Achilles tendon rupture
Causes, incidence, and risk factors
There are two large muscles in the calf, the gastrocnemius and soleus. These muscles generate the power for pushing off with the foot or going up on the toes. The large Achilles tendon connects these muscles to the heel.
These are important muscles for walking. This tendon can become inflamed, most commonly as a result of overuse or arthritis, although inflammation can also be associated with trauma and infection.
Tendinitis due to overuse is most common in younger individuals and can occur in walkers, runners, or other athletes, especially in sports like basketball that involve jumping. Jumping places a large amount of stress on the Achilles tendon.
Tendinitis from arthritis is more common in the middle aged and elderly population. Arthritis often causes extra bony growths around joints, and if this occurs around the heel where the Achilles tendon attaches to the heel bone, the tendon can become inflamed and painful.Symptoms
Symptoms usually include pain in the affected heel when walking or running. The tendon is usually painful to touch and the skin over the tendon may be swollen and warm.
Achilles tendinitis may predispose the patient to achilles rupture. Patients who experience this usually describe the injury as a sharp pain, like someone hit them in the back of the heel with a stick.Signs and tests
On physical exam, a doctor will look for tenderness along the tendon and for pain in the area of the tendon when the patient stands on their toes.
Imaging studies can also be helpful. X-rays can help diagnose arthritis and an MRI will demonstrate inflammation in the tendon.
When to seek medical advice
See your doctor if you experience persistent pain near the back of your heel or in the area of your Achilles tendon, and especially if the pain doesn't greatly improve within 1 to 2 weeks despite self-care measures. See your doctor immediately if you experience symptoms of an Achilles tendon rupture.
Screening and diagnosis
To diagnose Achilles tendon problems, your doctor will likely ask questions about your physical activities and perform an examination of your feet, ankles and legs. If it's clear that your Achilles tendon is ruptured, you may be scheduled for surgery. If there's a question about a partial rupture of your Achilles tendon, your doctor may order a magnetic resonance imaging (MRI) scan, a painless procedure that uses magnetic fields to create a computer image of the soft tissues of your body.
If Achilles tendinitis is left untreated and the tendon continues to develop multiple small tears through exercise and repeated movement, the tendon can rupture. Untreated Achilles bursitis can lead to increased swelling, pain and disability.