Achilles tendon is a large ropelike band of fibrous tissue in the back of the ankle that connects the powerful calf muscles to the heel bone (calcaneus). It is present between gastrocnemius and soleus muscle. During the contraction of the calf muscles, Achilles tendon helps in pulling up and tightening up the heel and helps in walking, running and jumping. When there is a complete tear in the tendon about 2 inches above the heel bone, it called an Achilles tendon rupture. It becomes prone to injury as we age because if its thinning.
Most common in middle age athletes and people who are into sports occupation such as basketball, tennis, jumping, pivoting players.
A sudden increase in the stress on the tendon during exercise.
Decreased range of motion-tight calf muscles
If someone falls from a significant height.
During a sudden jerk while your knee is straightened during foot race or jumping.
When you suddenly trip or stumble during overstretching the tendon.
Certain illness such as arthritis and diabetes.
Medications such as some antibiotics like levofloxacin and ciprofloxacin, quinolones and steroids.
Sudden sharp shooting pain is felt at the back of the ankle with a sudden pop sound.
Swelling and stiffness is also associated with the pain
Foot becomes floppy and weak.
Unable to stand on tiptoe, run, jump, walk.
The patient feels a snapping sound like someone is hitting at the back of the ankle.
No plantar flexion or movement of the affected area.
A complete or partial tear is visible.
A good physical examination is done by the physician.
One simple test can be performed by squeezing the calf muscles while lying on the stomach, indicates that tendon is still connected.
Achilles tendon is often misdiagnosed as a strain or minor tendon injury so it should be ruled out based on the symptoms and signs.
Other radiological tests such as MRI, X-RAYS, and ULTRASOUND can be used to determine the degree of injury. On X-ray examination, there will be a loss of fat pad on the affected side.
The objective of the treatment is to restore normal length and tension to the tendon by:
Try to protect your already injured tendon so that healing can take place.
To prevent further stiffness, try to move your feet and ankle gradually.
Beginner balance and proprioception exercises to restore normal muscle tone.
Calf strengthening exercises are great to prevent further weakness.
Casting and special braces are required during the initial six weeks of surgery. it can be combined with strengthening and movement of the ankle to improve strength and flexibility.
Heel lift device and regular physiotherapy are required for further healing.
It is important to consult an orthopedic surgeon for the follow-up and the correct treatment.
Surgical treatment includes suturing both the ends of the tendon together. It is a great choice of treatment for people in sports or who are indulged in high physical activity.
Electrical stimulation is used to control pain and improve muscular function
Kinesiology taping is also applied to improve muscle function and decrease spasm.
Pain and swelling can be reduced by using analgesics and NSAIDs Non-steroidal anti-inflammatory agents such as ibuprofen can be taken under prescription.
Note: Certain antibiotics such as fluoroquinolones group –such as ciprofloxacin and levofloxacin increase the risk of Achilles tendon rupture.
Stretching: it helps in preparing the tendon for more flexibility and more force.
The intensity of physical activity: avoid a gradual increase in the intensity of any exercise or sports activity.
Try not to run on jump on the surface that is slippery or too hard to avoid chances to fall.
Alternative exercises with low impact on the tendon such as swimming can be a good replacement instead of running and jumping.
Maintain a healthy weight to decrease the stress on the Achilles tendon.