Tendonitis – Achilles tendon rupture

What is Achilles tendonitis?

The inflammation that a tendon may undergo is called tendonitis. The Achilles tendon, being the largest and most powerful tendon of the human body, is responsible for its support. Achilles tendon connects the muscles of the gastrocnemius to the heel.

However, despite being the largest and most powerful tendon, it does not have its own blood supply. This makes it directly dependent on neighboring tissues. This dependency makes him particularly vulnerable. Injuries are very common and any injury to the Achilles tendon is very difficult to heal.


How is tendonitis related to Achilles rupture?

While Achilles tendonitis appears to have similar symptoms to rupture, there are some differences.

Achilles tendonitis, first of all, is manifested with severe pain in the posterior heel area. In addition, tendinopathy is usually a pre-existing injury to the Achilles tendon rupture.

Achilles tendon rupture is an injury with much more severe symptoms than tendonitis. The most common is that the rupture usually completely obstructs the tendon’s functionality.

In addition to the pain the patient experiences, the leg typically is not supported.


What are the symptoms of Achilles tendon tendonitis and rupture?

The symptoms of Achilles tendon tendonitis are severe pain, difficulty in movement and gradual weakness of the tendon. The sensation of pain is very likely to be affected by vigorous physical activity but even in activities of moderate intensity (such as walking).


Symptoms that are likely to accompany pain are:

  • sensitivity
  • redness
  • heat
  • edema

The above are the clinical signs of inflammation, that is, tendonitis.


Symptoms of Achilles tendon rupture:

The symptoms of Achilles tendon rupture are different from those of tendonitis.

At the time of rupture, the patient may not observe any symptoms. Patients even characteristically report that the first symptom is a kick in the posterior surface of the ankle.

All of the symptoms follow the above feeling and include severe pain and inability to perform any leg movement.


What are the causes of Achilles tendonitis?

Achilles tendon rupture or tendonitis usually results from a sharp increase in tendon tension. In other cases the patient’s anatomy is partly responsible.

Some causes are listed below:

  • Excessive use of the tendon
  • Tight gastrocnemius
  • Short Achilles tendons
  • Running uphill
  • Increased athletic activity with inappropriate shoes
  • Foot pronation
  • High heels
  • Falling from height
  • Falling into a puddle while walking


What are the risk factors that can cause a tendinopathy episode or even rupture?

There are a number of factors that influence the likelihood of injury to the Achilles tendon:

Age: People aged 30-40 are more prone to Achilles tendon injuries

Gender: Most patients are male

Sporting Activities: Achilles injuries are more common in tennis, basketball and football.

Antibiotics administration: It has been observed that the administration of certain antibiotics increase the risk of Achilles tendon rupture. Such antibiotics are quinolones (ciprofloxacin, levofloxacin).

Obesity: When the tendon is overburdened it is reasonable to get injured.


How is tendonitis and Achilles tendon rupture diagnosed?

The diagnosis of tendonitis is initially set after an orthopedic clinical examination of the patient. During clinical examination it is necessary to check the patient’s medical history. The findings will indicate partial or complete rupture of the tendon.

In addition, a reliable diagnostic method is the Thompson test. It is likely that the orthopedist will indicate the need for a diagnostic ultrasound or magnetic resonance imaging (MRI). Imaging examinations will precisely determine the severity of the tendon’s rupture.


Is it possible to prevent tendonitis or Achilles tendon rupture?

Prevention of tendonitis or rupture of the Achilles tendon is possible.

In principle, systematic stretching of the tendon is recommended. These exercises will strengthen the gastrocnemius by stimulating the Achilles tendon.

However, as it has been mentioned above, anatomy can affect the onset of the disease. Therefore, those with weakness in this area should avoid activities that place excessive tension on the tendon, such as jogging or uphill running or jumping.

Finally, the use of the right footwear should not be neglected. Footwear is responsible for the absorption of the vibrations and for the support of the heels.


What is the treatment recommended for Achilles tendon rupture?

The treatment of Achilles tendon rupture can be performed either by conservative treatment or by surgery.


Conservative therapy:

A plaster splint is applied as a conservative approach. The foot inside the splint is required to be in a plantar flexed position. The patient usually stays with the splint for about a month. It is then necessary to re-examine the patient before removing the splint. After this period, the orthopedist may recommend the use of a functional splint. The required period of time is determined by the orthopedist and is related to the healing of the rupture and its severity. With this splint, the patient can gradually restore mobility to the affected leg.


Surgical Treatment:

The treatment of a transverse rupture is often surgical. The preferred reason for surgery is the short recovery time of the tendon. An advantage of surgery is the patient’s brief return to their daily routine.

The operation can be performed either by open surgery or by transcutaneous tendon suturing. In the latter case, the ends of the tendon are joined together with strong sutures. The healing capacity of the body thus creates a new tendon.

If you also suffer from Achilles tendonitis or rupture, contact the specialized Orthopedic Surgeon Dr. George Besiris for the suggested treatment method.