The 26 Review
- What is an Achilles Tendon Injury A partial tendon tear or complete tendon rupture (separation)
- Causes Overuse injury, twisted ankle injury, recreational injury
- Symptoms Pain, swelling, difficulty walking, difficulty flexing the toes downward
- Diagnosis Physical exam, MRI, X-ray, and/or Ultrasound
- Treatment Rest, taping, Physical Therapy, Laser Therapy, PRP injection, walking boot or cast, surgery
Let’s take a closer look…
The Achilles Tendon is a thick, long band of connective tissue that attaches the heel bone to the calf muscles. It is the strongest and longest tendon in the body, intended to endure great amounts of stress and pressure from daily activities and sports. This tendon allows individuals to walk, run, jump, and stand on their toes. Although the Achilles tendon is incredibly durable, tears, ruptures, and degeneration over time can occur. An injury to the Achilles tendon causes the fibers to break down and either partially or completely tear in two. Torn Achilles tendons are grouped into two groups; minor/ partial or complete/ rupture. Differentiating between a partial or complete tear can be difficult, however, observing one’s symptoms is a great way to determine the severity of an injury. Individuals with feet that naturally turn outward are at a larger risk of a torn tendon, as well as athletes and patients over the age of 40. There are a few ways to diagnose this type of injury, but patients can expect to receive a physical exam to test the flexibility and mobility of the tendon. If you or someone you know is experiencing pain located in the ankle, contact a skilled professional today.
The blood supply to the thickened tendon is very poor and therefore, this area of the tendon is prone to injury, including tendon tears and/or tendon ruptures. Most medical professionals and researchers attribute Achilles tendon partial and complete tears to high-intensity sports or recreational activities. However, daily activities that involve significant lower leg movement, such as walking, running, climbing stairs, or even standing still could cause a tear or rupture in adults older than 40. Listed below are a few activities and sports that see the highest volume of Achilles-related injuries.
- Over Stretching
There is a small degree of difference between symptoms of a torn or ruptured Achilles tendon. With both injuries, patients can expect to feel pain behind the ankle, difficulty bearing weight on the leg, inability to be active, delayed swelling, bruising behind the ankle, and at times, a deformity where the tendon is damaged. Individuals may also experience trouble flexing the toes, especially downward, and changes in the skin surrounding the ankle. All in all, localized pain in the ankle can be indicative of an Achilles tendon injury if it persists or inhibits the ability to be mobile. Individuals with an Achilles tendon tear can typically still walk, however, with pain. Individuals with a complete tendon rupture typically are not able to push off and functionally walk.
Diagnosis will likely include a physical exam and a discussion on the cause of injury. A podiatrist will examine the ankle and calf muscles by assessing their ability to move in varying directions and testing how they respond to pressure. In more severe cases, a medical professional may order an MRI, X-ray, or ultrasound to determine if the tendon is torn completely or partially, as well as to determine if surgery is necessary.
Generally, the recommended Achilles Tendon tear repair depends on the extent of the injury. For minor or partial tears, the first approach is typically to apply bracing or casting to help reduce the movement of the ankle and allow the tear to heal on its own, accompanied by rest and elevation. For a fully torn or ruptured Achilles tendon, rest, elevation and bracing may be recommended but usually, the symptoms are severe enough to recommend surgery. Achilles tendon surgery involves making an incision into the calf and sheath surrounding the tendon. From there the surgeon will stitch the tendon back together and finish by closing the layers of skin and muscle with sutures. In older patients, surgery can pose a high risk of infection or skin-related complications, so immobilization and physical therapy solely can only aid in healing the tendon.