Achilles Tendon Rupture
The Achilles tendon is the strongest and most resistant tendon in the human body, connecting the posterior leg muscles (“calves”) to the heel. Despite its strength, it is the most common tendon injury in the lower limb, with preponderance in men and in the 30-50 age group.
Tears of the Achilles tendon result in a separation or discontinuity of the tissues making up the tendon and can be classified as total rupture (most frequent) or partial rupture.
Most ruptures occur during sports such as football, athletics, tennis, basketball, etc., and mainly affect athletes, sedentary middle-aged people or so-called “weekend warriors”.
The main causes of this injury include excessive and repetitive strain on the tendon, due to a significant increase in sports activity or a change in habitual exercise habits.
Other factors that can result in ruptures include direct trauma to the leg or heel, chronic inflammation or even the use of certain medications, such as corticosteroids and some antibiotics.
Symptoms
Symptoms – sudden, severe pain in the “back” of the ankle or “calf”; a snapping sound (at the moment when the rupture occurs); swelling and redness at the site of the injury; a discontinuity or depression that can be felt and seen in the tendon above the heel bone; the inability to stand on “tiptoes” or put the foot on the ground and walk.
Diagnosis is based on clinical assessment and complementary diagnostic tests, namely ultrasound or MRI.
Treatment
Two types of treatment can be considered: conservative and surgical, depending on the severity of the injury, the person’s age, physical condition and the level of activity. Regardless of the treatment chosen, both will require a period of immobilisation, followed by a rehabilitation protocol to regain mobility, strength, gait and function.
In general, all tendon ruptures benefit from the RICE approach (Rest, Ice, Compression, Elevation). Reducing the load on the joint by using crutches or an orthosis such as a “walker boot” and physiotherapy are essential parts of the rehabilitation process.
Some of the techniques used in physiotherapy include:
- physical agents such as ultrasound, laser or TENS (electrotherapy) which act as analgesics and anti-inflammatories;
- lymphatic drainage massage and mesotherapy techniques to reduce haematomas and oedema;
- scar massage techniques to loosen tissue adhesions so that the skin returns to its original position;
- joint mobilisation techniques to restore ankle range of motion and reduce joint stiffness;
- gait and posture correction training to improve the functionality of the different body structures, resulting in a more correct gait;
- physiotherapy sessions with muscle strengthening, proprioceptive and stretching techniques for the posterior muscles of the leg and ankle to improve muscle strength, flexibility and stability of the lower limb, taking into account injury times, tendon healing and adapting loads to the muscle and tendon structures.
Recovery is usually long, around 6 to 8 months, but can take up to 1 year, and generally requires physiotherapy several times a week, both for those who underwent surgery and those who have had conservative treatment, with a customised programme recommended at the end to prevent future injury.
If you need treatment for Achilles tendon rupture, contact our physiotherapy clinics in Lisbon.
