Achilles Tendon Rupture
The Achilles tendon is the thickest and strongest tendon in the body, joining the calf muscles to the back of the calcaneus (heel bone). As the calf muscles contract, the Achilles tendon is stretched, pulling the heel off the ground. The Achilles tendon is usually approximately 15 cm long and is subjected to great loads, about 6-8 times normal body weight during running.
Achilles tendon rupture refers to a sudden tearing of the tendon, either partial or complete. It is encountered more frequently in adults from 30 to 50 years of age. As we age, the blood supply to our Achilles tendon declines, and hence this injury is more prevalent in older people. Men are more prone to rupture their Achilles tendon, probably because the tendon is not as thick and is subjected to comparatively more stress than in women.
This is a simple headline
Achilles tendon rupture occurs due to a sudden overload or over-the-limit stretching of the tendon.
- A sudden forced upward or downward (dorsiflexion) bending of the foot
- Twisting the foot or upward bending of the foot beyond normal limits
- Direct trauma
Risk group
Age and lack of activity weakens the tendon. Other factors that increase the risk of Achilles tendon rupture include:
- On and off activity
- A sudden increase in the intensity or duration of physical activity
- Lack of fitness or inadequate warm-up
- Use of certain drugs such as flouroquinolone antibiotics or steroids
- Diseases such as arthritis, diabetes
Symptoms:
The tendon may rupture with an audible sound, a sudden popping, followed by severe debilitating pain in the back of the lower leg, often associated with swelling. One is unable to lift the heel off the ground and walking is severely impaired. The tendon extends from about half-way down the shin to the heel. The area most commonly ruptured is about 2-6 cm above the heel bone, known as the “watershed zone”. This area suffers greater degeneration with age as it lacks good blood supply, which diminishes further as one ages, making it more prone to rupture.
Diagnosis:
The person is not able to stand on tiptoe or to lift his or her leg while lying prone on the table, face down with legs hanging loosely (Thompson test).
Ultrasound and MRI are useful diagnostic aids.
Treatment:
In mild cases, conservative treatment may suffice. This approach is also preferred in sedentary patients and those who are not fit enough to undergo surgery. It includes immobilizing the affected leg in a plaster cast for about 6 to 8 weeks. The cast is applied, with the foot pointing downwards (this allows for better approximation of the ruptured tendon ends).
Recent research has shown that the patient may recover better and faster if the immobilization period is shortened to about two weeks. Instead of casts, removable boots are available to be used during weight-bearing activities.
Treatment:
In mild cases, conservative treatment may suffice. This approach is also preferred in sedentary patients and those who are not fit enough to undergo surgery. It includes immobilizing the affected leg in a plaster cast for about 6 to 8 weeks. The cast is applied, with the foot pointing downwards (this allows for better approximation of the ruptured tendon ends).
Recent research has shown that the patient may recover better and faster if the immobilization period is shortened to about two weeks. Instead of casts, removable boots are available to be used during weight-bearing activities.
