Partial damage to the Achilles tendon treatment. How to "fix" a torn Achilles tendon. Symptoms of an Achilles Tendon Sprain

According to statistics, most Achilles tendon ruptures are recorded among people involved in active sports. This is an injury in which the tendon that connects the muscles of the back of the leg to the calcaneus is completely or partially torn.

With this damage, you can feel a click or crackle, after which the strong and back of the ankle sharply appears. An injury almost always prevents normal walking, and many doctors recommend surgery as the most effective treatment for a tear. However, more conservative approaches can also work.

Symptoms

Although Achilles tendinitis and its subsequent rupture may be asymptomatic, most people notice one or more signs of damage:

pain (often severe and accompanied by swelling in the ankle area);
inability to bend the foot downwards or push off the ground with the affected leg while walking;
inability to stand on the tips of the fingers on the injured leg;
clicking sound or crackling sound at the time of tendon rupture.

Even if there is no pain syndrome as such, it is necessary to seek medical advice immediately after you hear a click or crack in the heel, especially if you lose the ability to walk normally immediately after this sound.

The reasons

Helps to lower the moving part of the foot down, rise on tiptoe and push off the foot from the ground when walking. It gets involved in one way or another every time you move your foot.

The rupture usually occurs at an area six centimeters above the junction of the tendon with the calcaneus. This area is especially vulnerable, as blood circulation is difficult here. For the same reason, the tendon heals very slowly after an injury.

There are very common examples of Achilles tendon ruptures caused by sharp rise loads:

increasing the intensity of sports, especially if they include jumping;
falling from height;
foot in a hole.

Risk factors

Certain circumstances increase the risk of Achilles tendon ruptures:

Age. Most often, injuries of this type are observed in patients from thirty to forty years.
Floor. According to statistics, for every female patient, there are five men with a tendon rupture.
Sports. Most often, damage is caused by physical activities, including running, jumping, and alternating sudden movements and stops. Examples are football, basketball, tennis.
Steroid injections. Doctors sometimes prescribe steroid injections to reduce pain and inflammation. However, these substances can weaken nearby tendons and eventually lead to ruptures.
Taking some, such as "Ciprofloxacin" or "Levofloxacin", increase the risk of injury in everyday activities.

Before visiting the doctor

Considering that a torn (as well as simple inflammation) of the Achilles tendon can lead to the inability to walk normally, you should immediately seek medical help. You may also need to visit a doctor who specializes in sports medicine or orthopedic surgery.

To make the consultation as effective as possible, immediately before the appointment, write down the following information on paper:

a detailed description of the symptomatology and the previous event that caused the injury;
information about past health problems;
a list of all medications and nutritional supplements taken;
questions you would like to ask your doctor.

What will the doctor say?

The specialist is likely to ask you the following questions:

How did the tendon injury happen?
Did you hear (or perhaps not hear, but feel) a click or pop when you were injured?
Can you stand on your fingertips on an injured leg?

Diagnostics

At primary medical examination the doctor will examine the lower leg for tenderness and swelling. In many cases, a specialist can manually feel the rupture in the tendon if it has completely torn.

Your doctor may ask you to kneel in a chair or lie on your stomach on the examination table with your feet hanging over the edge of the table. With this diagnostic method, the doctor squeezes the patient's calf muscle to check the reflex: the foot should automatically bend. If it remains motionless, it is likely that the Achilles tendon has become inflamed. That is what ultimately led to the injury.

If there is a question about the extent of damage (that is, whether the tendon is completely torn or only partially), the doctor will prescribe an ultrasound or magnetic resonance imaging. Thanks to these painless procedures, detailed images of any tissues and organs in the body can be taken.

Treatment

Many people injure their Achilles tendons to some extent. Treatment often depends on age, level of physical activity, and the severity of the injury. In general, young patients and physically active people usually choose surgical intervention, this is the most effective method. Patients of older age groups tend to conservative treatment more often. According to latest research, correctly prescribed conservative therapy can be no less effective than surgery.

Treatment without surgery

With this approach, patients usually wear special orthopedic shoes with a platform under the heel - this allows the torn tendon to heal on its own. This method eliminates many such as infection. However, recovery while wearing orthopedic shoes takes much longer than the treatment of an injury with surgery, and there is high risk repeated break. In the latter case, you still have to resort to surgery, but there is a high probability that it will now be much more difficult for the surgeon to correct the Achilles tendon rupture.

Operation

Usually surgery consists of the following. The doctor makes an incision in the back of the leg and stitches the torn parts of the tendon together. Depending on the state damaged tissue it may be necessary to reinforce the sutures with other tendons. Among possible complications after surgery, infections and nerve damage are reported. The risk of infection is greatly reduced if the surgeon makes small incisions during the operation.

