Achilles tendon injuries

An Achilles tendon injury can be several different things. An acute rupture of the Achilles tendon can be treated conservatively or with operation and suturing.

It is important that the injury is examined within the first few days by a doctor and ultrasound scanned, in order to assess whether operation should be performed. In case of operation, this should take place within the first week.

If a completely ruptured tendon is not operated on, the strength of the calf musculature in the subsequent course can be considerably reduced. This can be extremely inhibiting for a physically active person.

Achilles tendon pain over a longer period of time can have several different causes. It can be an irritation in the tendon itself, in front of the tendon or at the attachment to the heel bone. The first and best examination to see what is wrong is an ultrasound examination.

Symptoms of Achilles tendon injury

A rupture of the Achilles tendon is rarely in doubt if it tears completely. One feels a distinct snap and sharp pain. It is difficult to walk and the strength in the calf is almost completely gone. Most often the patient believes it is a blow from behind.

Most often it is a prolonged gradually built-up irritation in or around the Achilles tendon, where exercise becomes more and more difficult to perform due to increasing stiffness or pain.

Examination

Consultation with an orthopaedic surgeon is the first step towards investigation. Ultrasound scanning is a “must”, and can possibly be supplemented with an MRI scan.

Treatment of Achilles tendon injury

In case of total rupture of the tendon in younger sports-active individuals, operation is the standard treatment, with relief in splint/boot for the subsequent 6 weeks, with gradual correction of the ankle inclination to 90 degrees.

Conservative treatment can be an option, where the ankle is bandaged for 8 weeks, with gradual correction from plantar flexion to 90 degrees.

The chronic irritations of the Achilles tendon are treated based on the ultrasound scanning findings. It can involve a longer rehabilitation course, injection treatment, ESWT treatment, HVI (high volume injection) or operation.