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Achilles tendon ruptures

Achilles tendon ruptures
Maintenance

The Achilles tendon, located at the back of the leg (connecting the calf muscle to the calcaneus), is the thickest tendon in the human body and can withstand very high tensile forces. Despite its robustness, it is the most frequently ruptured tendon in the lower limbs. Injuries to this tendon usually occur as a result of an acceleration mechanism where the hip and knee extend (leg back from the center of the body), and the Achilles tendon stretches rapidly due to a sudden increase in the ankle's range of motion (dorsiflexion), causing a rupture. In addition to this mechanism, these injuries can also be caused by rapid changes of direction (especially crossing), jumps and landings, or direct impact on the tendon. Due to the nature of these injuries, Achilles tendon ruptures are often reported in multidirectional or jumping sports, where numerous high-intensity actions are present. They occur mainly in individuals who rarely take part in sporting activities, alternating periods of inactivity with intense physical activity (e.g. soccer, basketball, tennis), commonly known as “weekend athletes”. These patients generally present with a weak overall condition of the tendon (often associated with reduced mobility, weakness, impaired quality of movement and general deconditioning).

The management of patients with Achilles tendon ruptures is still the subject of debate within the medical community, with surgical and conservative treatment both valid options. Non-surgical treatment is often considered for partial ruptures or recent complete ruptures where the tendon and calf muscle are not significantly retracted. In such cases, rapid intervention using a boot to hold the two ends of the tendon together (foot in plantar flexion), limiting stress on the area and supporting its healing process (with the addition of crutches), may be considered. The protocol then progresses with a gradual increase in ankle range of motion over several weeks, combined with rehabilitation to preserve function as much as possible. When conservative management is not a viable option (e.g. long-standing ruptures with significant calf retraction), surgery is performed to repair the ruptured tendon, using a variety of techniques discussed between the patient and the medical-surgical team. After surgery, a similar protocol of protection and gradual recovery of mobility is implemented using a boot and crutches. Regardless of the management strategy adopted, it is strongly recommended that you consult a specialized center capable of managing all your treatment needs.