The Achilles tendon is an important part of the foot. One of the largest tendons, it connects the heal bone to the calf bone, thus partially enabling the foot to move and perform its daily
functions. Partial or total rupture of the Achilles tendon is a painful experience usually results in surgery. But new developments have shown that conservative treatments can work just as
well for partial tears.
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Why Does the Tendon Tear?
- The Achilles tendon is prone to rupture and tears because of its location. Repetitive movement of the foot and calf leads to wearing down of the tendon as well as
inflammation (called tendinitis). Other possible causes of ruptures include chronic joint illnesses like lupus SLE, rheumatoid arthritis or too much corticosteroid. Excess
corticosteroids can be a result of taking oral steroids, injections of the medicine into the foot, or Cushing's disease (in which the body makes too much of its own corticosteroids).
Surgery vs. Conservative Treatment
- Since the late 1980s, surgery has been the favored way to treat these types of injuries. However, a study at Hadassah University Hospital in Ein Kerem, Israel in 2001
found that surgical treatment might not always be the best option. After treating 18 patients over five years, doctors found that those with a partial tear and nonsurgical treatments fared
just as well or better than those who had undergone more radical treatments. Only one patient in the study suffered a re-rupture of the tendon; everyone else reported a favorable outcome.
Conservative Treatment
- Conservative treatment of an Achilles tendon rupture includes casting the foot for four to six weeks. During this time, the patient will be advised to stay off of his
foot and rely on the aid of crutches or a walker. As time goes on, he will graduate to a brace and be able to place more and more weight on the foot. He will participate in physical therapy
exercises to strengthen the weakened tendon, such as stretches and weight-bearing exercises. After 4 to 12 months, depending on the severity of the injury, he will be able to return to all of
his pre-injury activities.