ruptured achilles tendon

Anatomy
The Achilles tendon is the largest tendon in the human body. It is a strong, fibrous band that connects the calf muscle to the heel. The calf is actually formed by two muscles, the underlying soleus and the thick outer gastrocnemius. Together, they form the gastroc-soleus muscle group. When they contract, they pull on the Achilles tendon causing your foot to point down and helping you raise up on your toes. This powerful muscle group helps when you sprint, jump, or climb.

Several different problems can occur that affect the Achilles tendon. In severe cases, the tendon may even rupture. The classic example is the middle aged tennis player who places too much stress on the tendon. In some instances, the rupture may be preceded by a period of tendonitis which renders the tendon weaker than normal.

Causes
As we age, a tendon is subject to degeneration within the substance of the tendon. The term degeneration means that wear and tear occurs in the tendon over time and leads to a situation where the tendon is weaker than normal.

Degeneration in a tendon usually shows up as a loss of the normal arrangement of the fibers of the tendon. Tendons are made up of strands of a material called collagen (think of a tendon as similar to a nylon rope and the strands of collagen as the nylon strands). Some of the individual strands of the tendon become jumbled due to the degeneration, other fibers break, and the tendon loses strength. The healing process in the tendon causes the tendon to become thickened as scar tissue tries to repair the tendon. This process can continue to the extent that a nodule forms within the tendon. This condition is called tendonosis. The area of tendinosis in the tendon is weaker than normal tendon.

The weakened, degenerative tendon sets the stage for the possibility of actual rupture of the Achilles tendon.

Treatment
Surgery is often suggested if you have a ruptured Achilles tendon. Repair is acheived by reattaching the two ends of the torn tendon. This procedure is usually done through an incision on the back of the ankle near the Achilles tendon. There are numerous ways that have been used to actually repair the tendon, but most all involve sewing the two ends of the tendon together in some fashion. There are some repair techniques that have been developed to minimize the size of the incision.

After surgery, you will most likely be placed in a cast, or brace, to protect the repair and the skin incision. A cast or brace will probably be required for 6-8 weeks. An injury like this must be rested. Sadly this rarely happens when the patient is forced to use crutches to stay mobile and recovery can take longer. The Orthopaedic Leg Trolley offers a practical solution to increase mobility and actively encourage recovery.

If you have suffered from a ruptured Achilles tendon and would like further details on the Orthopaedic Leg Trolley please contact us.

I am an orthopaedic surgeon at the Royal Orthopaedic Hospital in Birmingham and last week ruptured my Achilles Tendon whilst playing squash. Fortunately I had to spend only one day on crutches and an unpleasant day it was too. After a morning on the wards and an afternoon in the clinic I had blisters on my hands and chest wall and was exhausted.

Since then I have been using K9 and it has proved to be a revelation. I have done ward rounds, clinics and a full day operating (including major spinal surgery) with only the minimal discomfort and inconvenience.

P Roberts F.R.C.S.

Injuries - Ruptured Achilles Tendon