A tear of the Achilles tendon is not an uncommon problem in sports activity and is very dramatic when it happens, as the calf muscles and the connected Achilles tendon play such an significant function. It is more likely to occur in explosive activities like tennis. The real problem is that the achilles tendon and the two muscles attached to it cross two joints (the knee as well as the ankle) and if the two joints are moving in opposite directions simultaneously, especially if abruptly (as might happen in tennis), then the risk of something going wrong is pretty high.
The management of an achilles tendon rupture is a little debatable as there are two alternatives that most of the published research shows have got quite similar outcomes. One option is conservative and the other is surgical. The conservative option is typically placing the lower limb in cast which supports the foot pointing downwards a little. Normally it takes approximately six weeks to get better and after the cast is taken away, there ought to be a slow and gentle return to physical activity. Physical rehabilitation is usually used to help with this. The operative choice is to surgically stitch the two ends of the tendon back together again, this is followed by a period in a cast which is shorter than the conservative choice, and will be followed by a similar steady and slow return to activity. If longer term results are compared the final result is typically about the same, but the surgical method has the added potential for surgical or anaesthetic complications which the conservative strategy doesn't have. The decision as to which approach is best will have to be one based on the experiences of the surgeon and the choices of the individual with the rupture. There is a trend for competitive athletes to go on the operative pathway because it is believed that this may give a improved short term outcome and get them back to the sports field faster.
