Definition
The Achilles’ Tendon is one of the longest and strongest tendons in your body. It flexes your foot and allows you to point your toes. It can become injured in almost every type of athletic activity. In addition, sedentary individuals that suddenly become active are prone to this injury. Other common causes of Achilles’ tendon injuries include overuse, wearing high heeled shoes, flatfeet, and ankle equinus. Achilles’ tendon tears generally occur with sudden movements in sports activities or traumatic events.
Signs and Symptoms
Rupture or tearing of the Achilles’ tendon is often reported as a sudden “snap” or “pop” in the back of the ankle followed by pain, weakness, and difficulty walking. If there is a complete tear the ankle will have no strength at all. Bruising and swelling occur around the ankle soon after the tear.
Diagnosis
Diagnosis is made by palpating a gap in in the continuity of the tendon between the lower leg and the heel, testing muscle strength of the tendon, and by x-ray if a heel spur was avulsed as a result of the rupture. Thompson’s test, or squeezing the calf, is positive if it fails to produce plantarflexion of the foot.
Treatment
The treatment of an Achilles’ rupture will require surgical repair if more than 25% of the tendon is involved. Depending on the severity of the rupture the repair may be more involved than primarily sewing the ends back together. Many tears are longitudinal and the tendon appears “shredded” intra-operatively. In this case repair may require a graft or wrap to restore length and function.
Post surgical treatment includes casting for 6-8 weeks, followed by immobilization in a walking boot and intensive physical therapy.
