Achilles Tendon

posted on 24 Mar 2015 15:33 by lolareem
Overview
Achilles Tendonitis The exact number of people who develop Achilles tendon injury is not known, because many people with mild tendonitis or partial tear do not seek medical help. It is believed to be more common in men but with the recent participation of women in athletics, the incidence of Achilles tendon injury is also increasing in this population. Overall, injury to the Achilles tendon is by far most common in the athlete/active individual.

Causes
There are a number of factors that can increase the risk of an Achilles tendon rupture, which include the following. Youre most likely to rupture your Achilles tendon during sports that involve bursts of jumping, pivoting and running, such as football or tennis. Your Achilles tendon becomes less flexible and less able to absorb repeated stresses, for example of running, as you get older. Small tears can develop in the fibres of the tendon and it may eventually completely tear. There is a very small risk of an Achilles tendon rupture if you have Achilles tendinopathy (also called Achilles tendinitis). This is where your tendon breaks down, which causes pain and stiffness in your Achilles tendon, both when you exercise and afterwards. If you take quinolone antibiotics and corticosteroid medicines, it can increase your risk of an Achilles tendon injury, particularly if you take them together. The exact reasons for this aren't fully understood at present.

Symptoms
Often the person feels a whip-like blow that is followed by weakness in the affected leg - usually he or she is not able to walk afterwards. At place where the tendon ruptured, a significant dent is palpable. Often the experienced physician can diagnose a ruptured Achilles tendon by way of clinical examination and special function tests. Imaging techniques, such as ultrasound and magnetic resonance imaging (MRI) allow for a more precise diagnosis.

Diagnosis
The diagnosis of an Achilles tendon rupture can be made easily by an orthopedic surgeon. The defect in the tendon is easy to see and to palpate. No x-ray, MRI or other tests are necessary.

Non Surgical Treatment
A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. Use support devices as directed. You may need crutches or a cane for support when you walk. These devices help decrease stress and pressure on your tendon. Your caregiver will tell you how much weight you can put on your leg. Ask for more information about how to use crutches or a cane correctly. Start activity as directed. Your caregiver will tell you when it is okay to walk and play sports. You may not be able to play sports for 6 months or longer. Ask when you can go back to work or school. Do not drive until your caregiver says it is okay. Achilles Tendon

Surgical Treatment
There are two different types of surgeries; open surgery and percutaneous surgery. During an open surgery an incision is made in the back of the leg and the Achilles tendon is stitched together. In a complete or serious rupture the tendon of plantaris or another vestigial muscle is harvested and wrapped around the Achilles tendon, increasing the strength of the repaired tendon. If the tissue quality is poor, e.g. the injury has been neglected, the surgeon might use a reinforcement mesh (collagen, Artelon or other degradable material). In percutaneous surgery, the surgeon makes several small incisions, rather than one large incision, and sews the tendon back together through the incision(s). Surgery may be delayed for about a week after the rupture to let the swelling go down. For sedentary patients and those who have vasculopathy or risks for poor healing, percutaneous surgical repair may be a better treatment choice than open surgical repair.

Prevention
Prevention centers on appropriate daily Achilles stretching and pre-activity warm-up. Maintain a continuous level of activity in your sport or work up gradually to full participation if you have been out of the sport for a period of time. Good overall muscle conditioning helps maintain a healthy tendon.