Contraindications

Surgical treatment of Achilles tendon ruptures is contraindicated in those who have been diagnosed with an active infection or skin disease at the site of injury. Conservative therapy is also prescribed for patients with general poor health, diabetes, smoking addiction. Circumstances such as sedentary image life, steroid use, and inability to follow the surgeon's postoperative instructions. Any health concerns should be discussed with your doctor first.

Rehabilitation

In order to permanently heal a torn Achilles tendon (after surgery or conservative therapy - it doesn’t matter), you will be prescribed a rehabilitation program that includes physical exercises to train the muscles of the legs and Achilles tendon. Most patients return to their normal lifestyle four to six months after the end of therapy or surgery.

Exercises

After conservative treatment rehabilitation exercises can be started immediately after the disappearance of the pain syndrome, after surgery - as soon as the surgical wound heals. Physical activity is the key to a full recovery from injuries (especially if the injury is an Achilles tendon rupture). Rehabilitation begins with massage and increasing the overall mobility of the ankle - the feeling of stiffness should disappear. After two weeks of gentle therapy, active exercises are prescribed, and best results can be achieved if you shine the much-needed physical activity from 12 to 16 weeks. The load begins with stretching, then they move on to strength exercises, including bending and straightening the knee.

If the pain syndrome has passed completely, you can connect a more sports-oriented load to training. It is desirable for athletes to go jogging and make more jumps. Recurrent Achilles tendinitis and subsequent rupture will become much less likely if the patient adheres carefully to the prescribed rehabilitation measures.

In most cases, separation Achilles tendon due to intense physical activity given area. This condition may be the result of direct or indirect exposure. The main contributing factors are:

A sharp blow to the tendon is possible with active games, as well as professional football.
Increased stress on the heel is a condition predominantly found in sports that involve jumping.
Injury to the ankle during a sharp fall with socks stretched forward.
Unnatural and sudden bending of the foot - occurs when you stumble, get your foot into a hole or slip off the stairs.

Often, damage to the ligaments and tendons is localized in the area close to the heel. This is due to the fact that this locally has poor blood circulation and, in case of injury, heals for a long time.

Classification

According to complex structure, causes and degree of damage, the detachment of the Achilles tendon is different:

Depending on the causes of the injury, there are types of Achilles tendon rupture:

mechanical break is open type injury and is divided into complete (when all fibers are torn) or partial (part of the fibers are damaged).
Direct and indirect trauma refers to closed break type tendons when skin remain intact. As in the first case, there may be a complete and partial rupture.

Achilles tendon rupture can be:

open;
closed;
complete;
partial;
fresh;
old;
direct;
indirect.

Symptoms

Achilles tendon rupture is accompanied by certain symptoms, which, depending on the severity, type and degree of damage, can be bright or weak.

Often they look like an ordinary sprain, a simple bruise, to which people do not pay due attention and do not seek help from a doctor.

Common symptoms Achilles tendon ruptures are:

The symptoms in each case are absolutely similar and are a direct indication for diagnosing a patient for a calcaneal tendon injury.

A person has:

This disease is characterized by the following symptoms:

The injury is characterized by sharp pain, then pain become constant and aching.

Active foot movements are impossible, passive ones are very painful.
A positive symptom of Thomson takes place - the calf muscle is strongly pressed, while the flexion of the foot does not occur, although it should be normal.
Inability to stand on toes, lameness.
With Pirogov's symptom, the following is noted: the patient lies on his stomach, with a contraction of the calf muscles by healthy leg there are contours, this was not revealed on the damaged one.
On palpation, there is a failure in the place where the tendon was torn.

Damage to the Achilles tendon is accompanied by quite unpleasant and sometimes very serious manifestations. Symptoms of injury or inflammation usually consist of local signs and do not worsen the general condition of the patient.

However, they can have a significant impact on the psycho-emotional background and quality of life.

breaks

Basically, there are complete ruptures, but there is also a simple stretching of the Achilles tendon, when only individual fibers. It all depends on strength external factor acting on the back of the ankle. With ruptures, patients report the following symptoms:

Sudden and sharp pain.
Crunch or crack at the moment of injury.
Swelling and hematoma in the tendon area.
Decreased muscle strength in the back of the leg.
Inability to dorsiflex the foot.

Visually, a hole is also visible in the area of the gap - the place where the fibers parted. During palpation, pain is characteristic.

The hematoma reaches the fingers within a few days. The patient cannot stretch the foot, stand on toes, lameness appears.

Sometimes severe pain does not allow you to lean on your leg at all.

Separation tendon fibers completely turns off the function of the gastrocnemius and soleus muscles, which provide movement in the foot.

