Today on the Doc On The Run podcast, we’re talking about an easy at home test you can do if you think you have a complete rupture of the Achilles tendon.
If you’re a runner and you get a complete rupture of the Achilles tendon, this is probably one of the worst things could possibly happen to you. It’s way worse than a broken bone, but that’s what you got, that’s what you got. But the main thing is you do not want to ignore it. So I got a call from a guy that I’ve seen before, and he had this swelling in his Achilles, and he was worried about it. He was worried that it could be ruptured and I just said, “Okay, well, look, first of all, it’s going to take a day or two to get an MRI, but we need to check right now. You do not want to wait.”
If you rupture your Achilles tendon, if you completely tear it, and you wait, and you get what we call a neglected Achilles rupture, the reason that’s significant is the Achilles tendon starts to contract. So if you have a tear in the tendon and the tendon’s kind of like the ends are sitting next to each other and you don’t do anything about it’ll start to shrink up and contract, and then you can’t get it back together. Even if we take you to surgery, we have to put in some cadaver graft or some material that sort of bridges that gap and try to sew it together. And that’s never as good as your own tendon, so you don’t want to ignore it.
So how do you check for it? Well, this is really simple. There’s a thing called the Thompsons test. It’s a very simple test and the concept is very simple. And it’s something that you can do at home real easily to see if you have a complete rupture or not. There are basically three ways to do it, and I’m going to explain those.
Your Achilles tendon obviously starts in your big calf muscle on the back of your leg. And the tendon itself, the cord of collagen that comes down attaches to your heel bone, plantar flexes your foot. It pulls your foot down like you’re pushing the gas pedal when you squeeze and contract the calf muscle. So the way that Thompsons test works is that all we do is we actually take our hand, we put it on your calf muscle, the muscle belly itself, and we squeeze firmly. When we do that your foot plantar flexes or points your toes down slightly and then really, it’s just a comparison of the right versus left and there’s three ways to do it.
The first way is the way that most doctors will do it. If you go see your primary care doctor and you express this concern to her, she’s going to have you sit on the exam table with your feet, dangling down and then she’s going to reach up and grab your calf muscle and if she grabs your calf muscle on your healthy leg, the one that’s not injured, squeezes, your foot’s going to point down like that every time she squeezes it. Your feet are hanging at about the same level, presumably and then if she squeezes your other one, the one that is torn, nothing happens. It doesn’t move at all. But if it’s intact and your Achilles is intact, then it’ll point down each time that she squeezes it with her hand between her fingers and her thumb.
That’s the first way you can do it. Second way you can do it is sitting. Like if you lay on the bed and you scoot down to where your feet and your ankles are hanging off, so your feet are dangling down free, you do the same thing. Somebody, your wife, your girlfriend, your boyfriend, whoever’s there that can help you. They basically have you laying face down. Your feet are off the bed. So your feet are free and they squeeze the calf muscle and see does your foot move or not and if your foot moves, then you know the Achilles is intact and if your foot does not move compared to your other one, then you know that there’s a concern that you could have a full rupture of the Achilles tendon.
The third way, now, this is the way that I like to do it, is we have you lay face down on a bed or on an exam table. Then you bend your knees so that your legs are straight up, straight up off of the bed and your feet are kind of dangling there in the air just a little bit. Then we squeeze the calf muscle and we see if your foot moves down and plantar flexes moving down toward the bed or not. If it does, then the Achilles is intact and if it does not move, particularly compared to the other one, well then you know you might have a complete rupture.
Now, one word of warning with this. This is a great test and I think it’s very easy to do. It will show you if you have a complete rupture or not. But the problem is, is it does not rule out a partial tear. So if you had an injury and it really hurts. It’s really tender. It’s really swollen and you do the Thompsons test and it moves the pretty much the same as your other one, that will happen if it’s partially torn, because a lot of the collagen’s still intact. So it doesn’t rule that out.
Don’t go do anything dumb. You got to check with your doctor. You got to make sure you don’t have a partial tear. But if you have a full tear, this is one way to know for sure. Now if you have that, you have to get immediate treatment. You do not want to ignore it. So make sure you seek medical advice. You get help from a professional and get it taken care of right away. So you can get back to running as quickly as possible.
Now, if you haven’t checked it out yet, you might want to check out the Achilles tendon masterclass for runners. It’s a deep dive into all things about the Achilles tendon for runners. So go check it out. You can get it free at docontherun.com/Achillesmasterclass. I’ll see you in the training.
