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Achilles tendon rupture

Definition


Disease: Achilles tendon rupture Achilles tendon rupture
Category: Bones, joints, muscles diseases
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Disease Definition:

The typical sensations of an Achilles tendon rupture include a snap or pop, which is immediately followed by a sharp pain in the back of the ankle and lower leg that makes is impossible to walk properly, and feels almost like being kicked or shot.

The rupture of the Achilles tendon could be partial or complete. The Achilles tendon is a large, strong fibrous cord that connects the muscles in the back of the lower leg to the heel bone. The Achilles tendon may rupture or tear in case it is overstretched. The rupture can happen anywhere along the tendon, but it usually occurs just above the heel bone. Although an Achilles tendon rupture often requires surgical repair, however, other injuries that affect the Achilles tendon usually improve with home treatment.
 

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Some of the signs and symptoms of an Achilles tendon rupture may be:
 

  • Severe pain and swelling near the heel.
  • In case the rupture is complete, an inability to rise on the toes of the injured leg
  • An inability to walk normally or bend the foot downward
  • Hearing a popping or snapping sound when the injury occurs
  • In the case of a partial rupture, the person may still be able to move the affected foot and experience only minor pain and swelling

 

Other conditions that involve the Achilles tendon may cause the same symptoms, such as tendinitis or bursitis:

Tendinitis:
Tiny tears and inflammation in the tissue of the tendon itself results in pain. Achilles tendinitis is the inflammation of the Achilles tendon. It usually develops just above the attachment point of the tendon to the heel bone. Swelling and pain when pushing off during walking or after periods of rest are the signs and symptoms of Achilles tendinitis.

Bursitis:
These are the tiny sacs of fluid located throughout the body (Bursae) that facilitate movement by limiting friction and providing cushion movement between bones, and muscles and tendons attached to bones. Bursitis is the inflammation and irritation of the bursa, which can occur between the heel bone (calcaneus) and the Achilles tendon. retrocalcaneal bursitis is the name of this type of bursitis.

In case bursitis occurs in the area where the Achilles tendon is attached to the heel bone, it usually begins with pain and irritation at the back of the heel. There may be visible redness and swelling in the area, and further irritation can be caused due to fraction between the foot and the back of the shoe.
 

Causes:

The Achilles tendon, which is also called the heel cord, helps a person rise on their toes, point the foot downward and push off the foot when walking, meaning that a person relies on the Achilles tendon every time they move their feet. Injuries could result from repeated stress on the tendon, which may be caused by:
 

  • Flatfeet
  • Tight calf muscles
  • Weak calf muscles
  • Overuse
  • Running on hard surfaces and hills
  • Poor stretching habits
  • Worn-out or ill-fitting shoes


Taking part in an activity involving stop and start footwork, for which a person isn't conditioned or hasn't stretched properly, can result in the injury of the Achilles tendon. These activities may include playing basketball, tennis or racquetball for the first time after a long break.

Occasionally, even highly conditioned athletes may rupture an Achilles tendon. Other times, it can occur simply from putting too much stress on the Achilles tendon in the course of a simple activity like gardening.

The risk of Achilles tendon rupture may increase as a person gets older, because the Achilles tendon weakens and becomes thin and more susceptible to injury, in case a person doesn't exercise regularly.
 

Complications

Complications:

None

Treatments:

There are surgical as well as non-surgical treatments for Achilles tendon ruptures.

Surgical treatment:
In case of a complete rupture of the Achilles tendon, surgery is a common treatment. In this procedure, an incision will be made in the back of the lower leg and the torn tendon will be stitched together. The repair may also be reinforced with other tendons, depending on the condition of the torn tissue. After the surgery, the leg should stay in a cast, brace, splint or walking boot for about six to eight months. To avoid stretching the surgical repair and to promote healing, the affected foot may initially be pointed slightly downward in the boot or cast, and then gradually moved to a neutral position.

Non-surgical treatment:
To allow the ends of the torn tendon to reattach themselves on their own, the person should wear a cast or walking boot. This method can be quite effective, while avoiding the risk of infection associated with surgery. However, recovery may take longer and the probability of re-rupture is higher with this method. Additionally, surgical repair may be more difficult if re-rupture occurs.

Surgical repair is generally preferable if a person leads an active life and wants to resume strenuous sports or recreational activities. Usually, surgery is very effective and the risk of complications is quite low. However, if a person leads a sedentary lifestyle, or has a chronic illness, then non-surgical treatment may be best for them, precluding wound complications and exposure to anesthesia.

A person should go through a rehabilitation program after surgical or non-surgical treatment, involving physical therapy exercises to strengthen the muscles of the leg and the Achilles tendon. The extent of the recovery depends not only on the quality of the rehab program, but also on the person's commitment, and usually after four to six months people return to their former level of activity.
 

Prognosis:

Not available

Expert's opinion

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