Diagnosis of the disease

How to detect damage to the ankle and ligaments? To do this, the doctor instrumental diagnostics, allowing you to accurately diagnose, assess the extent of the lesion, the type and possible consequences.

As a survey, often resort to the following methods:

Ultrasound - used to determine the separation classification, helps to identify a complete or partial violation.
MRI - is used for a more accurate, thorough examination. With the help of magnetic resonance imaging, the doctor assesses the degree of damage and establishes the cause, which could have torn the tendon.
Radiography is also a mandatory diagnostic method, but is used less frequently than ultrasound and MRI.

Diagnosis of rupture of the Achilles tendon can be carried out by several methods, the main method is test diagnostics.

Possible tests for diagnosing injury:

Treatment Methods

Reduce pain and reduce inflammatory processes after a break, traditional medicine will help. It has long been popular in the treatment various diseases, including effectively fights tendonitis.

good recipes are considered:

Ice - can relieve inflammation and pain. To use it, you can make it yourself or purchase it at a pharmacy. With ice cubes, it is necessary to wipe the ankle area several times daily for 15-20 minutes.
Salt dressings- for this you need a glass warm water and some salt. The ingredients are mixed, a napkin is soaked in the solution, then squeezed out, wrapped in a bag and sent to the freezer for 5 minutes. The finished bandage is applied to the leg, fixed with a bandage and kept until dry.
Wormwood tincture - stimulates the immune system, reduces inflammation. Easy to prepare: 2-3 tbsp. spoons of herbs are poured hot water, insist 30 minutes. Apply 3-4 times a day for 1 tbsp. spoon.
Clay ointment - well suppresses symptoms, removes swelling, pain. Clay in an amount of 500 g is dissolved with water until thick sour cream, 4 tbsp. spoons apple cider vinegar, mix. The finished ointment is applied to a napkin or bandage, applied to the leg, held for an hour. General course therapy is 6 days.
Calendula ointment - used to reduce inflammation. To cook, you will need plant flowers and baby cream. Components in equal quantities are mixed and used as needed.
Elecampane - excellent remedy for a compress. It is necessary to fill the plant with water and boil for 15 minutes. For therapy, a napkin is moistened with a solution and applied to the injury site. Can be done several times a day.

It is advisable to consult with your doctor before using traditional medicine recipes in order to exclude undesirable consequences.

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Treatment for this injury includes conservative method treatment and the period of rehabilitation of the patient. In many cases, instead of a conservative method, a surgical one is used, which has established itself as more reliable.

In any case, the technique is determined after assessing the patient's condition and the severity of the injury. Let's take a look at each type in more detail.

Therapy with conservative methods

A conservative technique provides conditions for self-fusion of tendon fibers. The patient's leg is placed in such a position that the site of tendon rupture forms a minimum distance of fibers from each other.

This becomes possible when a splint is applied, which pulls the toe of the foot up, thereby providing the necessary position of the leg. More often this method is used for mild degree injury or if the patient has contraindications for surgery.

It should be taken into account that this species therapy entails some inconveniences:

Also, prickly heat or callus sometimes appears at the place where the plaster is applied (with high friction of the splint against the skin). All these are unpleasant factors that aggravate therapy.

Surgery for a torn Achilles tendon

There are several options for the use of surgical intervention. Their use depends on the type of damage and general condition patient's health.

Attention

Operational Method most effective when treated soon after injury. Over time, the tendon ligaments deform at the site of the rupture and contract, making it difficult to reattach them.

Most commonly used:

So, there was a rupture of the Achilles tendons.

Treatment is usually standard.

When the tendon is ruptured, surgery is indicated. It varies depending on the type of damage.

If the Achilles tendon is damaged - due to injury or inflammation - then you need to see a doctor in time. After all, to treat pathology on early stages much easier, and the effect will come much faster.

Correction methods are determined by the type of damage and some contributing factors, for example, the age of the patient, the level of his motor activity, the presence of another pathology that affects the result (for example, diabetes or obesity).

Conservative therapy

Treatment with conservative methods is indicated in cases where stretching or inflammation of the Achilles tendon is confirmed. If a rupture has occurred, then in young patients, surgical correction is preferable. In other situations, they try to treat damage in the following ways:

Orthopedic correction.
Medicines.
Physiotherapy.
Gymnastics and massage.

The choice of this or that method is carried out by the doctor. He recommends the most effective means for the treatment of pathology.

The conservative treatment of complete tears is considered by many to be of low success and high risk of re-injury.

Orthopedic correction

With incomplete tendon ruptures, it is important to create rest for the injured limb so that the injured fibers can heal quietly. For this use various means orthopedic correction:

They are much more comfortable than plaster bandages. If there is a complete detachment of the tendon, then immobilization is needed for a rather long period - from 6 to 8 weeks. In this case, the foot is fixed in a position with an extended toe.

