Achilles Tendon Injury | Rupture

What is an Achilles tendon injury?

The Achilles tendon, the thickest tendon in the human body, connects the calf muscles to the calcaneus (heel bone). The plantaris, soleus, and gastrocnemius muscles of the calf rely on the Achilles tendon to perform the foot movements that enable us to walk. Even though it is the thickest tendon of the body, the Achilles tendon is still susceptible to injury. This tendon can rupture after experiencing a sudden increase in the amount of stress loaded onto the tendon, such as a falling from a height, a sports-related injury, or stepping into a hole. Dr. Ronak Mukesh Patel, orthopedic ankle specialist serving patients in Sugar Land, Pearland, and the Houston, Texas area, has the knowledge and understanding as well as substantial experience in treating patients who have experienced an Achilles tendon injury.

Are there certain risk factors that can increase the chances of an Achilles tendon injury?

There are several risk factors that can increase an individual’s likelihood of experiencing an Achilles tendon injury, these risk factors include:

• Age and Gender: An Achilles tendon injury is most prevalent among men between the ages of 30 to 40.
• Athletic Activities: Athletes that participate in sports involving sudden starting and stopping, running, and jumping have a greater risk of sustaining an Achilles tendon injury. These motions are seen in sports such as basketball, tennis, lacrosse, and soccer.
• Obesity: The more weight that is loaded onto the Achilles tendon can weaken it and increase the chances of an Achilles tendon injury.
• Medications: Fluoroquinolone antibiotics, such as Cipro (ciprofloxacin), have been shown to enhance the risk of an Achilles tendon injury. Corticosteroid injections administered near the Achilles tendon can weaken it and cause an injury.

What are the symptoms of an Achilles tendon injury?

The most common complaint of an Achilles tendon injury is hearing an audible “pop” in the back of the ankle following an injury. This is often followed by a sharp pain in the lower leg and difficulty walking properly. Other common symptoms of an Achilles tendon injury can include:

• Swelling near the heel
• Difficulty standing on the toes or bending the foot downward of the injured leg
• A feeling of being kicked in the calf
• Abnormal gait or limp

How is an Achilles tendon injury diagnosed?

A comprehensive medical history is obtained by Dr. Patel with an emphasis on lower leg injuries and conditions that can affect tendon integrity. A thorough physical examination is then performed to evaluate the lower leg for pain, tenderness, inflammation, and any palpable deformities. Diagnostic imaging studies, such as magnetic resonance imaging (MRI) and ultrasound, are helpful in analyzing the extent of injury to the Achilles tendon and any other surrounding structures.

What is the treatment for an Achilles tendon injury?

Prevention:

Although athletes frequently experience Achilles tendon injuries, non-athletic individuals are still susceptible to injury as well. There are a number of strategies that can be implemented to prevent an Achilles tendon injury from occurring altogether. Establishing a proper warm-up routine involving calf-strengthening exercises can help the calf muscles and Achilles tendon withstand more force and prevent an injury. Fluctuate the intensity of exercises between high-impact (i.e. running) and low-impact (i.e. biking and swimming) activities. Well-fitted shoes with proper heel cushioning should be worn during athletic activities. It is recommended to progressively increase the intensity of physical activities by no more than 10% a week. Achilles tendon injuries commonly occur when the intensity is increased too quickly.

Non-surgical treatment:

A patient that experiences mild symptoms of an Achilles tendon injury may respond well to non-surgical treatment alone. The latest studies suggests some patients may be candidates for treating a complete Achilles tear with a functional rehabilitation protocol without surgery. Dr. Patel will make this decision after a discussion with the patient on a case-by-case basis. A cast or ankle boot can be applied to limit ankle movement during the first weeks of the healing process. Weight-bearing should be restricted with the assistance of crutches or a walker. Ice application and non-steroidal anti-inflammatory medications (NSAIDs) are encouraged for pain and inflammation management.

Surgical treatment:

Patients with more severe or complex symptoms of an Achilles tendon injury may require surgical intervention to restore the tendon. Athletes and younger individuals also tend to opt for surgical repair of the Achilles tendon. Surgical repair of the Achilles tendon typically involves suturing the torn pieces back together. This can be accomplished through a minimally invasive approach with specialized surgical instruments and tools. Alternatively, Dr. Patel may favor an open surgical approach utilizing a slightly larger incision to visualize the entire lower leg while making the necessary revisions. A tendon graft, either from the patient (autograft) or donor tissue (allograft), can be implemented if tendon retraction has occurred.