Achilles Tendon Tear
Overview
The Achilles tendon is the largest tendon in the body which attaches to the back of the heel. It is part of the calf muscles and primarily helps in push off during running. Achilles tendon integrity is necessary for running, climbing stairs and a lot of other daily activities.
How does the tendon tear?
The area of Achilles tendon insertion to the heel bone is subject to a lot of stress as we sprint suddenly. Without proper warm up sudden sprinting is one of the common reasons for the tendon tear. The tendon tear is typically seen in middle aged sprinters. The tear is typically seen in the distal 1/3rd of the tendon 5 to 6 cm away from the insertion.
Who gets Achilles Tendon Tear?
This is often seen in the age group between 30 and 50. It can occurs in both sporting and non-sporting population. In sporting population the reason for Achilles tendinopathy are
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Poor warm up
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Restarting playing / running after a long gap
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Sudden escalation in the intensity of the workouts
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Over use (Not having gap days or rotation to help heal the stress injuries).
Occasionally it can be due to direct injury to the achilles tendon.
Symptoms
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Sudden pain while sprinting. It feels as if you have been suddenly hit by a heavy stick in the calf area.
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Sudden loss of power.
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difficulty walking.
Natural History (Progression of disease in the absence of treatment)
The Achilles tendon tear leads to loss of power to propel the body weight over the forefoot. The tear does not heal naturally. Although pain resolves over a period of few months, clumsiness with walking over the steep surfaces and climbing the stairs up and down perseveres for long term.
When to seek medical help?
If the pain is not getting relieved with heat therapy, analgesic gels and sprays and with basic warm up stretches, then it is necessary to see a Sports Orthopedics Surgeon. The diagnosis is based on the symptoms and clinical examination. X-ray may sometimes be asked for, however the x-ray helps to rule out the heel bone (Haglund deformity) abnormality causing the Achilles tendon irritiation.
What happens to Achilles tendinopathy if no treatment is undertaken?
The micro-injuries of the Achilles tendon may persist and are likely to keep stopping you from doing further activities such as running. Natural healing of the tendon can take place over a period of 12 to 24 months, but in majority the pain persists unless the right kind of remedies is undertaken.
What happens when I visit the Consultant?
You will be asked about your sporting history, symptoms further to that so far. Consultant will examine you and discuss the treatment modalities.
What are the treatment modalities?
The treatment modalities vary from conservative management such as walker boot with wedges to Achilles tendon repair.