Medicines

Inflammation of the Achilles tendon or its stretching requires the use of certain drugs. Basically, they try to achieve elimination of pain, reduction of swelling and stimulation of healing processes. For this, the following medicines are used in the treatment:

Non-steroidal anti-inflammatory.
Muscle relaxants.
Chondroprotectors.
Vitamins and microelements.

Purulent bursitis should be treated with antibacterial agents and sometimes detoxification therapy. With tendinitis, bursitis and sprains, anti-inflammatory and warming ointments can be applied to the tendon area, as well as injected into tissues hormonal agents.

Physiotherapy

You can eliminate symptoms such as pain, swelling, and also activate blood flow in the affected tissues using methods physical treatment. They are also used in rehabilitation programs after tendon surgery. Therapeutic effect provide:

Electrophoresis.
UHF therapy.
laser treatment.
Magnetotherapy.
Paraffin therapy.

Treat an injured tendon physical methods it is possible even during immobilization, temporarily removing the splint or orthosis.

Gymnastics and massage

You can actively engage in gymnastics after the elimination of acute manifestations pathology, as well as completed the immobilization period. With sprains and tendonitis, you should try to start moving the foot early, gradually developing the damaged tendon.

And physical recovery is carried out in parallel with the massage of the ankle area.

Operation

Complete recovery of the Achilles tendon after a rupture is possible only operational way. This is the most best method for those patients who want to have high level physical activity and not have difficulty moving the foot.

The surgeon stitches the dispersed ends of the tendon, thereby restoring its integrity. There are various methods of such operations, including minimally invasive ones.

With purulent bursitis, a puncture of the bag with drainage and the introduction of antiseptics and antibiotics is indicated.

Achilles tendon injury should be treated taking into account the nature of the pathology. It should be remembered that conservative methods are not always effective, in particular, with complete ruptures. But chronic inflammation and sprains are successfully amenable to non-operative correction.

Tendon injury can be treated folk methods. To reduce swelling, fresh water can be applied to the sore spot. cabbage leaf, fix it on top with a tight bandage and wrap it with a warm scarf or towel.

The Achilles tendon is the most powerful ligament in the human body that unites the muscles of the lower leg and calcaneus. Because of the place of localization, it received the name - heel. A large and strong fibrous ligament, with strong stretching, can rupture either partially or completely. Achilles tear is a common injury to the back of the leg, often occurring in athletes and people who actively play sports.

Causes of injury and risk group

The anatomical structure of the heel ligament is such that when active movements(running, walking, jumping) it is she who is responsible for pushing off the surface with her foot and easy lifting on tiptoes. The tendon is simultaneously involved in the flexion of the foot, and is responsible for the lower leg - it is associated with the calf and soleus muscles. Achilles "pulls" the foot down, followed by the entire ankle joint. Even a simple tear of the Achilles tendon can lead to the loss of the ability to run.

An injury to any tendon is dangerous and unpredictable, so treatment must be started in a timely manner. Achilles injury is a complex injury related to trauma to the musculoskeletal system, so you should not delay its treatment.

At risk are adults in the age range from 30 to 50 years old, accustomed to leading an active lifestyle. Such an injury is common for them, it happens during active activities or games. This happens due to the wear and tear of connective tissues arising from degenerative age-related changes in the joints.

You can get an Achilles tendon stretch in everyday life, there is no certain insurance here. The conducted studies made it possible to reveal a kind of statistics that this tendon is most often damaged not by professional athletes, but by amateurs. Non-professional exercisers make the popular mistake of engaging in exercise and play without warming up their muscles sufficiently.

Injury classification

Classification of tendon disorders according to the type of damage:

Direct impact to the tendon - the injury occurs at the moment of impact on the ligament. Considered a direct type of injury, with high probability happens to football players due to the hit of an accelerated ball on the leg.
An indirect type of injury is caused by a sharp contraction of the muscles in the extended leg. This happens at the time of the jump, common among volleyball and basketball players.

An injury can occur due to an unexpected bend of the foot - occurs during landing on an extended toe of the foot. The usual type of injury is a closed rupture, but an open rupture often occurs. The reason for this is damage sharp object specifically the Achilles tendon.

Common factors that increase the likelihood of injury include:

the age of the victim statistically ranges from 30 to 50 years, the injury occurs due to the weakening of the entire ligamentous apparatus, where microscopic damage accumulates. In case of injury, they have the role of a "snowball" - the more of them, the higher the likelihood of a tendon rupture;
active games associated with a full range of movements - jumping, running, the need to quickly respond and stop movement. The cause of the injury is the lack of a full-fledged warm-up and warm-up of the muscles before classes;
gender of the injured person - most often they are men;
taking medication for treatment ankle joint- with its inflammation and discomfort from pain. Many drugs can cause laxity of the surrounding ligaments, which is why increased stress can injure the Achilles tendon. In addition to steroid drugs, antibiotics cause a similar effect.

