Achilles tendon ruptures

Which patients sustain Achilles tendon ruptures?

Achilles tendon ruptures are most commonly seen in men who are around the age of 30-40 years old. About 15-20% of patients have symptoms of Achilles tendonitis prior to sustaining an Achilles tendon rupture, but the vast majority of patients have no history of prior Achilles tendon problems.
Over 75% of Achilles tendon ruptures are associated with playing ball sports (commonly basketball or tennis).
Other risk factors that are associated with Achilles tendon rupture include:
o Cortisone injections into the tendon
o Gout
o Fluoroquinolone antibiotic use
Fluoroquinolone antibiotics are used very commonly in medicine for treatment of respiratory infections, urinary tract infections, and other bacterial infections. These antibiotics, such as Cipro, Levaquin, and others, are associated with Achilles tendon rupture. Exactly why this is the case is unclear, but patients on these medications should consider an alternative medication if Achilles tendon pain develops.

What is an Achilles tendon rupture?

An Achilles tendon rupture occurs when the tendon attaching the calf muscle to the heel is ruptured. This is a common injury, most often seen in middle-age, male, "weekend warriors."
What are the symptoms of an Achilles tendon rupture?An Achilles tendon rupture is a traumatic injury that causes sudden pain behind the ankle. Patients may hear a 'pop' or a 'snap,' and will almost always say they feel as though they have been kicked in the heel (even though no one has kicked them). Patients have difficulty pointing their toes downward, and may have swelling and bruising around the tendon.

Treatment and treatment Options

Achilles tendonitis can develop into a chronic problem if treatment is not initiated in a timely manner. Over time, inflammation can lead to degenerative changes within the tendon, and may even contribute to a higher chance of Achilles tendon rupture. Therefore, it is important to initiate treatment for symptoms of Achilles tendonitis.
What are the treatment options for Achilles tendonitis?The best treatment of Achilles tendonitis is prevention. Stretching the Achilles tendon before exercise, even at the start of the day, will help to maintain flexibility in the ankle joint. Problems with foot mechanics can also be treated with devices inserted into the shoes. Products such as heel cups, arch supports, and custom orthotics can be used to correct for abnormalities such as overpronation and help prevent Achilles tendonitis.
Shoe inserts for foot and heel pain
The treatments of Achilles tendonitis include:
RestResting the painful Achilles tendon will allow the inflammation to subside and allow for healing. A period of rest after the onset of symptoms is important in controlling Achilles tendonitis.
ImmobilizationIn patients who have more significant symptoms, a period of immobilization can help. Either a removable walking boot, or sometimes even a cast, can allow the inflamed tissue to cool down quickly.
Heel WedgeA heel wedge can be inserted into the shoe to minimize the stress on the Achilles tendon. These can be placed in both athletic shoes and work shoes.
Ice the InjuryApplying ice to the area of inflammation can help stimulate blood flow to the area, and relieve the pain associated with inflammation. Apply ice after exercise, as well as several other times over the course of the day.
Anti-Inflammatory MedicationsNonsteroidal anti-inflammatory medications (NSAIDs) include a long list of possibilities such as Ibuprofen, Motrin, Naprosyn, Celebrex, and many others.
Achilles tendonitis treatment can be improved by these medications that will decrease pain and swelling. Be sure to talk to your doctor before starting these medications.
Physical TherapyPhysical therapists can help formulate a stretching and rehabilitation program to work on flexibility of the Achilles tendon.
Cortisone injections are infrequently used in patients with Achilles tendonitis because studies have shown an increased incidence of Achilles tendon rupture after cortisone injections.

Achilles Tendonitis - Symptoms and Diagnosis

What are the symptoms of Achilles tendonitis?

The main complaint associated with Achilles tendonitis is pain over the back of the heel. This is the point where the tendon inserts on the heel bone. Patients with Achilles tendonitis usually experience the most significant pain after periods of inactivity. Therefore patients tend to experience pain after first walking in the morning and when getting up after sitting for long periods of time. Patients will also experience pain while participating in activities, such as when running or jumping. Achilles tendonitis pain associated with exercise is most significant when pushing off or jumping.
How is Achilles tendonitis diagnosed?

