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Achilles Tendon Rupture

Achilles Tendon Rupture

What is Achilles Tendon Rupture?

Just as the hero Achilles was vulnerable to attack at his heel, so are you. Medicine recognizes tendon tear, also known as Achilles Tendon Rupture (ATR), as a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.

What Causes Achilles Tendon Rupture?

The Achilles tendon can rupture suddenly, usually due to strenuous athletic activity but sometimes as a result of gradual wear. Such a rupture should be treated immediately to prevent loss of strength and weakening. There are a variety of treatment options for an achilles tendon rupture, and the decision on how to best regain strength and mobility is an individual one. Patients who aren’t active in sports likely won’t need surgery on an Achilles rupture if they aren’t experiencing pain or have decided to take it easy. Generally, the patients who are most likely to benefit from surgical intervention are those who engage in sports or lead a more active lifestyle.

Signs and Symptoms of Achilles Tendon Rupture

If you’re experiencing one or more of the following symptoms, you may have a ruptured Achilles tendon.

  • Sudden pain in the back of your ankle or calf. This often feels like a kick or sharp stabbing pain, which subsides into a dull ache.
  • A popping or snapping sensation at the back of your ankle.
  • Swelling on the back of the leg between your heel and calf
  • Difficulty walking and/or rising up on the toes, especially while walking upstairs or uphill

Whether the source of the issue is Achilles Tendon Rupture or another cause, these symptoms are serious ones that require prompt medical attention to prevent further damage. Until you are able to see a doctor to diagnose the source of your pain, the RICE method (Rest, Ice, Compression, Elevation) should be used.

Contact us immediately if you hear a pop in your heel, especially if you can't walk properly afterward.

How Is Achilles Tendon Rupture Diagnosed?

The good news is that diagnosing an Achilles tendon rupture is typically a straightforward process. In some cases, however, the surgeon may order an MRI or other advanced imaging tests to rule out possible fracture.

To diagnose an Achilles tendon rupture, the foot and ankle surgeon will start by asking questions about how and when the injury occurred and whether the patient has previously injured this particular ligament or experienced similar symptoms. Next, the surgeon will examine the foot and ankle, feeling for any defect in the tendon that may indicate a tear. Your surgeon will evaluate your range of motion and muscle strength in comparison to the uninjured foot and ankle. One clear indication that a patient has sustained an Achilles tendon rupture is that he or she will have less strength in pushing down (as on a gas pedal) and will have difficulty rising up onto their toes.

Treatment for Achilles Tendon Rupture

The Achilles tendon is vulnerable to tearing and slow healing. If a completely torn Achilles tendon is not treated properly, it may heal with scar tissue resulting in stiffness or weakness that hampers daily activities such as walking, let alone running or other athletic activities. The two main treatment options are surgery or casting. The decision of whether to proceed with surgery or nonsurgical treatment is an individual one. Some of the factors to consider are the severity of the rupture, as well as the patient’s health status, activity level, and mobility goals.

Casting

The goal of casting is to keep the foot and ankle in proper alignment and to bring the torn ends of the tendon in proximity. Slowly, casting will allow the tendon to heal without using invasive surgical techniques. On average, it is necessary to wear a cast or brace for up to 12 weeks or more. One of the biggest benefits of casting is that by avoiding surgery, you can reduce the risks of skin breakdown or infection. The drawback is that the tendon rarely regains full strength or endurance without surgery, and there is a higher risk of re-rupture in the future.

Surgery

The surgical treatment of Achilles tendon ruptures is associated with quicker healing and increased strength of the repaired tendon when compared to traditional casting techniques. Unfortunately, surgery remains relatively more risky due to the potential for painful skin breakdowns and infections which tend to be more likely during surgeries than with other treatments. Such complications can occur due to swelling around the injury and the relatively poor blood supply in the area of the surgery.

How do I prevent Achilles Tendon Rupture?

If you feel you might be at risk for Achilles tendon problems, we recommend follow the tips below to help prevent injury:

  • Stretch and strengthen calf muscles. It’s important to listen to your body during stretches. When you stretch your calf, you should feel a noticeable pull — but not pain. Remember not to bounce during a stretch. You can also try calf-strengthening exercises to help the muscle and tendon absorb more force, thus preventing injury.
  • Vary your exercises. If you’re a fan of high-impact sports (like running), it’s important to alternate these intense activities with low-impact sports, such as walking, biking or swimming.
  • Limit running on hard or slippery surfaces or avoid it altogether. Wear comfortable, supportive athletic shoes with proper cushioning in the heels.
  • Increase intensity slowly. Achilles tendon injuries happen most often as a result of an abrupt increase in activity or intensity. Remember the 10% rule — increase the distance, duration and frequency of your training by no more than 10 percent every week.

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