Ask the Expert: Dr. Andrew Elliott, Orthopedic Surgeon, Answers Your Questions About Achilles Tendon Ruptures
Q1. I’m a runner and have heel pain that won’t go away. How does a doctor determine if it’s my Achilles?
An examination can usually determine if it is your Achilles or different problem that is the cause of your pain. Sometimes an MRI might be necessary if the exam is inconclusive.
Q2. I have Achilles tendonitis, but I’m concerned that it could become more serious. Am I at a higher risk for an Achilles rupture?
Tendonitis is a normal tendon that is inflamed and should not put you at a higher risk for an Achilles rupture. However, tendonosis involves some degeneration of the tendon that can be painful. Tendonosis may put you at a higher risk for rupture.
Q3. I’ve heard about paratenonitis and insertional tendonitis of the Achilles, can you explain the difference?
Paratenonitis is inflammation of the paratenon, the surrounding “tube” that the tendon glides in. Insertional tendonitis is where there is some degeneration of the fibers of the tendon where they attach to the heel. It can be painful and you may form some thickness in the tissues there. An X-ray may show some calcification or a bone spur.
Q4. I’m an active runner. Are there ways to prevent myself from rupturing my Achilles tendon?
Stretching before and after activity may help prevent an Achilles rupture. Also, many of the running shoes these days have a slightly more elevated heel, which can take strain off the tendon. Varying your workout and cross training may help avoid overuse syndromes that can lead to tendon problems. In some patients, fluoroquinolone antibiotic medications may be associated with raising the risk of tendonosis and ruptures, so if you can avoid taking these drugs that may also help.
Q5. What are my treatment options for a ruptured Achilles tendon?
Repairing the Achilles with open surgery (3-4 inch long incision) or minimally invasive (1 inch incision) are two ways that may fix the tendon. Depending on the type of rupture, and the time from rupture to treatment, using a specially designed boot may also allow the tendon to repair by itself.