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Foot/Ankle

home Foot/Ankle Achilles Tendon Rupture

Achilles Tendon Rupture

The achilles tendon is the largest and most powerful tendon in the human body. Specifically, the gastrocnemius and soleus muscles form a common tendon, which is connected to the upper back-side of the calcaneus. The main functions of the gastrocnemius and soleus muscles that make up the Achilles tendon include the plantar flexion of the ankle, and flexion of the knee.
Overall, it is an important anatomical structure that is responsible for approximately 70% of the ankle joint’s function. Excessive use or overbearing repetitive movements can lead to degenerative changes, tissue deterioration, inflammation, and pain in the back of the ankle. Failure to treat these symptoms early on may lead to tendinitis, recurrent micro ruptures, and chronic inflammation, all of which can lead to a full rupture of the achilles tendon.

Cause

Achilles tendon ruptures are mostly attributed to sports activities that involve running and jumping, such as football, basketball, and badminton. In recent years, however, an increasing number of office workers and professionals appear to be suffering from achilles tendon ruptures. This is due to the fact that office workers are often required to sit down for extended periods of time. This sedentary lifestyle leads to a decrease in blood circulation to the achilles tendon and poor nutritional supply, which leads to the weakening and degenerative changes in the achilles tendon. If a weakened achilles tendon is repeatedly exposed to stress and shock, it develops a disease that leads to inflammation and micro ruptures, and even a full achilles tendon rupture.
Internal and external factors of achilles tendonitis
Internal factors
Age, decreased flexibility, decreased tendon vessels, abnormal mechanical structure of the foot or leg

External factors
Sudden increase in physical intensity (distance, frequency of impact), changes in shoes (heel height), resumption of training after long layoffs, running on irregular ground

Symptoms

Achilles tendonitis limits the flexion muscles in the lower ankle area. This can cause pain, tenderness, heat, and swelling around the heel area or the achilles tendon. If the tendon ruptures, patients experience severe limitations to their walking and daily activities.

Treatment

Conservative treatment
Typically, achilles tendonitis is curable with mostly non-surgical treatments. First, patients must stop exercising, then massage their heel and ankle area with ice. They can also use nonsteroidal analgesic drugs (NSAIDs), physical therapy, injection therapy (PDRN, prolotherapy), and rehabilitation exercises (massage, stretching, strength exercises) to treat their achilles tendonitis.
If a patient suffers from a complete rupture of the achilles tendon, the best option is to either immobilize the ankle with a cast or surgically reconstruct the tendon.
Surgical treatment
An achilles tendon typically ruptures when a sudden dorsiflexion force is applied to a strained dorsoventral muscle. Fortunately, most ruptures remain subcutaneous.
If the patient does not have any metabolic disorders, such as lower extremity edema, skin necrosis and diabetes, surgical repair is recommended to reconstruct a ruptured achilles tendon.

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