Achilles Rupture: Those Active In Sports Should Know The Signs
For those who spend time on the courts each week playing tennis or pickleball – or the weekend warriors who enjoy a pick-up game of basketball – knowing the signs and symptoms of a ruptured Achilles tendon can prevent further injury. Often, it happens without warning. The Achilles tendon is the body’s largest and strongest tendon. It is attached to the big calf muscle and allows you to push down on your foot. When the tendon ruptures, you may feel a sudden “pop,” or feel pain as if someone kicked you from behind, or threw a rock at your lower calf. You will have a sense of weakness when you try to push off your foot. “If this happens, don’t assume it’s a sprain,” warns Richard J. de Asla, MD, NCH Orthopedic Division Director. “Get off of your
treatment can be as effective as operative treatment. However, the benefits of non-operative treatment are lost if treatment is delayed.” Dr. de Asla says that the greatest advantage of surgical treatment is a markedly reduced risk of re-rupturing the tendon. The risk for re-rupture with non-operative treatment methods is between three and four times greater. There may also be a strength benefit as well. However, every surgical procedure carries an inherent risk of complications due to surgical incisions. Using a minimally invasive surgical approach, the Percutaneous Achilles Repair System (PARS) allows surgical repair of the tendon with a very small incision. However, patients with a degenerative tendon may need more advanced surgical techniques for reconstruction. Recovery from an Achilles tendon rupture usually requires about four weeks of staying off the foot; after which patients can start bearing weight in a protective boot. Physical therapy is normally ordered at six to eight weeks. Full or nearly full healing of the tendon takes 16weeks. Most patients find that a full recovery can take as long as a year.
Dr. Richard J. de Asia
foot immediately and immobilize it, with the foot in a slightly downward position. Do this within 24 hours until you get a diagnosis, so that the gap between the ruptured ends of the tendons doesn't get bigger.” Dr. de Asla says that the vast majority of Achilles tendon ruptures produce relatively littlediscomfort shortlyafter the rupture itself luring somepatients to believe the injury isn’t serious. Individuals at greatest risk are in their late 30s and in their 60s. The younger group typically has no preceding pain, while some in the older group will report some preceding discomfort. Some victims are already suffering with a degenerative condition like tendinosis. Diagnosis is usually straight forward to make clinically, says Dr. de Asla, since the defect in the tendon can be felt by the doctor during a hands-on examination. The classic test for Achilles rupture, the Thompson test, is also used. With the patient lying face down, the calf is squeezed for a response. Sometimes, the doctor will order an MRI. Depending on the results of testing, the physician and the patient then discuss treatment options such as surgery or non-operative treatment methods.
“Non-operative treatment does not mean no treatment. It means we are treating it non-sugically,” explains Dr. de Asla. “Some studies suggest that non-operative
Signs of Achilles rupture • A sudden snap at the lower calf
• Initial intense pain that improves quickly • Weakness to point the foot downward • Inability to stand on toes • Difficulty walking (particularly stairs) • Bruising and swelling around the lower calf into the ankle and foot Benefits of surgical treatment of Achilles rupture • Lower risk for re-rupture • Less time being immobilized • Faster recovery time and return to regular activity Patients who are not candidates for surgery to correct Achilles rupture • Patients who smoke • Patients who have poorly controlled diabetes • Patients with peripheral vascular disease • Patients with significant neuropathy and pain
Richard de Asla, MD, NCH Physician Group - Orthopedic Surgery , located at 1280 Creekside Blvd., Suite 101, in Naples, (239) 624-0310
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