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Transcript of sports injuries
Tennis - Achilles tendon rupture
Achilles tendon rupture
An Achilles Tendon Rupture is when the Achilles tendon breaks or snaps. This is caused by the strong contraction of the gastrocnemius causing the Achilles tendon to break or snap. It is an indirect injury and a soft tissue injury. This can occur when performing explosive actions such as running or jumping, or sudden trauma or sudden activity after long periods of inactivity. Other factors that contribute to its occurrence are old age, previous injury to the tendon or use of Quinolones. Most common in tennis when lunging forward to sprint to a ball.
Wearing the right shoes is very important because everyone's biomechanics are different, and some biomechanical issues such as high or low arches, or having legs different lengths can lead to rupturing your Achilles tendon.
These issues can often be fixed or reduced by wearing the right type of sneakers, with the right arch, cushioning and heel height.
Correct shoes should bend where your foot bends, which is at the ball of your foot. If a shoe bends anywhere else, then it is not providing adequate support for your foot.
It is the players responsibility to wear the right shoes for them, and is a pre-event preventative measure.
The type of treatment needed is dependent on the age of the patient. Generally surgery is the most appropriate form of repair, especially those who need the highest level of function back. This usually includes 1-2 months in a plaster cast, then 3-6 months of rehabilitation with extensive physiotherapy.
Conservative (non-surgical) repair may be appropriate for older people. This includes immobilizing the tendon in a shortened position in a plaster cast for approx. 6-10 weeks. The tendon is then gradually stretched and strengthened.
Health care professionals
If somebody suspects they may have ruptured their Achilles tendon, seeing a doctor or GP is the first step. They will either do an x-ray, ultrasound or MRI to determine the extent of the injury.
Then the patient will either be sent to an orthopaedic surgeon for surgical intervention or will be put in a special cast for non-surgical treatment.
After the cast is taken off the patient will often undergo physical therapy from a physiotherapist to restore movement and regain strength.
The patient can also see a massage therapist to massage the area daily and have a deep massage every other day. This can reduce swelling, aid circulation and prevent the build up of adhesions.
1. wear the right
shoes or sneakers
2. warm up
Warming up before before stretching or exercising is essential - stretching cold muscles can do more harm than good. Warming up and then doing dynamic stretches will increase elasticity of the muscles which will decrease the chances of straining muscles and the Achilles tendon.
Warm ups can include jogging around the court, slow cross-court movements and volleying.
Often the coach will start a session with warm ups, but if not with a coach then it is the players responsibility to warm up.
It is important to stretch between warming up and exercising, then after exercising.
Stretching between warming up and exercising increases the flexibility of the muscles to decrease the chance of straining them.
Stretching after exercise are performed to get the muscle groups that have been continually used during exercise back to their normal length.
Tennis players should focus on back, hip, thigh and calf muscles.
It is the coaches responsibility make sure players stretch before playing, but if not with a coach it is the players responsibility to stretch.
4. strengthen the
Strengthening the leg muscles, especially the calf muscles will decrease the chance of - Achilles tendon injuries are more common in people with weak calf muscles. Strengthening the anterior tibialis (muscle opposite to the calf muscle) is also important to not have one muscle pulling harder than the other.
This is the players responsibility, but a coach can recommend which particular exercises would benefit the player most.
Surgical intervention is recommended for patients for young, healthy and active individuals, and it is the first choice of treatment for athletes. This is because it has the highest success rate and gives the best possible strength back.
There are 2 ways to repair the Achilles tendon, either the open technique or closed technique.
The open technique includes making an incision from just above the heel to the lower leg. The Achilles tendon is then sewn up with sutures and the incision is closed.
The closed technique involves making a small incision at the place of rupture. The Achilles tendon is then pulled out and sewn together and the opening is closed.
Immediately after the surgery weight bearing is not allowed for 3 weeks. A boot is worn and locked into 30 degrees of plantar flexion.
Gentle exercises like toe curls, toe spreads, knee flexion/extension and straight leg raises can be done.
Also cycling, swimming and weight training for the uninjured leg is important.
Weight bearing can gradually increase from toe touching to partial weight bearing, and after 6 weeks full weight bearing is allowed. Gentle exercises such as isometrics, proprioception exercises (wobble board) & stationary cycling are recommended to help with regaining strength and flexibility in the ankle.
After 8 weeks full weight bearing is allowed and normal shoes with a heel can be worn, and can wean into a regular shoe over 2-4 weeks.
At this point you can begin isotonic & isometric exercises with weights (with caution) to help strengthen the Achilles.
Swimming & cycling are recommended.
After 3-6 months you can wean yourself off the heel lifts in your shoes.
Can progress to closed chain exercises, such as squats, lunges, calf raises and toe raises.
Other exercises are cycling, swimming and rowing machine.
Can progress to jogging, running, jumping, non-competitive sporting activities and eccentric loading exercises.
Can return to physically demanding sport or work.