#achilles #achillestendon #achillesrupture #achillesinjury

So.... this happened in the weekend - at my brother-in-law’s on a Sunday (physio never stops!) 🤣, but unfortunately it’s to diagnose an acute Achilles’ tendon rupture 😱

He was playing soccer yesterday and turned, felt (and heard) a pop in his left Achilles. It was “kind” of painful and he knew he had done something and he couldn’t walk properly on it.

ASSESSMENT

1️⃣ Visual loss of plantar flexion

Firstly to help with an initial provisional diagnosis without imaging you look for a loss of plantar flexion in prone. As you can see on his left his foot is resting in neutral, NOT plantar flexion meaning the calf tension on the heel is not there (the town of the calf doesn’t pull on the heel as the tendon is disconnected), compared to his right which is in plantar flexion.

2️⃣ Palpable thickening, swelling, bruising band tenderness

The Achilles is significantly thicker and grossly swollen compared to the other side. There is also a thicker section which is tender and sometimes you can get a feeling of a “gap” (the rupture site).

3️⃣ Calf Squeeze Test

To see the active connection integrity of the tendon, in prone slowly squeeze the upper calf and see if the foot naturally plantar flexes. As you can see on the left it doesn’t move at all, indicative of a complete rupture.

So, it’s rest, compression and ice if needed for pain - but he doesn’t have any of that really which is mostly due to the tendon fibres not being connected. So no pain it’s not really a good sign!

He is booked in for an Ultrasound tomorrow, and then into the foot and ankle surgeon for an assessment and a MRI after. To help him through that waiting period a long walker boot is perfect to stabilise him so he can get around.

I will follow his recovery and keep you updated on his outcome (Sugery Vs non-surgery)

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