Many sports fanatics will engage in highly competitive weekend activities. These activities may include football, volleyball, softball and even paintball. I love paintball and I broke my ankle and ruptured multiple ligaments last year while playing this exciting sport. However, one condition that plagues athletes is the dreaded Achilles tendon rupture.
This condition usually occurs while running and jumping; also, it can happen while making sharp movements. Some patients relate to someone hitting the back of their ankle or even describe as a “pop” like a gunshot. Many will fall to the ground with extreme pain. Once patients gather their wits, they try to flex there ankle and realize there no muscle power or total loss of function while trying to flex that Achilles tendon.
The weakest part of the Achilles tendon is the cord of the muscle. This cord is similar to a braided telephone cord and it compasses three muscles: medial and lateral head of the gastroc and the soleus muscle. The thin plantaris tendon runs along the side of this tendon. This tendon flexes your foot and ankle. Also, it aids in inverting and supinating your foot and ankle which is turning your foot and ankle in an inward fashion. There is very little blood flow supplied to this cord. This is known as the water shed area. Most Achilles tendon ruptures will tear approximately 2.0-2.5 cm above the insertion which is above the heel bone or calcaneus.
Their appearance is pretty frightening!!!! The back of the ankle will start changing from a normal skin color to black and blue. Patients will fear the worst like lose of circulation. The color change is related to the bleeding that is occurring at the rupture. Swelling will ensue. The most profound clinical finding is the deficit. When I examine these patients in the office or ER, you can press right in the deficit and the finger just falls in the “hole.” Other clinical test are performed, like a Thompson test, where the patient is placed on their stomach and the gastroc or the calf muscle is squeezed and this is to determine if there is any flexion. Usually there is none. An MRI is sometimes performed but it is usually not necessary if the patient is treated early.
Treatment for the rupture should be surgical repair. The patient can be immobilized with cast or CAM walker; however, with this type of non-surgical treatment, the chances of re-rupture are high. Age, medical history and social history are considered when considering surgical treatment.
Once the rupture is healed, physical therapy should be implemented and this is important. During the healing process, the patient may develop atrophy or weakness in the muscle group and regaining strength is important so the patient can return to activity.
So, you weekend warriors have fun!!!! If you do have an injury which is an Achilles tendon rupture, treat and repair the tendon early so you can return to activity. It is important muscle which help you flex your foot and ankle which you need to walk, drive and play sports.
Any injuries or trauma to the foot and ankle, please feel free to consult or call any of our office locations, which are Howell, Edison, Carteret and Monroe. We will be happy to see you in the office of emergency and tend to all your foot and ankle needs.
