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Tear of Achilles tendon : Defenition, Causes Symptoms, Diagnosis, Preventive and Treatment

Thursday, July 26th 2012. | Disease, Joints Health, Knee Pain

Achilles Tendonitis Definition

According to legend, the invulnerable Achilles died of a heel injury. Even today, the Achilles tendon is a part of the body susceptible to injury, although one of the strongest tendons in the body.

We distinguish acute tear of the Achilles tendon, without symptoms, and tear with partial onset of wear.

Chronic problems are due to degeneration of tendon tissue. Elderly or suffering from a chronic condition such as diabetes, rheumatoid arthritis or other rheumatic diseases are most affected.

Tear of the Achilles tendon often occurs when playing sports, after work on the tennis court, dancing, doing aerobics. The typical patient, aged 30 to 50 years, is often an amateur sportsman.

Tear of the Achilles tendon is conservative – treated without surgery. Experts recommend instead the operation because prolonged immobilization of the leg without surgical approach, can cause muscle atrophy, thrombosis, a new tear of the Achilles tendon and a loss of strength.

Achilles Tendon

Achilles Tendonitis (img : thanks to : forwardarch.com)

Achilles Tendonitis Causes

Jumping or hopping are common causes of this type of tear. Among these causes, it was noted a high load on the tendon.

Professional athletes rarely suffer from a torn Achilles tendon because they have a proper warm a sport.

Achilles Tendonitis Symptoms

A loud popping sound detects the acute tear of the Achilles tendon. The movement of the foot towards the tibia is impossible because of pain and it is also impossible to stay on his toes as the tendon is torn.

Achilles Tendonitis Other Cymptoms

  • Immediate and severe pain after the accident
  • Formation of depressions on the heel, typical sign of a tear of the Achilles tendoni
  • Inability to actively move the foot and jump
  • It can occur effusion or swelling on the back of the ankle

Achilles Tendonitis Diagnosis

The description of the accident and the symptoms, especially the existence of a” slam”, unable to move the foot or standing on tiptoe, allow the physician to the diagnosis of a torn Achilles tendon.

A special test confirms the diagnosis:

  • Test Thomson: the physician squeezes the calf, and flexion of the foot should be done automatically, if it is not the case, the diagnosis is confirmed.

Radiological

  • Ultrasonography (ultrasound) can detect a gap in the tendon. This includes 70% of cases.
  • Radiographs to rule out a fracture or tearing of the tendon bone.
  • MRI performed in cases of suspected partial tear of the Achilles tendon.

Achilles Tendonitis Treatment Options

Achilles Tendonitis Emergency treatment

The first treatment, which if possible should be done at the scene of the accident, follows the pattern:

  • Break – immediate termination of the sport – due to inability to automatically place the foot.
  • Ice – cooling of the wound, since this is a closed wound (no open wound), attention: do not place ice directly on skin, risk of cold injury.
  • Compression – a compression bandage to prevent swelling and should be checked regularly.
  • Elevation – in case of injury involving the extremities (arms, legs), the flow of blood and the deflation limb is facilitated by the high position.

Tear of the Achilles tendon is treated conservatively or surgically.

Conservative treatment

If the doctor finds that the ends of torn tendons touching the extension, the operation is not always necessary. In many cases the two ends are welded.

Method

Relief of Achilles tendon using special shoes. The shoe has a special lightweight heel, which guarantees the position on tiptoe; this position promotes contact of the two ends of the tendon. This partial relief lasts two weeks. We can then use a normal load. Warning: regular monitoring of the healing process by the doctor. Healing should occur within weeks.

The conservative method avoids the risk of anesthesia associated with surgery. The disadvantages are: muscle atrophy and risk of thrombosis and immobility longer.

Surgical treatment

Both ends of the tendons must be sewn. There are two methods: open surgery or minimally invasive operation. The type of surgery chosen depends on the patient’s condition and the tendon. If membership form requires an open operation. The minimally invasive operation is only suitable for a first tear and provided that there are no symptoms of rupture of the Achilles tendon preexisting.

Postoperative treatment

Hospitalization is short: 2 to 3 days.

Treatment includes :

  • Partial load of the foot (at most half of body weight), and then gradual increase of the load
  • Wearing a bandage or splint (orthosis)
  • Physiotherapy based on need and the wish of the patient
  • Total charge after about 6 to 7 weeks
  • After about two months, one can remove the splint
  • The patient can resume jogging slowly after 12 weeks. Combat sports require a waiting period of approximately six months

Achilles Tendonitis Possible Complications

The healing process normally takes place without complications. This means that after a conservative treatment such as surgery, the drive to before the accident must be restored.

In rare cases there is vascular disorders, infections and a shortening or lengthening of the tendon.
As with other operations there are risks of infection or thrombosis.

Achilles Tendonitis Preventive Measures

  • Regular exercise maintains the elasticity of muscles and tendons
  • Stretching and warm-up before and after sport
  • Avoid too heavy
  • It is best to avoid risk sports, where one must “slow” (eg. squash), in a pinch make movements before and after sport
  • May be a protection for sports involving high foot.
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