The Achilles tendon is the strongest and largest tendon in the body. It connects the calf muscles to the heel bone. Despite its strength, it is the most commonly ruptured tendon due to a flexed foot, most commonly associate with sporting events, typically when the foot quickly moves from being pointed downwards to the being pointed upwards.
The incidence of Achilles tendon ruptures is on the rise due the aging population, and increased participation in sports. Men are 2-12 times more prone to Achilles tendon ruptures than women. 75% of these injuries affect adult men in their 30s to 50s who engage in sporadic physical activities, usually called weekend warriors. Ruptures most often occur during soccer, racket games and basketball, but also affect dancers, runners, gymnasts, and football players. In 20% to 25% of patients, the injury is misdiagnosed as an ankle sprain.
The causes of Achilles tendon ruptures can be multifactorial, including:
- Overuse and stress: Repetitive stress on the Achilles tendon, common in athletes, can lead to overuse injuries and eventual rupture.
- Sudden increase in physical activity: A sudden increase in the intensity or frequency of physical activities, especially in individuals who are not regularly active, can cause the tendon to rupture.
- Age-related degeneration: The tendon’s structure and strength deteriorate with age, making older adults more susceptible to ruptures.
- Underlying health conditions: End – stage kidney disease is highly associated with an increase in the risk of an Achilles tendon rupture. Other conditions such as obesity, hypertension, and diabetes mellitus can weaken the tendon.
- Medications: Some medications, including corticosteroids and certain types of antibiotics, have been linked to an increased risk of Achilles tendon ruptures.
- Direct Trauma: A direct blow to the Achilles tendon can result in a rupture.
Individuals often describe feeling a sudden, severe pain in the back of the ankle or calf, akin to being hit or kicked in the area. At the time of rupture, many report hearing a popping or snapping sound.
Swelling and bruising around the heel and calf area are common. It may be difficult to impossible to walk on the affected foot, and difficult to stand on the toes. Heel pain is common. In some cases, a gap can be felt in the tendon just above the heel.
Timely and accurate diagnosis is crucial for optimal treatment and recovery. Your Silicon Valley Orthopedics surgeon will take a detailed medical history, inquire about how the injury occurred, your symptoms, and previous injuries.
They will conduct a physical examination and use special tests to diagnose the tear including The Thompson test, where the calf muscle is squeezed to see if the foot flexes. Patients with an Achilles tendon rupture cannot stand on their toes. Palpating the area can help identify a gap in the tendon, which indicates a complete rupture. Range of motion and strength will be assessed to provide insight into the impact of the rupture.
X-rays may be used to rule out other problems. Ultrasound imaging is useful to determine a complete vs. partial rupture. Magnetic resonance imaging (MRI) may be ordered to evaluate acute and chronic ruptures. Imaging can help to confirm the diagnosis and assess the extent of the rupture.
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When you or a loved one has an ankle injury, contact Silicon Valley Orthopedics to schedule a consultation. We have offices in Fremont, Los Gatos and Menlo Park. At Silicon Valley Orthopedics we strive for compassionate, personalized care and treatment options geared to your needs.