The Achilles tendon is the largest and strongest tendon in the human body. The Achilles tendon connects the heel bone (calcaneus) to the muscles at the back of the calf (using gastrocnemius and soleus muscles). The synchronous function of the tendon and calf muscles is critical for activities like jumping, running, standing on the toe, and climbing stairs. When climbing stairs or running, the forces within the tendon have been measured and indicate that the structure is able to withstand at least 10 times the body weight of the individual. The function of the Achilles tendon is to help raise your heel as you walk. The tendon also assists in pushing up the toes and lifting the rear of the heel. Without an intact Achilles tendon, almost any motion with the ankle (for example, walking or running) is difficult.
Factors that may increase your risk of Achilles tendon rupture include some of the following. Age. The peak age for Achilles tendon rupture is 30 to 40. Sex. Achilles tendon rupture is up to five times more likely to occur in men than in women. Recreational sports. Achilles tendon injuries occur more often during sports that involve running, jumping, and sudden starts and stops, such as soccer, basketball and tennis. Steroid injections. Doctors sometimes inject steroids into an ankle joint to reduce pain and inflammation. However, this medication can weaken nearby tendons and has been associated with Achilles tendon ruptures. Certain antibiotics. Fluoroquinolone antibiotics, such as ciprofloxacin (Cipro) or levofloxacin (Levaquin), increase the risk of Achilles tendon rupture.
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.
A diagnosis can be made clinically, but an MRI or ultrasound scan can confirm it. On examination, the patient will present with reduced plantarflexion strength, a positive Thompson test and potentially, a palpable gap in the Achilles. The whole length of the tendon should be examined to check for injuries that can occur at the insertion and the musculotendinous junction.
Non Surgical Treatment
As debilitating as they can be, the good news is that minor to moderate Achilles tendon injuries should heal on their own. You just need to give them time. To speed the healing, you can try the following. Rest your leg. Avoid putting weight on your leg as best you can. You may need crutches. Ice your leg. To reduce pain and swelling, ice your injury for 20 to 30 minutes, every three to four hours for two to three days, or until the pain is gone. Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down swelling. Elevate your leg. Prop you leg up on a pillow when you’re sitting or lying down. Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) will help with pain and swelling. However, these drugs have side effects, such as an increased risk of bleeding and ulcers. They should be used only occasionally unless your health care provider says otherwise and should be taken with food. Check with your doctor before taking these if you have any allergies, medical problems or take any other medication. Use a heel lift. Your health care provider may recommend that you wear an insert in your shoe while you recover. It will help protect your Achilles tendon from further stretching. Practice stretching and strengthening exercises as recommended by your health care provider. Usually, these techniques will do the trick. But in severe cases of Achilles tendon injury, you may need a cast for six to 10 weeks or even surgery to repair the tendon or remove excess tissue.
There are two types of surgery to repair a ruptured Achilles tendon. In open surgery, the surgeon makes a single large incision in the back of the leg. In percutaneous surgery, the surgeon makes several small incisions rather than one large incision. In both types of surgery, the surgeon sews the tendon back together through the incision(s). Surgery may be delayed for about a week after the rupture, to let the swelling go down.
Prevention centers on appropriate daily Achilles stretching and pre-activity warm-up. Maintain a continuous level of activity in your sport or work up gradually to full participation if you have been out of the sport for a period of time. Good overall muscle conditioning helps maintain a healthy tendon.