ACHILLES-TENDON

WHAT IS THE ACHILLES TENDON?

The Achilles tendon is the strongest tendon in the human body. It connects the heel bone, known as the calcaneus, with the calf muscles. The Achilles tendon enables us, for example, to stand on our toes and push off when running and jumping.

The most common complaints of the Achilles tendon are irritation and inflammation. Tears or ruptures of the Achilles tendon can also occur. An Achilles tendon injury can be successfully treated if recognised in good time and treated specifically. The combination of the treating doctor’s experience and state-of-the-art medical treatments are the key to success.

The experts at ECOM® specialise in the treatment and therapy of Achilles tendon complaints and are renowned nationally and internationally.

WHAT INJURIES TO THE ACHILLES TENDON ARE THERE?

Achilles tendon injuries are quite common. Anyone, regardless of their circumstances or sporting activities, can be affected by Achilles tendon complaints.

Basically, we differentiate between irritation and inflammation of the Achilles tendon and a tear or rupture of the Achilles tendon. While irritation or inflammation of the Achilles tendon is usually treated conservatively, surgery is often the better choice for a tear or rupture of the Achilles tendon.

IRRITATION OR INFLAMMATION OF THE ACHILLES TENDON

If the Achilles tendon is irritated or inflamed, pain occurs repeatedly when the calf muscles are strained or stretched or when the ankle is loaded for a longer period of time. If pain recurs in the area of the Achilles tendon, a doctor should be consulted in order to avoid consequential damage and rule out a possible Achilles tendon rupture.

Achilles tendon irritation is usually treated conservatively, i.e. without surgery. Various measures are available for this, such as rest, cooling, special positioning of the affected foot, orthopaedic aids and physiotherapy.

If the symptoms recur or occur over a longer period of time, we speak of chronic irritation or inflammation of the Achilles tendon.

TEAR OR RUPTURE OF THE ACHILLES TENDON

If the Achilles tendon is torn or ruptured, the tendon that connects the muscles in the calf to the heel bone is completely or partially severed. This often results in severe pain and the foot can no longer be bent downwards properly at the ankle joint.

Not every torn Achilles tendon needs to be operated on. Recent studies have shown that conservative treatment can also lead to acceptable healing success. However, surgery is often the better choice for young or athletically active people. The torn or ruptured Achilles tendon is operated on using modern suturing techniques.

If the Achilles tendon is torn or ruptured, there are various surgical procedures to choose from, depending on the size and extent of the damage. The treating doctor must decide which procedure is to be used on an individual basis. As a general rule, small defects are usually operated on in a minimally invasive manner with a small incision using endoscopy. For larger defects or old tears, a conventional normal incision is recommended.

CAUSES OF A DISEASE OF THE ACHILLES TENDON

The causes of Achilles tendon disorders vary: while inflammation and irritation are often due to overloading, Achilles tendon ruptures are usually caused by traumatic events. An already damaged Achilles tendon is significantly more susceptible to a tear or rupture of the Achilles tendon.

CAUSES OF IRRITATION OR INFLAMMATION OF THE ACHILLES TENDON

Despite intensive research efforts, there are still no clear causes for irritation or inflammation of the Achilles tendon. Muscle imbalances, for example in tense or shortened calf muscles, weak ligaments in the ankle joints, deformities of the foot or problems with the knee, hip or spine can cause persistent strain on the Achilles tendon. An inflamed Achilles tendon insertion on the heel bone is often associated with bursitis or a heel spur. The adjacent connective tissue can also become inflamed.

CAUSES OF A RUPTURE OR TEAR OF THE ACHILLES TENDON

The causes of a tear or rupture of the Achilles tendon are rarely external force, but rather a sudden, heavy load. This happens, for example, during sport due to movements that place particular strain on the ankle joint. Such movements are particularly common in sports that require fast sprints, sudden stops or rapid changes of direction, such as tennis or football.

However, tears also occur in everyday life when the tendon is suddenly overstretched, for example because people want to cross the road quickly when the traffic lights turn yellow. A factor that favours a tear or rupture of the Achilles tendon is often a tendon that has already been damaged by inflammation or overloading.

SYMPTOMS OF A RUPTURE OR TEAR OF THE ACHILLES TENDON

A rupture or tear of the Achilles tendon almost always occurs during a so-called high-speed effort, for example when sprinting or jumping. When the Achilles tendon ruptures, the affected person often feels a whiplash-like impact with subsequent weakness in the affected leg. As a result, the tip of the foot can no longer be bent downwards. Standing up or walking is occasionally still possible, but causes severe pain. Standing on the balls of the toes is no longer possible and the foot can no longer be rolled.

A clear dent can often be felt at the level of the tear. The experienced doctor can diagnose an Achilles tendon rupture based on the clinical examination and special functional tests. Imaging procedures such as ultrasound or magnetic resonance imaging refine the diagnosis.

