Adena Saadat
Art is the lie that enables us to realize the truth.
Acute Achilles Tendon Rupture Treatment

Overview
Achilles Tendon
Achilles tendon rupture is an injury that affects the back of your lower leg. It most commonly occurs in people playing recreational sports. The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture) completely or just partially. If your Achilles tendon ruptures, you might feel a pop or snap, followed by an immediate sharp pain in the back of your ankle and lower leg that is likely to affect your ability to walk properly. Surgery is often the best option to repair an Achilles tendon rupture. For many people, however, nonsurgical treatment works just as well.

Causes
Your Achilles tendon helps you point your foot downward, rise on your toes and push off your foot as you walk. You rely on it virtually every time you move your foot. Rupture usually occurs in the section of the tendon located within 2 1/2 inches (about 6 centimeters) of the point where it attaches to the heel bone. This section may be predisposed to rupture because it gets less blood flow, which also may impair its ability to heal. Ruptures often are caused by a sudden increase in the amount of stress on your Achilles tendon. Common examples include increasing the intensity of sports participation, especially in sports that involve jumping, falling from a height, stepping into a hole.

Symptoms
You may notice the symptoms come on suddenly during a sporting activity or injury. You might hear a snap or feel a sudden sharp pain when the tendon is torn. The sharp pain usually settles quickly, although there may be some aching at the back of the lower leg. After the injury, the usual symptoms are as follows. A flat-footed type of walk. You can walk and bear weight, but cannot push off the ground properly on the side where the tendon is ruptured. Inability to stand on tiptoe. If the tendon is completely torn, you may feel a gap just above the back of the heel. However, if there is bruising then the swelling may disguise the gap. If you suspect an Achilles tendon rupture, it is best to see a doctor urgently, because the tendon heals better if treated sooner rather than later.

Diagnosis
Diagnosis of Achilles tendon rupture is not difficult. Usually, the diagnosis is obvious after examination of the ankle and performing some easy foot maneuvers (such as attempting to stand on the toes). When an Achilles tendon rupture occurs, there is often clinical confirmation of tenderness and bruising around the heel. A gap is felt when the finger is passed over the heel area, where the rupture has developed. All individuals with a full-blown rupture of the tendon are unable to stand on their toes. There is no blood work required in making a diagnosis of Achilles tendon rupture. The following are three common radiological tests to make a diagnosis of Achilles tendon rupture. Plain X-rays of the foot may reveal swelling of the soft tissues around the ankle, other bone injury, or tendon calcification. Ultrasound is the next most commonly ordered test to document the injury and size of the tear. For a partial tear of the Achilles tendon, the diagnosis is not always obvious on a physical exam and hence an ultrasound is ordered. This painless procedure can make a diagnosis of partial/full Achilles tendon rupture rapidly. Ultrasound is a relatively inexpensive, fast, and reliable test. MRI is often ordered when diagnosis of tendon rupture is not obvious on ultrasound or a complex injury is suspected. MRI is an excellent imaging test to assess for presence of any soft-tissue trauma or fluid collection. More importantly, MRI can help detect presence of tendon thickening, bursitis, and partial tendon rupture. However, MRI is expensive and is not useful if there is any bone damage.

Non Surgical Treatment
A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. Use support devices as directed. You may need crutches or a cane for support when you walk. These devices help decrease stress and pressure on your tendon. Your caregiver will tell you how much weight you can put on your leg. Ask for more information about how to use crutches or a cane correctly. Start activity as directed. Your caregiver will tell you when it is okay to walk and play sports. You may not be able to play sports for 6 months or longer. Ask when you can go back to work or school. Do not drive until your caregiver says it is okay.
Achilles Tendinitis

Surgical Treatment
Surgery is the most common treatment for this condition. An incision is made in the lower leg and the tendon is sewn back together. A cast, splint, walking boot, or brace is worn for 6-8 weeks. One of the benefits of surgery is that it lowers the risk of re-rupturing the tendon. Surgery may also be a better option if you are athletic.