Rupture Of Achilles
The mythical Greek warrior, Achilles was extraordinarily strong, courageous and was said to be invincible, and he was, until an arrow pierced his Achilles tendon. The Achilles tendon stretches down the lower leg to the heel and connects the calf muscle to the heel. You can have many different injuries to this tendon, and one of them is the rupturing of the tendon. It is usually a distinct diagnosis, whether the Achilles is rupture or not. There are both surgical and non-surgical treatment options to repair a ruptured Achilles tendon (2). Physical therapy can be very helpful to the healing process even if treatment is non-surgical (6). A rupture is either a complete or partial tear that happens when the tendon is stretched more than its capability. Most of the time it is torn by strenuous jumping or pivoting or unexpected accelerations of running (2). It is possible to have no signs or symptoms with an Achilles tendon rupture, but most people
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experience a lot of the signs and symptoms. Sometimes it’s possible to have no signs or symptoms when the Achilles tendon is ruptured, but very uncommon. Someone who has ruptured their Achilles tendon might experience unexpected, possibly severe pain in the back of the calf or ankle often decreasing into a dull pain, and swelling near the area. There may be an inability to push your foot downward, stand on the toes, or push off the injured leg. There may also be a popping sound or feeling in your heel or ankle when the injury occurs (1). It’s less painful to prevent rupturing the Achilles tendon rather than managing the signs and symptoms of it, so taking preventative measures can reduce the risk of a rupture. Most musculoskeletal injuries can be prevented simply by stretching. Stretching is presumed to reduce muscle and tendon stiffness and increase muscle length which reduces the force production transferred through the musculotendinous unit and prevents possible injury (12). Stretching and strengthening the calf muscles by stretching the calf to the point when there’s a pull but the point when pain occurs can help prevent a rupture. Also avoid bouncing while stretching because this can be unexpected and cause the tendon to rupture. Other ways to prevent a rupture of the Achilles tendon is to alternate between high impacts sports and low impact sports. Try to avoid doing activities that put stress on the tendon like running hills or activities that involve jumping. When running it also helps to avoid running on hard or slippery surfaces and wear the appropriate shoes with the right cushioning on the heel. Preventing a rupture doesn’t just involve stretching and techniques, but also strengthen the tendon too. It is good to strengthen but increasing the intensity suddenly can cause the tendon to rupture. If there is increase in the training it needs to be by no more than 10% each week to avoid injury in the Achilles tendon (3). Although preventing an Achilles tendon rupture is easier than managing it, medications can be used to help manage pain. Medication can be used to relieve the pain from a rupture of the Achilles tendon, because it can be very painful, especially after surgery.
The medications used can be prescribed or over the counter. Most over the counter medication used to relieve pain will be acetaminophen, like Tylenol. Other medication that could be used are nonsteroidal anti-inflammatory drugs (NSAIDs), which are normally used to reduce and treat inflammation, although aren’t used often because most tendon problems don’t include inflammation (4). The only other pharmacological use is when surgery is done. If you choose the surgical treatment option you may have spinal anesthesia. Spinal anesthesia will not allow you to feel anything from the waist down. Choosing the surgical treatment means you may also be given sedation, meaning you will sleep through the surgery (5). Despite the fact that medication can be very helpful while managing an Achilles tendon rupture, friends, family, and medical professionals can also help you get through your injury
too.
There is not just a physical effect while having an injury, there is also an emotional side. Having a ruptured Achilles tendon restricts the activities and this can affect a person’s emotional well-being. At the beginning of the healing phase the patient will not be able to put weight on the injured foot for 12 or more weeks, and will be required to use assistive devices(11). After the first 12 weeks patients will start to work with a physical therapist to regain their range of motion and strength but it will still take a while (8). Having limited actives while recovering can cause frustration and boredom, and often depression. This is why it is important to have a great support system including friends, family, and often time’s medical professions like counselors. It takes patients a long time to restore full activity, typically 6 months to a year (9). Not having the same ability as before the injury for a long amount of time can make it hard to be independent, so this is where support systems can also be essential, so it doesn’t get frustrating trying to do things independently. It is also important to keep a positive perspective while recovering and support systems can help with that. Maintaining a positive attitude guarantee that readiness to work hard when it comes to working with the physical therapist. It is important to work hard in physical therapy because physical therapy is important to help heal an Achilles tendon rupture (6). “Physical therapy involves exercises that strengthen the muscles and improve the range of motion of the foot and ankle” (6).
