Tags

Overview
Achilles Tendon
Achilles tendon rupture are common. Most athletes describe a sudden acute event with an associated popping sensation and pain in the Achilles tendon. They often think that they have been kicked or struck in the calf. It is important to get prompt treatment and to be placed in an equinous cast (a cast with the foot in a pointed position). More definitive treatment options can be discussed after this has occurred.

Causes
Often an Achilles rupture can occur spontaneously without any prodromal symptoms. Unfortunately the first “pop” or “snap” that you experience is your Achilles tendon rupture. Achilles tendon rupture most commonly occurs in the middle-aged male athlete (the weekend warrior who is engaging in a pickup game of basketball, for example). Injury often occurs during recreational sports that require bursts of jumping, pivoting, and running. Most often these are tennis, racquetball, squash, basketball, soccer, softball and badminton. Achilles rupture can happen in the following situations. You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping. You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully over stretching the tendon. You fall from a significant height. It does appear that previous history of Achilles tendonitis results in a degenerative tendon, which can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Certain illnesses (such as arthritis and diabetes) and medications (such as corticosteroids and some antibiotics) can also increase the risk of rupture.

Symptoms
Often the person feels a whip-like blow that is followed by weakness in the affected leg – usually he or she is not able to walk afterwards. At place where the tendon ruptured, a significant dent is palpable. Often the experienced physician can diagnose a ruptured Achilles tendon by way of clinical examination and special function tests. Imaging techniques, such as ultrasound and magnetic resonance imaging (MRI) allow for a more precise diagnosis.

Diagnosis
A staggering 20%-30% of Achilles tendon ruptures are missed. Thompson (calf squeeze) test is 96% sensitive and 93% sensitive. Unfortunately, some health practitioners fail to perform this simple clinical test. Ultrasound examination or an MRI can confirm an Achilles tendon rupture.

Non Surgical Treatment
Non-surgical treatment of Achilles tendon rupture is usually reserved for patients who are relatively sedentary or may be at higher risk for complications with surgical intervention (due to other associated medical problems). This involves a period of immobilization, followed by range of motion and strengthening exercises; unfortunately, it is associated with a higher risk of re-rupture of the tendon, and possibly a less optimal functional outcome.
Achilles Tendon

Surgical Treatment
Surgery may be indicated directly following injury rather than conservative care. Repair of an achilles tendon rupture is greatly varied for each clinical situation. There may be a direct repair of the ends of the tendon with suture, or possibly a tendon graft used to augment the tendon. Post-operatively, the period of immobilization will depend on the size of the defect that was repaired and how it was completed. Usually the immobilization is between 6-10 weeks. This repair may allow for a complete return to normal function, but in many instances the healing is complicated with adhesions and a partial loss of range of motion. There may be a continued soft tissue defect noted and a permanent or prolonged swelling.

Prevention
There are things you can do to help prevent an Achilles tendon injury. You should try the following. Cut down on uphill running. Wear shoes with good support that fit well. Always increase the intensity of your physical activity slowly. Stop exercising if you feel pain or tightness in the back of your calf or heel.

Advertisements