Materiały źródłowe

• #1 Achilles Tendon Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430844/

  Achilles tendon rupture is the most common tendon rupture in the lower extremity. The injury most commonly occurs in adults in their third to fifth decade of life. Acute ruptures often present with sudden onset of pain associated with a „snapping” or audible „pop” heard at the injury site. Patients may describe a sensation similar to being kicked in the lower leg. Achilles tendon rupture causes significant pain and disability. […] Causes of Achilles tendon rupture include sudden forced plantar flexion of the foot, direct trauma, and long-standing tendinopathy or intratendinous degenerative conditions. Sports often associated with Achilles tendon rupture include soccer, basketball, and racquet games. Risk factors for a rupture of the Achilles tendon include poor conditioning before exercise, prolonged use of corticosteroids, overexertion, fluoroquinolone antibiotics, oral bisphosphonates, and previous Achilles tendinopathy, diabetes, hyperparathyroidism, and genetic factors.

• #2

  https://www.orthobullets.com/foot-and-ankle/7021/achilles-tendon-rupture

  Achilles Tendon Ruptures are common tendon injuries that occur due to sudden dorsiflexion of a plantarflexed foot, most commonly associated with sporting events. […] Mechanism usually traumatic injury during a sporting event. […] may occur with sudden forced plantar flexion. […] violent dorsiflexion in a plantar flexed foot. […] rupture usually occurs 4-6 cm above the calcaneal insertion in hypovascular region.

• #3 Achilles Tendon Rupture

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3752187/

  Achilles tendon (AT) rupture in athletes is increasing in incidence and accounts for one of the most devastating sports injuries because of the threat to alter or end a career. […] The purpose of this review is to identify potential intrinsic and extrinsic risk factors for AT rupture in aerial and ground athletes stated in the current literature. […] Aerial and ground athletes share many intrinsic risk factors for AT rupture, including overuse and degeneration of the tendon as well as anatomical variations that mechanically put an athlete at risk. […] Older athletes, athletes atypical in size for their sport, high tensile loads, leg dominance, and fatigue also may increase risk. […] Tendon degeneration and poor mechanics are the most common explanations for AT ruptures. […] Degeneration can cause spontaneous rupture accelerated by a limited blood supply to the watershed region of the AT, approximately 2 to 6 cm from the calcaneal insertion.

• #4 Achilles Tendon Rupture: Symptoms & Causes | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/achilles-tendon-rupture

  The Achilles tendon is the connective tissue between the heel bone and calf that enables walking, running, and jumping. A tear or rupture to the Achilles tendon can cause pain, limit mobility, and make walking difficult. […] An Achilles tendon tear can occur in any athletic activity where the athlete is running or jumping. The injury usually occurs about two inches from where the tendon connects to the heel bone, potentially because less blood reaches this area. […] Common causes of an Achilles tendon tear during athletic activity include: A sudden stop or start that puts increased stress on the Achilles tendon. A traumatic twist or pivot can stretch an Achilles tendon to the point of tearing. […] Achilles tendon tears are common in soccer, basketball, tennis, squash, pickleball, and football. They’re most likely to occur during high-intensity activity after a long period without regular training, like an impromptu game of basketball after years off the court.

• #5 Achilles Tendon Injuries: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/309393-overview

  Family history is also a possible risk factor for Achilles tendon disorders. […] Drugs that can play a role in Achilles tendon pathology include the following: Steroids, Quinolones. […] Extrinsic causes of Achilles tendinosis also include the following: Overuse, Activities with jumping and running, Participation in a new activity, Increased intensity of activity, Increased duration of training, Stairs, Hill climbing, Poor conditioning, Improper shoes, Improper training surfaces, Improper stretching exercises. […] Most Achilles tendon tears occur in the left leg in the substance of the tendo-Achilles, approximately 2-6 cm above the calcaneal insertion of the tendon. […] The most common mechanisms of injury include sudden, forced plantar flexion of the foot; unexpected dorsiflexion of the foot; and violent dorsiflexion of a plantar-flexed foot.

• #6 Achilles Tendon Injuries: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/309393-overview

  Other mechanisms include direct trauma and, less frequently, attrition of the tendon as a result of longstanding paratenonitis, with or without tendinosis. […] Achilles tendon rupture resulting from forced dorsiflexion during active plantar flexion is commonly seen in basketball, diving, tennis, and other sports that require forceful push off from the foot. […] Other risk factors for Achilles tendon rupture, aside from those previously noted, include Poor conditioning, Fluoroquinolone antibiotic use, Corticosteroid use, Overexertion. […] Traditionally, tendinosis is thought to occur with overuse, causing microtrauma to a degree and at a frequency at which the tendon can no longer heal itself.

