Diagnosis

ACHILLES TENDON TEAR


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 Definition Tearing of the tendon behind the ankle that connects the leg and ankle to the heel bone
Details The achilles tendon is a strong band of tissue that is the continuation of the large calf muscles. It serves as the power source for pushing off with the foot.
Causes Achilles tendon tears typically occur during cutting and jumping type sports such as basketball, tennis or football. These tears are the result of a violent contraction of the large calf muscles and usually do not involve any contact with another player. In some cases, achilles tendon ruptures occur after a long history of achilles tendonitis (inflammation).
Diagnosis Achilles tendon tears are diagnosed by a history of a sudden injury followed by a "pop" felt behind the ankle. The tear is confirmed by squeezing the calf muscles. If the foot does not move, the tendon is probably torn. Occasionally, an MRI or ultrasound is needed to establish that the tendon is indeed ruptured.

Physical Examination of a Torn Achilles Tendon
Treatment Nonoperative: For inactive patients or patients who are not willing to accept surgical risks, nonoperative care is given. This care is in the form of a cast for 4-6 weeks followed by rehabilitation. The risks of nonoperative care include a higher risk of rerupture and possible loss of strength with pushing off type activities.

Operative: For active patients, surgical reattachment of the torn tendon is recommended. It involves a 3-4 inch incision behind the ankle, suturing the torn tendon ends together and then splinting for 4-6 weeks. The risks of operative care include infection, scarring, and poor wound healing. The benefits are a lower risk of rerupture and a better chance of restoring full power to the leg.

Treatment of achilles tendon tears is controversial. Each case must be evaluated on a individual basis.

Surgical Repair of an Achilles Tendon Tear
Prevention

Warming up before exercising and proper stretching are essential to the prevention of achilles tendon tears.


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