What are the common symptoms of a ruptured tendon. How can you identify the causes of tendon ruptures. What treatment options are available for ruptured tendons. When should you seek medical care for a possible tendon injury.

Understanding Tendon Ruptures: An Overview

A tendon rupture occurs when the fibrous tissue connecting muscle to bone tears or snaps. While relatively uncommon, these injuries can cause severe pain and disability if left untreated. Tendon ruptures most frequently affect the quadriceps, Achilles, rotator cuff, and biceps tendons.

Tendon ruptures typically occur in middle-aged or older individuals, as aging tendons become more susceptible to injury. However, certain medical conditions and lifestyle factors can increase the risk at any age.

Recognizing the Signs and Symptoms of a Ruptured Tendon

Identifying a tendon rupture early is crucial for proper treatment and recovery. Common signs and symptoms include:

• A sudden snapping or popping sensation
• Severe, immediate pain
• Rapid bruising in the affected area
• Significant weakness or loss of function
• Inability to use the affected limb
• Visible deformity at the injury site

The specific symptoms may vary depending on the location of the rupture:

Achilles Tendon Rupture

An Achilles tendon rupture prevents you from standing on your toes or flexing your foot downward on the affected side.

Rotator Cuff Rupture

With a rotator cuff tear, you’ll struggle to lift your arm out to the side or overhead.

Biceps Tendon Rupture

A biceps tendon rupture results in decreased elbow flexion strength and difficulty raising your arm with the palm facing upward.

Common Causes and Risk Factors for Tendon Ruptures

Various factors can contribute to tendon ruptures:

• Age-related degeneration
• Sudden, forceful movements or impacts
• Overuse and repetitive stress
• Steroid injections into the tendon
• Certain medical conditions (e.g., gout, hyperparathyroidism)
• Having type O blood (for reasons not fully understood)

Understanding these risk factors can help individuals take preventative measures and seek prompt medical attention when necessary.

Diagnosing Tendon Ruptures: Medical Examinations and Imaging Tests

Accurate diagnosis is essential for effective treatment of tendon ruptures. Healthcare providers typically use a combination of physical examination and imaging studies to confirm the diagnosis and assess the severity of the injury.

Physical Examination

A thorough physical exam is often the first step in diagnosing a tendon rupture. The doctor will assess your range of motion, strength, and any visible deformities in the affected area.

Specific Tests for Different Tendon Ruptures

• Thompson test for Achilles tendon ruptures
• Blood pressure cuff test for Achilles tendon injuries
• Specialized maneuvers to evaluate rotator cuff and biceps tendon function

Imaging Studies

To confirm the diagnosis and determine the extent of the injury, your doctor may order one or more of the following imaging tests:

• X-rays: Can show changes in bone positioning related to tendon ruptures
• MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues, helping to distinguish between partial and complete ruptures
• Ultrasound: Offers real-time imaging of tendons and can be useful for dynamic assessments

Treatment Options for Ruptured Tendons: Surgical and Non-Surgical Approaches

The treatment of tendon ruptures depends on various factors, including the location and severity of the injury, the patient’s age and activity level, and the surgeon’s assessment. Treatment options generally fall into two categories: surgical and non-surgical.

Surgical Treatment

Surgical intervention is often recommended for complete tendon ruptures or in cases where optimal function is crucial. Surgical procedures may include:

• Direct tendon repair: Reattaching the torn ends of the tendon
• Tendon grafting: Using a graft to bridge large gaps in the tendon
• Tendon transfer: Rerouting nearby tendons to restore function

Surgery is typically followed by a period of immobilization and a structured rehabilitation program.

Non-Surgical Treatment

In some cases, particularly for partial ruptures or in patients with certain health conditions, non-surgical treatment may be appropriate. This approach often includes:

• Immobilization with a cast, splint, or brace
• Physical therapy to improve strength and flexibility
• Pain management techniques
• Gradual return to activities as healing progresses

The choice between surgical and non-surgical treatment should be made in consultation with a medical professional, considering the individual’s specific circumstances and goals.

Rehabilitation and Recovery Following Tendon Rupture Treatment

Regardless of the treatment approach, rehabilitation plays a crucial role in recovery from tendon ruptures. The rehabilitation process typically involves several phases:

1. Protection and pain control: Immobilization and management of initial symptoms
2. Range of motion exercises: Gentle movements to prevent stiffness and promote healing
3. Strengthening: Progressive exercises to rebuild muscle strength and tendon integrity
4. Functional training: Activities that mimic daily tasks or sport-specific movements
5. Return to full activity: Gradual resumption of normal activities or sports participation

The duration and specifics of rehabilitation vary depending on the location and severity of the tendon rupture, as well as the chosen treatment method. Adherence to the rehabilitation program is crucial for optimal recovery and prevention of re-injury.

