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The Facts Not Misguided Beliefs About Ruptured Achilles Tendons

Overview

The Achilles tendon runs from the calf muscles at the back of the lower leg and inserts at the back of the heel. A torn achilles can be a partial rupture or a total rupture. A total rupture is more common in men affecting them 10 times more than women. Injury typically occurs 30 to 40 minutes into a period of exercise rather than at the start of a session and nearly always happens from a sudden explosive movement or bending the foot upwards. Many patients are able to continue to function following an achilles rupture due to other muscles compensating although the injured leg will be significantly weaker. There are four key tests which can help diagnose a ruptured achilles tendon.


Causes
The tendon is susceptible to injury and can rupture during vigorous activities such as running and jumping. Rupture can also occur as a result of gradual wear. After becoming chronically weakened, it can rupture during non-stress activities like walking.


Symptoms
If your Achilles tendon is ruptured you will experience severe pain in the back of your leg, swelling, stiffness, and difficulty to stand on tiptoe and push the leg when walking. A popping or snapping sound is heard when the injury occurs. You may also feel a gap or depression in the tendon, just above heel bone.


Diagnosis
To diagnose an Achilles tendon injury, your health care provider will give you a thorough physical exam. He or she may want to see you walk or run to look for problems that might have contributed to your Achilles tendon injury.


Non Surgical Treatment
Treatment of the initial injury is with use of ice, elevation, and immobilization. If suspected you should contact your podiatrist or physician. Further treatment with continued immobilization, pain medication, or anti-inflammatory medications may be advised. If casted the foot is usually placed in a plantarflexed position to decrease the stretch on the tendon. As healing progresses the cast is changed to a more dorsiflexed position at the ankle. The casting processes can be up to 8 weeks or more.


Surgical Treatment
Surgery offers important potential benefits. Besides decreasing the likelihood of re-rupturing the Achilles tendon, surgery often increases the patient?s push-off strength and improves muscle function and movement of the ankle. Various surgical techniques are available to repair the rupture. The surgeon will select the procedure best suited to the patient. Following surgery, the foot and ankle are initially immobilized in a cast or walking boot. The surgeon will determine when the patient can begin weight bearing. Complications such as incision-healing difficulties re-rupture of the tendon, or nerve pain can arise after surgery.


Prevention
You can help to reduce your risk of an injury to your Achilles tendon by doing the following. When you start a new exercise regime, gradually increase the intensity and the length of time you spend being active. Warm up your muscles before you exercise and cool them down after you have finished. The benefit of stretching before or after exercise is unproven. However, it may help to stretch your calf muscles, which will help to lengthen your Achilles tendon, before you exercise. Wear appropriate and well-fitting shoes when you exercise.

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