Achilles Tendon Rupture

Achilles Tendon Rupture Description
Achilles Tendon Rupture is a common injury to the ankle in the weekend warrior.  Achilles Tendon Ruptures generally occur in men in their 30's 40's and 50's.  It often occurs during recreational sports such as basketball, tennis and raquetball.  Achilles tendon ruptures are thought to occur when tendons that are already weakend by degenerative changes are overloaded.  

Achilles Tendon Rupture Anatomy
The Achilles tendon is formed by the gastrocnemius and soleus muscles around 15cm above the heel bone (calcaneous).  The Achilles tendon attaches the main muscles in the calf to the heel bone and is important for push-off strength in the foot and ankle.  The Achilles tendon has an area of poor blood supply (hypovascular) 3-6cm above the heel bone.  Most Achilles tendon ruptures occur in this area.

Achilles Tendon Rupture Symptoms
Achilles Tendon Rupture causes pain and swelling in the back of the ankle.  Most people with an Achilles tendon rupture feel a pop or snap in the back of the ankle, usually after a sudden push-off movement during sports.   People with a complete Achilles tendon rupture with have a defect in the Achilles tendon, weakness when pushing off with their foot and trouble standing on their toes.  

Achilles Tendon Rupture Treatment 
Achilles Tendon Rupture is diagnosed based on a detailed history, physical exam and xrays performed by an orthopaedic surgeon, or sports medicine specialist.  MRI or ultrasound is frequently used to confirm the injury or assess how severe it is.  

Treatment options for Achilles tendon ruptures include surgical repair as well as non-surgical treatment. 

Non-surgical treatment of Achilles tendon ruptures involves casting generally for 8-12 weeks.  Non-surgical treatment is less expensive and has less risks involved such as wound infections and risks of anesthesia.  Unfortunately patients with an Achilles tendon rupture who are treated non-surgically have a higher risk of tendon rerupture (15%), lower satisfaction with their overall outcome and may have significant loss of power, strength and endurance compared to Achilles tendon ruptures that are treated surgically. 

Most athletes elect to have Achilles tendon ruptures repaired surgically.  Surgical repair of Achilles tendon ruptures has a lower risk of rerupture (1.1%) and has a higher percentage of satisfaction, and return to sports.  Surgically treatment generally also provides greater strength, power and endurance than non-surgical treatment of Achilles tendon ruptures.  Surgical treatment of Achilles tendon ruptures does have risk of surgery such as infection and risks of anesthesia.

Athletes returning to sports after Achilles Tendon Rupture should begin with a graduated exercise program. First they should be pain free with daily activities with full range of motion and at least 85% strength in the injured leg compared to the uninjured leg. Exercise begins with light jogging in a straight line, followed by sprinting in a straight line. When these have been done without pain the athlete can proceed to doing agility type drills such as 45º cuts, 90º cuts and jumping. Agility drills should begin at half-speed and proceed to full-speed provided the athlete remains pain free.

Achilles Tendon Rupture Prevention
As in all sports and exercise, injury rates can be reduced by maintaining flexibility by stretching before and after practice or games.  Maintaining a proper diet and overall physical fitness is very important.  Recreational athletes should maintain their physical fitness by doing some form of exercise for at least 30-60 minutes daily. Avoid abrupt increases in exercise or sports. Achilles tendonitis braces

Achilles tendon ruptures typically occur in athletes who do not exercise daily and play a recreational sport infrequently (weekend warrior).   

Achilles Tendon Rupture Risk Factors
Risk factors for Achilles tendon rupture include steriod injections into the Achilles tendon sheath or retrocalcaneal bursa, ciprofloxacin or fluorquinolone antibiotic use, type O blood, male gender, history of gout, hyperthroidism, renal insufficiency and arteriosclerosis.  

Achilles Tendon Rupture is associated with the following sports: Baseball; Basketball; Boxing; Cycling; Dance; Football; Gymnastics; Running; Soccer; Tennis; Volleyball.  

People that have sustained an Achilles tendon rupture in one leg, the risk of have an Achilles tendon rupture in the opposite side is around 26%.  

Achilles Tendon Rupture Rehab and Exercise Program
Achilles Tendon Rupture

Achilles Tendon Rupture Outcomes
Achilles Tendon Rupture outcomes are good.  Both non-surgical and surgical treatment of Achilles tendon ruptures have satisfactory outcomes.  Surgical treatment provides better strength and higher return to preinjury activity levels than non-surgical treatment. 

Similar injuries that can be confused with Achilles Tendon Rupture include:

Gastrocnemius muscle tear

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