Tendon rupture often occurs during sports. But a tendon tear can also occur when overstimulated tendons are suddenly subjected to mechanical overload. In the case of pre-stressed tendons, it can even happen that the tendon tears during everyday stress, while healthy tendons in principle only tear when they are subjected to extreme stress or external force.
What is a torn tendon?
The job of tendons is to transmit the force of muscles to the skeleton. Tendons are made of tensile collagenous fiber bundles. Since they do not have their own blood vessels, they feed on tissue fluid, but this fluid is slow to pass into the tendons. Exercise is necessary for optimal nourishment, as it allows the tensile strength of the various tendons to be trained. A torn tendon is therefore a tear or rupture of a tendon caused by a sudden overload. A tendon tear can also be caused by jerky contraction of the associated muscle. Often there is already a degenerative damage of the corresponding tendon. The most common tendon rupture is the rupture of the Achilles tendon. But other tendons can also be affected. For example, quadriceps tendon rupture, biceps tendon rupture or patellar tendon rupture are just as common. The rotator cuffs of the shoulders are also commonly affected.
Causes
From the age of 30, degenerative changes already occur in tendon tissue, which means that from this point on, tendon tissue already loses elasticity due to age. Just like ligaments, tendons can tear partially or completely. In this case, the attachment point of a tendon to the bone can also be torn out (apophysis). Likewise, the bone may be fractured in the case of a tendon avulsion (avulsion fracture). Tendon damage is particularly common in areas with limited blood supply, for example near the heel at the Achilles tendon or near the humerus at the supraspinatus tendon. In different sports, corresponding clusters of tendon injury can be detected in each case, for example, the Achilles tendon in sports such as running, skiing or tennis, or the extensor tendons of the individual finger end links in volleyball or basketball.
Disease progression
After an injury to the tendon, swelling and discoloration occur in the affected area as bleeding enters the tissue. Tear of the tendon is usually detected based on physical changes, pain felt by the affected person, and functional tests performed by the physician and [[X-ray]6 images. Movement, of the muscles affected, is severely restricted after a tendon rupture. In the case of a tendon rupture, the pain is also very great. However, it is still possible to move the muscles, albeit with severe pain. If therapy is started immediately and performed professionally, the prognosis that full recovery will occur is positive.
Symptoms, complaints, and signs
Tendon rupture is usually caused by a strong external load or force. This results in typical and very painful symptoms, which provide for a strong impairment in the daily life of the affected person. Immediately after the rupture of a tendon, a stabbing pain develops. The course of movement is considerably disturbed, so that walking or running is no longer possible. Every movement causes severe pain, so that treatment by an appropriate physician becomes essential. A further and at the same time frequent sign is a strong swelling, which appears in the respective region of the tear. Bruising can also indicate an existing tendon tear. Anyone who leaves such a condition without any treatment is taking a great risk. The symptoms just mentioned will intensify considerably if left untreated, so that permanent consequential damage may even occur under certain circumstances. For this reason, a torn tendon is a serious injury that is usually accompanied by fairly typical and distinct symptoms. However, for a specific diagnosis, a specialist should be consulted so that a targeted treatment can be initiated. With appropriate treatment, the corresponding symptoms should subside promptly and quickly, allowing for a smooth recovery.
Complications
As a result of a tendon rupture, movement restrictions initially occur.If the disease persists for a long time, this can lead to malposition or muscle atrophy in the affected region. If the swelling becomes inflamed, an abscess may develop, which can develop into a serious infection if not treated. In the long term, a torn tendon can reduce the performance of the muscle. Dysfunction and paralysis are still possible years after the injury, although this is extremely rare. More often, chronic pain occurs as a result of a tendon tear, which requires prolonged therapy. Muscle stiffness can also occur. A severe tendon rupture can also have psychological consequences – for example, excessive avoidance behavior. During surgery, bleeding, infection, thrombosis, or tearing of the suture rarely occurs. If nerves are injured, numbness or paralysis may occur. Wound healing problems and excessive scarring are also rare complications of tendon surgery. More often, prescribed medications cause complications. For example, various side effects can occur after taking painkillers and anti-inflammatories. Common complaints: Gastrointestinal tract problems, headaches, and skin irritation. Kidney and liver damage is possible with prolonged medication.
