Tendons are bands of connective tissue that connect muscles to bones and allow us to move. They are located throughout the body, especially at the joints, and are composed of strong collagen fibers, which are necessary because of the force placed on them from muscle contraction and movement.
The Achilles tendon, which connects the muscles in the calf of the leg to the heel bone, is the largest, as well as the strongest, tendon in the body. It is easy to find at the back of the ankle and feels like a thick, somewhat-springy cord. This powerful tendon is what enables us to flex the foot up and down. It is called upon for walking, running, jumping and a wide range of other activities. Not only is it flexible, but it is strong enough to withstand the force created during movements like running and climbing stairs, which can equal that of 10 times body weight.
Despite how strong it is, injuries to the Achilles tendon are fairly common. Because this type of fibrous tissue has a more limited blood supply, healing for even minor injuries requires more time. This, combined with the constant and often excessive force placed upon the tendon, can lead to tear or rupture of the Achilles tendon.
What Is an Achilles Tendon Rupture?
When the Achilles tendon becomes irritated or inflamed from overuse, the condition is known as Achilles tendinitis. It is not the result of an injury and the tendon itself is not torn. When there has been extreme overstretching or stress placed on the tendon to the point that there is a tear and separation of the fibers making up the tendon, however, the ailment is known as an Achilles tendon rupture.
An Achilles tendon rupture can be a complete break or severing of the tendon’s fibers or it can be partial, sometimes referred to as a tear. Either can be very painful and both can impair mobility. A rupture of the Achilles tendon is much more serious than tendonitis and requires medical attention.
Symptoms of Achilles Tendon Rupture
The symptoms of an Achilles tendon rupture run from no signs or symptoms at all, which is rare, to the telltale “pop” accompanied by sudden, intense pain. An Achilles tendon rupture is often experienced by professional athletes. Other common symptoms include:
- Pain in the calf area of the leg, especially near the heel
- Swelling, often painful, that worsens with activity
- The sensation of having been hit or kicked in the back of the leg
- Swelling as well as pain, which may be severe, near the heel
- Difficulty bending or flexing the injured foot
- Pain and stiffness in the tendon when first walking in the morning
- Noticeable thickening of the tendon
Every time we take a step or make any movement involving the foot, we rely on the Achilles tendon. Many different factors can contribute to an Achilles tendon rupture, but, most often, the cause is a forceful downward movement of the foot that meets with resistance, like the sudden push off at the beginning of a jump, burst of speed or change in direction. This is why it is such a common injury in sports like basketball, football, gymnastics and tennis.
Achilles tendon ruptures are typically the result of traumatic injuries rather than overuse or degeneration. Men tend to generate greater force in their movements, which leads to a higher incidence of injury to the tendon, and men over the age of 30 are the ones most likely to experience ruptures of the Achilles tendon.
Some of the other common factors that may contribute to an Achilles tendon rupture include:
- Prolonged overuse of the tendon making it more vulnerable to injury
- Inadequate stretching habits prior to exercise or other physical activity
- Insufficient conditioning before returning to physical activity following a long break
- Steroid injections in the ankle joint to reduce pain and inflammation
- Taking fluoroquinolone antibiotics, such as levofloxacin (Levaquin) or ciprofloxacin (Cipro)
- Running on uneven or difficult terrain
Diagnosis of Achilles Tendon Rupture
The symptoms of a ruptured Achilles tendon can be mistaken for tendonitis, bursitis or even a sprained ankle. This makes it important to consult with a healthcare professional as soon as possible. Diagnosis will be made through a combination of medical history and physical exam, including range of motion tests. To determine the extent of the injury, imaging tests, such as X-rays, ultrasounds or MRI scans may be ordered.
Treatment for Achilles Tendon Rupture
There are surgical and nonsurgical options for the treatment of an Achilles tendon rupture; which is indicated depends primarily on the severity of the injury, as well as the age and level of activity of the individual. For those who are older and less active, the nonsurgical route for treatment typically consists of:
- Relieving pressure on the tendon with the use of crutches
- Using ice to reduce swelling
- Taking over-the-counter pain medication
- Immobilizing the ankle and keeping the foot flexed down with a cast or special boot
Younger, more-active individuals, especially athletes who are eager to get back to their sport, tend to opt for surgery to repair the tendon and have function and mobility restored as soon as possible. Repairing the Achilles tendon surgically is done through an incision in the back of the lower area of the leg. Once the surgeon has accessed the damaged tendon, it is stitched back together. If there is extensive damage, additional tendon tissue may also be required for reinforcement.
Recovery and Rehabilitation
Whether treatment was surgical or nonsurgical, patients will need physical therapy to regain strength and restore full function to the Achilles tendon, as well as the leg muscles. For most people, full recovery to their previous level of activity will take between four and six months. It will then be important to continue the strength and stability exercises for an additional six months to prevent any problems from developing.
Contact Dr. Hubbard Today to Make an Appointment
If you have suffered from an Achilles tendon rupture, Dr. Christopher Hubbard has the experience and training to provide you with options, designed specifically for you, to give you the very best potential for recovery. Contact our office today to schedule an appointment.