RISK FACTORS FOR A RUPTURE OF THE ACHILLES TENDON

Tears to completely healthy Achilles tendons are extremely rare. If the Achilles tendon has no previous damage, a part of the heel bone is more likely to break off at the tendon insertion in the event of an accident than the tendon itself tearing. Tears are much more common in weakened, previously damaged Achilles tendons that have been overloaded by persistent irritation and inflammation.

There are also other factors that increase the risk of an Achilles tendon rupture: Foot misalignment, unsuitable footwear, shortened calf muscles, inadequate warm-up before sport, repeated overloading during sport and older age.

DIAGNOSIS AND TREATMENT OF DISEASES OF THE ACHILLES TENDON

A targeted diagnosis is crucial for successful treatment. The doctor will therefore first enquire about current and previous complaints in the area of the Achilles tendon.

This is followed by an examination to determine whether walking on tiptoe and standing on one leg is possible. The affected ankle joint is assessed for function and pain sensitivity. In addition, the area of the tendon is palpated – in the case of an Achilles tendon rupture, a dent can be detected a few centimetres above the heel.

Details of the injury can be determined in further imaging procedures such as magnetic resonance imaging or X-ray examination.

DIAGNOSIS AND TREATMENT OF DISEASES OF THE ACHILLES TENDON

Achilles tendon injuries can affect almost anyone. The good news is: Surgery is not always necessary. If the Achilles tendon is irritated, conservative therapy consisting of rest, cooling, special positioning of the affected foot, orthopaedic aids and physiotherapy often leads to a significant improvement. Heavy exertion and sport should be avoided during the regeneration period if the Achilles tendon is irritated.

SURGERY FOR A RUPTURE OR TEAR OF THE ACHILLES TENDON

Surgery is often recommended if the Achilles tendon is completely severed or torn. Younger, active people in particular benefit from the procedure, as the Achilles tendon is restored after a short time.

A tear or rupture of the Achilles tendon is usually performed using a minimally invasive endoscopic procedure. The ends of the torn tendon are brought together through a small incision and sutured together.

If the tear has been present for some time, there are larger defects or the tendon is particularly worn, it may be reinforced. This is done, for example, with an autologous tendon that is located near the surgical area (tendonplasty). For surgery on older or larger defects, the conventional surgical method with a normal incision is often recommended, as this approach achieves better results.

REHABILITATION AFTER SURGERY ON THE ACHILLES TENDON

After an operation on the Achilles tendon, rehabilitation plays a crucial role in accelerating the healing process and enabling a quick return to everyday life.

Close collaboration between the doctor and physiotherapist is an essential part of rehabilitation following Achilles tendon surgery. The experts at ECOM® therefore work together with the responsible therapists to develop a customised rehabilitation concept. Always with the aim of getting patients back into sport and everyday life as quickly as possible.

YOUR SPECIALISTS FOR ACHILLES TENDON INJURIES AND OTHER COMPLAINTS

Prof. Dr. Norbert Harrasser*

Specialist in orthopaedics and trauma surgery,
specialised orthopaedic surgery

“Numerous deformities and wear and tear disorders of the foot and ankle can also be treated excellently using minimally invasive techniques.”

Dr. Erich Rembeck - München

Dr. Erich Rembeck

Specialist in orthopaedics, sports medicine

“Minimally invasive surgical procedures and regenerative treatment methods help patients with Achilles tendon injuries to quickly return to sport and everyday life”.

Dr. Alexander Rauch

Specialist in orthopaedics and trauma surgery
Specialist in orthopaedic surgery

“The patient is often in a state of emergency. Targeted diagnosis and individualised therapy are the key to successful treatment”.

ADVICE AND CONTACT FOR QUESTIONS ABOUT INJURIES TO THE ACHILLES TENDON

Do you have questions about treatment and therapy for an acute or chronic injury to the Achilles tendon? Our experts will be happy to provide you with detailed information and advice in a personal consultation. Simply make an appointment. We look forward to hearing from you.

AKTUELLES

Regenerative Medizin

Sehr geehrte Besucher,

Sie verlassen nun den Internetauftritt der ECOM® – Praxis für Orthopädie, Sportmedizin und Unfallchirurgie Dr. Erich Rembeck, Dr. Alexander Rauch, Prof. Dr. Hans Gollwitzer, Prof. Dr. Patrick Weber – Ärztepartnerschaft aus München.

Sie werden weitergeleitet auf den Internetauftritt von ECOM – Zentrum für Regenerative Medizin und Stammzelltherapie Dr. Erich Rembeck, Dr. Alexander Rauch, Prof. Dr. Hans Gollwitzer, Prof. Dr. Patrick Weber in Thiersee, Österreich.

Die im folgenden beschriebenen Therapien finden ausschließlich in Österreich statt und sind von der Ärztekammer Tirol, sowie der Österreichische Agentur für Gesundheit und Ernährungssicherheit (AGES) genehmigt.

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