This paper provides a comprehensive overview of Achilles tendon ruptures, one of the most common and debilitating tendon injuries in the human body. It examines the anatomy of the Achilles tendon, the primary causes of both partial and full ruptures, and the characteristic symptoms used for clinical diagnosis. The paper then outlines standard surgical treatment options — including open and percutaneous procedures — and presents a detailed week-by-week rehabilitation protocol covering immobilization, physiotherapy, range-of-motion exercises, and progressive weight-bearing activities. Most patients, the paper notes, can expect a full return to prior activity levels within four to six months of injury.
Every time a person takes a step, their entire weight is placed on their Achilles tendon. Depending on how fast they walk, the terrain they are on, or the length of their stride, the Achilles tendon may be subject to up to twelve times a person's body weight. This vital tendon is a very strong, fibrous tissue that connects the muscles of the lower leg to the heel of the foot. It is also the strongest and thickest tendon in the human body. However, due to strain, overuse, and accidents, there are "over 230,000 Achilles tendon injuries per year in the U.S. alone" ("Everything About Achilles Tendons"). While the two most common types of Achilles tendon injuries are tendonosis and tendon rupture, this paper focuses on tendon rupture. If the Achilles tendon suffers a tear — either partial or full — it is considered a tendon rupture. Although it may be painful and affect a person's ability to walk, it is not a life-threatening injury.
A rupture of the Achilles tendon can be caused by a number of factors, including "overuse, misalignment, improper footwear, medication side effects, and/or accidents" ("Everything About Achilles Tendons"). The most common way to suffer an Achilles tendon rupture is through an accident, such as falling from a height, stepping into a hole, or similar incidents. While a major accident is a common cause of a full Achilles tendon rupture, overuse, a sudden increase in physical activity, or sports injuries are frequent causes of a partial rupture.
"Tendons are strong, tough bands of inelastic fibrous connective tissue that connect muscle to bone. They are the body's highest-strength connective tissue and consist of elongated cells, minimal ground substance, and collagen fibers" ("Everything About Achilles Tendons"). The Achilles tendon is located on the back of the lower leg, just above the heel, and connects the two calf muscles — the gastrocnemius and the soleus — as well as the plantaris muscle, to the heel bone. It is the thickest and strongest tendon in the body, but when ruptured, the most common treatment is surgery. Whether the rupture is full or only partial, the procedure is generally straightforward and usually does not affect surrounding tissues.
While tendonosis develops gradually over time, an Achilles tendon rupture happens suddenly, is immediately debilitating, and can be accompanied by a distinct "popping" sound. Most people who experience this injury also have severe pain and swelling around the heel, an inability to bend the foot downward, or an inability to stand on their toes. A physical examination of the heel area may reveal a gap in the tissue just above the heel.
A physician may ask the patient to lie face down and let their legs hang over the end of the examination table. The physician can then squeeze the calf muscle to observe whether the foot moves — which it should under normal circumstances. If the Achilles tendon is ruptured, however, the foot will not move. To confirm the diagnosis, a doctor may order an X-ray of the area or, more commonly, an MRI, which is better suited to imaging tears in soft tissue. When surgery is required, these symptoms typically persist for several weeks following the procedure.
"Open and percutaneous surgical repair options"
"Week-by-week recovery protocol and timeline"
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