Achilles Tendon Rupture

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CAUSES:

• 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.

SYMPTOMS:

• 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.

DIAGNOSIS:

• 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.

TREATMENT:

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.

SURGICAL:

• 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.

MEDICATIONS:

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.

PREVENTION:

• 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.
• Wear shoes with proper heel cushioning
• Rest during exercise when pain is experienced.