It is necessary not only to thoroughly warm up before active exercises, but also to monitor the diet. An unbalanced diet can weaken the ligamentous apparatus and become indirect cause injury.

Clinical symptoms of injury

The rupture of the fibers of the connective tendon shows all the symptoms characteristic of such injuries:

the strongest pain syndrome, from pain in the literal sense "legs bend under." It is permanent and aching in nature, localized at the site of injury;
at the site of injury, tissues are seen to sink inward;
the damaged area immediately swells strongly;
are damaged blood vessels, gradually develops extensive hemorrhage in soft tissues. The maximum period of appearance is 3 days. The hematoma may eventually spread from the heel to the toes;
when palpating the tendon, a strong defect is revealed - thickenings at different ends of the gap;
it is not possible to bend the foot - with a complete rupture, a partial one entails weakened movements, while activity drops sharply;
complete or partial tear do not affect the passive activity of the ankle, only accompanied by severe pain- sprain of a torn calcaneal tendon;
a characteristic crunch is inherent in the injury;
severe limitation of mobility - there is no way to climb stairs, walking is painful;
the victim is unable to stand on tiptoe.

Many of the problems associated with such an injury are associated with the triceps muscle. This results in lameness.

Damage Diagnosis

Determining a torn heel ligament is quite simple if the symptoms listed above appear. Accurate Diagnosis can only be given by an orthopedic traumatologist, so seeking medical help is essential.

In the diagnosis, the method of palpation is used, which determines likely symptom"failure" - a clear rupture of the ligament. Calf muscle compression tests are used.

A symptom such as " positive symptom Thomson". It is characterized following method diagnostics: the calf muscle is fixed, with a healthy limb, the foot should bend. Rupture of the calcaneal tendon is demonstrated by the fact that there is no flexion - the tension does not extend to the heel, the movement of the ankle is paralyzed.

Another one salient feature- "positive Pirogov's symptom". The victim must be placed on his stomach, while the feet should hang above the floor. The injured person is urged to contract the triceps muscles on both legs. Contours will appear on a healthy calf muscle, but they will be missing on the damaged one.

An accurate diagnosis is made after ultrasound and MRI on the local area of damage. Pictures of these procedures allow you to determine not only the extent of the rupture, but also to find out whether the ligament is completely or partially torn.

Emergency First Aid

At the moment of injury, a characteristic crack or crunch is obviously audible, with which the fibers are torn connective tissue. Mobility is sharply disturbed, any movement is accompanied by increasing pain.

It is necessary to ensure complete rest and immobility of the injured leg until the pain subsides. The victim should sit or lie down so as to minimize the load on the injured limb. You should raise your leg - this will reduce swelling, reducing swelling. A backpack, a folded jacket, a small pillow can serve as a kind of roller - if the injury occurred at home.

The affected area must be anesthetized. The easiest way to achieve this is to apply ice. The role of a cold compress can be performed by ice from the refrigerator, wrapped in a cloth and a plastic bag. bottle with cold water, semi-finished products, raw frozen meat - they will relieve swelling, reduce hemorrhage due to the fact that the vessels narrow under the influence of cold. Do not apply a compress for a long time, 10 minutes will be enough, after which you need to take a break for 20 minutes.

You can relieve the pain syndrome with painkillers - this is necessary for the period of the trip to the hospital in order to get there without problems. For the duration of the movement, the limb must be tightly bandaged with an elastic bandage.

Medical therapy

Treatment can occur in two ways: conservative and surgical. The choice of therapy is made depending on the age of the victim, the activity and severity of the injury. Surgery typical for young victims, while for the elderly it is preferable to use a conservative method of treatment. Both methods are equally effective, but the choice is made individually depending on the overall picture of the diagnosis.

Traditional treatment

The basis for conservative treatment is the complete immobilization of the injured leg. superimposed gypsum bandage or an ankle brace is used. The limb is fixed in the position of the raised heel - thus the minimum distance between the ends of the torn calcaneal ligament is achieved.

Immobilization is safer than surgery and its consequences - anesthesia and infection of the incision. But the risk of re-injury increases, in which recovery will be significantly slowed down.

Possible types of immobilization used to achieve full fixation of the leg:

plaster splint - the foot is extended forward, the knee is slightly bent. Superimposed for 2 months;
polymer plaster cast - the principle is the same, but it is much easier to live - you can wash yourself leg light due to lightweight materials, while maintaining strength;
orthosis - a corset for the leg, a kind of boot that fixes the damaged foot in one position. The superiority of the method lies in its ability to individually adapt to each patient.

