Achilles Tendon Rupture CAT Flashcards
Where does the achilles tendon rupture occur?
1-2 inches above the tendinous insertion in the calcaneus
For what demographic is an Achilles tendon rupture most common?
30-50 y/o men w/o history of calf or heel pain
What is theorized to lead to an achilles tendon rupture?
- Degenerative changes that begin w/ hypovascularity
- Lack of blood flow + repetitive microtrauma
Most common MOI for Achilles rupture
1) Pushing off a weight bearing extremity w/ an extended knee
2) Forceful eccentric contraction of plantar flexors
Participation in what kind of activities are at risk for achilles tear?
Sports that require quick change of direction footwork
Other contributing factors to risk of Achilles tear
- Poor stretching routine
- Tight calves
- Improper footwear
- Altered biomechanics (such as flattened arch)
Likely clinical presentation for Achilles tear
- Swelling over distal tendon
- Palpable defect in tendon above calcaneal tuberosity
- Pain + weakness w/ plantar flexion
- Snap or pop associated w/ MOI
- Limping during gait
- Thompson test +
Role of imaging in achilles rupture
- X-ray to rule out avulsion fracture
- MRI for presence and severity of tear or rupture
What are the implications w/ Achilles tears if your patient is a “weekend warrior”
Achilles tears are more common in men and individuals that don’t consistently exercise
Describe the most effective management of an Achilles tear
- Immobilization through casting (~10 weeks for conservative, 6-8 weeks for surgical repair)
- Surgical approach for repair or reconstruction
- PT occurs after the brace is removed, consists of ROM, stretching, icing, assistive device training, endurance programming, gait training, strengthening, plyometrics, and skill specific training
Role of pharmacological management
Not necessary except for pain relief
What will the HEP look like for Achilles repair?
- Icing and elevation early in rehab
- ROM, strengthening, gait, endurance activities, high-level skill and sport specific tasks
Expected timeline for return to activity
6-7 months
What are the outcomes associated with conservative management of an achilles tear?
- Higher chance of rerupture (40%)
- Reduced risk of infection from surgery
- Possibly an incomplete return to function
What are the outcomes associated with surgical management of an achilles tear?
- 0-5% rerupture
- Higher rate of return to athletic activities
