendon Rupture

• Achilles tendon rupture is a sudden onset injury resulting in rupture of the Achilles tendon and a loss of the connection between the calf muscles (gastrocnemius and soleus) to the heel (the calcaneus bone)
• Risk Factors for Achilles tendon rupture

  • Sports that stress the Achilles (e.g., basketball, tennis and track athletics)
  • Increasing age
  • Existing Achilles tendinopathy
  • Family history
  • Fluoroquinolone antibiotics (e.g., ciprofloxacin and levofloxacin)
  • Systemic steroids
• Rupture can occur spontaneously within 48 hours of starting fluoroquinolone antibiotics treatment
• It is important to warn patients to look out for any signs of Achilles tendinitis and stop treatment if they occur
• Presentation of Achilles tendon rupture

  • Sudden onset of pain in the Achilles or calf
  • A snapping sound and sensation
  • Feeling as though something has hit them in the back of the leg
  • No prior warning signs or Achilles symptoms
• Signs on examination of Achilles tendon rupture

  • When relaxed in a dangled position, the affected ankle will rest in a more dorsiflexed position
  • Tenderness to the area
  • A palpable gap in the Achilles tendon (although swelling might hide this)
  • Weakness of plantar flexion of the ankle (dorsiflexion is unaffected)
  • Unable to stand on tiptoes on the affected leg alone
  • Positive Simmonds’ calf squeeze test
• Achilles Tendon Rupture

  • Tenderness to the area
  • Palpable gap in the Achilles tendon (although swelling might hide this)
  • Weakness of plantar flexion of the ankle (dorsiflexion is unaffected)
  • Unable to stand on tiptoes on the affected leg alone
  • Positive Simmonds’ calf squeeze test
• Simmonds’ calf squeeze test

  The patient is positioned prone or kneeling with the feet hanging freely off the end of the bench or couch. When squeezing the calf muscle in a leg with an intact Achilles, there will be plantar flexion of the ankle. Squeezing the calf pulls on the Achilles. When the Achilles is ruptured, the connection between the calf and the ankle is lost. Squeezing the calf will not cause plantar flexion of the ankle in a leg with a ruptured Achilles. A lack of plantar flexion is a positive result
• Last updated

  August 2021