Traditional treatment and subsequent passive recovery are recommended for those who live a quiet life that does not require increased activity. It is also used if a person is contraindicated in surgery due to chronic and hereditary diseases- hemophilia, sick heart, kidneys, etc.

Modern methods have gone far ahead, so two types of surgery can be performed: open - the skin is cut to open access to injured tendon, and closed - the incision is not made.

An open operation is performed to stitch the tear - the ends of the ligament are connected by stitching together. If the injury is serious, then the ligament is additionally strengthened with artificial material.
Closed surgery consists in the treatment of a heel tear by applying a “percutaneous” suture. Threads are passed through the skin, capturing and connecting the ends of the tendon. A significant disadvantage is that the doctor cannot accurately see the ligaments and therefore does not match them too tightly. The result will be a bad splice.

Surgery has a number of complications - infection and trauma nerve endings. The infection can be introduced even during a sterile operation, due to which the suture will fester. Only a small incision, together with the use of antiseptics during dressings, can reduce the risk.

Every surgeon can damage a nerve by accident, but this happens extremely rarely. The consequences of the operation include a cosmetic defect in the heel area - a scar. For some time, the mobility of the foot may be limited.

Recovery from surgery also requires the wearing of a cast to ensure complete immobilization of the injured leg. The bandage is applied for 1-2 months. You can only move with crutches.

Regardless of the type of treatment, anti-inflammatory painkillers are prescribed to relieve pain and inflammation in the damaged foot.

Recovery period

After successful treatment a course is prescribed aimed at restoring habitual mobility and strengthening muscles. rehabilitation period lasts about 3 months full recovery tissues and a return to the usual way of life can be expected only after six months.

The course includes physiotherapy exercises and physiotherapy. After removing the plaster splint, the use of massage techniques is allowed. All methods are aimed at strengthening damaged tissues.

Exercise should be started as soon as possible to muscle tissue, for a long time immobile began to stretch. To begin with, it is enough to strain and relax the muscles of the lower leg. Gradually, it is worth moving on to performing complicated exercises in the gym.

Ankle and foot massage best effect. The circulation of lymph and blood will improve, tissue repair will accelerate. Physiotherapy in the course of rehabilitation is a supportive process aimed at relieving pain and swelling.

Prevention

It is important to avoid re-injury because it increases the risk unpleasant consequences. After the course of treatment, you must follow some rules:

develop and strengthen the muscles of the ankle and foot;
alternate sports with good rest;
choose good orthopedic shoes;
do not start training immediately, you need to gradually increase their intensity;
pay attention to the road when walking, bypass slippery and uneven places.

If the treatment is delayed, diagnostics are not carried out, or the victim decided not to seek help at all, then the ends of the tendon will gradually disperse, aggravating the injury. Often repeated or subsequent treatment will be useless. Timely diagnosis of the injury, its treatment and full recovery will save the victim from lameness for life.

Achilles (calcaneal tendon) injury is a common soft tissue injury. The heel tendon is very strong. Violation of the integrity of the Achilles is possible with an excessive load that does not correspond to its strength. More often, the disease is diagnosed in males, aged 30 to 50 years, involved in sports. Violation of the integrity of the calcaneal tendon is complete, compared with trauma to other soft tissues. This pathology is called a rupture of the Achilles tendon.

Cause of damage

In the first place among the causes of occurrence is overstrain of the calf muscle of the lower leg. This happens with a sharp, excessive load on the leg.

An example of such a load is a sharp start in runners or when jumping. This happens with insufficient warm-up. Sometimes an Achilles injury (photo below) occurs against the background congenital anomaly, in this case, the person is especially susceptible to the occurrence of this pathology.

Due to the nature of the structure, women are less susceptible to trauma. In older people, injuries are due to inaccurate walking, when climbing or descending stairs.

More rarely, the etiology is a direct blow with a blunt object directly above the heel. Also, the cause may be wound with a sharp object.

Classification of Achilles tendon injuries

The concept of trauma is quite broad and includes nosologies that are similar in appearance and clinic, but different in therapy tactics. What is Achilles injury? It includes the following nosologies:

injury;
stretching or tearing;
complete break.

Depending on the strength of the tissues and the force acting on them, the violation of integrity can be of varying degrees. A contusion is a closed soft tissue injury, without severe violation structure integrity. Stretching is a tear of tissues, with partial preservation of the structure. Rupture - a complete divergence of the structure, with a violation of anatomical continuity.

In the practice of doctors there is a concept: chronic sprain. This pathology is given to patients in case of prolonged absence treatment of Achilles tendon injury. Clinical picture involves enlargement of the calf muscle on the affected leg.

