Your Achilles tendon is the largest tendon in your body. It is tasked with aiding movement and handling stress when you do things like walk, run and jump. Because of all it is asked to do, the tendon can gradually wear down and weaken, and if it is overloaded during an explosive movement, the tendon can rupture. Here’s a closer look at what causes your Achilles to tear, and the different ways you can treat the injury.
The Causes and Symptoms of Achilles Tendon Tears
As we alluded to in the intro, Achilles tendon tears occur when the tendon is overstressed in an eccentric contraction position. While the tendon is attempting to handle the stress it is bearing, it lengthens, but if the forces are too great, the tendon will tear. Aside from the mechanical forces at play, there are also some risk factors that increase your likelihood of suffering an Achilles tendon tear, which include:
- Failing to stretch before exercise or athletics.
- Participating in certain sports with quick movements, like soccer, football, tennis and basketball.
- Overexertion, or failing to give your body ample rest between activities.
- Having flat feet, as this can put more stress on the Achilles with each step.
- Wearing high heels regularly, as these can put additional stress on the tendon.
- Age, because our tendon can degenerate or develop microtrauma over years of repetitive stress.
Did you know that when a person tears their Achilles tendon, the action is sometimes accompanied by an audible snap or pop? Many patients say they could actually hear the tendon rupture, which was then accompanied by sharp pain in their lower calf. Other symptoms of an Achilles tendon rupture include tenderness or swelling in the lower leg, regionalized stiffness, the inability to flex or point your toes and inability to walk normally. If you are dealing with any of these symptoms, especially if they were preceded by a popping or snapping sound, head to a foot specialist’s office for an evaluation.
Diagnosing and Treating Achilles Tendon Ruptures
If you believe that you’ve suffered a partial of full tear of your Achilles tendon, you’ll want to get a diagnosis from your primary care physician or an orthopaedic specialist. If you go to a specialist, there’s a good chance that you can get your diagnosis without the need for imaging tests, as those are usually only used in cases where a diagnosis is difficult to make.
In order to make a diagnosis, your doctor will conduct a physical exam of the leg and ask questions about your symptoms and medical history. A common diagnostic test involves squeezing the calf muscle while the patient is lying on their stomach to look for signs that the tendon is still connected. Other physical tests may also be conducted prior to an official diagnosis. If the doctor is unsure about the degree of tearing, or if they want to learn more about the best potential treatment options, they may order an MRI or ultrasound to take a direct look at the tendon.
When it comes to caring for a ruptured Achilles tendon, there are two main course of treatments. There’s the non-surgical route, which requires the patient to be non-weight bearing and in a cast, while the other method involves surgical correction. Either method may be best for your situation, but in general, orthopaedic specialists typically recommend surgery to treat an Achilles tendon rupture. Here’s a closer look at both treatment options.
Non-Operative Treatment – Non-operative Achilles tendon rupture treatment involves casting the foot below the knee. Foot braces and walking boots are other ways that doctors may attempt to immobilize the tendon. Although each case is different, non-surgical treatment usually involves 6-10 weeks of immobilization before the patient can begin physical therapy and strength training exercises. Pain medications may also be prescribed during this time, but are not necessary for every patient.
Surgery for Achilles Tendon Repair – Surgery is often the preferred route because of its tendency to better strengthen the injured tendon, which leads to a reduction in pain levels and a decreased likelihood of a subsequent Achilles tear. The surgery involves making a few small incisions on the back of your ankle and identifying the torn ends of the tendon. The surgeon will then reattach the tendon using sutures before closing the incision sites. The way the sutures are tied together aids the tendon in the natural healing process. Partial weight bearing is possible in the first few days after surgery, and physical therapy exercises can usually begin much sooner, although it can still take up to six months to return to pre-injury levels of activity.