Overview
A torn or ruptured Achilles tendon is simply no fun at all. This essential cord of strong, fibrous material attaches the heel bone to the calf muscles and is used in just about every movement, from walking and running to jumping and standing on your tip-toes. It also helps bend the foot downwards at the ankle. As the strongest tendon in the body, the Achilles can withstand a force of about 1,000 pounds. About 7 out of every 100,000 people will suffer from a ruptured Achilles at some point in time, with over 80% of these injuries occurring during a recreational sports activity. Athletes have a 24% chance of tearing their Achilles, but competitive runners have a 40 to 50% chance of Achilles tendon rupture during their lifetime.
Causes
The cause of Achilles tendon ruptures besides obviously direct trauma, is multifactorial. In many instances the rupture occurs about 2-6 cm before its attachment to the calcaneous (heel bone). In this area there is a weaker blood supply making it more susceptible to injury and rupture. Rigid soled shoes can also be the causative factor in combination with the structure of your foot being susceptible to injury.
Symptoms
If the Achilles tendon is ruptured you may experience a sudden pain in the back of your leg, as if someone had kicked you, followed by, swelling, stiffness, and difficulty to stand on tiptoe and push the leg when walking. A popping or snapping sound may be heard when the injury occurs. You may also feel a gap or depression in the tendon, just above heel bone. Ruptures usually occurs in those aged 30 - 70 years, during a sudden forceful push off from the foot. Without proper healing of the tendon, you will have a permanent limp and weakness when using the leg.
Diagnosis
During the physical exam, your doctor will inspect your lower leg for tenderness and swelling. In many cases, doctors can feel a gap in your tendon if a complete rupture has occurred. Achilles tendon rupture can be diagnosed reliably with clinical examination, but if there?s a question about the extent of your Achilles tendon injury then your doctor may order a magnetic resonance imaging (MRI) scan.
Non Surgical Treatment
As debilitating as they can be, the good news is that minor to moderate Achilles tendon injuries should heal on their own. You just need to give them time. To speed the healing, you can try the following. Rest your leg. Avoid putting weight on your leg as best you can. You may need crutches. Ice your leg. To reduce pain and swelling, ice your injury for 20 to 30 minutes, every three to four hours for two to three days, or until the pain is gone. Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down swelling. Elevate your leg. Prop you leg up on a pillow when you're sitting or lying down. Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) will help with pain and swelling. However, these drugs have side effects, such as an increased risk of bleeding and ulcers. They should be used only occasionally unless your health care provider says otherwise and should be taken with food. Check with your doctor before taking these if you have any allergies, medical problems or take any other medication. Use a heel lift. Your health care provider may recommend that you wear an insert in your shoe while you recover. It will help protect your Achilles tendon from further stretching. Practice stretching and strengthening exercises as recommended by your health care provider. Usually, these techniques will do the trick. But in severe cases of Achilles tendon injury, you may need a cast for six to 10 weeks or even surgery to repair the tendon or remove excess tissue.
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.
Prevention
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.
A torn or ruptured Achilles tendon is simply no fun at all. This essential cord of strong, fibrous material attaches the heel bone to the calf muscles and is used in just about every movement, from walking and running to jumping and standing on your tip-toes. It also helps bend the foot downwards at the ankle. As the strongest tendon in the body, the Achilles can withstand a force of about 1,000 pounds. About 7 out of every 100,000 people will suffer from a ruptured Achilles at some point in time, with over 80% of these injuries occurring during a recreational sports activity. Athletes have a 24% chance of tearing their Achilles, but competitive runners have a 40 to 50% chance of Achilles tendon rupture during their lifetime.
Causes
The cause of Achilles tendon ruptures besides obviously direct trauma, is multifactorial. In many instances the rupture occurs about 2-6 cm before its attachment to the calcaneous (heel bone). In this area there is a weaker blood supply making it more susceptible to injury and rupture. Rigid soled shoes can also be the causative factor in combination with the structure of your foot being susceptible to injury.
Symptoms
If the Achilles tendon is ruptured you may experience a sudden pain in the back of your leg, as if someone had kicked you, followed by, swelling, stiffness, and difficulty to stand on tiptoe and push the leg when walking. A popping or snapping sound may be heard when the injury occurs. You may also feel a gap or depression in the tendon, just above heel bone. Ruptures usually occurs in those aged 30 - 70 years, during a sudden forceful push off from the foot. Without proper healing of the tendon, you will have a permanent limp and weakness when using the leg.
Diagnosis
During the physical exam, your doctor will inspect your lower leg for tenderness and swelling. In many cases, doctors can feel a gap in your tendon if a complete rupture has occurred. Achilles tendon rupture can be diagnosed reliably with clinical examination, but if there?s a question about the extent of your Achilles tendon injury then your doctor may order a magnetic resonance imaging (MRI) scan.
Non Surgical Treatment
As debilitating as they can be, the good news is that minor to moderate Achilles tendon injuries should heal on their own. You just need to give them time. To speed the healing, you can try the following. Rest your leg. Avoid putting weight on your leg as best you can. You may need crutches. Ice your leg. To reduce pain and swelling, ice your injury for 20 to 30 minutes, every three to four hours for two to three days, or until the pain is gone. Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down swelling. Elevate your leg. Prop you leg up on a pillow when you're sitting or lying down. Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) will help with pain and swelling. However, these drugs have side effects, such as an increased risk of bleeding and ulcers. They should be used only occasionally unless your health care provider says otherwise and should be taken with food. Check with your doctor before taking these if you have any allergies, medical problems or take any other medication. Use a heel lift. Your health care provider may recommend that you wear an insert in your shoe while you recover. It will help protect your Achilles tendon from further stretching. Practice stretching and strengthening exercises as recommended by your health care provider. Usually, these techniques will do the trick. But in severe cases of Achilles tendon injury, you may need a cast for six to 10 weeks or even surgery to repair the tendon or remove excess tissue.
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.
Prevention
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.
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