If more than six months have passed since the appearance of torn tissues, the development of excessive bending of the foot is likely.

Achilles injury symptoms

The signs of an Achilles rupture are quite typical and are similar to those of other soft body structures. The symptoms and treatment of both a tear and an Achilles tendon sprain are nearly identical. The first and most important symptom for all types of injuries of the calcaneal ligaments and muscles is local sharp pain when standing on the leg in the projection above the calcaneus, the Achilles tendon injury is also accompanied by pain on palpation. Locally tissues swell at the site of injury.

When sprained, it is difficult to bend the foot, there is a violation of the contours of the structures, there is a small hematoma. A complete separation visually looks like a divergence of tissues, with a hole in the center.

It is impossible to flex the foot, and when the calf muscle is compressed, complete absence movements. Achilles rupture injury is accompanied by a large hematoma.

A contusion of the Achilles tendon is accompanied by smoothed symptoms or their absence. There may just be a sensation above the heel that the Achilles tendon is pulling.

Diagnostics

It is not difficult to make a diagnosis of Achilles tendon injury and start treatment. The main method for diagnosing an injury is anamnestic data obtained from the mouth of the patient.

Usually, when collecting an anamnesis, there will be information about playing sports where jerky movements feet or other overload. The anamnesis may include injury with sharp or blunt objects, in the area above the calcaneus, such injuries of the Achilles tendon are called sharp or blunt, respectively.

Additional information about the state of the limb is provided by palpation, if there is severe swelling and hematoma, palpation helps to make a preliminary conclusion about the presence or absence of a complete detachment.

A mandatory study is radiography. It allows you to exclude the presence of a broken bone, torn ankle ligaments or other violations of nearby structures.
Be sure to conduct an ultrasound examination to determine the percentage of separation. Only ultrasound can unambiguously differentiate the tear and rupture of the Achilles.

Magnetic resonance imaging is usually not resorted to as unnecessary. However, if desired, MRI can be performed for a detailed picture of the damaged structures.

With a belated diagnosis and the absence of treatment for Achilles injury, a chronic carriage of partially torn structures develops, which will complicate therapy in the future.

It is not difficult to identify Achilles tendon injuries based on a textbook. They must be distinguished from the following ailments:

rupture of the calf muscle;
fissures and fractures of the calcaneus;
pertendita;
thrombosis of the leg veins.

Treatment

If someone has sprained their Achilles tendon, what is the first thing to do? First you need to lay the person down to create peace for the leg. Then apply ice to the Achilles sprain, avoiding direct contact with the skin. Get the patient to the emergency room as soon as possible.
Treatment of an Achilles tendon bruise has no special features compared to bruises of other soft tissues. Basic postulates in this case- this is peace and cold for a sore leg. If necessary, anesthetic ointments can be applied.

If there is a tear or gap, what to do? The basis of therapy is surgery. The essence of the operation is the mechanical comparison of parts torn from each other by suturing.

Obligatory is the equinus installation of the leg and the imposition of gypsum in this position for a period of 2-3 weeks. The leg is then set to a 90 degree position to avoid leg shortening. The number of weeks in plaster depends on the regenerative properties of the body and the degree of tissue damage.

A necessary stage of treatment after an injury to the Achilles tendon is rehabilitation. It consists in assigning physiotherapy exercises, the purpose of which is to completely put a person on the foot, it is still necessary to stand on toes after an Achilles injury, these exercises are mandatory. Plus, wearing is prescribed special footwear. Rehabilitation after any injury to the Achilles tendon is long, but necessary, so be patient. Approximate dates Recovery after an Achilles injury depends on the regenerative abilities of the body and compliance with the necessary exercises.

A conservative method of treating sprains is common. However, when deciding how to treat an Achilles tendon tear, the choice usually leans in favor of surgical therapy. Conservative therapy allowed only with very slight stretching. So how do you treat a minor Achilles tear? The use of ointments that relieve swelling and reduce inflammation is prescribed, plus the obligatory rest of the leg.

When chronic disease, an operation is performed, the purpose of which is to dissect the resulting scars that interfere with free movement. Then sutures are placed and further tactics does not differ from that of a recent injury.

Achilles rupture injury is a serious injury. With the correct therapy, compliance with the terms of recovery of the Achilles tendon injury, the disease will pass without a trace. However, there is a possibility of re-tearing, as the fabric is weaker and will not withstand huge loads, such as an intact leg. If recovery from an Achilles tendon injury is not sufficient, then leg function will be impaired.

Achilles tendon injuries are quite common. For yourself, be sure to remember the need to see a doctor as soon as possible. A rupture of the Achilles tendon over the heel is a very serious injury, often requiring emergency surgical care.

