Achilles tendonitis and rupture

Question 1

What is achilles tendonitis?

Answer 1

Inflammation of the Achilles (calcaneal) tendon

Question 2

What can achilles tendonitis lead to?

Answer 2

Achilles tendon rupture

Question 3

What are risk factors for achilles tendonitis or rupture?

Answer 3

High intensity activities such as running and jumping
(particularly if there is a sudden increase in exercise frequency)
Poor footwear
Obesity
Male

Question 4

How does achilles tendonitis present?

Answer 4

Gradual onset of pain and stiffness - posterior ankle
Worse with movement
Tenderness over the tendon

Question 5

How does an achilles rupture present?

Answer 5

Sudden onset severe pain in posterior calf
Audible popping sound
Loss of plantarflexion

Question 6

What test can be done to assess for Achilles tendon rupture?

Answer 6

Simmonds Test

Question 7

What does Simmonds test for achilles tendon rupture involve?

Answer 7

Get patient to kneel on a chair with the affected ankle hanging over the edge.

Squeeze the calf. This should normally cause plantar flexion of the foot.

In a rupture this movement is not present

Question 8

How is acute achilles tendonitis managed?

Answer 8

Rest
Ice
Anti-inflammtory meds
Analgesia
May require physio to improve strength over time

Question 9

How is an achilles tendon rupture managed?

Answer 9

Analgesia
Immobilisation - splinted in plaster - with ankle and toes pointed

Surgical fixation may be required with an end to end tendon repair