A rupture of the Achilles tendon is not uncommon in a soccer injury, but it is frequently missed. Often times, a soccer player with an Achilles tendon rupture may not even realize it, thinking its nothing more than a bad sprain, when in fact the tendon has torn completely.
Part of the reason why it is often missed is due to the innocuous nature of the injury. There is often no tackle or fall. The classic description by the injured person is “I felt someone kick me from behind and I fell down. But when I looked back there was nobody who tackled me”. Some players can feel or hear a loud “Pop”. Many injured players think they have only sprained their ankle, but in actual fact their Achilles tendon has ruptured.
The Achilles tendon is one of the strongest tendons in the body. It is vital for plantar-flexion of the foot and ankle. A complete tear of the Achilles tendon is best treated with surgery. The tear can be confirmed with an MRI scan.
Surgery needs to be performed as soon as possible after the injury as the longer the interval between injury and surgery, the further away the tendon ends retract away from each other and makes it harder to repair. Old chronic tears cannot be repaired and can only be treated with tendon transfers or tendon grafts, which are more complicated.
Surgery involves a direct repair of the tendon using special strong sutures. The surgery takes about 1 hour and patients will need to be on crutches for 6 weeks. The ankle is fixed in a flexed position to protect the tendon repair, and rehabilitation is started after 4 to 6 weeks to gradually regain the mobility and strength of the tendon. The use of a special boot for walking can allow the patient to start weight bearing early.