Preventing Tendon Ruptures: Strategies for Maintaining Tendon Health

While not all tendon ruptures can be prevented, there are several strategies individuals can employ to reduce their risk:

• Proper warm-up and cool-down routines before and after physical activity
• Gradual increase in exercise intensity and duration to avoid overuse injuries
• Regular stretching and flexibility exercises
• Strength training to support tendons and improve overall musculoskeletal health
• Maintaining a healthy weight to reduce stress on tendons
• Using proper technique and equipment during sports and physical activities
• Listening to your body and allowing adequate rest and recovery time

For individuals with known risk factors or a history of tendon injuries, working with a healthcare provider or physical therapist to develop a personalized prevention plan can be beneficial.

Long-Term Outlook and Potential Complications of Tendon Ruptures

The prognosis for tendon ruptures varies depending on several factors, including the location and severity of the injury, the chosen treatment approach, and the individual’s adherence to rehabilitation protocols. In general, with proper treatment and rehabilitation, many people can return to their previous level of function.

Potential Complications

While most tendon ruptures heal well with appropriate care, some potential complications may occur:

• Re-rupture: Particularly during the early stages of healing
• Chronic pain or weakness: May persist in some cases
• Infection: A risk primarily associated with surgical treatment
• Scar tissue formation: Can lead to stiffness or reduced range of motion
• Muscle atrophy: Due to prolonged immobilization

Regular follow-up with healthcare providers and strict adherence to rehabilitation guidelines can help minimize these risks and optimize long-term outcomes.

Future Considerations

Individuals who have experienced a tendon rupture may need to make some long-term lifestyle modifications to prevent future injuries. This might include:

• Adopting a more structured approach to physical activity and exercise
• Incorporating regular stretching and strengthening exercises into daily routines
• Being mindful of proper body mechanics during work and recreational activities
• Regular check-ups with healthcare providers to monitor tendon health

By understanding the causes, symptoms, and treatment options for tendon ruptures, individuals can take proactive steps to maintain tendon health and seek prompt medical attention when needed. With proper care and rehabilitation, many people can successfully recover from tendon ruptures and return to their desired level of activity.

Ruptured Tendon: Symptoms, Causes, and Treatments

Written by WebMD Editorial Contributors

In this Article

• Ruptured Tendon Overview
• Ruptured Tendon Causes
• Ruptured Tendon Symptoms
• When to Seek Medical Care
• Exams and Tests
• Ruptured Tendon Treatment
• Next Steps
• Outlook
• Synonyms and Keywords

A tendon is the fibrous tissue that attaches muscle to bone in the human body. The forces applied to a tendon may be more than 5 times your body weight. In some rare instances, tendons can snap or rupture. Conditions that make a rupture more likely include the injection of steroids into a tendon, certain diseases (such as gout or hyperparathyroidism), and having type O blood.

Although fairly uncommon, a tendon rupture can be a serious problem and may result in excruciating pain and permanent disability if untreated. Each type of tendon rupture has its own signs and symptoms and can be treated either surgically or medically depending on the severity of the rupture and the confidence of the surgeon.

The 4 most common areas of tendon rupture include:

• Quadriceps
  • A group of 4 muscles that come together just above your kneecap (patella) to form the patellar tendon.
  • Often called the quads, this group of muscles is used to extend the leg at the knee and aids in walking, running, and jumping.
• Achilles
  • This tendon is located on the back portion of the foot just above the heel. It is the site where the calf muscle attaches to the heel of the foot (the calcaneus bone).
  • This tendon is vital for pushing off with the foot. The Achilles helps you stand on your tiptoes and push off when starting a foot race.
• Rotator cuff
  • Your rotator cuff is located in the shoulder and is actually composed of 4 muscles that function together to raise your arm out to the side, to help you rotate the arm, and to keep your shoulder from popping out of its socket.
  • The rotator cuff tendon is one of the most common areas in the body affected by tendon injury. Some studies of people after death have shown that 8% to 20% have rotator cuff tears.
• Biceps
  • The biceps muscle of the arm functions as a flexor of the elbow. This muscle brings the hand toward the shoulder by bending at the elbow.
  • Ruptures of the biceps are classified as proximal (close) or distal (far). Distal ruptures are extremely rare. The proximal rupture occurs where the biceps attaches at the top of your shoulder.

