Episode Summary
Discover how Achilles tendon ruptures are best diagnosed, treated, and rehabilitated using the latest evidence and real-world physiotherapy guidance. Learn when clinical tests are enough, why conservative care is often preferred, and how recovery should progress from early loading to return to sport.
Achilles tendon rupture management is covered from diagnosis to treatment and rehabilitation, with recommendations largely based on the 2023 Dutch multidisciplinary guideline. Key background points include who is most affected: mainly men around age 45, often active in sport, with incidence rising over time, especially in older age groups.
Diagnosis focuses on clinical assessment. Learners are taught to look for an acute injury, a snapping or “kicked from behind” sensation, and sudden loss of calf function. The main recommendation is to combine the Thompson test with palpation of a tendon gap, ideally within three days. Ultrasound is reserved for unclear cases or possible false-negative findings.
Treatment compares surgery with conservative care. Functional outcomes and patient satisfaction are similar in both approaches, while surgery has slightly lower rerupture rates but higher complication risks such as infection and sural nerve injury. Conservative treatment is therefore generally preferred first, with surgery considered for highly active athletes at greater rerupture risk.
Rehabilitation principles include early but guided loading, bracing for 6–8 weeks, progressive calf strengthening, gait retraining, balance work, and later sport-specific progression. Return to daily activity usually occurs within 3–6 months, while return to sport often takes around 6–12 months.