• #7 Achilles tendon rupture – Wikipedia

  https://en.wikipedia.org/wiki/Achilles_tendon_rupture

  Achilles tendon rupture usually occurs due to a sudden, forceful push-off movement, an abrupt dorsiflexion of the foot while the calf muscle is engaged, or direct trauma. Chronic degeneration of the tendon, often from tendinosis, also increases the likelihood of rupture. Common risk factors include fluoroquinolone or corticosteroid use, sudden increases in physical activity, inflammatory conditions such as rheumatoid arthritis, gout, and chronic overuse or improper training. […] The Achilles tendon is most often injured by sudden downward or upward movement of the foot, or by forced upward flexion of the foot outside its normal range of motion. Other ways the Achilles tendon can be torn involve sudden direct trauma or damage to the tendon, or sudden use of the Achilles after prolonged periods of inactivity, such as bed rest or leg injury. Some other common tears can happen from intense sports overuse. Twisting or jerking motions can also contribute to injury.

• #8 Achilles Tendon Rupture: Causes, Symptoms, and Treatment

  https://patient.info/foot-care/heel-and-foot-pain-plantar-fasciitis/achilles-tendon-rupture

  The Achilles tendon can be ruptured by sudden force on the foot or ankle. […] As with any muscle or tendon in the body, the Achilles tendon can be torn if there is a high force or stress on it. This can happen with activities which involve a forceful push off with the foot – for example, in football, running, jumping, basketball, diving and tennis. The push off movement uses a strong contraction of the calf muscles which can stress the Achilles tendon too much. […] The Achilles tendon can also be damaged by injuries such as falls, if the foot is suddenly forced into an upward-pointing position – this movement stretches the tendon. Another possible injury is a deep cut at the back of the ankle, which might go into the tendon. […] Sometimes the Achilles tendon is weak, making it more prone to rupture. Factors that weaken the Achilles tendon are: corticosteroid medication (such as prednisolone) – mainly if it is used as long-term treatment rather than a short course; corticosteroid injection near the Achilles tendon; certain rare medical conditions, such as Cushing’s syndrome, where the body makes too much of its own corticosteroid hormones; tendinopathy of the Achilles tendon; other medical conditions which can make the tendon more prone to rupture; for example, rheumatoid arthritis, gout and systemic lupus erythematosus; certain antibiotic medicines may slightly increase the risk of having an Achilles tendon rupture. These are the quinolone antibiotics such as ciprofloxacin and ofloxacin. The risk of having an Achilles tendon rupture with these antibiotics is still low and mainly applies if you are also taking corticosteroid medication.

• #9 Achilles tendon rupture – UpToDate

  https://www.uptodate.com/contents/achilles-tendon-rupture

  Achilles tendon rupture is at risk of acute injury, particularly during competitive and recreational athletics. […] The incidence of Achilles tendon rupture in the general population is approximately 5 to 10 per 100,000, but may be higher in some regions and populations, and is increasing overall. […] Over 80 percent of ruptures occur during recreational sports. […] Approximately 10 percent of patients who sustain an Achilles tendon rupture had preexisting Achilles tendon problems. […] Increased age, male sex, and obesity are risk factors for Achilles tendon problems. […] The peak age for rupture is 30 to 40 years for both men and women; this may be when degenerative changes and occasional high stress from sports coincide. […] Rupture is four to five times more common in men than women. […] As participation in recreational sports has increased over the past 50 years, so has the rate of tendon rupture. […] Achilles tendon rupture is rare among children and more likely to be sustained through direct, often penetrating, trauma.

• #10 Ruptured Achilles Tendon: Diagnosis, Treatment, and More

  https://www.healthline.com/health/sports-injuries/ruptured-achilles-tendon

  Achilles tendon injuries may not be very common in the general population, but if you frequently engage in sports and other recreational activities, the risk of rupturing your Achilles tendon is very real. […] In fact, research suggests that more than 80% of Achilles tendon ruptures happen in people who engage in sports or active hobbies. […] A 2018 study published in the Orthopedic Journal of Sports Medicine found that almost 82% of Achilles tendon ruptures resulted from sports or recreational activities. While the researchers attributed most of these injuries more than 42% to playing basketball, other common causes of a ruptured Achilles tendon included: football, soccer, tennis, running, hiking, stretching. […] However, other activities can also cause this type of injury. The same study found that common daily activities involving stairs, doors, and even sinks could cause Achilles tendon ruptures in older adults. […] Without the right treatment, a torn Achilles tendon can heal improperly and cause a number of potential complications, including re-rupture, blood clots, chronic nerve issues, and ongoing pain.

