Achilles Tendon Rupture

What is the Achilles Tendon?

The Achilles tendon is the thick band of tissue at the back of the leg that connects the calf muscle with the heel bone (calcaneus). Along with the calf muscle, the Achilles tendon aids in walking by lifting the heel. 

Achilles Tendonitis

and Achilles Tendonosis

The two most common injuries to the Achilles tendon are Achilles tendonitis and Achilles tendonosis.

Achilles tendonitis results from an inflammation of the Achilles tendon. While the initial inflammation is typically short lived, if not treated the condition can degrade to full blown Achilles tendonosis. With achilles tendonosis the tendon loses it overall structure and can develop small tears, further weakening the tendon. This can, in some cases, result in a tendon rupture. 

Causes

Achilles tendonosis and Achilles tendonitis are overuse disorders, usually brought on by a sudden increase of activities that place repetitive strain on the tendon. Because of this ongoing stress on the tendon the body does not have time to repair the damaged tissue.

 

People engaging in athletic activities are at a higher risk of injury, especially when these activities are infrequent and intense. People with low or collapsed arches are also at a higher risk of injury, because the tendon needs to do more work to compensate for the lack of natural arch in the foot. This group is at a higher risk if they do not wear supportive footwear.  

Symptoms

The following are common symptoms associated with both tendonitis and tendonosis.

  • Pain. Soreness, aching, tenderness and stiffness anywhere along the tendon are typical. Pain is most common immediately following long periods of rest, such as first thing in the morning. While the pain may dissipate with continued use, it is common for pain to increase with increased activity.

  • Tenderness. Tenderness and pain when squeezing the sides of the tendon.

  • Swelling. If the problem progresses the tendon may develop growths and swelling in the areas that are most damaged.   

Treatments

Treatments for Achilles Tendonitis and Achilles Tendonosis depend primarily on how long the injury has been present. In early acute stages the following treatments may be recommended by your podiatrist:

  • Immobilization - the use of a cast or walking boot will immobilize the foot and allow for the tendon to heal.

  • Ice - the use of ice to reduce inflammation of the tendon is recommended. An ice pack can be wrapped in a towel and applied to the area (never apply ice directly to the skin) for periods of no greater than 20 minutes. 

  • Oral Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may be used to reduce inflammation and pain.

  • Orthotics. For those with overpronation or flat feet, custom orthotics may be prescribed by your podiatrist.

  • Night splints. Night splints are a medical device designed help to maintain stretching in the Achilles during sleep.

  • Physical therapy. Common therapy may include strengthening exercises, soft-tissue massages, stretching and ultrasound therapy.

Surgical intervention may be recommended for injuries that have progressed past the point which conservative treatment measures would have a positive outcome. Several factors would help the podiatrist decide which surgical procedure would be most effective, based upon the the patient’s age and activity level, the extent of the injury, and several other factors.

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