A tear of the Achilles tendon is actually quite common. It occurs as the muscle tendon complex passes across two joints and the muscle connected to the Achilles tendon is quite powerful. If the two joints that the muscle/tendon crosses move in opposite directions simultaneously that the muscle contracts powerfully, then it is not difficult to appreciate the loads which are going through the tendon predisposing it to a tear. The risk for an Achilles tendon rupture raises considerably over the age of 40. It is likely to happens in sporting activities, such a tennis, when the player strides out when attempting to get at the ball. Surprisingly the snap that occurs as the rupture develops isn't that painful. It definitely leads to a limp as you lose function of the muscle. There is commonly some bruising after a few hours.
There is a lot of controversy over the management of an Achilles tendon rupture . The two techniques are surgical and conservative. The non-surgical solution is to put the foot and leg into a cast and allow the tendon to heel by natural means. The surgical technique is to tie a surgical knot to the separated parts of the tendon to reattach them back together. Generally, the outcomes between the two methods are similar, therefore, the controversy on which one is best. Some consider that the recurrence is greater with the non-surgical approach. Others believe that there is always a risk of anaesthetic issues and infection risk in the operatively treated cases. No matter what solution is used, then the treatment following the initial management is to use physiotherapy to slowly and gradually strengthen the tendon and muscle and guide a slow and progressive return to higher levels of sport. If that process is performed too quickly the prospect of it occurring again or other long-term problems are high and really need to be prevented. The choice of treatment depends on the understanding and experience of the clinician.