• #11 Achilles Tendon Rupture: Symptoms & Causes | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/achilles-tendon-rupture

  Age, gender, and physical condition all contribute to the likelihood of a ruptured Achilles tendon: Achilles tendon ruptures are most common in your 30s and 40s. Men are five times more likely to rupture an Achilles tendon than women. Regular training strengthens the Achilles tendon, reducing the risk of an Achilles tendon tear. Infrequent sports participation increases risk by encouraging brief, high-intensity movements in an unprepared athlete. Being overweight or obese places additional stress on the Achilles tendon. Tendons can weaken with some medications, such as specific antibiotics and steroid injections. […] A rupture typically refers to a grade 3 tear (the most severe of the three tear grades), when most of the tendon is torn. […] A torn Achilles tendon needs to be treated to heal properly. Left untreated, it may heal poorly or incompletely, resulting in loss of strength and mobility.

• #12 Achilles Tendon Injury Treatment | MD West ONE Specialists

  https://mdwestone.com/achilles-tendon-injuries/

  Achilles tendon ruptures are often seen in weekend warriors typically middle-age men and women participating in sports in their spare time. […] Less commonly, illness or medications, such as steroids or certain antibiotics, and may weaken the tendon and contribute tears. […] The following factors put you at an increased risk for an Achilles Tendon Rupture: […] Steroid Injections – Injections around the tendon can sometimes weaken the tendon, increasing the risk of an Achilles tendon rupture […] Certain Antibiotics – Fluoroquinolone antibiotics, such as ciprofloxacin or levofloxacin have been shown to increase the risk of an Achilles tendon rupture […] Obesity – Increased weight puts more strain upon the tendon, increasing the risk of rupture. […] Achilles tendon injuries are a rather rare occurrence so there has been no prospectus but study that has been ever able to answer this question well. However, common sense would dictate that a stretching program for the Achilles tendon decrease the chance of rupture, however this has not been able to be shown in studies.

• #13 Achilles Tendon Rupture: What Is It, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21703-achilles-tendon-rupture

  The Achilles tendon is a thick band of tissue that attaches your calf muscle to your heel bone. It is built to handle a lot of stress. But you can rupture your Achilles tendon under extreme stress like during a sudden start or stop, or if you fall. […] An Achilles tendon rupture is a full or partial tear of the Achilles tendon. This acute (sudden) injury occurs when the tendon stretches to its breaking point. It happens most frequently while playing sports. Tripping, falling or twisting your ankle can also cause an Achilles tear. […] Sudden movement that puts stress on the Achilles tendon can lead to a rupture. Typically, people tear the Achilles tendon while playing sports. The biggest culprits are sports with sudden stops, starts and pivots such as soccer, football, basketball, tennis or squash. Achilles tendon tears aren’t always a sports injury. You can tear your Achilles tendon by tripping, missing a step when going downstairs or accidentally stepping into a hole and twisting your ankle. Some medications including certain antibiotics and steroid injections in the area can weaken the Achilles tendon. This can put you at a higher risk for a tear. […] An Achilles tendon rupture is a common sports injury. People who play sports that involve running, frequent stopping and starting, and changing directions are most at risk. You can also tear your Achilles tendon by tripping, missing a step going down the stairs or twisting your ankle.

• #14 Achilles Tendon Rupture Treatment Carlsbad, CA | Achilles Tendon Injury Encinitas, CA

  https://www.erikstarkmd.com/achilles-injuries-repair-orthopaedic-sports-surgeon-carlsbad-encinitas-ca.html

  The majority of Achilles tendon ruptures are the result of traumatic sports injuries in middle aged, healthy, active men. A sudden strong force on the foot or ankle as found in football, running, basketball, diving and tennis can rupture this tendon. Weekend warriors frequently experience a rupture. Any sport that requires the foot to push off causing the calf muscles to contract can stress the tendon. […] Other causes include a fall that forces the foot into an upward pointing position, or a deep cut to the back of the ankle. Importantly, a rupture can result in older men who have chronic degeneration of the tendon and repetitive stress, without a physical blow. […] Potential predisposing factors that increase the risk of rupture include: corticosteroid medications, corticosteroid injections near the ankle, certain medical conditions like Rheumatoid Arthritis, Gout, and some rare diseases, some antibiotics, long-standing tendinitis or tendinosis. Tendinosis is when the tendon degenerates, swells and inflames. Tendinitis is inflammation that irritates the tendon, that results from repetitive stress, overuse and age-related degeneration of the tendon, obesity.