In general, tendon rupture occurs in a middle-aged or older man. In the young, muscle usually tears before the attached tendon does. But in older people and in those with certain diseases (such as gout and hyperparathyroidism) tendon ruptures are more common.

An injury that is associated with the following signs or symptoms may be a tendon rupture:

• A snap or pop you hear or feel
• Severe pain
• Rapid or immediate bruising
• Marked weakness
• Inability to use the affected arm or leg
• Inability to move the area involved
• Inability to bear weight
• Deformity of the area

Symptoms associated with specific injuries include the following:

• Achilles tendon rupture: You will be unable to support yourself on your tiptoes on the affected leg (you may be able to flex your toes downward because supporting muscles are intact).
• Rotator cuff rupture: You will be unable to bring your arm out to the side.
• Biceps tendon rupture: You will have decreased strength of elbow flexion and decreased ability to raise the arm out to the side when the hand is turned palm up.

Call a doctor if you hear or feel a snap or pop, have severe pain, rapid or immediate bruising after an accident, and are unable to use the affected arm or leg. You may have a tendon rupture.

Visit the hospital’s emergency department whenever an injury occurs that produces severe pain and is accompanied by a pop or snap. Weakness, inability to move the area involved, inability to bear weight, and deformity of the area are other key symptoms that require a visit to the emergency department.

Because you know your body the best, if something appears to be serious to you, it is usually the best course to be conservative and have an evaluation.

Tendon rupture is usually diagnosed using a physical examination. Any imaging is done to confirm the diagnosis and decide the severity of the rupture

Quadriceps

• X-rays often show that your patella (kneecap) is lower than its normal position on a side view of the knee.
• Using an MRI, your doctor can tell whether your rupture is partial or complete.

Achilles tendon

• Your doctor may do a Thompson test. In this test, your doctor will have you kneel on a chair and dangle your foot over the edge. The doctor will then squeeze your calf in a particular place. If the toes on your foot don’t point downward when the doctor squeezes, then you probably have a ruptured Achilles tendon.
• In a test called the blood pressure cuff test, your doctor will place a blood pressure cuff on your calf. The cuff is then inflated to 100 mm Hg. The doctor will then move your foot into a toes-up position. If your tendon is intact, it will cause the pressure to rise to about 140 mm Hg. If you have a tendon rupture, the pressure will increase only a small amount.
• You may be able to flex your foot downward because your supporting muscles are intact. You will be unable to support yourself on your tiptoes on the affected side however.
• X-rays taken from the side may show darkening of the triangular fatty tissue-filled space in front of the Achilles tendon or a thickening of the tendon.
• MRI or ultrasound may be used to decide how severe your rupture is, although these tests are usually not needed to make the diagnosis.

Rotator cuff

• You will be unable to initiate bringing your arm out to the side.
• Your doctor may do a drop arm test. In this test, your arm is passively raised to 90°, and you are asked to hold your arm at this position. If you have rotator cuff rupture, slight pressure on the forearm will cause you to suddenly drop the arm.
• X-rays may show that the long bone in your upper arm (the humerus) is slightly out of place.
• Shoulder arthrography is most helpful in identifying a suspected rotator cuff tear. In this test, a dye that shows up on X-rays is injected directly into the shoulder joint, and the joint is then moved around. Then an X-ray of the shoulder is taken. If any dye is seen leaking from the joint, then it is highly likely that you have a ruptured rotator cuff.
• MRI provides a noninvasive means of assessing the integrity of the rotator cuff although it is more costly and not as specific as arthrography.

Biceps

• X-rays may show that your upper arm bone is out of place or that the place where the muscle attaches has changed.
• If your biceps tendon is completely ruptured, the biceps retracts toward the elbow causing a swelling just above the crease in your arm. This is called the Popeye deformity.
• You will experience decreased strength of elbow flexion and arm supination (moving the hand palm up).
• You will have decreased ability to raise the arm out to the side when the hand is turned palm up.

