2015-05-01 05:34:02Josephine Hores
Achilles Tendon Rupture How Do I Know I Suffered One?
Overview
The Achilles tendon is the tough sinew that attaches the calf muscle to the back of the calcaneus, or heel bone. It is also known as the tendo calcaneus or the tendo Achilles and happens to be one of the longest tendons in the body. An Achilles tendon rupture occurs when the Achilles tendon is partially or completely broken or torn. The average age of patients who suffer Achilles tendon ruptures is 30 to 40 years. The male-to-female ratio is nearly 20 to 1.
Causes
The most common cause of a ruptured Achilles' tendon is when too much stress is placed through the tendon, particularly when pushing off with the foot. This may happen when playing sports such as football, basketball or tennis where the foot is dorsiflexed or pushed into an upward position during a fall. If the Achilles' tendon is weak, it is prone to rupture. Various factors can cause weakness, including corticosteroid medication and injections, certain diseases caused by hormone imbalance and tendonitis. Old age can also increase the risk of Achilles' tendon rupture.
Symptoms
It is important to know that pain at the back of the heel is not always due to Achilles tendon rupture. It may be due to bursitis (fluid accumulation in the heel due to repeated irritation) and tendonitis (pain along the Achilles tendon due to constant friction and irritation). The above disorders tend to improve with use of pain medications and rest, whereas Achilles tendon rupture requires surgery and/or a cast.
Diagnosis
Other less serious causes of pain in the back of the lower leg include Achilles tendonitis or bursitis. To distinguish between these possibilities, your physician will take a thorough history and examine your lower leg to look for signs of a rupture. The presence of a defect in the tendon that can be felt, evidence of weakness with plantarflexion, and a history consistent with Achilles tendon rupture are usually sufficient for diagnosis. Your physician may also perform a ?Thompson test,? which consists of squeezing the calf muscles of the affected leg. With an intact Achilles tendon, the foot will bend downward; however, with a complete rupture of the tendon, the foot will not move. In cases where the diagnosis is equivocal, your physician may order an MRI of the leg to diagnose a rupture of the Achilles tendon.
Non Surgical Treatment
Treatment of the initial injury is with use of ice, elevation, and immobilization. If suspected you should contact your podiatrist or physician. Further treatment with continued immobilization, pain medication, or anti-inflammatory medications may be advised. If casted the foot is usually placed in a plantarflexed position to decrease the stretch on the tendon. As healing progresses the cast is changed to a more dorsiflexed position at the ankle. The casting processes can be up to 8 weeks or more.
Surgical Treatment
Surgery to repair an Achilles tendon rupture is performed under a spinal or general anaesthetic. During surgery the surgeon makes an incision in the skin over the ruptured portion of the tendon. The tendon ends are located and joined together with strong sutures (stitches), allowing the tendon to closely approximate its previous length. The skin is then closed with sutures and the foot is immobilised in a cast or splint, again in the toes-pointed position. Seven to ten days after surgery the cast or splint is removed in order for the sutures in the skin to be removed. Another cast or splint will be applied and will stay in place a further 5 - 7 weeks.
The Achilles tendon is the tough sinew that attaches the calf muscle to the back of the calcaneus, or heel bone. It is also known as the tendo calcaneus or the tendo Achilles and happens to be one of the longest tendons in the body. An Achilles tendon rupture occurs when the Achilles tendon is partially or completely broken or torn. The average age of patients who suffer Achilles tendon ruptures is 30 to 40 years. The male-to-female ratio is nearly 20 to 1.
Causes
The most common cause of a ruptured Achilles' tendon is when too much stress is placed through the tendon, particularly when pushing off with the foot. This may happen when playing sports such as football, basketball or tennis where the foot is dorsiflexed or pushed into an upward position during a fall. If the Achilles' tendon is weak, it is prone to rupture. Various factors can cause weakness, including corticosteroid medication and injections, certain diseases caused by hormone imbalance and tendonitis. Old age can also increase the risk of Achilles' tendon rupture.
Symptoms
It is important to know that pain at the back of the heel is not always due to Achilles tendon rupture. It may be due to bursitis (fluid accumulation in the heel due to repeated irritation) and tendonitis (pain along the Achilles tendon due to constant friction and irritation). The above disorders tend to improve with use of pain medications and rest, whereas Achilles tendon rupture requires surgery and/or a cast.
Diagnosis
Other less serious causes of pain in the back of the lower leg include Achilles tendonitis or bursitis. To distinguish between these possibilities, your physician will take a thorough history and examine your lower leg to look for signs of a rupture. The presence of a defect in the tendon that can be felt, evidence of weakness with plantarflexion, and a history consistent with Achilles tendon rupture are usually sufficient for diagnosis. Your physician may also perform a ?Thompson test,? which consists of squeezing the calf muscles of the affected leg. With an intact Achilles tendon, the foot will bend downward; however, with a complete rupture of the tendon, the foot will not move. In cases where the diagnosis is equivocal, your physician may order an MRI of the leg to diagnose a rupture of the Achilles tendon.
Non Surgical Treatment
Treatment of the initial injury is with use of ice, elevation, and immobilization. If suspected you should contact your podiatrist or physician. Further treatment with continued immobilization, pain medication, or anti-inflammatory medications may be advised. If casted the foot is usually placed in a plantarflexed position to decrease the stretch on the tendon. As healing progresses the cast is changed to a more dorsiflexed position at the ankle. The casting processes can be up to 8 weeks or more.
Surgical Treatment
Surgery to repair an Achilles tendon rupture is performed under a spinal or general anaesthetic. During surgery the surgeon makes an incision in the skin over the ruptured portion of the tendon. The tendon ends are located and joined together with strong sutures (stitches), allowing the tendon to closely approximate its previous length. The skin is then closed with sutures and the foot is immobilised in a cast or splint, again in the toes-pointed position. Seven to ten days after surgery the cast or splint is removed in order for the sutures in the skin to be removed. Another cast or splint will be applied and will stay in place a further 5 - 7 weeks.