• #15 Causes and Risk Factors for Achilles Tendon Damage

  https://www.sports-health.com/sports-injuries/ankle-and-foot-injuries/causes-and-risk-factors-achilles-tendon-damage

  Anyone can hurt their Achilles tendon, but some people are more prone than others. Factors that increase the likelihood of Achilles tendonitis and other tendon problems include […] A change in the athletes training schedule and/or intensity level, such as adding another few miles to a daily running routine or participating in plyometric exercises that require explosive movement, such as burpees or box jumps […] A change in playing surface, such as when a tennis player shifts from playing on grass courts to clay courts, or when the athlete changes footwear […] Tight or weak calf muscles can be overstretched, resulting in soft-tissue damage. […] Excessive pronation, defined as rolling inward on the foot when walking or running […] Chronic ankle instability, or a recurrent giving way or rolling of the ankle

• #16 Causes and Risk Factors for Achilles Tendon Damage

  https://www.sports-health.com/sports-injuries/ankle-and-foot-injuries/causes-and-risk-factors-achilles-tendon-damage

  Leg-length discrepancy, even if quite small, can cause the body to compensate and put soft-tissue structures like the Achilles tendon at risk for injury […] Wearing high heels regularly can shorten the Achilles tendon, making it more prone to injury […] Excessive training, particularly running on hills, exposes the Achilles tendon to repeated micro-traumas that may add up to a symptomatic injury […] Increasing age (over 30 years of age) contributes to decreased blood supply to tendons, making them more prone to injury […] Use of fluoroquinolone antibiotics, such as ciprofloxacin (Cipro), gemifloxacin (Factive), or levofloxacin (Levaquin), puts a person at temporary risk of tendon injury […] High-arched feet are associated with a higher risk of developing Achilles tendinopathy […] Certain types of arthritis, such as ankylosing spondylitis or psoriatic arthritis, may also put a person at a greater risk of Achilles tendinopathy.

• #17 Causes and Risk Factors for Achilles Tendon Damage

  https://www.sports-health.com/sports-injuries/ankle-and-foot-injuries/causes-and-risk-factors-achilles-tendon-damage

  Acute injury risk Achilles tendon tears or ruptures can result from a single hard athletic training session, a sudden push-off (i.e., when a track athlete starts a race), or a sudden change in direction. […] Tears or ruptures to the Achilles tendon are most associated with acute injuries. But chronic tendinopathy can develop after multiple tears or acute inflammatory conditions fail to heal, which sometimes can occur when athletes are unwilling or unable to take adequate rest periods following injury.

• #18 Achilles Tendon Rupture

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3752187/

  As many as 97% of spontaneously ruptured tendons examined histologically had degenerative changes consistent with tendinosis. […] This process usually correlates with aging, but the younger, competitive athlete may accelerate this process through a combination of macro- and microtrauma related to high training loads and shorter recovery phases. […] The AT is at the greatest risk for rupture when concentrated forces are oblique to the tendon. […] Malfunction or suppression of the proprioceptive component of the skeletal muscle due to fatigue or disturbed coordination of the musculotendinous unit predisposes athletes to the rupture of the AT. […] Athletes who resume training after a period of rest may be particularly susceptible to rupture of the AT as a result of this malfunction. […] Intrinsic factors play a larger role for ground athletes because of the shoe-surface interaction.