Diagnosis of Achilles tendonitis is accomplished by history and physical examination. The symptoms associated with this condition are typical and can be elicited by a thorough history. A physical examination is used to determine the location of the problem.
X-rays are usually normal in patients with Achilles tendonitis, but are performed to evaluate for other possible conditions. Occasionally a MRI is needed to evaluate a patient for tears within the tendon. If there is a thought of surgical treatment a MRI may be helpful for preoperative evaluation and planning.

Achilles Tendonitis

What is Achilles tendonitis?
Achilles tendonitis is a condition of irritation and inflammation of the large tendon in the back of the ankle. Achilles tendonitis is a common overuse injury that tends to occur in middle-age recreational athletes. The overuse causes inflammation that can lead to pain and swelling. Furthermore, Achilles tendonitis can lead to small tears within the tendon, and make it susceptible to rupture.

What causes Achilles tendonitis?

The two most common causes of Achilles tendonitis are:
Lack of flexibility
Overpronation Other factors associated with Achilles tendonitis are recent changes in footwear, and changes in exercise training schedules. Often long distance runners will have symptoms of Achilles tendonitis after increasing their mileage or increasing the amount of hill training they are doing. As people age, tendons, like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to Achilles tendonitis.

WT treatment and surgery

What is the treatment for wrist tendonitis?
· Immobilization

Placing the wrist in a splint or a cast is usually the first treatment step. Wrist tendonitis is due to recurrent irritation of the tendon and its sheath. By resting the tendon, the inflammation should decrease.
o Find a Wrist Splint
· Ice the Injury

Applying an ice pack intermittently to the area of inflammation may also be beneficial. Icing wrist tendonitis can help to cool inflammation and also stimulates blood flow to the area of tendonitis.
· Anti-Inflammatory Medications

Nonsteroidal anti-inflammatory medications will help control symptoms of pain, but more importantly they help in the treatment of wrist tendonitis to decrease inflammation and swelling of the soft-tissues. These treatment medications will decease the inflammatory response which is the cause of the pain.
· Cortisone Injection

Cortisone is a more powerful anti-inflammatory treatment option that is given by injection directly to the site of inflammation. Cortisone injections are safe, but can weaken tendons over time if too many injections are given.
· Surgery

Surgery is only done when these other treatment methods have failed to solve the problem. If that is the case, the area of tight tendon sheath that cause the painful and difficult tendon movements can be released. The inflammatory tissue can also be removed in an effort to create more space for the tendon to move freely.

The answer to this question:

What are the symptoms of wrist tendonitis?

The most common and consistent complaint of patients diagnosed with wrist tendonitis is pain over the area of inflammation.
Swelling of the surrounding soft-tissues is also quite common.
How is the diagnosis of wrist tendonitis made?Diagnosis of wrist tendonitis is a made by looking for the characteristic signs of this problem. In addition, depending on the tendon that is inflamed, the physician can perform tests that stretch the area of concern to locate the precise source of inflammation.
For example, one type of wrist tendonitis is called DeQuervain's tenosynovitis. This is inflammation of the tendon at the base of the thumb. Often seen in new mothers, DeQuervain's tenosynovitis is diagnosed by a specific test called 'Finkelstein's test' where the patient makes a fist and the wrist is pulled away from the thumb. Pain from this maneuver is diagnostic of this type of wrist tendonitis.

What is wrist tendonitis

Wrist tendonitis, also called tenosynovitis, is a common condition characterized by irritation and inflammation of the tendons around the wrist joint. Many tendons surround the wrist joint. Wrist tendonitis usually affect one of the tendons, but it may also involve two or more. Often wrist tendonitis occurs at points where the tendons cross each other or pass over a bony prominence.
The wrist tendons slide through smooth sheaths as they pass by the wrist joint. These tendon sheaths, called the tenosynovium, allow the tendons to glide smoothly in a low-friction manner.
When wrist tendonitis becomes a problem, the tendon sheath or tenosynovium, becomes thickened and constricts the gliding motion of the tendons. The inflammation also makes movements of the tendon painful and difficult.