Achilles Tendon Rupture | Plenty Physiotherapy, Bundoora

Achilles Tendon Rupture Document

The Achilles tendon is a strong fibrous cord that  connects the muscles in the back of your calf to  your heel bone. It is the largest and longest  tendon in the body and can withstand high  . An Achilles tendon rupture (complete or  partial tear) usually occurs 2–6 cm proximal to  its insertion on the calcaneus, a region with relatively poor blood supply. Common in active  adults aged 30–50 years, often in recreational  athletes; The weekend warriors who may not  train as regularly at those higher intensities. Symptoms: - Sudden sharp pain at the back of the  ankle, often described as being  "kicked" or "hit." - Audible “pop” at time of injury. - Weakness with plantarflexion (toe  down movement), difficulty walkingor  pushing off. - Swelling and bruising around the  calf/ankle. ontributing Factors:A) Intrinsic: a. Previous Achilles tendinopathy (See tendinopathy information sheet for  further detail on principles).  b. Age-related degeneration (30–50 yrs highest risk- See tendinopathy  information sheet for further detail on principles). c. Male sex (higher incidence). d. Corticosteroid injections into tendons. B) Extrinsic: a. Sudden explosive loading (sprinting, jumping, cutting). b. Inadequate warm-up or fatigue. c. Poor footwear or slippery surfaceTreatment/Management: anagement depends on whether the patient is treated surgically (tendon repair) or  conservatively (functional bracing/casting). Both scenarios will require long-term  physiotherapy.  1) POLICE method principals:Protect: Moonboot.  (Optimal Loading): Nil weight-bearing. Ice: 15–20 min every 2–3 hours. Compression: Tubigrip or compression bandages to manage swelling and pain. Elevation: Ankle above heart height for swelling management. 2) Ice/medication: Ice as well as using forms of pain killers (as directed by your  medical professionals) can help manage acute bouts of pain.  3) Imaging: An ultrasound will be recommended to see the severity of the injury  and confirm the diagnosis.  4) (CAM Boot) Moonboot: Nonsurgical treatment for a torn Achilles tendon  requires immobilising the injured foot and ankle. Your physiotherapist/specialist  will place your foot, ankle and calf in a moonboot. Your foot and ankle will be  flexed downwards (plantarflexed/heel raised) so that the Achilles tendon can be  offloaded and can heal.  5) Surgery: Many cases recommend surgical repair of a torn Achilles tendon in  people who are active and middle-aged or younger. During surgery, a surgeon  stitches the two ends of the torn tendon back together. After surgery, you’ll need  a boot and to be non-weight bearing for a period. Often the boot will be weaned  off after 10-12 weeks. This is to immobilise the tendon while it heals. 6) Physiotherapy/rehab: Exercises targeting the muscle imbalances and poor  biomechanical patterns above and below the ankl joint will aid in proper  tendon healing and optimal loading going forwards to minimise risk of re-injury.  Specifically targeting a gradual range of motion program with the progressive  tolerated strengthening of calf and ankle muscles. Over time, building this  strength training into more power and plyometric lower limb exercises followed  by specific return to sport activities. Your physiotherapist will also provide  education and guidance of proper warm-ups of the ankle to prevent Achilles  ruptures. Manual therapy such as soft tissue work can be utilised to help with pain  reduction, and ankle mobility and stiffness.