Achilles Tendon Rupture

Aşil Tendonu

Achilles Tendon Rupture

One of the Greek heroes of the Trojan War, Achilles (Greek: χιλλεύς Akhileus, French: Achille Achilles) was immersed in the river of immortality by his mother when he was born. While doing this, his mother has to hold Achilles' left ankle, and years later, Achilles is killed by an arrow that hit his left ankle in the Trojan War. This tendon, which originates from this mythological story, is called the Achilles Tendon. Tendons are connective tissues that attach muscles to bone surfaces. The Achilles tendon is a tendon formed by the attachment of two muscles located at the back of the ankle and at the back of the calf, to the heel bone (calcaneus). For this reason, it is also known as the calcaneal tendon.
The Achilles tendon is the largest and strongest tendon in the human body. When the calf muscles contract, this tendon pulls the heel up and helps rise to the toe. For this reason, it is necessary and active in many functions from simple and basic functions such as standing to functions such as walking, running and especially jumping. Although the tendon is physically large and strong, it has a limited blood flow like all other tendon structures. This negatively affects the regeneration processes of the tissue. There is also an intense tension on it. These conditions make the tendon more susceptible to injury. Achilles tendon rupture is mostly caused by trauma. Its rupture may be partial or complete; can be acute or chronic.
Although the cause of Achilles tendon rupture cannot be determined exactly, in most of the cases, situations that cause sudden and high-intensity tension in the muscle constitute the rupture mechanism. Indirect traumas, mechanical effects, vascular disadvantage and poor tissue quality are the causes of Achilles tendon injury. In addition, conditions characterized by pain caused by activity in the tendon area called tendinopathy, localized pain on palpation, localized edema and decreased performance also predispose to Achilles tendon rupture.

Symptoms of Achilles Tendon Rupture

People with Achilles tendon rupture often describe severe pain of acute onset and a popping sound depending on the degree of rupture. In some cases, limping may occur. People with Achilles tendon rupture cannot perform functions such as walking, running, jumping, and toe-up or have difficulty in doing these.

For the diagnosis, first of all, the person is asked questions about the injury by the doctors and special examination methods are applied. Thompson Test, which is a clinically easy and highly reliable test, is helpful in diagnosing Achilles tendon injury. Achilles tendon rupture is suspected if the compression force applied by the clinician to the calf muscles of the patient in the prone position with the feet in the space does not reveal movement in the ankle. In some patients, the diagnosis of Achilles tendon rupture may be overlooked in cases where there is no problem in walking and finger tip elevation. In such cases, MRI (magnetic resonance imaging) and USG (ultrasound imaging) are applied as the gold standard diagnostic method.

thompson-test

 

Treatment

In the case of Achilles tendon rupture, treatment varies depending on whether the rupture is acute or chronic and its degree. Depending on the person, situation and expectations, surgical or non-surgical treatment options are applied. Surgery is often preferred in chronic ruptures and in athletes to restore ankle functions. A rehabilitation program following the surgery is applied by physiotherapists, taking into account other health problems and physical activity levels of people who will undergo surgery. In non-surgical treatment, an orthosis or plaster is applied to fix the ankle and tendon healing is followed at regular intervals. The person is prepared to return to normal functions with the necessary rehabilitation support under the follow-up of a physiotherapist and doctor.

In case of early signs of tendinopathy, pain, tenderness, edema in the Achilles or calf region, and in cases where there is difficulty due to use, people should definitely apply to health institutions. It should be noted that Achilles tendon rupture is a health problem that can lead to serious problems if left untreated.