A rupture of the Achilles tendon is not an uncommon trauma in sports activity and is very dramatic if it occurs, as the calf muscles and the connected Achilles tendon play such an necessary function. It is more likely to happen in explosive activities like tennis. The real problem is that the achilles tendon and the two muscles connected to it cross two joints (the knee and the ankle) and if the two joints are moving in opposite directions at the same time, especially if abruptly (as might happen in tennis), then the probability of something failing is fairly high.
The management of an achilles tendon rupture is a little controversial as there are two alternatives that almost all the research shows have got quite similar outcomes. One option is conservative and the other is operative. The conservative choice is commonly putting the leg in cast that supports the foot pointing downwards a little. It can take approximately six weeks to get better and after the cast is removed, there should be a slow and gentle come back to physical activity. Physical rehabilitation is normally used to assist with this. The operative option is to surgically sew the two ends of the tendon back together again, this is followed by a period of time in a cast which is shorter compared to the conservative option, and will be followed by a similar slow and steady return to sport. When longer term outcomes are compared the final outcome is generally about the same, but the operative approach has the additional potential for surgical or anaesthetic complications that the conservative strategy does not have. The decision as to which approach is best will have to be one dependent on the experiences of the doctor and the preferences of the person with the achilles tendon rupture. There is a trend for competitive athletes to go down the surgical option because it is considered that this does give a improved short term outcome and get the athlete back to the sports field faster.
