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ACHILLES TENDON RUPTURE

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ACHILLES TENDON RUPTURE

Achilles tendon rupture is a condition marked by a complete or partial tear of the Achilles tendon at the back of the ankle.

  • The Achilles tendon is the largest, strongest and thickest tendon in the body stretching from the bones of the heel to the calf muscle.
  • The Achilles tendon is about 5.9 inches longs and begins near the middle portion of the calf.
  • This tendon enables activities such as jumping, running, walking, and standing on the balls of the feet. It can withstand great stresses from these activities.
  • A tear usually occurs in the section of the tendon located within 2.5 inches of the point where it attaches to the heel bone. This is due to the poor blood flow to this section, which can also impair its ability to heal.
  • Although the condition mainly occurs in people playing recreational sports, it can as well happen to anyone.
  • Males are commonly affected than females.
  • The rupture is commonly observed in individuals in their 30s to 50s.

CAUSES

Rupture usually occurs as a result of sudden or forced flexion of the ankle outside its range of motion. This may be from:

  • Sudden or direct trauma to the tendon such as falling from a height, or stepping into a hole
  • Increased intensity or overuse while participating in sports, especially in sports that involve jumping
  • Twisting or jerking motion

Factors that might increase your chance of getting the condition are:

  • Age
  • Recreational sports such as running, jumping, soccer, basketball, tennis
  • Obesity
  • Previous history of the condition
  • Participating in new activities
  • Direct steroid injection into the tendon
  • Certain antibiotics such as fluoroquinolone antibiotics
  • Being older than 60 and taking corticosteroids, or have kidney disease
  • Frequent use of high heels

SYMPTOMS

  • A sudden pain and swelling at the heels
  • A snapping sound or sensation
  • Difficulty walking especially upstairs or uphill
  • Difficulty standing on the toes on the injured leg

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will perform a physical examination. During the physical examination. The doctor will check the lower leg for swelling and tenderness. The doctor will examine the feet and ankle, feeling for a gap in the tendon to check for rupture. The doctor might do a calf squeeze test where you kneel on a chair or bench or you lay on your stomach on the exam table and your calf muscle is squeezed to see if your foot will automatically flex.  If your Achilles tendon is torn, your foot won’t move because the calf muscle won’t be connected to your foot.

An MRI scan or an ultrasound may help to see the extent of the injury – whether it is partially or completely ruptured.

TREATMENT

Treatment option may be surgical, non-surgical, or physical therapy.

Non-surgical treatment includes:

  • Resting the tendon by using crutches
  • Applying ice to the ruptured area
  • Keeping the legs elevated to reduce swelling
  • Compressing the leg with an elastic bandage to reduce swelling
  • Using a cast, walking boot or brace to restrict motion and allow healing

Surgical treatment involves making an incision in the back of the lower leg and stitching the torn tendon together.s

Physical therapy will help to strengthen leg muscles and the Achilles tendon

While non-surgical treatments are recommended for older patients, people who are less active, and have a higher risk for surgery, surgical treatment is recommended for the young, healthy and active individuals.

With surgery, there is a decreased risk of re-rupture and a great risk of complications including infection and nerve damage