“Physical therapy will be important in helping you regain your strength and motion, begin walking again without assistive devices, and help you to eventually return to your regular function” (11). “A physical therapist will access the tendon. An exercise program will be created to help recovery and to strengthen the muscles” (10). Just like strengthening and stretching the tendon to try and prevent injury , “in physical therapy you will learn exercises to make your calf muscles stronger and your Achilles tendon more flexible” (7). Physical therapist is a big component of the recovery, and “with the help of physical therapy most people can return to normal activity in 4 to 6 months” (7).
experience a lot of the signs and symptoms. Sometimes it’s possible to have no signs or symptoms when the Achilles tendon is ruptured, but very uncommon. Someone who has ruptured their Achilles tendon might experience unexpected, possibly severe pain in the back of the calf or ankle often decreasing into a dull pain, and swelling near the area. There may be an inability to push your foot downward, stand on the toes, or push off the injured leg. There may also be a popping sound or feeling in your heel or ankle when the injury occurs (1). It’s less painful to prevent rupturing the Achilles tendon rather than managing the signs and symptoms of it, so taking preventative measures can reduce the risk of a rupture. Most musculoskeletal injuries can be prevented simply by stretching. Stretching is presumed to reduce muscle and tendon stiffness and increase muscle length which reduces the force production transferred through the musculotendinous unit and prevents possible injury (12). Stretching and strengthening the calf muscles by stretching the calf to the point when there’s a pull but the point when pain occurs can help prevent a rupture. Also avoid bouncing while stretching because this can be unexpected and cause the tendon to rupture. Other ways to prevent a rupture of the Achilles tendon is to alternate between high impacts sports and low impact sports. Try to avoid doing activities that put stress on the tendon like running hills or activities that involve jumping. When running it also helps to avoid running on hard or slippery surfaces and wear the appropriate shoes with the right cushioning on the heel. Preventing a rupture doesn’t just involve stretching and techniques, but also strengthen the tendon too. It is good to strengthen but increasing the intensity suddenly can cause the tendon to rupture. If there is increase in the training it needs to be by no more than 10% each week to avoid injury in the Achilles tendon (3). Although preventing an Achilles tendon rupture is easier than managing it, medications can be used to help manage pain. Medication can be used to relieve the pain from a rupture of the Achilles tendon, because it can be very painful, especially after surgery.
The medications used can be prescribed or over the counter. Most over the counter medication used to relieve pain will be acetaminophen, like Tylenol. Other medication that could be used are nonsteroidal anti-inflammatory drugs (NSAIDs), which are normally used to reduce and treat inflammation, although aren’t used often because most tendon problems don’t include inflammation (4). The only other pharmacological use is when surgery is done. If you choose the surgical treatment option you may have spinal anesthesia. Spinal anesthesia will not allow you to feel anything from the waist down. Choosing the surgical treatment means you may also be given sedation, meaning you will sleep through the surgery (5). Despite the fact that medication can be very helpful while managing an Achilles tendon rupture, friends, family, and medical professionals can also help you get through your injury
too.
There is not just a physical effect while having an injury, there is also an emotional side. Having a ruptured Achilles tendon restricts the activities and this can affect a person’s emotional well-being. At the beginning of the healing phase the patient will not be able to put weight on the injured foot for 12 or more weeks, and will be required to use assistive devices(11). After the first 12 weeks patients will start to work with a physical therapist to regain their range of motion and strength but it will still take a while (8). Having limited actives while recovering can cause frustration and boredom, and often depression. This is why it is important to have a great support system including friends, family, and often time’s medical professions like counselors. It takes patients a long time to restore full activity, typically 6 months to a year (9). Not having the same ability as before the injury for a long amount of time can make it hard to be independent, so this is where support systems can also be essential, so it doesn’t get frustrating trying to do things independently. It is also important to keep a positive perspective while recovering and support systems can help with that. Maintaining a positive attitude guarantee that readiness to work hard when it comes to working with the physical therapist. It is important to work hard in physical therapy because physical therapy is important to help heal an Achilles tendon rupture (6). “Physical therapy involves exercises that strengthen the muscles and improve the range of motion of the foot and ankle” (6).
“Physical therapy will be important in helping you regain your strength and motion, begin walking again without assistive devices, and help you to eventually return to your regular function” (11). “A physical therapist will access the tendon. An exercise program will be created to help recovery and to strengthen the muscles” (10). Just like strengthening and stretching the tendon to try and prevent injury , “in physical therapy you will learn exercises to make your calf muscles stronger and your Achilles tendon more flexible” (7). Physical therapist is a big component of the recovery, and “with the help of physical therapy most people can return to normal activity in 4 to 6 months” (7).