Self-Care at Home

For all ruptured tendons, regardless of the site, follow the standard RICE (Rest, Ice, Compression, Elevation) home therapy procedure as you seek medical attention. RICE involves:

• Resting the affected extremity
• Applying ice to the affected area
  • Apply ice in a plastic bag wrapped in a towel or with a reusable cold pack wrapped in a towel.
  • Applying ice directly to skin may lead to further damage if left on for a prolonged period of time.
• Compression of the affected area to minimize swelling
  • Apply compression by loosely wrapping the affected area with an ACE bandage.
  • Be sure that the bandage does not cut off blood flow to the area in question.
• Elevation of the extremity if possible
  • Try to keep the area above the level of your heart to minimize swelling.
  • It is recommended that the quadriceps rupture should be immobilized in an extended (straight knee) position and that biceps rupture should be immobilized in a sling with the elbow bent at 90°.

Medical Treatment

• Quadriceps
  • Partial tears may be treated without surgery by placing your straight leg in a cast or immobilizer for 4-6 weeks.
  • Once you are able to raise the affected leg without discomfort for 10 days, it is safe to slowly stop the immobilization.
• Achilles tendon
  • Treatment without surgery involves immobilizing your foot so that the sole of the foot is pointed downward for 4-8 weeks.
  • This treatment has been advocated by some because it gives similar results to surgery in motion and strength. The problem with this treatment is that it has a rerupture rate of up to 30%. Nevertheless, it may still be a reasonable option for those who are at increased operative risk because of age. medical problems. or inactivity.
• Rotator cuff
  • The rotator cuff is unique because treatment without surgery is the treatment of choice in most tendon injuries. More than 90% of tendon injuries are long term in nature, and 33-90% of these chronic rupture symptoms go away without surgery.
  • In contrast, acute rupture, as occurs with trauma, may or may not be repaired surgically depending on the severity of the tear.
  • If the tear is either less than 50% of the cuff thickness or less than 1 cm in size, the dead tissue is removed arthroscopically. A small incision is made and a tool called an arthroscope is passed into the joint. Through it, the surgeon can see and remove dead tissue without actually cutting the joint open. The shoulder is then left to heal.
• Biceps
  • Most surgeons prefer not to operate on a ruptured biceps tendon because function is not severely impaired with its rupture.
  • Studies suggest that after biceps rupture, only a small fraction of elbow flexion is lost and approximately 10%-20% strength reduction in supination (ability to turn the hand palm up). This is considered to be a moderate loss and not worth the risk of surgery in middle-aged and older people.

Surgery

• Quadriceps
  • Unless the doctor is sure that the injury is a partial tear, surgery will be done to repair the tendon.
  • After your operation, you will be placed in a cast or immobilizer as if you had a partial tear.
  • With physical therapy, your injured leg should be up to speed with your noninjured leg in 6 months.
• Achilles tendon
  • Surgery to repair your Achilles tendon is recommended for active people who desire near normal strength and power in plantarflexion. An additional advantage with surgical correction is a lower rerupture rate of the tendon.
  • After your operation, your foot will be immobilized with your toes pointing downward for 3-4 weeks and then progressively brought into neutral position over 2-3 weeks before weight-bearing is started. Surgery carries with it a higher risk of infection than closed treatment.
• Rotator cuff
  • Many surgeons will not attempt surgical repair until nonoperative treatment has failed, even in cases of larger tears.
  • Surgical treatment is usually reserved for a severe tear in a young person or in an older person (aged 60-70 years) who is suddenly unable to externally rotate their arm.
  • Acromioplasty, removal of the coracoacromial ligament and repair of the rotator cuff tendon, usually results in near full rotator cuff strength.
• Biceps
  • In young people unwilling to accept the loss of function and mild deformity involved with this injury, surgery is performed to repair the tendon.
  • Surgery is also considered for the middle-aged person who requires full supination strength in their line of work.
  • You should leave your arm in a sling for a few days after surgery and then begin to use the affected arm as tolerated. After surgery, your elbow flexion and arm supination is near normal in about 12 weeks.

Prevention

To prevent future tears, avoid the cause of the ruptured tendon or treat the problem that led to the tear.

The prognosis for both surgery and nonsurgical treatment varies with the location and severity of the rupture.

Surgical repair, in concert with additional physical therapy, can result in return to normal strength. Nonoperative repair has also shown promise in tendon ruptures.

