Overview
An Achilles Tendon Rupture is a traumatic event that needs appropriate treatment by your physician. The rupture can either be partial or complete depending on the severity. A thorough evaluation needs to be made to differentiate a tendonitis from a rupture and to evaluate the extent of the rupture.
Causes
Your Achilles tendon helps you point your foot downward, rise on your toes and push off your foot as you walk. You rely on it virtually every time you move your foot. Rupture usually occurs in the section of the tendon located within 2 1/2 inches (about 6 centimeters) of the point where it attaches to the heel bone. This section may be predisposed to rupture because it gets less blood flow, which also may impair its ability to heal. Ruptures often are caused by a sudden increase in the amount of stress on your Achilles tendon. Common examples include increasing the intensity of sports participation, especially in sports that involve jumping, falling from a height, stepping into a hole.
Symptoms
An Achilles tendon rupture is when the tendon that connects the heel bone to the calf muscle tears and the fibers separate. This happens mostly between the ages of 30 and 50, and usually is caused by sports. Symptoms of Achilles tendon rupture include the following. A pop or snap when the tendon tears. Severe pain in back of the ankle, making it nearly impossible to walk. Swelling and discoloration. Tenderness. Inability to rise on toes. A gap in the back of the ankle where the tendons are separated.
Diagnosis
An Achilles' tendon injury can be diagnosed by applying the Thompson Test (or Calf Squeeze Test) this is where the person who has suffered the injury lies on their front with their legs bent. Whoever is performing the test, usually a doctor, will then squeeze the calf muscle. If the tendon has not ruptured then the foot should point briefly away from the leg.
Non Surgical Treatment
There are two treatment options available which are non-operative and operative. Non-operative treatment involves the use initially of a below-knee plaster with the foot held fully bent downwards. This usually stays in place for 2 weeks then is changed for a brace(this is a boot from the knee down to the toes with Velcro straps) which should be worn day and night. The brace will be regularly altered to allow the foot to come up to a more neutral position. The brace will be on for a further 6 weeks. After the 8 weeks you will be referred for physiotherapy to regain movement and calf strength but will probably need to wear the brace during the day for a further 4 weeks. Non-operative treatment avoids the risks of surgery but the risk of the tendon re-rupturing, which normally occurs within 3 months of discarding the brace, is 10%.
Surgical Treatment
Most published reports on surgical treatment fall into 3 different surgical approach categories that include the following: direct open, minimally invasive, and percutaneous. In multiple studies surgical treatment has demonstrated a lower rate of re-rupture compared to nonoperative treatment, but surgical treatment is associated with a higher rate of wound healing problems, infection, postoperative pain, adhesions, and nerve damage. Most commonly the direct open approach involves a 10- to 18-cm posteromedial incision. The minimally invasive approach has a 3- to 10-cm incision, and the percutaneous approach involves repairing the tendon through multiple small incisions. As with nonsurgical treatment there exists wide variation in the reported literature regarding postoperative treatment protocols. Multiple comparative studies have been published comparing different surgical approaches, repair methods, or postoperative treatment protocols.
Prevention
To help prevent an Achilles tendon injury, it is a good practice to perform stretching and warm-up exercises before any participating in any activities. Gradually increase the intensity and length of time of activity. Muscle conditioning may help to strengthen the muscles in the body.
An Achilles Tendon Rupture is a traumatic event that needs appropriate treatment by your physician. The rupture can either be partial or complete depending on the severity. A thorough evaluation needs to be made to differentiate a tendonitis from a rupture and to evaluate the extent of the rupture.
Causes
Your Achilles tendon helps you point your foot downward, rise on your toes and push off your foot as you walk. You rely on it virtually every time you move your foot. Rupture usually occurs in the section of the tendon located within 2 1/2 inches (about 6 centimeters) of the point where it attaches to the heel bone. This section may be predisposed to rupture because it gets less blood flow, which also may impair its ability to heal. Ruptures often are caused by a sudden increase in the amount of stress on your Achilles tendon. Common examples include increasing the intensity of sports participation, especially in sports that involve jumping, falling from a height, stepping into a hole.
Symptoms
An Achilles tendon rupture is when the tendon that connects the heel bone to the calf muscle tears and the fibers separate. This happens mostly between the ages of 30 and 50, and usually is caused by sports. Symptoms of Achilles tendon rupture include the following. A pop or snap when the tendon tears. Severe pain in back of the ankle, making it nearly impossible to walk. Swelling and discoloration. Tenderness. Inability to rise on toes. A gap in the back of the ankle where the tendons are separated.
Diagnosis
An Achilles' tendon injury can be diagnosed by applying the Thompson Test (or Calf Squeeze Test) this is where the person who has suffered the injury lies on their front with their legs bent. Whoever is performing the test, usually a doctor, will then squeeze the calf muscle. If the tendon has not ruptured then the foot should point briefly away from the leg.
Non Surgical Treatment
There are two treatment options available which are non-operative and operative. Non-operative treatment involves the use initially of a below-knee plaster with the foot held fully bent downwards. This usually stays in place for 2 weeks then is changed for a brace(this is a boot from the knee down to the toes with Velcro straps) which should be worn day and night. The brace will be regularly altered to allow the foot to come up to a more neutral position. The brace will be on for a further 6 weeks. After the 8 weeks you will be referred for physiotherapy to regain movement and calf strength but will probably need to wear the brace during the day for a further 4 weeks. Non-operative treatment avoids the risks of surgery but the risk of the tendon re-rupturing, which normally occurs within 3 months of discarding the brace, is 10%.
Surgical Treatment
Most published reports on surgical treatment fall into 3 different surgical approach categories that include the following: direct open, minimally invasive, and percutaneous. In multiple studies surgical treatment has demonstrated a lower rate of re-rupture compared to nonoperative treatment, but surgical treatment is associated with a higher rate of wound healing problems, infection, postoperative pain, adhesions, and nerve damage. Most commonly the direct open approach involves a 10- to 18-cm posteromedial incision. The minimally invasive approach has a 3- to 10-cm incision, and the percutaneous approach involves repairing the tendon through multiple small incisions. As with nonsurgical treatment there exists wide variation in the reported literature regarding postoperative treatment protocols. Multiple comparative studies have been published comparing different surgical approaches, repair methods, or postoperative treatment protocols.
Prevention
To help prevent an Achilles tendon injury, it is a good practice to perform stretching and warm-up exercises before any participating in any activities. Gradually increase the intensity and length of time of activity. Muscle conditioning may help to strengthen the muscles in the body.