The Achilles tendon is the biggest yet highly vulnerable tendon in the body. The is responsible for connecting the gastrocnemius and the soleus muscles of the lower leg to the heel of the foot. Since the gastrocnemius muscle crosses the ankle, knee and the subtalar joints, it can produce tension and strain in the Achilles tendon. Even though the tendons are sturdy, they are not flexible and only stretch on certain limits before they end up inflamed and tear or even rupture.
What are the possible causes?
The main reason for a ruptured Achilles tendon is difficult to distinguish. The injury can occur abruptly without any warning or right after Achilles tendonitis.
- Weak calf muscles might also contribute to the issue. In case the muscles are weakened and become fatigued, they can tighten and shorten.
- Overuse is also a contributing factor to muscle fatigue. If the calf muscles are fatigued, they shorten and become tight. The ensuing tightness can increase the strain on the Achilles tendon and eventually result to a rupture. The injury is likely to occur among middle-aged individuals who engage in athletic activity during the weekends.
A characteristic sign of a ruptured Achilles tendon is the sensation of being hit in the Achilles area. - An imbalance in the strength of the front lower leg muscles and the rear lower leg muscles can put an individual at risk for damaging the tendon.
- If the force of the tendon is higher than the strength of the tendon, a ruptured Achilles tendon is likely to occur. In case the foot is in a dorsiflexed position while the lower leg drives onward and the calf muscles tighten, a rupture can develop. Most cases of ruptures occur during a strong stretch of the tendon while the calf muscles are contracting.
Indications of a ruptured Achilles tendon
A characteristic sign of a ruptured Achilles tendon is the sensation of being hit in the Achilles area. There is often a “popping” sound with minimal pain or an abrupt pain in the region, but the individual could not lift up onto his/her toes while bearing weight and walking upstairs or uphill can be difficult. In addition, swelling can develop on the back part of the leg in the Achilles region.
It is vital to seek immediate medical care after the injury. The doctor will conduct a physical exam and discuss what happened. This is usually enough to come up with a diagnosis, but an MRI is oftentimes required.
Management
A fully ruptured Achilles tendon requires surgical intervention. The individual is required to use a cast or walking boot. Surgery is usually preferred since it has a lower rate of re-rupture unlike with the non-surgical measures.
As for partial tears, they are oftentimes managed with surgery followed by a cast. Since the tendon shortens as it heals, a heel lift is utilized for 6 months or more after the cast is removed. Physical therapy is required to restore flexibility and strengthening is started as soon as the cast is taken off.