Achilles Tendon Tears
By Laurence Schubert APAM
After the Kevin Durant injury in Game 5 of this years NBA finals series, we have been asked by many people about this. Rather than speculate and give opinion of whether or not he should have been on the court, Laurence gives a brief description of an Achilles Tendon injury.
What is it?
Tendons are a continuation of muscle that acts as a band/connective tissue in order for the muscle to create movement. The Achilles tendon is thick, strong and the largest tendon in the human body. When the calf muscle contracts it pulls the heel up, allowing you to stand on your toes or point your foot.
Achilles tendon tear commonly occur in athletes, however, anyone can be affected by this injury. A complete tear is actually more common than a partial tear. Typically, the tear will occur approximately 6cm above where the tendon attaches to the heel. However, the tear does not always occur in this location.
What are the symptoms?
Following an Achilles tendon tear, there will be difficulty with any locomotion (walking/running), and jumping. If there is a complete tear, you will be unable to walk. Other signs that you may have ruptured your Achilles include:
- A loud pop or snapping noise is heard
- Extreme and sudden pain in the back of the calf
- Feeling of being shot in the back of the calf
- A gap where the complete rupture has occurred
- Swelling, bruising and stiffness
- Difficulty standing on toes
What causes it?
The Achilles tendon will be injured if a force exceeds the amount of the tendon can withstand. Commonly, the injury will occur during running or jumping.
Over time, the Achilles tendon can weaken as we age and become more susceptible to injury. Being inactive will further increase your chances as the tendon’s load capacity will decrease. Having pre-existing Achilles tendinopathy further increases the chances of a tear. Other factors also affect the health of a tendon, such as: medication, diabetes, arthritis and diet. Being overweight also increases the straining force that is put through the tendon.
How can Physiotherapy help?
If the tendon is completely ruptured then surgery will be the likely management option. However, it can still be managed conservatively depending on your goals. Physiotherapy will confirm the diagnosis and propose a management plan over the rehabilitation period. Initially, physiotherapy will assist to manage pain and inflammation and then begin the journey back to normal movement. Typically, the rehabilitation program will include stretching, strengthening and training certain aspects of movement/co-ordination. Return to sport will typically take between 6 – 12 months.