The Achilles tendon is the strong band of tissue that connects the calf muscle to the heel. If stretched too far, the tendon can tear, or rupture, causing severe pain in the ankle and lower leg that can make it difficult or even impossible to walk. An Achilles tendon rupture, which may be partial or complete, often occurs as a result of repeated stress on the tendon while playing sports such as soccer or basketball. Although frequently resulting from the same stresses that cause Achilles tendonitis, a rupture of the Achilles tendon is a far more serious injury, usually requiring surgical repair.
Risk Factors for Achilles Tendon Rupture
An Achilles tendon may rupture if it has been previously over-stretched or weakened by:
- Poor stretching habits prior to exercise
- Tight or weak calf muscles
- Wearing shoes that do not fit properly
- Engaging in physical activity after a long break
- Taking certain types of antibiotics, such as Cipro or Levaquin
- Having steroid injections into the ankle joint
- Running on difficult terrain or in extremely cold weather
Being a man, being obese, having flat feet or having diabetes or hypertension increase the risk for an Achilles tendon rupture.
Symptoms of Achilles Tendon Rupture
Achilles tendon ruptures are usually caused by traumatic injury, frequently accompanied by a popping or snapping sound as the tendon tears. Patients usually experience severe pain and swelling near the heel of the foot and are unable to walk normally or bend their foot. Because these symptoms are similar to those of other conditions, such as bursitis and tendonitis, it is important to seek prompt medical attention in order to determine the correct diagnosis.
Treatment of Achilles Tendon Rupture
Treatment for an Achilles tendon rupture depends on the severity of the condition, but most often requires surgery to repair the tendon and restore function to the foot. Less severe cases may only require a cast or walking boot for several weeks, although the risk of a recurring rupture is higher with this treatment than with surgical repair. When surgery is necessary, the tendon is reattached and sometimes reinforced with other tendon tissue. Physical rehabilitation for several months is usually necessary after an Achilles tendon rupture, whether or not an operation is performed.
Ankle Ligament Reconstruction
An ankle sprain is a common injury that occurs when the ankle is twisted or turned, and results in torn ligaments within the joint. This injury often causes pain, swelling and bruising, and if it does not heal properly, it may lead to chronic ankle instability or repeated ankle sprains. Ankle ligament reconstruction is a procedure commonly performed on patients experiencing chronic ankle instability and repeated ankles sprains. It is effective in repairing torn ligaments, tightening loosened ligaments and improving the overall stability of the joint.
The Ankle Ligament Reconstruction Procedure
The ankle ligament reconstruction procedure is performed on an outpatient basis while the patient is sedated under general anesthesia. Different techniques may be used by the surgeon, depending on the condition of the ankle. During the procedure, torn ligaments may be repaired with stitches or sutures, two ligaments may be reattached, or part of a lateral tendon around the ankle may be used to repair the torn ligament. After the procedure is complete, a splint or cast is applied to the ankle. This procedure may take up to 2 hours to perform.
Risks of Ankle Ligament Reconstruction
As with any surgery, there are possible complications associated with ankle ligament reconstruction which may include:
- Reaction to anesthesia
- Nerve damage
After surgery, blood clots within the veins of the legs may also occur.
Recovery from Ankle Ligament Reconstruction
After surgery, patients will use crutches for up to two weeks. After this time, they may begin walking in a removable walking boot. Physical therapy is a crucial part of the healing process, and usually begins after about six weeks. Physical therapy treatments focus on improving range of motion without putting excessive strain on the healing tendons. Muscle-stengthening exercises and range of motion exercises may all be used to increase movement and mobility.
Most patients fully recover from ankle ligament reconstruction after three to four months, and at that time they can resume all regular activities including running and exercise.