Overview
The Achilles tendon is the largest tendon in your body and is responsible for pushoff up to 10 times body weight. Surgery is a common treatment for chronic Aquila?s tendinitis or complete rupture of the Achilles tendon. The Achilles tendon had connects the calf muscle to the heat. When the tendon tears or ruptures the variety of surgical techniques are available to repair the damage and restore the tendons function. Recent research that is done at Emory University Department of orthopedics have perfected the repair of the Achilles tendon. The procedure is generally involves making an incision in the back of your leg and stitching the torn tendon together using a technique developed and tested by Dr. Labib. Depending on the condition of the torn tissue the repair may be reinforced with other tendons. Surgical complications can include infection and warned healing problems. The repair performed at Emory allows the patient quick return to weight-bearing and function. Healing and return to full function may take up to four months.
Causes
The Achilles tendon usually ruptures as a result of a sudden forceful contraction of the calf muscles. Activities such as jumping, lunging, or sprinting can cause undue stress on the Achilles tendon and cause it to rupture. Often there is a background of Achilles tendinitis. Direct trauma to the area, poor flexibility or weakness of the calf muscles or of the Achilles tendon and increasing age are some of the other factors that are associated with an Achilles tendon rupture.
Symptoms
Tendon strain or tendon inflammation (tendonitis) can occur from tendon injury or overuse and can lead to a rupture. Call your doctor if you have signs of minor tendon problems. Minor tenderness and possible swelling increases with activity. There is usually no specific event causing sudden pain and no obvious gap in the tendon. You can still walk or stand on your toes. Acute calf pain and swelling can indicate a tear or partial tear of the Achilles tendon where it meets the calf muscle. You may still be able to use that foot to walk, but you will need to see a specialist such as an orthopedic surgeon. Surgery is not usually done for partial tears. Sometimes special heel pads or orthotics in your shoes may help. Follow up with your doctor to check for tendonitis or strain before resuming activity, because both can increase the risk of tendon rupture. Any acute injury causing pain, swelling, and difficulty with weight-bearing activities such as standing and walking may indicate you have a tear in your Achilles tendon. Seek prompt medical attention from your doctor or emergency department. Do not delay! Early treatment results in better outcome. If you have any question or uncertainty, get it checked.
Diagnosis
Diagnosis is made mostly by clinical examination with a defect usually noted on visual examination and by touching the area. A simple test can be done by squeezing the back of the calf with the foot resting in the air. Normally when squeezing the muscle belly the tendon will shorten causing the foot to move in a downward position. With a rupture this squeezing effect may show no movement of the foot if it is not attached properly. A negative test does not mean there isn't some degree of rupture as some of the tendon fibers may still be attached. Sometimes x-rays, an mri, or an ultrasound can be helpful in determining the extent of the rupture.
Non Surgical Treatment
A medical professional will take MRI scans to confirm the diagnosis and indicate the extent of the injury. Sometimes the leg is put in a cast and allowed to heal without surgery. This is generally not the preferred method, particularly for young active people. Surgery is the most common treatment for an achilles tendon rupture.
Surgical Treatment
This injury is often treated surgically. Surgical care adds the risks of surgery, there are for you to view. After the surgery, the cast and aftercare is typically as follows. A below-knee cast (from just below the knee to the tips of the toes) is applied. The initial cast may be applied with your foot positioned in a downward direction to allow the ends of the tendon to lie closer together for initial healing. You may be brought back in 2-3 week intervals until the foot can be positioned at 90 degrees to the leg in the cast. The first 6 weeks in the cast are typically non-weight bearing with crutches or other suitable device to assist with the non-weight bearing requirement. After 6 weeks in the non-removable cast, a removable walking cast is started. The removable walking cast can be removed for therapy, sleeping and bathing. The period in the removable walking cast may need to last for an additional 2-6 weeks. Your doctor will review a home physical therapy program with you (more on this program later) that will typically start not long after your non-removable cast is removed. Your doctor may also refer you for formal physical therapy appointments. Typically, weight bearing exercise activities are kept restricted for at least 4 months or more. Swimming or stationary cycling activities may be allowed sooner. Complete healing may take 12 months or more.
Prevention
The following can significantly reduce the risk of Achilles tendon rupture. Adequate stretching and warming up prior to exercising. If playing a seasonal sport, undertake preparatory exercises to build strength and endurance before the sporting season commences. Maintain a healthy body weight. This will reduce the load on the tendon and muscles. Use footwear appropriate for the sport or exercise being undertaken. Exercise within fitness limits and follow a sensible exercise programme. Increase exercise gradually and avoid unfamiliar strenuous exercise. Gradual ?warm down? after exercising.
