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© 2012-2024 Isokinetic Medical Group Srl
P.Iva 03740671205 – Cap. Soc. Int. Vers. Euro 10.400 – Reg. Imp. n.03696800378 – R.E.A. n.309376
The Achilles Tendon, located in the posterior aspect of the leg (connects the calf muscle to the calcaneus) is the thickest tendon in the human body and it can withstand high levels of tensile forces. Despite being the strongest tendon in the human body, the Achilles tendon is the most commonly ruptured in the lower extremities. Injuries to this tendon typically happen through an acceleration mechanism in which the hip and knee extend (leg behind the centre of the body), and the Achilles tendon quickly stretches due to a sudden increase in the ankle range of motion (dorsiflexion) leading to tendon rupture. Aside from the aforementioned mechanism, injuries to this structure can additionally be caused by cutting manoeuvre (specifically a cross-over cut), jumping and landing, or a direct hit to the tendon itself. Because of the nature of these injuries, Achilles tendon ruptures are often reported in multidirectional or jumping sports where a significant number of high-intensity actions are present. Achilles tendon ruptures predominantly occur in subjects that rarely practice sports, alternating periods of inactivity with high-intensity physical activities (e.g.: soccer, basketball, tennis, etc.), the so-called “weekend warrior”. These patients tend to have a general low conditioning of the tendon (often coupled with decreased mobility, strength, movement quality and general deconditioning) which suddenly gets overloaded by a boost of physical activity, leading to its rupture due to its inability to cope with the level of forces at which it has been exposed. Patients typically report a snapping sensation and an audible “pop” that is often described as being hit in the lower part of the leg. Pain located in the injured area, inability to stand on the toes (ankle plantarflexion), decreased functioning and a deformity of the lower leg area (e.g.: visible tendon gap and calf muscle belly retraction) are other symptoms often presented by the patient after the injury.
The management of patients affected by Achilles tendon rupture is still discussed in the medical community, with both surgical and conservative management being valuable options. Non-surgical treatment is often considered in cases of partial ruptures, or full-thickness recent injuries where the tendon and the muscle belly of the calf are not significantly retracted. In these cases, a prompt intervention with the implementation of a boot that sets the two ends of the tendon closer (foot in plantarflexion), limiting the stress to the area supporting its healing process (with the additional implementation of crutches), can be considered. The protocol then progresses with a gradual increment of the allowed ankle range of motion throughout multiple weeks, combined with rehabilitation to preserve as much functioning as possible. When conservative management is not a valid option (e.g.: old full tears with significant calf retraction), surgical intervention has the function of repairing the ruptured tendon through the implementation of different techniques that are always discussed between the patient and the medical-surgical staff. Following the surgery, a similar protocol of protection and gradual mobility recovery will be implemented using boot and crutches. Regardless of the implemented management strategy, our strong advice is to seek medical attention from a specialised facility that can take care of your whole recovery process from the beginning, as malpractices in the early stage (e.g.: delayed rehabilitation start, early aggressive mobilization, etc.) can significantly affect your recovery process and expose you to potential complications (e.g.: tendon elongation, reduced mobility recovery, etc.). In Isokinetic, after being visited by one of our specialised doctors, you will be prescribed a rehabilitation plan tailored to your condition. Your rehabilitation will take place in four different environments, the pool, gym, movement analysis and retraining room, and the pitch. You will work with a specialised rehabilitation team that will help you to minimise your symptoms and recover your mobility in the pool and gym, recover your strength and muscle endurance in the gym, restore your movement quality and movement explosivity in our movement analysis room, and finally support your return to sport through our on-field rehabilitation service.
© 2012-2024 Isokinetic Medical Group Srl
P.Iva 03740671205 – Cap. Soc. Int. Vers. Euro 10.400 – Reg. Imp. n.03696800378 – R.E.A. n.309376