Overview

A rupture of the Achilles (uh-KILL-eez) tendon affects the back of your lower leg. It mostly affects people who participate in recreational sports, but it can affect anyone.

The Achilles tendon is a dense fibrous cord that connects the back of your calf muscles to your heel bone. Your Achilles tendon can tear (rupture) completely or partially if you overstretch it.

If your Achilles tendon ruptures, you may hear a pop followed by a sharp pain in the back of your lower leg and ankle that will likely make it difficult for you to walk properly. The rupture is frequently repaired through surgery. Nonsurgical treatment, on the other hand, is effective for many people.

Types of Achilles Injuries

While there is still a lot to understand about the injury epidemic, it is critical that individuals understand the indicators of Achilles damage and when to seek medical help, as this can make all the distinctions in terms of recovery.

There are three different types of Achilles tendon injuries.

Tendinitis

This is the most familiar injury, which happens when the Achilles sheath gets inflamed, usually as a result of overuse.

These can occur as a result of a training blunder, such as doing too much too quickly. It’s sometimes related to walking up a high incline’s step, but for young to middle-aged persons, overuse is often the main concern.

When a person has tendinitis, they will experience pain when moving their ankle. They may also experience soreness and swelling in the affected area.

Tendinosis

This is not an inflammatory injury but rather a degenerative disorder in which the collagen in the tendon deteriorates. This injury affects middle-aged adults more than tendinitis.

Tendinosis is similar to arthritis in that it affects tendons. This degenerative process can occur at the insertion, where the tendon connects to the heel bone or farther up the tendon, referred to as the proximal end.

Tendinosis is frequently confused with tendinitis, which is the more prevalent diagnosis. To distinguish between the two in patients, doctors may use a musculoskeletal ultrasound or an MRI.

Traditionally, the two conditions were thought to be separate. Recent laboratory investigations, on the other hand, have blurred the distinctions between these circumstances. This emphasizes how much more we need to learn about tendon biology.

Rupture or Tear of the Achilles Tendon

This could happen when playing tennis, jogging after a toddler, or playing pickup basketball at the park. Someone places their feet, pushes off, and a pop is heard.

This is virtually always the case. Because it may seem like a chop to the back of the leg, they check behind them to see who hit them. This type of rip is most common among middle-aged weekend warriors. Sure, you see it in athletes, but it’s usually a middle-aged man who participates in court sports.

The Achilles tendon breaks away from its attachment on the calcaneus, or heel bone, in a much more rare occurrence. This condition is more commonly linked to previous steroid injections in the area or extensive degenerative changes at the attachment, both of which cause substantial weakening.

Symptoms of Achilles Tendon Rupture

Although an Achilles tendon rupture might cause no signs or symptoms, the majority of patients experience:

• The sensation of being kicked in the calf
• Swelling and maybe acute pain at the heel
• When walking, the ineptitude to “push off” the damaged leg or bend the foot downward.
• The wounded leg’s inability to stand on its toes

When an injury occurs, it makes a popping or snapping sound.

If you hear a crackling sound in your heel, seek medical help right once, especially if you can’t walk normally thereafter.

Causes of Achilles Tendon

As you walk, your Achilles tendon assists you in pointing your foot downward, rising on your toes, and pushing off your foot. It’s something you rely on almost every time you walk or move your foot.

Rupture commonly occurs within 2 1/2 inches (approximately 6 centimeters) of the tendon’s attachment to the heel bone. Because blood supply is weak in this area, it may be prone to rupture, compromising its ability to mend.

A rapid increase in the stress on your Achilles tendon is a common cause of the rupture. Here are a few examples:

• Increasing the intensity of sports involvement, particularly in jumping sports
• Falling from a great height is a terrifying experience.
• Taking a step into a chasm

Risk Factors

The following factors may enhance your chance of Achilles tendon rupture:

• Achilles tendon rupture is most common between the ages of 30 and 40.
• Males are about five hundred percent more likely than women to rupture their Achilles tendon.
• Sporting activities for fun. Achilles tendon injuries are more typical in sports like soccer, basketball, and tennis, which include running, jumping, and quick starts and pauses.
• Injections of steroids. To relieve pain and inflammation in the ankle joint, doctors may inject steroids. However, this medicine has been linked to Achilles tendon ruptures because it weakens neighboring tendons.
• Antibiotics in particular. Antibiotics that contain fluoroquinolones, including ciprofloxacin (Cipro) or levofloxacin (Levaquin), raise the risk of Achilles tendon rupture.
• The tendon is strained more by excess weight.

When Should You Consult a Physician?

Continued aggravation and chronic pain that does not subside in tendinosis and tendinitis are signs that it’s time to contact a doctor.

The damage may not feel very painful in the case of a tear, which can be a problem.

People attempt to walk them off; it doesn’t hurt too much, and it’s easy to walk on. That’s a major problem because if you keep walking on it and don’t seek treatment within a day or two, the affected muscle will often pull unopposed, widening the space between the two ends of the tendon.

Even if the pain is minor, a person should see a doctor if they hear or feel a pop or chop in the back of their leg.

Treatment Options for Achilles Tendon Injuries

There is evidence to support both operational and non-operative care of Achilles tears, depending on the circumstances. Individual patient characteristics, timing from injury to treatment initiation, amount of tendon gap, and medical comorbidities are all aspects to consider.

Bracing the wounded leg and following up with physical therapy to regain strength in the limb is a non-operative treatment option. In other circumstances, doctors may choose surgery to enhance healing by triggering the body’s natural reparative reaction after removing degenerative tissue that is impeding a patient’s development.

Rest and occasional heel lifts are frequently indicated for tendinosis and tendinitis. However, there is no one-size-fits-all treatment for these injuries.

This is a discussion that patients should have with their doctors in order to make the best option possible in each circumstance.

Is it Possible to Avoid Achilles Injuries?

While some people advise stretching, it is still debatable when it comes to preventing Achilles injuries. Regular exercise and strength training tailored to the individual is the most effective preventative care.

Only a few research have looked into the effectiveness of specific prevention techniques. Apart from specialized training, doctors no longer advise people to use corticosteroids for long-term discomfort. While corticosteroids may help some pain, they may also hinder the tendons from adjusting, and there is little evidence to back up their usage.

The first step toward prevention is to understand your limitations and your pain. Sadly, there isn’t always anything one can do about bad luck. Even if there are no early indicators of deterioration or training faults, a random event can cause a total rupture.

It is critical to engage and educate patients about their problem, treatment alternatives, and the justification for your advice in order to achieve a good outcome and return to function. Patient education is an important necessity in the treatment of this and all other ailments, and it is something we are proud of.

Preventative Measures

Follow these guidelines to lower your chances of having Achilles tendon problems:

Calf muscles should be stretched and strengthened. Stretch your calf till you perceive a slight tug but no pain. During a stretch, don’t bounce. Calf-strengthening exercises can also aid in injury prevention by allowing the muscle and tendon to absorb more stress.

Vary your workouts. Alternate high-impact activities like running with low-impact activities like walking, cycling, or swimming. Avoid exercises that put an excessive amount of strain on your Achilles tendons, such as hill running and leaping.

Choose your running surfaces with caution. Running on hard or slick surfaces should be avoided or limited. For cold-weather exercise, dress appropriately and wear well-fitting athletic shoes with adequate heel cushioning.

Gradually increase your training intensity. A rapid increase in exercise intensity is a typical cause of Achilles tendon injury. Increase your weekly training distance, duration, and frequency by no more than 10%.