The Achilles tendon is a large band of strong fibrous tissue that looks like a rope and is present at the back of the lower leg near the ankle. It is the largest tendon in the human body and connects the heel bone to the power calf muscles. The contraction of the calf muscles results in the tightening of the Achilles tendon which pulls the heel. This allows humans to stand on tiptoe and point the feet in a desired direction. The Achilles tendon is essential to activities such as walking, jumping and running.
The Achilles tendon tear usually occurs around two and a half inches from the heel bone and is medically called an Achilles tendon rupture. The Achilles tendon receives a lot less supply of blood than other regions of the body and hence has lowered ability to self-repair and heal. One can safely say that this section of the body is predisposed to injury and tear
Symptoms of Achilles tendon tear
Some of the signs and symptoms of Achilles tendon tear are listed below:
- People may experience a sudden and extreme pain in the back of the calf or the ankle. The feeling is often described as ‘someone stepping onto the hind portion of the ankle’ or as ‘being shot or hit by a rock’
- The early signs of swelling, pain and stiffness may be replaced by weakness and bruising. The pain tends to fade away quickly, and the smaller tendons may still retain the capability to point the toes. In case, the Achilles tendon tear is severe, then even this would be difficult.
- One may feel or see a depression or gap in the tendon about 2.5 inches above the heel bone, indicating Achilles tendon tear
- People may report the sound of a loud snap or pop
- The chances of a complete Achilles tendon tear are greater than partial tear of the tendon
- Individuals may find it difficult to push off while walking and to stand on tiptoe
Causes of Achilles tendon tear
- Lack of use of the Achilles tendon and the onset of old age makes it to grow weak. As a result, it can become prone to rupture, tear or injury. Individuals who have preexisting conditions such as tendinitis of the Achilles tendon are at greater risk to develop Achilles tendon tear than others.
- The presence of certain conditions such as diabetes and arthritis and the use of some medications such as corticosteroids and certain types of antibiotics also increase the risk to Achilles tendon tear.
Some of the causes of Achilles tendon tear are discussed below
- Achilles tendon tear usually tend to occur in individuals who are middle aged and engage in physical activities such as playing badminton or other such sports. Most of the injuries happen when people engage in activities that require bursts of running, pivoting and jumping. They can be recreational activities or sports such as basketball, racquetball or tennis.
Achilles tendon tear may also be caused in the following situations:
- When individuals engage in a forceful push off using the foot and the string thigh muscles straighten the knee. Jumping and a foot race are examples of such a situation.
- When individuals suddenly stumble or trip, or when the foot is shoved in the front to break a fall, then the Achilles tendon may get forcefully overstretched.
- When individuals suddenly step off the curb or into a hole, or fall from a significant height then it may lead to an Achilles tendon tear
Achilles tendon tear treatment
The main aim of treatment for Achilles tendon tear is to restore the tension and normal length to the tendon, so that affected individuals can do all that they could before the injury. Treatment involves a balance between early motion and protection.
- Motion of the ankle and foot is essential to void loss of muscle tone and stiffness
- Protection is essential to prevent any further injuries and to give time for healing purposes
One may opt for either surgical or non surgical treatment methods.
- Both the treatment methods require special braces or casting for an initial time-frame of about six weeks. The doctor may change the cast at intervals of 2 to 4 weeks to allow the injured tendon to stretch to its normal length. Such casting may be accompanied by physical therapy that involves early movement of the foot and ankle to improve the overall flexibility and strength.
- Regardless of the treatment method, the remainder of the treatment involves additional and regular physical therapy and the use of a heel lift device.
- Regular consultation and follow up with an orthopedic surgeon is vital to complete recovery of Achilles tendon tear
- Surgical treatment of Achilles tendon tear involves an operation to physically sew the ends of the torn tendon back together. It rarely results in relapse of the tear and also facilitates faster recovery from the injury. However, there are several risks and side effects to surgical treatment of Achilles tendon tear such as infection, scarring, blood clots, higher cost and accidental nerve injury.
- Professional athletes and individuals who cannot delay the treatment process are the ones who usually opt for surgical treatment for Achilles tendon tear