When should you see a doctor?
Tendon rupture should always be treated by a doctor. It is not possible for this condition to heal on its own, with symptoms usually continuing to worsen without treatment, significantly reducing the sufferer’s quality of life. In the case of a torn tendon, early diagnosis and treatment is of great importance. A doctor should be consulted if the affected person suffers from very severe pain in the respective tendon. As a rule, this pain occurs during any movement, although the pain can also take the form of pain at rest. It is not uncommon for it to spread to neighboring regions and cause severe discomfort there as well. Furthermore, bruising or severe swelling on the affected tendon also indicate a tendon rupture and should then be examined by a doctor if they do not disappear on their own. In the case of a torn tendon, a general practitioner or an orthopedist can be consulted in the first instance. In emergencies or if the injury is severe and pain is severe, a hospital may be visited directly or an emergency physician may be called.
Treatment and therapy
A medical examination must be performed immediately if a tendon rupture is suspected. Repressing the pain and swelling is especially important at first. Good cooling and high positioning should be initiated as initial measures. Furthermore, it is important to immobilize the corresponding area. If the tendon ends are close enough to each other so that optimal fusion is possible, conservative therapy is usually performed. If this is not the case, surgical intervention is preferred. Surgery is also often necessary if the therapy is to be carried out as quickly as possible, for example in competitive athletes. In surgical procedures, the ends of the tendons are sutured together. Sometimes the suture is reinforced with the skin of adjacent muscles. The extensor and flexor tendons of the hands are operated on within the next 24 hours. Afterwards, a special splint is used to fix the corresponding area. In most cases, injuries to the Achilles tendon also require surgery. In order to relieve these after the operation, special shoes are worn for several weeks. The next months are for rest and slow training. In the case of torn tendons, immobilization with a support bandage or plaster is sufficient in most cases.
Prevention
To prevent tendon rupture, appropriate warm-up exercises should be performed before any athletic activity. Likewise, the application of elastic bandages to particularly stressed areas is recommended for prevention. If the tendon tear is treated surgically, special aftercare is required. Thus, the patient must spend a few more days in the hospital following the operation. Physiotherapy is already started there.
Aftercare
If it is a tendon tear close to the knee joint, a functional orthosis is applied while the patient is still in the hospital. Initially, flexion is limited to 30 degrees. At intervals of two weeks, it is released by a further 30 degrees.Following discharge from the hospital, physiotherapy treatment is continued on an outpatient basis. In addition, regular check-ups are held with a specialist in orthopedics and trauma surgery. After an initial partial load, the leg can be fully loaded again after a few weeks. If there is a rupture of the Achilles tendon, the affected leg is immobilized in a stabilizing boot after both surgical and conservative therapy. A pointed foot position of 20 degrees is used to avoid unnecessary strain on the suture. The patient is already able to put full weight on his leg again. In addition, early functional treatments can be performed, during which the muscles can be trained and the tendon can be progressively stretched again.
Here’s what you can do yourself
A torn tendon is a sudden event that, unlike a torn muscle fiber, can hardly be prevented by specific warm-up before sports. Self-help in everyday life means therefore above all to arrange the regeneration with the tendon tear optimally and to avoid a recurrence, thus a renewed tear. The measures for regeneration are sparing for the duration determined by the doctor and performing learned physiotherapeutic exercises at home. It also depends on the region of the tear what the self-help can look like concretely. For example, in the case of a rupture of the biceps tendon, overhead work is not possible or should be avoided for a while, so that the household or professional routine may have to be restructured accordingly. A rupture of the Achilles tendon means that the muscles of the calf must not be overloaded, as they exert direct traction on the tendon. High footwear can also relieve the Achilles tendon in this context. Precise instructions in this context are also provided by the attending physician or physiotherapist. Those who are prone to tendon tears can perform fascia training. This is possible with special rollers. Yin yoga is a form of yoga that also focuses on fascia stretching and can thus have a positive influence on the stability of the tendon in the body. Hot baths can also decongest the tissues and make them less prone to injury.