The Achilles tendon is the largest tendon in your body and is responsible for pushoff up to 10 times body weight. Surgery is a common treatment for chronic Aquila?s tendinitis or complete rupture of the Achilles tendon. The Achilles tendon had connects the calf muscle to the heat. When the tendon tears or ruptures the variety of surgical techniques are available to repair the damage and restore the tendons function. Recent research that is done at Emory University Department of orthopedics have perfected the repair of the Achilles tendon. The procedure is generally involves making an incision in the back of your leg and stitching the torn tendon together using a technique developed and tested by Dr. Labib. Depending on the condition of the torn tissue the repair may be reinforced with other tendons. Surgical complications can include infection and warned healing problems. The repair performed at Emory allows the patient quick return to weight-bearing and function. Healing and return to full function may take up to four months.
Causes
The Achilles tendon usually ruptures as a result of a sudden forceful contraction of the calf muscles. Activities such as jumping, lunging, or sprinting can cause undue stress on the Achilles tendon and cause it to rupture. Often there is a background of Achilles tendinitis. Direct trauma to the area, poor flexibility or weakness of the calf muscles or of the Achilles tendon and increasing age are some of the other factors that are associated with an Achilles tendon rupture.
Symptoms
Tendon strain or tendon inflammation (tendonitis) can occur from tendon injury or overuse and can lead to a rupture. Call your doctor if you have signs of minor tendon problems. Minor tenderness and possible swelling increases with activity. There is usually no specific event causing sudden pain and no obvious gap in the tendon. You can still walk or stand on your toes. Acute calf pain and swelling can indicate a tear or partial tear of the Achilles tendon where it meets the calf muscle. You may still be able to use that foot to walk, but you will need to see a specialist such as an orthopedic surgeon. Surgery is not usually done for partial tears. Sometimes special heel pads or orthotics in your shoes may help. Follow up with your doctor to check for tendonitis or strain before resuming activity, because both can increase the risk of tendon rupture. Any acute injury causing pain, swelling, and difficulty with weight-bearing activities such as standing and walking may indicate you have a tear in your Achilles tendon. Seek prompt medical attention from your doctor or emergency department. Do not delay! Early treatment results in better outcome. If you have any question or uncertainty, get it checked.
Diagnosis
Diagnosis is made mostly by clinical examination with a defect usually noted on visual examination and by touching the area. A simple test can be done by squeezing the back of the calf with the foot resting in the air. Normally when squeezing the muscle belly the tendon will shorten causing the foot to move in a downward position. With a rupture this squeezing effect may show no movement of the foot if it is not attached properly. A negative test does not mean there isn't some degree of rupture as some of the tendon fibers may still be attached. Sometimes x-rays, an mri, or an ultrasound can be helpful in determining the extent of the rupture.
Non Surgical Treatment
A medical professional will take MRI scans to confirm the diagnosis and indicate the extent of the injury. Sometimes the leg is put in a cast and allowed to heal without surgery. This is generally not the preferred method, particularly for young active people. Surgery is the most common treatment for an achilles tendon rupture.
Surgical Treatment
This injury is often treated surgically. Surgical care adds the risks of surgery, there are for you to view. After the surgery, the cast and aftercare is typically as follows. A below-knee cast (from just below the knee to the tips of the toes) is applied. The initial cast may be applied with your foot positioned in a downward direction to allow the ends of the tendon to lie closer together for initial healing. You may be brought back in 2-3 week intervals until the foot can be positioned at 90 degrees to the leg in the cast. The first 6 weeks in the cast are typically non-weight bearing with crutches or other suitable device to assist with the non-weight bearing requirement. After 6 weeks in the non-removable cast, a removable walking cast is started. The removable walking cast can be removed for therapy, sleeping and bathing. The period in the removable walking cast may need to last for an additional 2-6 weeks. Your doctor will review a home physical therapy program with you (more on this program later) that will typically start not long after your non-removable cast is removed. Your doctor may also refer you for formal physical therapy appointments. Typically, weight bearing exercise activities are kept restricted for at least 4 months or more. Swimming or stationary cycling activities may be allowed sooner. Complete healing may take 12 months or more.
Prevention
The following can significantly reduce the risk of Achilles tendon rupture. Adequate stretching and warming up prior to exercising. If playing a seasonal sport, undertake preparatory exercises to build strength and endurance before the sporting season commences. Maintain a healthy body weight. This will reduce the load on the tendon and muscles. Use footwear appropriate for the sport or exercise being undertaken. Exercise within fitness limits and follow a sensible exercise programme. Increase exercise gradually and avoid unfamiliar strenuous exercise. Gradual ?warm down? after exercising.