Gelenk-Klinik

What is the Achilles tendon? What function does it have?

The Achilles tendon is the strongest tendon in the human body. She is an average of 20-25 cm long and connects (the joint terminal tendon of the three-headed calf muscle) muscles of the calves ¬ on their approach to the heel bone of the foot. It ensures that the foot is the impression from the floor in the ankle bent back and sole of the foot turned slightly inward.

If we run, are involved in every step forces on the Achilles tendon, which can exceed 10 times its own weight. Even higher are the forces in jumping loads.

Why the tears Achilles tendon?

The most common Achilles tendon injury is the crack, the sudden cutting of the achilles tendon (Achilles tendon). For a rupture may be for several reasons. Although the Achilles tendon is mechanically sturdy, it can in the event of excessive tension / tension get to the breaking point. In most cases, degenerative predamages by over-and improper loading the reason why. It is primarily for smaller injuries that disrupt the blood supply to the tissues, leading to a lack of strength. Affected are disproportionately often physically active people, especially (physically active) men aged 30-50 years.

What are the symptoms of an Achilles tendon rupture?

The rupture of the Achilles tendon, which is often with a loud bang, like a whip, noticeable, is associated with sudden stabbing pain in the calf, usually just above the heel. Outwardly, there may be a swelling on the back of the ankle or the lower part of the calf, combined with a bruise or discoloration by punctate hemorrhages in the skin. After an Achilles tendon rupture is a plantar flexion of the foot (active flexion of the ankle) because of the lack of connection between Wade and Fersenbeinhinterkante no longer possible, the patient is no longer on the affected leg to one-leg-tiptoe in the situation and can no longer walk normally.

How the diagnosis is made with a hamstring injury?

In the diagnosis of Achilles tendon rupture, both the accident history and the view is the external signs of injury is important. By careful palpation of the calf there is a pressure pain, often a gap or depression. Pointing the way for an accurate diagnosis is the examination of the one legged toe-stand. Normally in a healthy Achilles heel pulled up and bent by the walk to the back foot. Thus, a diagnosis made by a pure functional test. Additional imaging techniques such as ultrasound or X then used the so-called fine diagnosis. Bony avulsions of the Achilles tendon at the calcaneus using an X-ray can be detected or excluded. The ultrasound (sonography) is used for accurate representation of the location of the crack.

Which therapeutic measures can be taken?

We distinguish in principle between Operative and conservative therapy.

Conservative treatment

If it is determined during the lowering of the foot that the split end / tendon stumps touch, including the integration of the tendon ends is possible. In this case, may be waived by a surgical treatment of the crack. This is possible because the Achilles tendon can be stretched up to about twice its size. The use of special shoes with an increase in the heel and solid tongue are helpful to the conservative therapy. This is the foot, similar to a heel shoe, placed in an equinus. This allows the tendon ends make a contact, and in many cases, a phase of partial weight be transferred relatively quickly to the normal load of the foot. Ongoing checks by the attending physician shall ensure that the healing process is monitored and if necessary, optimized. If you experience during that time no further complications, so the healing process is completed in about 6-8 weeks.

Surgical treatment

The Surgical treatment is mainly in young, athletic people applied, since this a safe approach of the two tendon stumps is ensured and a high stability is achieved. The skin over the torn Achilles tendon is cut, torn tendon and dead units are removed and the tendon ends are sewn back together ¬. After surgery, the patient receives a below-so that the leg and the seam in about 30 ° to 40 ° equinus be immobilized. The operated leg may thereby teilbelastet cautiously.

The stitches are removed after about two weeks. A new plaster cast is created, this time with a reduced degree of equinus (about 10 ° to 20 °). This plaster is removed after a further 2 weeks and replaced after a thorough review of the treatment success by the treating physician, with a new short leg. The leg can now be fully charged again, provided the patient is pain free.

After another two weeks, the last cast is removed. The patient may increase the burden of his foot operated step by step until he has a full load in the situation. Final rehabilitation measures, such as a movement therapy, supported him in the training and implementation of the increase of load and joint mobilization.