Don’t be careless, this is not a sprained foot!

Don’t be careless, this is not a sprained foot!

Achilles tendon rupture, this painful-sounding sports injury, does not only happen to professional athletes. In fact, it is more likely to happen to “weekend athletes”. Not only that, but in daily life, missing a step of stairs or jumping off a bicycle may cause Achilles tendon rupture. How to distinguish it from sprained ankle, which high-risk groups should pay special attention to, and listen to what orthopedic doctors have to say.

  This part of the Achilles tendon is the most vulnerable

The Achilles tendon, commonly known as the “hamstring”, is the largest tendon in the human body. It is located behind the heel and its main function is to plantar flex the ankle. It is formed by the fusion of the soleus and gastrocnemius tendons of the calf. Walking, running and jumping are inseparable from the participation of the Achilles tendon. Rupture usually occurs 2 to 6 cm above the insertion point of the Achilles tendon, because the Achilles tendon narrows and thickens from top to bottom, and is narrowest 2 to 6 cm above the calcaneal tubercle, where it is the weakest.

Achilles tendon rupture is a common sports injury, accounting for about 6% to 18% of sports injuries. It can cause pain, swelling, and weakness in movement. Hurdle superman Liu Xiang, basketball superstar Kobe Bryant, Durant, and Yi Jianlian all left the game due to Achilles tendon rupture.

 Two types of high-risk groups should pay attention to precautions

Why does Achilles tendon rupture occur? Intrinsic risk factors for Achilles tendon rupture include anatomical abnormalities, weak/imbalanced muscle strength, excess body weight, metabolic diseases, old Achilles tendon injuries, etc.; external risk factors include improper training, adverse environment, and drug side effects. Due to the sudden force and excessive joint movement, the Achilles tendon is subjected to loads and length changes beyond its endurance range, and rupture of the Achilles tendon occurs.

The most common group for Achilles tendon rupture is male patients aged 30-50 years. In fact, it is not only more common in professional athletes, but also in two types of high-risk groups that should also pay attention: one is “weekend athletes”, that is, people who do not exercise much due to busy study or work and engage in high-intensity exercise on weekends. The other category is people who engage in low-intensity and long-term physical activities all year round.

In daily life, in addition to sports, Achilles tendon rupture may also occur when stepping down stairs or jumping off a bicycle.

Therefore, in order to avoid Achilles tendon injury, we must fully warm up before exercising, pay attention to gradual progress, and wear protective gear if possible. If you have long-term chronic heel pain, you are more likely to rupture your Achilles tendon and avoid strenuous exercise.

If you have these symptoms, it may not be sprained ankle

I would like to remind everyone that a ruptured Achilles tendon can easily be mistaken for a sprained foot. What we usually call sprained ankle refers to a sprain of the ankle joint, which does not lead to rupture of the Achilles tendon. If you find that you are unable to walk, especially if you cannot touch the ground with the balls of your feet, and you feel that your feet are not strong enough when going up or down stairs, you should be careful about the possibility of Achilles tendon rupture.

In our outpatient clinic, patients with Achilles tendon rupture often describe their heel as if someone had kicked it, or a stick-like sensation, or a sudden popping sound. Then there was pain and swelling in the heel, weakness in walking, and a large depression in the Achilles tendon.

If you feel discomfort in your Achilles tendon during daily exercise, be very careful. It is recommended to go to the hospital immediately for ultrasound or MRI to rule out Achilles tendon rupture. Note that the injured limb cannot continue to walk on the ground to prevent secondary injuries.

Surgery or conservative treatment depends on the situation

At present, the treatment of Achilles tendon rupture is mainly surgery, and a few patients choose conservative treatment. Surgically treated Achilles tendons are less likely to re-rupture and recover more quickly. However, clinical studies have reported that patients with Achilles tendon rupture and separation less than 5 mm can also achieve good results with conservative treatment.

Rehabilitation after Achilles tendon rupture is more important than surgery. After surgery, patients must wear foot and ankle braces for protection and walk on crutches. The braces should be worn for 4 to 6 weeks; some weight-bearing walking activities and ankle joints should be started 4 weeks after surgery. Functional exercise recovery; normal walking activities can be resumed about 3 months after surgery.

Under professional rehabilitation treatment, professional athletes can resume strenuous exercise 3-6 months after surgery; ordinary people take longer. It is recommended that under the guidance of a professional rehabilitation therapist, combined with physical therapy, Achilles tendon healing can be promoted, normal life and work can be restored as soon as possible, and pre-injury sports ability can be restored.

Text/Li Xin (Beijing Ditan Hospital)

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