• #19 Achilles Tendon Rupture FAQ’s | Complete Orthopedics

  https://www.cortho.org/faq/foot-ankle/achilles-tendon-rupture/

  Yes, indirectly. Chronic Achilles tendon inflammation (tendonitis) can result in collection of scar tissue and inflammatory material in the tendon itself. This is called tendonosis. This tissue is not like your normal Achilles tendon. It causes pain and does not contribute to the tensile strength of the tendon. Over time, a significant portion of the tendon can be replaced with this unhelpful inflammatory tissue. This means that there is more force moving through the unaffected fibers. This placed the tendon at higher risk of rupture. […] Yes, indirectly. Chronic Achilles tendon inflammation (tendonitis) can result in collection of scar tissue and inflammatory material in the tendon itself. This is called tendonosis. Haglunds deformity is associated with chronic Achilles tendon inflammation at the insertion. This tissue is not like your normal Achilles tendon. It causes pain and does not contribute to the tensile strength of the tendon. Over time, a significant portion of the tendon can be replaced with this unhelpful inflammatory tissue. This means that there is more force moving through the unaffected fibers. This placed the tendon at higher risk of rupture.

• #20 Achilles Tendon Rupture: Symptoms, Treatment, Recovery | HSS

  https://www.hss.edu/conditions_achilles-tendon-rupture-injuries.asp

  Common Achilles tendon injuries include Achilles tendonitis, which can occur due to overuse, a change in activity or sudden increase in activity, or other anatomic causes. […] Achilles tendon ruptures are most often caused by sudden, strenuous athletic activity that was not preceded by proper stretching, Ruptures usually occur during high-stress activities such as running, cutting or jumping, but sometimes the tendon becomes chronically weakened and can give way during less strenuous activities like walking. […] About 10% of Achilles tendon ruptures occur in patients who have pre-existing Achilles tendinopathy. […] Certain medical conditions and some medicines are known to be associated with an increased risk of rupture.

• #21 Achilles Tendon Rupture

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3752187/

  Preexisting degenerative tendon, cavus foot, tibia vara, or underdeveloped hamstrings may increase the risk of AT ruptures. […] Over- or underpronating is linked with poor shock absorption and may increase stress on the AT. […] Increased femoral anteversion, leg length discrepancy, muscle weakness, increased body mass index, and aging increase intrinsic risk of AT rupture in running athletes. […] Excessive repetitive overload in running can be a pathologic stimulus that leads to Achilles tendinopathy and rupture. […] Inadequate athletic shoes with minimal flexibility, poor heel wedges, and soft heel counters all place the athlete at risk for AT injury. […] Sudden increases in interval training, solitary intense runs, increases in terrain elevation, uneven or density differing surfaces, or an increase in eccentric loading may increase the risk of injury.

• #22 Achilles Tendon Injuries: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/309393-overview

  In cyclists, low saddle height, resulting in extra dorsiflexion of the ankle with pedaling, may be a causative factor in tendinosis. […] Systemic diseases that affect the Achilles tendon include the following: Chronic renal failure, Rheumatoid arthritis, Systemic lupus erythematosus (SLE), Gout, Collagen deficiencies, Infectious diseases, Thyroid disorders, Parathyroid disorders, Diabetes mellitus. […] Other intrinsic factors in Achilles tendon injuries include the following: Varus alignment with functional hyperpronation, Cavus foot, Tibia vara (Blount disease), Insufficient gastrocsoleus strength and flexibility, Limited ankle dorsiflexion. […] As previously mentioned, age is another factor associated with Achilles tendinosis. Increased incidence of Achilles rupture and Achilles tendinosis has also been associated with having blood group O.

• #23 Achilles Tendon Rupture: Causes, Symptoms, Test, Treatment

  https://www.medicinenet.com/achilles_tendon_rupture/article.htm

  Rupture of the Achilles tendon is not uncommon in healthy, active individuals. The rupture is typically spontaneous and most commonly observed in individuals between 24-45 years of age. The majority have had no prior history of pain or previous injury to the tendon. In the majority of cases, rupture of the Achilles tendon occurs 2-6 cm above the insertion of the tendon into the heel bone. […] Most commonly, the Achilles ruptures when there is a sudden, forceful movement of the foot downward against resistance, such as when an individual pushes off the foot with great force to jump. This often occurs in sports like basketball, tennis, or football. […] About 1 million athletes a year develop Achilles tendon inflammation or rupture. Achilles tendon rupture tends to occur in athletic people between ages 30 and 50 and mostly in men (6:1 men: women). There may be an anatomical reason for the predominance of men. Achilles tendons in women have a smaller area and are thinner and there may not be enough force generated to cause a rupture.

