Achilles Tendonitis/Rupture
Description:
Tendons attach to muscles at one end and a bone at the other. Irritation, partial tears or complete rupture can occur at those attachments or the tendon itself. They vary in severity from a dull ache to severe pain. They also have a covering or “sheath” that can get irritated, tear or form a “ganglion” (fluid filled sack). Tendonitis can be a simple overuse syndrome, injury, or secondary problem from other foot and ankle conditions. All tendonitis, especially ones where a tear, rupture or associated fracture is suspected need to be evaluated by a physician with standard x-rays taken or other advanced testing.
This condition is associated with other foot and ankle conditions such as:
Treatment: Conservative Care:
| Weight bearing: | Tendonitis weight bearing status ranges from total and partial weight bearing to complete non-weight bearing. Keeping pressure off the area is the best way to minimize a more serious situation like a complete tear or rupture. Crutches, walkers, wheel chairs and strollers are helpful. |
| Rest: | Crutches and non-weight bearing on the affected foot or ankle for 1 to 3 weeks is the best care for a severe overuse syndrome or injury, but a simple decrease in activities may be enough to relieve symptoms. Depending on tendonitis location, shoe gear modification can also aid recovery. Try to avoid bare feet and shoes without support |
| Stretching: | Static stretching to the “point of discomfort” and holding those positions for 10 seconds each for 3 sets every day will help speed recovery and reoccurrence. Medication: Anti-inflammatory medication (Eg. Ibuprofen, Naprosyn) aspirin products, and Acetaminophen can help with the chronic pain, but are not much help with the acute pain. |
| Immobilization / Arch support: | Casting or a removable Cam Walker is the best “aggressive” conservative care for severe tendonitis or injuries. Temporary arch supports or supportive athletic shoes will support the foot and ankle in a more neutral position. This will put less strain on the injured area and decrease the incidence of re-injury when returning to activities or exercise. Custom molded orthotics are the best solution for immediate and long term treatment. |
| P.T.: | Examples of physical therapy include massage, cold therapy, contrast baths, stretching, ultrasound, and electric stimulation. |
Surgical Options:
No surgery is usually required for this condition, but partial tears, “attenuations” or complete ruptures may necessitate reattachment. The procedure is a simple suturing of the tendons ends unless a graft is needed or reattachment to the bone with a “bone anchor” device. The post-operative period is extended to 6-8 weeks non-weight bearing with physical therapy thereafter.