Nonoperative treatment is most effective in partial tendon ruptures. The drawback of nonoperative treatment is that strength is not as reliably returned to baseline with this type of treatment. The benefits include a decreased risk of infection and generally shorter recovery time.

patellar tendon rupture, Achilles tendon rupture, rotator cuff rupture, biceps tendon rupture, ruptured tendon
 

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Ruptured Tendon: Symptoms, Causes, and Treatments

Written by WebMD Editorial Contributors

In this Article

• Ruptured Tendon Overview
• Ruptured Tendon Causes
• Ruptured Tendon Symptoms
• When to Seek Medical Care
• Exams and Tests
• Ruptured Tendon Treatment
• Next Steps
• Outlook
• Synonyms and Keywords

A tendon is the fibrous tissue that attaches muscle to bone in the human body. The forces applied to a tendon may be more than 5 times your body weight. In some rare instances, tendons can snap or rupture. Conditions that make a rupture more likely include the injection of steroids into a tendon, certain diseases (such as gout or hyperparathyroidism), and having type O blood.

Although fairly uncommon, a tendon rupture can be a serious problem and may result in excruciating pain and permanent disability if untreated. Each type of tendon rupture has its own signs and symptoms and can be treated either surgically or medically depending on the severity of the rupture and the confidence of the surgeon.

The 4 most common areas of tendon rupture include:

• Quadriceps
  • A group of 4 muscles that come together just above your kneecap (patella) to form the patellar tendon.
  • Often called the quads, this group of muscles is used to extend the leg at the knee and aids in walking, running, and jumping.
• Achilles
  • This tendon is located on the back portion of the foot just above the heel. It is the site where the calf muscle attaches to the heel of the foot (the calcaneus bone).
  • This tendon is vital for pushing off with the foot. The Achilles helps you stand on your tiptoes and push off when starting a foot race.
• Rotator cuff
  • Your rotator cuff is located in the shoulder and is actually composed of 4 muscles that function together to raise your arm out to the side, to help you rotate the arm, and to keep your shoulder from popping out of its socket.
  • The rotator cuff tendon is one of the most common areas in the body affected by tendon injury. Some studies of people after death have shown that 8% to 20% have rotator cuff tears.
• Biceps
  • The biceps muscle of the arm functions as a flexor of the elbow. This muscle brings the hand toward the shoulder by bending at the elbow.
  • Ruptures of the biceps are classified as proximal (close) or distal (far). Distal ruptures are extremely rare. The proximal rupture occurs where the biceps attaches at the top of your shoulder.

In general, tendon rupture occurs in a middle-aged or older man. In the young, muscle usually tears before the attached tendon does. But in older people and in those with certain diseases (such as gout and hyperparathyroidism) tendon ruptures are more common.

An injury that is associated with the following signs or symptoms may be a tendon rupture:

• A snap or pop you hear or feel
• Severe pain
• Rapid or immediate bruising
• Marked weakness
• Inability to use the affected arm or leg
• Inability to move the area involved
• Inability to bear weight
• Deformity of the area

Symptoms associated with specific injuries include the following:

• Achilles tendon rupture: You will be unable to support yourself on your tiptoes on the affected leg (you may be able to flex your toes downward because supporting muscles are intact).
• Rotator cuff rupture: You will be unable to bring your arm out to the side.
• Biceps tendon rupture: You will have decreased strength of elbow flexion and decreased ability to raise the arm out to the side when the hand is turned palm up.

Call a doctor if you hear or feel a snap or pop, have severe pain, rapid or immediate bruising after an accident, and are unable to use the affected arm or leg. You may have a tendon rupture.

Visit the hospital’s emergency department whenever an injury occurs that produces severe pain and is accompanied by a pop or snap. Weakness, inability to move the area involved, inability to bear weight, and deformity of the area are other key symptoms that require a visit to the emergency department.

Because you know your body the best, if something appears to be serious to you, it is usually the best course to be conservative and have an evaluation.

Tendon rupture is usually diagnosed using a physical examination. Any imaging is done to confirm the diagnosis and decide the severity of the rupture

Quadriceps

• X-rays often show that your patella (kneecap) is lower than its normal position on a side view of the knee.
• Using an MRI, your doctor can tell whether your rupture is partial or complete.

