Achilles Tendon injury- Detailed Information on Injury

An Achilles tendon injury often meets physically active people. Almost always is an operation necessary. Usually precede the crack irritation or inflammation of the Achilles tendon. More about symptoms, diagnosis and treatments.

Achilles Tendon injury- Detailed Information on Injury

Achilles Tendon - Detailed Information on Injury

What are Achilles tendon injury ?

The Achilles tendon ( tendo calcaneus ) is the strongest tendon in the human body . It connects the heel bone - known as the heel bone - the calf muscles. The tendon allows us, for example , to stand on his toes and push off during running and jumping .

The most common Achilles tendon injuries are irritation and inflammation in the small - wear defects to complete plans (medical : Achilles tendon ) .

A crack occurs rarely by force from the outside . Much more often the cause is a chronic , severe overloading , such as during exercise or hard physical labor .

After an Achilles tendon injury , the affected ankle is still very limited functional. If anything, it is only possible from severe pain to put on the foot and lean to . It is no longer possible to stand on tiptoe .

A healthy tendon tears almost never . In most cases, the tendon tissue is already damaged : by a persistent irritation or inflammation caused by microtrauma ( small cracks) , which have reduced the strength of the tendon tissue . This can make ( a achillodynia ) felt in advance of the crack by recurring pain.

Achilles tendon injuries : Causes

The most common cause of Achilles tendon rupture is not about the violence from the outside , but a sudden , severe strain on already damaged tendon - for example, through movements that claim especially the ankle .

Such movements occur mainly in sports that require bursts of speed , sudden stops and changes of direction , such as tennis or soccer . But cracks also with completely untrained people who suddenly overwhelm their tendons - who want to run to the example in " yellow " still fast on the road .

Tendon damage increases the risk of a rift

Cracks completely healthy Achilles tendons are extremely rare. If the tendon without any previous damage , still breaks down at a corresponding accident rather a part of the heel bone to the tendon from when the tendon ruptures itself . Cracks occur much more frequently in debilitated , previously damaged tendons that were impacted by persistent irritation and inflammation.

Some diseases can promote such irritation in the area of the Achilles tendon , for example osteoarthritis , gout or diabetes mellitus ( sugar diabetes ) .

Achilles Tendon injury- Detailed Information on Injury

Other risk factors

There are other factors that increase the risk of Achilles tendon rupture : foot deformities , improper shoes ( especially with high out oppressive heel caps ) , shortened calf muscles , inadequate warm-up before exercise , repeated overloading during sports , and generally living longer .

A partial tear of past increases the likelihood of further rupture. A high risk also go a completely untrained , who suddenly deal with a sport in which they have to push off abruptly (for example, high or long jump) .

Achilles tendon injuries : Symptoms

When the Achilles tendon ruptures sometimes hear a sound whipping . Occurrence and walking is barely possible and prepares severe pain .

The Achilles tendon is often accompanied by a clearly audible , whip-like sound . It almost always occurs (sprint or jump) in a so-called explosive strength loading. The injured person often feels the tear of the tendon a painful sting or shock at the calf or the heel. In football, the injured often believed then , an opponent had kicked him in the heel.

As a result of the crack , the toe can not be reduced ( "downward " bent ) . Standing up or walking , although occasionally still possible, but prepare severe pain . Standing on the balls of the feet no longer possible , the foot can not be unrolled.

Symptoms of tendonitis

In chronic Achilles tendon irritation or inflammation occurs repeatedly in pain, when the calf muscles are strained or stretched , or if the ankle is charged a long time.

Typically, it also prepares severe discomfort in the morning to get up from the bed and barefoot to take the first steps . The reason is that the feet of the night are mainly held in an equinus - so toes to stretch the "bottom" , attracted heels. On the first morning appearance the Achilles tendon is then particularly tense .

Often the Achilles tendon is irritated to grope about five inches above the heel bone thickened fusiform . Pressure on the corresponding point of the thickened Umgebungsgleitgewebes the symptoms intensify . In a highly acute inflammation when moving the foot can be heard possibly a rough friction sound .

For recurring pain in the Achilles tendon should be a doctor , usually an orthopedic surgeon , will be examined. If you suspect a crack immediately medical advice is needed.

Achilles tendon injuries: diagnosis

The conversation between doctor and patient and physical examination provide the first evidence for the diagnosis of "hamstring injury".