Home treatment for an Achilles tendon injury is not possible. Only during the recovery period should you perform a group of exercises. Only experienced doctor Knowing the symptoms, and what kind of Achilles tendon injury you have, can lead to the right treatment.

Many people know that one of the important elements musculoskeletal system human body, is a tendon apparatus that connects muscle fibers to the joints. One of the most powerful and large tendons is considered to be the heel, which bears the name of the legendary Greek warrior Achilles. Despite the fact that this is the strongest ligament in the body, it often lends itself various kinds injuries (the most common injury is an Achilles tendon sprain, which often occurs in professional athletes).

The main function of the Achilles tendon is to provide motor ability ankle joint when performing leg movements, as well as a shock-absorbing function.

Causes of injury

At home, the Achilles tendon lends itself to stretching during dislocations or subluxations. Among athletes, the main cause of a sprain is a heavy load or a very sharp contraction of the ankle muscles. Also, stretching often occurs due to a blow that hit the tendon.

For example, sprains often occur when a foot slips on a stair or sidewalk. Very often, this injury occurs in women who, in pursuit of beauty, put on high heels, and the leg assumes pathological lateral flexion (ankle deviates to the outside, and the foot is tucked inward).

In addition to the above factors, there are several more:

Various changes and deformities of the calcaneus;
High arch of the foot;
Poorly developed stretching of the muscular apparatus of the leg (it includes the posterior femoral and calf muscles);
Congenital or acquired, O-shaped curvature of the legs;
Incorrect walking with stepping on the heels;
Sharp or strong eversion of the foot inward;
Increased stiffness of the heel tendon.

Stretch symptoms

Any signs that occur when the Achilles tendon is stretched should not be ignored. The clinical picture of the injury may develop in different ways, given the degree of injury.

The manifestation of symptoms can appear at lightning speed - against the background of a sharp injury to a large part of the tendon, or gradually - provided small area injury. If a person paid attention to the developed signs of damage to the vein late, over time the injury becomes more complicated, and the symptoms become brighter and more severe (inflammation and sharply limited mobility of the ankle joint appear).

A neglected form of chronic stretching of the Achilles tendon, which arose due to an injury, in the future may lead to a loss of elasticity and the ability to perform a shock-absorbing function. This picture is often observed when replacing damaged fibers in the tendon, on the connective scar tissue(it does not have sufficient elasticity, which could provide the vein with its physiological functionality). Ultimately, this leads to an increase in the likelihood of breaks.

The first signs by which you can suspect a stretched Achilles tendon:

sharp, sharp pain, which occurs in the leg area, just above the heel;
Swelling of the soft tissues that are around the ankle;
Attempts to perform flexion movements with the foot or toes cause pain, or are completely impossible;

To the group increased risk for sprains or any other injury to the Achilles tendon, include people aged 25-45 years. In the event of the above signs and symptoms, you need to contact a specialist traumatologist who will prescribe an x-ray of the ankle joint in order to exclude cracks or fractures of the bones of the articular part. Due to the fact that the sprain cannot be seen on the R-graphic image, the patient is prescribed an ultrasound or CT scan of the part that will help the doctor assess the extent of the injury.

Treatment

A certain therapeutic technique which is used by many physicians. It is aimed at treating patients who have received a calcaneal sprain. The entire course of treatment consists of two main stages: basic therapy and rehabilitation (recovery).

Treatment for sprains consists of the following therapies:

During the first 24-36 hours, the area of injury is cooled with ice packs;
The next three days establish warming compresses;
To save the patient from pain in the leg, you can use non-steroidal anti-inflammatory drugs (Ibuprofen, Baralgin, Ortofen and many others);
tight bandage, and the imposition of restrictions on the performance of physical activity for 2-3 months;

The second part of the treatment (rehabilitation) is aimed at avoiding cases of re-injury to the vein. The doctor selects special orthopedic shoes for the patient, talks about the rules for the correct distribution of physical activity on the leg, and prescribes a course of physiotherapy exercises. Among other things, during recovery, the patient needs therapeutic massage and some non-traditional methods treatments (such as acupuncture). A properly designed set of rehabilitation measures helps to avoid the development of scars and contractures in the future, which negatively affect the motor ability of the ankle.

Sprain Prevention

To protect yourself from damage to the Achilles tendon, you need to follow a few simple rules:

In the event of any attacks of pain in the calcaneal vein, you must immediately stop performing any loads on the ankle;
Need to wear proper shoes for everyday walks. For example, when choosing shoes for sports, the main focus is on the flexibility of the forefoot;
If the palpation of the heel of the ankle brings a feeling of discomfort, you should seek the advice of a traumatologist.