Achilles tendon

• Your doctor may do a Thompson test. In this test, your doctor will have you kneel on a chair and dangle your foot over the edge. The doctor will then squeeze your calf in a particular place. If the toes on your foot don’t point downward when the doctor squeezes, then you probably have a ruptured Achilles tendon.
• In a test called the blood pressure cuff test, your doctor will place a blood pressure cuff on your calf. The cuff is then inflated to 100 mm Hg. The doctor will then move your foot into a toes-up position. If your tendon is intact, it will cause the pressure to rise to about 140 mm Hg. If you have a tendon rupture, the pressure will increase only a small amount.
• You may be able to flex your foot downward because your supporting muscles are intact. You will be unable to support yourself on your tiptoes on the affected side however.
• X-rays taken from the side may show darkening of the triangular fatty tissue-filled space in front of the Achilles tendon or a thickening of the tendon.
• MRI or ultrasound may be used to decide how severe your rupture is, although these tests are usually not needed to make the diagnosis.

Rotator cuff

• You will be unable to initiate bringing your arm out to the side.
• Your doctor may do a drop arm test. In this test, your arm is passively raised to 90°, and you are asked to hold your arm at this position. If you have rotator cuff rupture, slight pressure on the forearm will cause you to suddenly drop the arm.
• X-rays may show that the long bone in your upper arm (the humerus) is slightly out of place.
• Shoulder arthrography is most helpful in identifying a suspected rotator cuff tear. In this test, a dye that shows up on X-rays is injected directly into the shoulder joint, and the joint is then moved around. Then an X-ray of the shoulder is taken. If any dye is seen leaking from the joint, then it is highly likely that you have a ruptured rotator cuff.
• MRI provides a noninvasive means of assessing the integrity of the rotator cuff although it is more costly and not as specific as arthrography.

Biceps

• X-rays may show that your upper arm bone is out of place or that the place where the muscle attaches has changed.
• If your biceps tendon is completely ruptured, the biceps retracts toward the elbow causing a swelling just above the crease in your arm. This is called the Popeye deformity.
• You will experience decreased strength of elbow flexion and arm supination (moving the hand palm up).
• You will have decreased ability to raise the arm out to the side when the hand is turned palm up.

Self-Care at Home

For all ruptured tendons, regardless of the site, follow the standard RICE (Rest, Ice, Compression, Elevation) home therapy procedure as you seek medical attention. RICE involves:

• Resting the affected extremity
• Applying ice to the affected area
  • Apply ice in a plastic bag wrapped in a towel or with a reusable cold pack wrapped in a towel.
  • Applying ice directly to skin may lead to further damage if left on for a prolonged period of time.
• Compression of the affected area to minimize swelling
  • Apply compression by loosely wrapping the affected area with an ACE bandage.
  • Be sure that the bandage does not cut off blood flow to the area in question.
• Elevation of the extremity if possible
  • Try to keep the area above the level of your heart to minimize swelling.
  • It is recommended that the quadriceps rupture should be immobilized in an extended (straight knee) position and that biceps rupture should be immobilized in a sling with the elbow bent at 90°.

Medical Treatment

• Quadriceps
  • Partial tears may be treated without surgery by placing your straight leg in a cast or immobilizer for 4-6 weeks.
  • Once you are able to raise the affected leg without discomfort for 10 days, it is safe to slowly stop the immobilization.
• Achilles tendon
  • Treatment without surgery involves immobilizing your foot so that the sole of the foot is pointed downward for 4-8 weeks.
  • This treatment has been advocated by some because it gives similar results to surgery in motion and strength. The problem with this treatment is that it has a rerupture rate of up to 30%. Nevertheless, it may still be a reasonable option for those who are at increased operative risk because of age. medical problems. or inactivity.
• Rotator cuff
  • The rotator cuff is unique because treatment without surgery is the treatment of choice in most tendon injuries. More than 90% of tendon injuries are long term in nature, and 33-90% of these chronic rupture symptoms go away without surgery.
  • In contrast, acute rupture, as occurs with trauma, may or may not be repaired surgically depending on the severity of the tear.
  • If the tear is either less than 50% of the cuff thickness or less than 1 cm in size, the dead tissue is removed arthroscopically. A small incision is made and a tool called an arthroscope is passed into the joint. Through it, the surgeon can see and remove dead tissue without actually cutting the joint open. The shoulder is then left to heal.
• Biceps
  • Most surgeons prefer not to operate on a ruptured biceps tendon because function is not severely impaired with its rupture.
  • Studies suggest that after biceps rupture, only a small fraction of elbow flexion is lost and approximately 10%-20% strength reduction in supination (ability to turn the hand palm up). This is considered to be a moderate loss and not worth the risk of surgery in middle-aged and older people.