The doctor asked about current and previous complaints in the area of the Achilles tendon. He wants to know, for example, what actions have triggered the current pain, it asks for accompanying diseases, after sports and exercise habits.

Then the doctor examines the patient: It checks how the patient is whether he will go on his toes, and can stand on one leg. The affected ankle is assessed for function and pain sensitivity. The doctor also scans the area around the tendon. Few centimeters above the heel is at a detectable crack a dent.

The "Wadenkneiftest" to Thompson: Suppresses the doctor the calf muscles together, the foot is normally moved reflexively in an equinus attitude - so toe "down" heel "up". No longer works correctly, the "Wadenkneiftest" is positive, so conspicuous. Then in all likelihood is after an Achilles tendon injury before.

The diagnosis should still be uncertain, the doctor may perform an ultrasound examination (sonography). Include details of the Achilles tendon injury can be seen. Further studies to confirm the diagnosis are possibly a magnetic resonance imaging of the body concerned. How can clarify whether small tissue portions have died inside the tendon, for example. A direct injury, for example, an impact injury, and an X-ray examination of the adjacent bone may be required.

Achilles Tendon injury- Detailed Information on Injury

What helps an Achilles tendon irritation ?

In an Achilles tendon irritation , the doctor usually recommends , to protect the ankle in slight equinus - so toe stretched " down " , attracted heel. This advice should be heeded . Because irritation tends to be chronic and increases the risk of a crack . To abate the pain, sufferers should refrain from sports that weigh heavily on the Achilles tendon and calf muscles.

Occasionally, the doctor advises to bandages or elevated shoe heels . In support of the painful area can be cooled in the first days or rubbed with circulation-stimulating ointments. Painkillers such as diclofenac or ibuprofen can provide significant relief . However, it must strictly on possible side effects in the gastrointestinal tract - and cardiovascular area are respected.

The doctor may be in the area around the inflamed area inject a mixture of anti-inflammatory cortisone and a local anesthetic effective and thus usually help you quickly and effectively . This infiltration but must be properly sealed . Too frequent doses may increase the risk for a crack .

Therapy for a torn Achilles tendon

If you suspect a ruptured Achilles tendon should a doctor as soon as possible , usually an orthopedic surgeon , will be examined. As a first aid measure , the leg is unloaded and stored high. The painful area can be gently cooled. Warning: do not put ice directly on the skin , or else face frostbite !

A tear usually requires surgery ( Achilles tendon reconstruction) . The tendon and the function of the ankle joint may be made completely possible only by a fast supply. Without timely treatment can cause the calf muscles to atrophy ( atrophy) under certain circumstances. When the Achilles tendon reconstruction of the doctor sews the torn tendon back together. If necessary, he reinforced it with a small neighboring tendon that is more elastic than the Achilles tendon and does not easily tear . If the injury already some time back , and has now shortened calf muscles , the Achilles tendon is extended by operational technical "tricks" .

During wound healing the injured 10 to 14 daily wear long known as a thigh plaster cast or a thigh -Gipslongette - this is a solid cast that reaches across the knee joint. This is followed by a below-knee walking cast or boot in relieving foot drop orthosis for a period of at least four weeks. Following a physiotherapy helps to get the shortened calf muscles and the ankylosed joints of the leg again.

Treatment without surgery

In a so-called conservative treatment of Achilles tendon rupture is omitted operation. This may be necessary , for example , if there are underlying medical conditions that would make surgery very risky. The patient must then take a significantly longer time for plaster casts or possibly special orthopedic shoes or orthotics ( railway equipment ) . Because the tendon needs time and rest to heal can . Physical therapy and heat therapy can aid the process eventually .

Conservative treatment for a ruptured Achilles tendon in this country is rarely chosen as the operational Achilles tendon reconstruction. In older people will tend to discourage an intervention , because the load on the tendon and thus the risk of another torn Achilles tendon at the age usually fall . Although conservative treatment is somewhat lengthy , satisfying healing results are also obtained here .

Which therapy in individual cases , the more appropriate , and what complications and drawbacks can bring the particular treatment method itself should be discussed individually with the orthopedist. It may also issue a recommendation as to when the foot is fully loaded again . At the latest after half a year , the patient can exercise after an Achilles operation normally again .