• #24 Achilles Tendon Rupture: Causes, Symptoms, Test, Treatment

  https://www.medicinenet.com/achilles_tendon_rupture/article.htm

  Underlying illness or disease may increase the risk of Achilles tendon injury. Examples include the following: Diabetes, Thyroid disease, Kidney failure, Rheumatoid arthritis, Systemic lupus erythematosus (SLE, lupus), Gout. […] Risk factors for Achilles rupture include poor conditioning, corticosteroid medications (either taken by mouth or injected near the tendon), fluoroquinolone antibiotics (ciprofloxacin, levofloxacin), and overuse. A previous ruptured Achilles tendon increases the risk for another, both on the side that was initially hurt, and on the other unaffected side. […] Some other risk factors for Achilles tendon injury also include the following: Older age, Activities or sports that involve running and jumping, Lack of flexibility, Excessive activity (overuse), Sudden changes in the intensity of exercise, Poor conditioning, Corticosteroid use (either by mouth or by injection), Fluoroquinolone antibiotics, Poorly fitting shoes, Jogging or running on hard surfaces, Hill climbing or stair walking, Previous Achilles tendon injury, Family history.

• #25 Achilles Tendon Rupture (Tear) – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendon-rupture-tear/

  Achilles tendon tears often occur from an injury to the tendon. […] A very strong force is needed to tear the Achilles tendon. Typically, Achilles tendon tears occur when the calf muscle is stretched too quickly. […] A weakened Achilles tendon is more likely to tear. Several things can lead to tendon weakness. […] Corticosteroid injections to treat Achilles tendinitis have been linked to an increased risk of tendon rupture. […] Chronic disease. Many diseases can disrupt blood supply and cause inflammation throughout the body. These diseases, which include the following, can weaken tendons: Inflammatory diseases (rheumatoid arthritis, systemic lupus erythematosus), Diabetes mellitus, Infection, Obesity, Metabolic disease. […] Use of certain antibiotics such as ciprofloxacin (Cipro) or levofloxacin (Levaquin) has been linked with tendon tearing. Also, medications like corticosteroids and anabolic steroids have been linked to increased muscle and tendon weakness.

• #26 Achilles Tendon Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430844/

  End-stage kidney disease (ESRD) is also highly associated with an increased incidence of Achilles tendon rupture due to a combination of factors. This population group is commonly prescribed fluoroquinolones and corticosteroids before or after a kidney transplant. In addition, when ESRD leads to weekly dialysis, it creates multiple metabolic abnormalities, such as hyperparathyroidism, which increases the risk of tendon ruptures even more.

• #27 Achilles tendon rupture – Wikipedia

  https://en.wikipedia.org/wiki/Achilles_tendon_rupture

  Many people may develop an Achilles rupture or tear, such as recreational athletes, older people, or those with a previous Achilles tendon injury. Tendon injections, quinolone use, and extreme changes in exercise intensity can contribute. Most cases of Achilles tendon rupture are traumatic sports injuries. The average age of patients is 29-40 years with a male-to-female ratio of nearly 20:1. Yet, recent studies have shown that Achilles tendon ruptures are rising in all ages up to 60 years of age. It has been theorized that this is due to the popularity of remaining active with older age. Additionally, even the occasional weekend exercise activity for „weekend warriors” may put one at risk. The risk continues to be higher in people who are older than 60, and also taking corticosteroids, or have kidney disease. Risk also increases with dose amount and for longer periods of time.

• #28 Achilles Tendon Rupture FAQ’s | Complete Orthopedics

  https://www.cortho.org/faq/foot-ankle/achilles-tendon-rupture/

  Systemic diseases that may be associated with Achilles tendon injuries include the following: Chronic renal failure Collagen deficiency Diabetes mellitus Gout Infections Lupus Parathyroid disorders Rheumatoid arthritis Thyroid disorders Foot problems that increase the risk of Achilles tendon injuries include the following: Cavus foot Insufficient gastroc-soleus flexibility and strength limited ability to perform ankle dorsiflexion Tibia vara Varus alignment with functional hyperpronation. […] The use of Fluoroquinolone antibiotics is associated with rupture of the Achilles tendon and tendonitis of all tendons. The risk of a rupture is 4 times more likely in those patients with recent fluoroquinolone use, and 46 times more likely in those patients with recent fluoroquinolone and corticosteroid exposure. Rupture can occur within days of use, but cases have been reported months later. The exact mechanism causing this is not well understood. Some examples of fluoroquinolone antibiotics include Ciprofloxacin, Levofloxacin, Norfloxacin, Pefloxacin, and ofloxacin.

