The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run, and jump. Although the Achilles tendon can withstand great stresses from running and jumping, it is vulnerable to injury. A rupture of the tendon is a tearing and separation of the tendon fibers so that the tendon can no longer perform its normal function.
The causes of an Achilles tendon rupture are very similar to Achilles tendinitis. Causes include. Running uphill. Running on a hard surface. Quickly changing speeds from walking to running. Playing sports that cause you to quickly start and stop.
Many people say that a ruptured Achilles feels like ?being shot in the heel?, if you can imagine how enjoyable that feels. You may hear a snap sound or feel a sudden sharp pain when the tendon tears. After a few moments, the pain settles and the back of the lower leg aches. You can walk and bear weight, but you may find it difficult to point the foot downward or push off the ground on the affected side. You will be unable to stand on tiptoe. Bruising and swelling are likely, and persistent pain will be present. Similar symptoms may be caused by an inflamed Achilles tendon (Achilles tendonitis), a torn calf muscle, arthritis of the ankle, or deep vein thrombosis in the calf, so an MRI or ultrasound scan will likely be used to diagnose your condition.
An Achilles' tendon injury can be diagnosed by applying the Thompson Test (or Calf Squeeze Test) this is where the person who has suffered the injury lies on their front with their legs bent. Whoever is performing the test, usually a doctor, will then squeeze the calf muscle. If the tendon has not ruptured then the foot should point briefly away from the leg.
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.
Some surgeons feel an early surgical repair of the tendon is beneficial. The surgical option was long thought to offer a significantly smaller risk of re-rupture compared to traditional non-operative management (5% vs 15%). Of course, surgery imposes higher relative risks of perioperative mortality and morbidity e.g. infection including MRSA, bleeding, deep vein thrombosis, lingering anesthesia effects, etc.
Good flexibility of the calf muscles plays an essential role in the prevention of Achilles tendon injuries. It is also important to include balance and stability work as part of the training programme. This should include work for the deep-seated abdominal muscles and for the muscles that control the hip. This might at first appear odd, given the fact that the Achilles are a good distance from these areas, but developing strength and control in this area (core stability) can boost control at the knee and ankle joints. Training errors should be avoided. The volume, intensity and frequency of training should be monitored carefully, and gradually progressed, particularly when introducing new modes of training to the programme. Abrupt changes in training load are the primary cause of Achilles tendinopathy.