A total rupture of the achilles tendon is a complete tear of the tendon and typically affects men over the age of 40 involved in recreational sport. A complete rupture of the achilles tendon is not always recognized at the time of injury, however it is very important it is treated properly as soon as possible to increase the chances of a good recovery.
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.
Patients present with acute posterior ankle/heel pain and may give a history of ?felt like someone kicked me from behind?. Patients may report a direct injury, or report the pain started with jumping or landing on a dorsiflexed foot. It is important to elicit in the history any recent steroid or flouroqunolone usage including local steroid injections, and also any history of endocrine disorders or systemic inflammatory conditions.
To diagnose an Achilles tendon injury, your health care provider will give you a thorough physical exam. He or she may want to see you walk or run to look for problems that might have contributed to your Achilles tendon injury.
Non Surgical Treatment
Medical therapy for a patient with an Achilles tendon rupture consists of rest, pain control, serial casting, and rehabilitation to maximize function. Ongoing debate surrounds the issue of whether medical or surgical therapy is more appropriate for this injury. Conservative management of Achilles tendinosis and paratenonitis includes the following. Physical therapy. Eccentric exercises are the cornerstone of strengthening treatment, with most patients achieving 60-90% pain relief. Orthotic therapy in Achilles tendinosis consists of the use of heel lifts. Nonsteroidal anti-inflammatory drugs (NSAIDs). Tendinosis tends to be less responsive than paratenonitis to NSAIDs. Steroid injections. Although these provide short-term relief of painful symptoms, there is concern that they can weaken the tendon, leading to rupture. Vessel sclerosis. Platelet-rich plasma injections. Nitric oxide. Shock-wave therapy.
Unlike other diseases of the Achilles tendon such as tendonitis or bursitis, Achilles tendon rupture is usually treated with surgical repair. The surgery consists of making a small incision in the back part of the leg, and using sutures to re-attach the two ends of the ruptured tendon. Depending on the condition of the ends of the ruptured tendon and the amount of separation, the surgeon may use other tendons to reinforce the repair. After the surgery, the leg will be immobilized for 6-8 weeks in a walking boot, cast, brace, or splint. Following this time period, patients work with a physical therapist to gradually regain their range of motion and strength. Return to full activity can take quite a long time, usually between 6 months and 1 year.
To reduce your chance of developing Achilles tendon problems, follow the following tips. Stretch and strengthen calf muscles. Stretch your calf to the point at which you feel a noticeable pull but not pain. Don't bounce during a stretch. Calf-strengthening exercises can also help the muscle and tendon absorb more force and prevent injury. Vary your exercises. Alternate high-impact sports, such as running, with low-impact sports, such as walking, biking or swimming. Avoid activities that place excessive stress on your Achilles tendons, such as hill running and jumping activities. Choose running surfaces carefully. Avoid or limit running on hard or slippery surfaces. Dress properly for cold-weather training and wear well-fitting athletic shoes with proper cushioning in the heels. Increase training intensity slowly. Achilles tendon injuries commonly occur after abruptly increasing training intensity. Increase the distance, duration and frequency of your training by no more than 10 percent each week.