• #29 6 Things that Can Cause an Achilles Tendon Rupture: AllCare Foot & Ankle Center: Podiatry

  https://www.allcarefootdoc.com/blog/6-things-that-can-cause-an-achilles-tendon-rupture

  Michael V. Tran, DPM at AllCare Foot Ankle Center understands that you want to remain active, but he and his staff would like to caution you to ramp up your activity levels carefully. If you happen to be male and between the ages of 30 and 40, your risk of rupturing your Achilles tendon is much higher if you dont take preventive action. […] Achilles tendon ruptures are often the result of one (or more) of the following six things. […] The more excess weight your Achilles tendon bears, the more likely it is to rupture if you accidentally step in a hole, or begin a new exercise program. […] Activity is good, but if it requires more movement or significantly different movement from the activities youve been doing, the strain on your Achilles tendon could lead to rupture. […] A bone spur on your heel can rub across your Achilles tendon, increasing the stress and the potential for a rupture.

• #30 6 Things that Can Cause an Achilles Tendon Rupture: AllCare Foot & Ankle Center: Podiatry

  https://www.allcarefootdoc.com/blog/6-things-that-can-cause-an-achilles-tendon-rupture

  Whether youre beginning a new sport or exercise regimen, or youre ramping up training within an activity youve been doing, increasing too quickly can lead to injury. […] The tighter your calf muscles are, the more they pull on your Achilles tendon. […] Sometimes an Achilles tendon rupture is just bad luck. […] If your Achilles tendon is prone to rupture because you have Achilles tendonitis, a simple misstep can lead to rupture.

• #31 What Causes Achilles Tendon Pain? Common Achilles Injuries, Treatments, And Prevention: Sports Medicine Oregon: Orthopedic Surgery

  https://www.sportsmedicineoregon.com/blog/what-causes-achilles-tendon-pain-common-achilles-injuries-treatments-and-prevention

  The Achilles tendon is the strongest tendon in the human body, capable of supporting loads up to 10 times our body weight! This reliable tendon, however, is susceptible to acute and overuse injury. […] Approximately one million athletes suffer some type of Achilles tendon injury annually and the number of Achilles tendon injuries is on the rise. […] Ramping up a workout routine suddenly can cause structural fatigue and may even result in severe injuries, including Achilles tendon ruptures. […] Achilles tendonosis is caused by overuse, repetitive injuries and strain over time, all of which results in microtears along the tendon. The overuse slowly degenerates and weakens the tendon, making the Achilles more susceptible to injury and even a full Achilles tendon rupture. […] A torn Achilles is a painful injury but, after sustaining an Achilles tendon rupture, some individuals are still capable of bearing weight on the affected foot, despite reduced overall mobility.

• #32 Achilles Tendon Rupture | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/achilles-tendon-rupture

  Achilles tendons may tear when people who are usually sedentary and have weakened tendons engage in strenuous activity. […] Tears can also occur in people who have had previous chronic injury to their Achilles tendons. Tendon injuries can be caused by overuse, improper stretching habits, worn-out or improperly fitting shoes, and poor biomechanics (flat-feet). The risk of tendon rupture is also increased with the use of quinolone antibiotics (e.g. ciprofloxacin, Levaquin).

• #33 Achilles Tendon Rupture

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3752187/

  In the fatigued or poorly trained athlete, injury occurs after 30 minutes of activity. […] As distances increase, muscle fatigue results in tendon elongation and microtearing. […] This damage can occur within the tendons physiologic limits, if time for repair is not adequate. […] Risk assessment of AT rupture in the competitive athlete is a vital consideration of training preparation. […] Aerial and ground athletes have several intrinsic and extrinsic factors that may put them at risk for AT injury and rupture. […] Aerial athletes can obliquely load the AT, while ground athletes can accelerate degeneration over time.

• #34 Achilles Tendon Rupture: Causes, Symptoms, Test, Treatment

  https://www.medicinenet.com/achilles_tendon_rupture/article.htm

  The complications of Achilles tendon rupture include tendon scarring and decreased range of motion, as well as muscle weakness. […] Tendon re-rupture is a significant concern and can occur in up to 5% of surgically repaired patients and some studies, up to 40% in conservatively treated patients. […] The two most important factors are having strong calf muscles and keeping a close eye on your workload, which can be a difficult balance to strike. The key is to keep your calf muscles strong, but the challenge for runners is to incorporate that into their training routine.

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