Surgery

• Quadriceps
  • Unless the doctor is sure that the injury is a partial tear, surgery will be done to repair the tendon.
  • After your operation, you will be placed in a cast or immobilizer as if you had a partial tear.
  • With physical therapy, your injured leg should be up to speed with your noninjured leg in 6 months.
• Achilles tendon
  • Surgery to repair your Achilles tendon is recommended for active people who desire near normal strength and power in plantarflexion. An additional advantage with surgical correction is a lower rerupture rate of the tendon.
  • After your operation, your foot will be immobilized with your toes pointing downward for 3-4 weeks and then progressively brought into neutral position over 2-3 weeks before weight-bearing is started. Surgery carries with it a higher risk of infection than closed treatment.
• Rotator cuff
  • Many surgeons will not attempt surgical repair until nonoperative treatment has failed, even in cases of larger tears.
  • Surgical treatment is usually reserved for a severe tear in a young person or in an older person (aged 60-70 years) who is suddenly unable to externally rotate their arm.
  • Acromioplasty, removal of the coracoacromial ligament and repair of the rotator cuff tendon, usually results in near full rotator cuff strength.
• Biceps
  • In young people unwilling to accept the loss of function and mild deformity involved with this injury, surgery is performed to repair the tendon.
  • Surgery is also considered for the middle-aged person who requires full supination strength in their line of work.
  • You should leave your arm in a sling for a few days after surgery and then begin to use the affected arm as tolerated. After surgery, your elbow flexion and arm supination is near normal in about 12 weeks.

Prevention

To prevent future tears, avoid the cause of the ruptured tendon or treat the problem that led to the tear.

The prognosis for both surgery and nonsurgical treatment varies with the location and severity of the rupture.

Surgical repair, in concert with additional physical therapy, can result in return to normal strength. Nonoperative repair has also shown promise in tendon ruptures.

Nonoperative treatment is most effective in partial tendon ruptures. The drawback of nonoperative treatment is that strength is not as reliably returned to baseline with this type of treatment. The benefits include a decreased risk of infection and generally shorter recovery time.

patellar tendon rupture, Achilles tendon rupture, rotator cuff rupture, biceps tendon rupture, ruptured tendon
 

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Tendon injury – symptoms, causes, treatment

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Tendon injury is a violation of the integrity of tendon tissues due to traumatic impact. Rupture of the tendon of the hand often occurs against the background of an open injury of the upper limb. Consider the main methods of diagnosing damage, methods of treatment and recovery.

CMRT specialist tells

Kuchenkov A.V.

Orthopedist • Traumatologist • Surgeon • Phlebologist • Sports doctor • 24 years of experience

Publication date: August 15, 2022

Verification date: February 23, 2023

All facts have been verified by a physician.

Article content

Causes of tendon injury

Sprain symptoms

Ligament injury severity

How to diagnose

The doctor makes a diagnosis on the basis of a survey, anamnesis, examination and analysis of the research results. During visual inspection and palpation, the specialist draws attention to the characteristic signs of sprain, movement disorders.

Diagnostic procedures:

• magnetic resonance imaging
• ultrasonography (ultrasound)
• arthroscopy
• radiography

MRI is the optimal imaging modality for this type of injury and is suitable for diagnosis and exclusion of associated injuries.

Which doctor to contact

An orthopedist or traumatologist can diagnose and prescribe treatment. In case of severe traumatic injury, you must call an ambulance or go to the emergency room.

Treatment of sprains in CMRT clinics

CMRT doctors select a conservative treatment regimen with proven effectiveness after a thorough study of the results of the examination. First aid includes elevating the limb, applying a cold compress, and removing stress. Immobilization is performed with a bandage. If the damage is minor, bandaging is enough to eliminate the load during movements.

Complementary treatments:

Medical therapy. The doctor gives the patient an appointment for taking analgesics and other drugs.

Massage and exercise therapy in the recovery phase. These therapies reduce pain and speed recovery.

The patient must understand that it will not be possible to quickly restore the ligamentous apparatus, since the body needs time to regenerate. After treatment for a sprain in the leg or arm, restriction of movement is required for several weeks.

Consequences

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Tendon injuries: diagnosis and treatment of tendon injuries in Odessa

Tendon rupture is a violation of its integrity in whole or in part. It can be caused by direct or indirect trauma, such as a hard blow or a deep cut.

As a result of damage, the muscles contract, which causes the tendon sections to diverge from each other, and therefore cannot grow together on their own. Damage limits the ability of the limb to move, accompanied by acute and severe pain.

