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The calf muscles are one of the most powerful muscle group in the body and the Achilles tendon is the thickest and strongest tendon in the body. Contracting the calf muscles pulls the Achilles tendon, which pushes the foot downward (plantarflex).  This allows one to stand on the toes, walk, run and jump.
Achilles tendon ruptures are most likely to occur in sports requiring sudden stretching, such as sprinting and racquet sports.
Common sporting activities related to Achilles tendon rupture include:  badminton, tennis, squash.
Less common sporting activities that can lead to Achilles tendon rupture include: TKD, soccer etc. Occasionally the sufferer may have a history of having had pain in the Achilles tendon in the past and was treated with steroid injection to around the tendon by a doctor.  This can lead to weakening of the tendon predisposing it to complete rupture.
There is acute pain and swelling in the back of the heel due to bleeding from the tendon rupture. The patient will have difficulty walking as they cannot toe off without pain.  This causes them to walk with a limp.
Ice the Achilles tendon to reduce the swelling.  Get a pair of crutches for walking and put less weight on the injured leg. A typical history as detailed above together with positive clinical examination usually will clinch the diagnosis.

With the patient lying on the tummy (prone position) with the knee flexed, the examiner should see the ankle and foot flex downwards (plantarward) when squeezing the calf muscles.  If there is no movement in the ankle and foot on squeezing the calf muscle, this implies that the calf muscle is no longer attached to the heel bone due to a complete Achilles tendon rupture. The following video shows the lack of plantarflexion of the patient’s ankle and foot when the calf muscles are being squeezed. If the diagnosis is in doubt, I will usually perform a bed-side ultrasound scan.  This will usually allow me to have a visual confirmation of the torn tendon as well as the size of the gap. MRI scans are usually not needed unless the diagnosis is not clear or if the patient gave a history of having been injured for a few weeks or months. Surgery involves a 3 to 5cm incision over the back of the ankle centred over the torn tendon. Physiotherapy is recommended from the 6th week onwards in order for the patient to regain flexibility and strength in the operated heel.
This video shows the physical examination of the patient after successful repair of the achilles tendon.
In both types of surgery, the surgeon stitch the ruptured tendons together through the incision. Repair of Achilles tendon is done to stitch together the tendon that has been torn into two pieces.
More than 80% of the patients who went through Achilles tendon repair are able to return to their daily activities including sports.

An Achilles tendon rupture usually is treated with surgery so that the tendon can be stitched back to normal. Open surgery can also performed using several grafting techniques (using other tendons and materials to reinforce the Achilles tendon in the repair site). Depending upon speed, stride, terrain and additional weight being carried or pushed, each Achilles tendon may be subject to up to 3-12 times a person’s body weight during a sprint or push off. Achilles tendon ruptures can happen to anyone, but are most likely to occur to middle age athletes who have not been training or who have been doing relatively little training. Our specialist will advise you on the weight bearing exercises after monitoring your progress after the surgery. Each individuals are different in age, extent of the Achillies tendon damage, rehabilitation program. Conservative treatments like wearing a cast or splint that prevents your lower leg from moving is not as effective as a surgery.

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