You step down or jump down and feel a sudden snap in the calf muscle. You've just ruptured your Achilles tendon. What do you do now? Doctors don't agree on the best treatment early after Achilles tendon rupture. Treatment for Achilles tendon rupture is divided into two basic groups: with or without surgery.

This study reports on 140 patients treated without surgery. Casting is the most common nonoperative treatment. At the Musgrave Park Hospital in Belfast, Northern Ireland, doctors used a cast right away. The patients didn't put any weight on the foot.

Four weeks later, patients were switched to a removable brace called an orthosis. The orthosis was worn for four weeks. Patients were given training in walking during this time. Physiotherapy continued until the patient could perform normal activities.

After eight weeks, pain levels, range of motion, and strength were measured on both legs. This way the injured leg could be compared to the normal leg. The results of orthotic treatment were better than results reported in other studies using surgery. The patients in this study were very happy with their final outcome.

As the number of cases of ruptured Achilles tendon rises, so has the use of surgery to treat it. The results of surgical treatment are usually good, but problems are common. That's why this group of researchers is studying ways to recover without an operation. The orthotic treatment in this study worked well in place of surgery. The authors suggest nonoperative treatment as the number one choice when experienced staff can follow the patients.