How a tendon ruptures

A tendon is a complex structure that consists of bundles of collagen fibers and fibroblasts – tendon cells. Tendons serve to connect muscles to bones, which provide a person with movement. Due to the fact that fibrous elements prevail over cellular elements in their structure, the tendons are strong, withstand heavy loads and have low extensibility.

The tendon part develops gradually, it grows most intensively after 15 and up to 25 years, and with the aging process, their elasticity decreases. Unlike muscles, tendons are much thinner and are short, long, rounded, narrow, wide, ribbon-like and cord-like.

The tendon is most often torn at the site of its attachment to the bone. Tears along the length of the tendon are preceded by changes or chronic diseases in the tissues due to primary and frequent injuries.

Damage may be open or closed. When open – the integrity of the skin is broken. Often these are deep injuries with sharp or cutting objects. Closed injuries – ruptures as a result of dislocations of the joints. At the site of injury, swelling and hematoma are visible.

They can also be combined, isolated or multiple, depending on the number of lesions. Depending on the time that has passed since the injury, damage can be:

• fresh – up to three days,
• stale – up to 20 days,
• old – more than three weeks.

Types of tears: causes and manifestations

Injury to the tendons of the fingers can occur in several areas on the hand. There are several tendons in each finger, and they are often injured due to the fact that they are close to the skin and poorly protected. The most difficult is damage to the extensor tendons, which occurs due to open injuries or strong blows of the hand on a hard surface.

This injury is accompanied by:

• acute pain in the arm,
• finger flexion disorder,
• limiting the operation of the entire brush,
• hemorrhage,
• lack of sensation in the finger.

Tendon ruptures in the shoulder area:

• Rotator cuff rupture – rupture of the muscle-tendon structures in the area of ​​the shoulder joint. It occurs due to strong tension of the muscle in this area, for example, during a fall on the elbow or a direct blow to the joint. The main symptoms are pain and limited movement in the joint.
• A rupture of the tendon of the biceps brachii most often occurs during contact sports and heavy falls on the arm. People who have diseases or disorders in the joint are most susceptible. The rupture is accompanied by acute pain, swelling of the limb and dysfunction of the hand.

A quadriceps tendon tear is a complete or incomplete tear at or above the patella. Most often it occurs in people after 40 years of age with heavy loads on the leg or indirect injuries. In older people, rupture can occur even without stress, as the tendon loses its elasticity. The injury is accompanied by a popping or clicking sound. The tear can be palpated as a retraction develops slightly above the patella because the muscle is no longer connected to the patella. At the same time, pain, instability in the cola, inability to straighten the leg are felt. The patella itself can fall below its location, and the knee swells badly.

Achilles tendon rupture occurs due to trauma or strain during muscle contraction. In a healthy state, this tendon can withstand simply enormous loads, and while running, a force acts on it, which is several times greater than a person’s weight. Most often, the gap occurs during sports activities. The patient feels a sharp pain in the lower leg, cannot lean on the leg. Quite often, a hematoma occurs at the site of the rupture.

Methods for diagnosing tendon injury

Several types of tests are used to diagnose a tendon rupture:

• Ultrasound is more informative than radiography, as it allows assessing the degree of damage to the tendon, muscles and ligaments. Often used for dynamic monitoring of the state of the affected organ.
• Magnetic resonance imaging is a modern and frequently used method that allows you to study the location and extent of the gap. The method is indicated even for children, does not carry radiation and allows you to identify concomitant pathologies in the structure of the joints.
• Diagnostic arthroscopy is a surgical method of examination in which an arthroscope is inserted into the cavity of the affected joint through several small punctures and the state of the joint is examined from the inside. This allows you to evaluate all the structures and departments of the joint. The method is minimally invasive, which does not leave large scars, but provides a complete picture of the injury, which accompanies successful treatment and the absence of surprises during the operation.

Treatments for tendon ruptures

The choice of treatment tactics depends on the nature of the damage. If the rupture is partial, it is possible to use conservative methods, but if the rupture is complete, it is necessary to operate.

In case of tendon ruptures in the area of ​​the fingers and hand, various types of splints are applied to the damaged area. If surgical treatment is necessary, the method of microsurgery of the hand is used. The surgeon may use different types of sutures, depending on the area of ​​damage. Often, ruptures are accompanied by damage to other structural elements of the hand, such as nerves or blood vessels. In order to restore motor function to the hand, it is necessary to restore all damaged elements during the operation.