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A tear of the Achilles tendon is not an uncommon problem in sport and could be very dramatic if it happens, since the calf muscles and the attached Achilles tendon play such an necessary function. It is more likely to occur in explosive activities such as tennis. The real issue is that the achilles tendon and the two muscles connected to it cross two joints (the knee and the ankle) and when both joints are moving in opposite directions simultaneously, particularly if instantly (as might happen in tennis), then the likelihood of something going wrong is pretty high. The management of an achilles tendon rupture is a little controversial as there are two options that most of the research shows have got virtually identical outcomes. One option is conservative and the other is surgical. The conservative option is typically placing the lower limb in cast which holds the foot pointing downwards slightly. It will take approximately six weeks to heel up and after the cast is taken away, there needs to be a slow and gentle return to physical activity. Physical therapy is normally used to help with that. The operative choice is to surgically stitch the two ends of the tendon together again, this is followed by a period in a cast which is shorter than the conservative option, and is followed by a similar steady and slow resumption of sport. When longer term outcomes are compared the final result is generally about the same, but the operative technique has the additional risk of surgical or anaesthetic complications which the conservative strategy doesn’t have. The choice as to which method is better will have to be one based on the experiences of the doctor and the preferences of the individual with  the rupture. There is a trend for competitive athletes to go down the operative pathway as it is believed that this will give a better short term outcome and get them back to the sports field faster.

 

What happens when the achilles tendon ruptures?
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