Achilles Tendon

Achilles Tendon Rupture

What Causes an Achilles Tendon Rupture?

When your Achilles tendon snaps it is known as Achilles tendon rupture. Often an Achilles rupture can occur spontaneously without any prodromal symptoms. Unfortunately the first “pop” or “snap” that you experience is your Achilles tendon rupture.

Achilles tendon rupture most commonly occurs in the middle-aged male athlete (the weekend warrior who is engaging in a pickup game of basketball, for example). Injury often occurs during recreational sports that require bursts of jumping, pivoting, and running. Most often these are tennis, racquetball, squash, basketball, soccer, softball and badminton. 

Achilles rupture can happen in these situations:

  • You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping.
  • You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon.
  • You fall from a significant height.

The biggest risk factor for Achilles tendon rupture is tendon cell death which occurs as a result of poorly managed tendinopathy

Higher Risk of Achilles Tendonitis History

It does appear that previous history of Achilles tendonitis results in a degenerative tendon, which can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Certain illnesses (such as arthritis and diabetes) and medications (such as corticosteroids and some antibiotics) can also increase the risk of rupture.

Achilles Tendon Diagnosis

A staggering 20%-30% of Achilles tendon ruptures are missed. Thompson (calf squeeze) test is 96% sensitive and 93% sensitive. Unfortunately, some health practitioners fail to perform this simple clinical test. An ultrasound examination or an MRI can confirm an Achilles tendon rupture. 

Totally Ruptured Achilles Tendon Treatment

Treatment of a ruptured Achilles tendon is usually conservative (non-operative) in a Controlled Motion Ankle (CAM) Boot or it may require surgery.

The current consensus based on research is to treat them conservatively since the functional outcome and chance of re-rupture is similar (7% to 15%) using both approaches but surgical intervention has a higher risk of infection.

Achilles tendon surgery is usually considered if your Achilles has re-ruptured or there is a delay of two weeks between the rupture and the diagnosis and commencement of conservative bracing and treatment. 

Post-Surgical Physiotherapy

Most surgeons will recommend that you commence physiotherapy about one-week post-op. It is important to not over-stress your Achilles tendon repair. Professional guidance of a physiotherapist experienced in Achilles tendon rupture rehabilitation is strongly recommended for your best outcome.

Ruptured Achilles Tendon Prognosis

You will normally be in your CAM brace for between 6 to 12 weeks. If everything goes perfectly during your rehabilitation it takes at least 12 weeks before a return to sport is possible. However, if there are complications, some Achilles tendon repairs can take six months to rehabilitate successfully and return to sport.

Seek Professional Advice

The best advice is to seek early advice from your physiotherapist, doctor or orthopaedic surgeon. Delay does result in a poorer prognosis.

If you are lucky, you may avoid surgery but require a walking boot, or similar, with a graduated rehabilitation program to strengthen your injured tendon and prevent a further injury.


The Benefits Of Cross Training

What Is Cross Training?

Cross training is a form of fitness training that combines different styles of exercise regimes to utilise the whole body. Cross training can include cardio exercises, strength training exercises and flexibility exercises to maximise your overall fitness. By cross training, you’ll be able to balance out your exercise routine to use all your muscle groups.

How Do You Cross Train?

By choosing a different form of exercise each day you train, or by mixing up your routine in one session you’ll be cross training. For example, on Mondays you might swim, on Tuesdays you might do strength training in the gym, and on Thursdays you might do Pilates. Or, you could swim for 30 minutes on one day, followed by a 40-minute Pilates class.

Another way to cross train is by changing up the equipment used in the gym that target different muscle groups – e.g. a leg exercise followed by an upper body one; a back exercise after a chest one.

What Are The Benefits Of Cross Training?

Cross training will improve your strength, flexibility, balance, cardiovascular system and aid weight loss or build muscle bulk, if desired. It can create balance and ensures you are working your whole body, either during your session or throughout the week.

By cross training you will reduce the boredom that comes with doing the same routine repeatedly, which helps improve attendance and motivation in participating in exercise. It also has social benefits, as you could opt to join a cross training class in the gym – as opposed to training by yourself on the gym floor.

Does Cross Training Reduce Injuries?

Another massive advantage of opting to cross train is how it can reduce the occurrence of injury. If your usual routine is to just go out for a run, then you may be leading yourself into the potential grounds of injury. If you do the same routine in every session, your muscles can become fatigued from not having enough rest or develop imbalances. These two factors can increase the risk of injury. By adding other types of exercise to your routine you can allow rest days from a repeated exercise but still keep your fitness levels up.

What’s more, if you are recovering from injury, this is a great way to keep up your fitness. Cross training can compliment your rehabilitation programme and allow you to maintain your cardio fitness, strength and flexibility by training the parts of your body that are not injured.

Moreover, it’s a nice way to learn new forms of exercise which can develop new physical skills and add a challenge to your usual routine, not to mention make your fitness journey more enjoyable!


Can Neck Pain Cause Dizziness?

Many people experience neck pain and dizziness at the same time. Sometimes this is referred to as cervical vertigo or cervicogenic dizziness. This dizziness may come and go or occur with motion of the cervical spine (neck), and it can involve unsteadiness, light-headedness, blurry vision, ringing in ears, nausea, headaches, and/or other troubling symptoms. Here are a few possible ways that a neck problem may contribute to dizziness.

Image of the impact of the head hitting a car seat

Besides neck pain, whiplash can cause other symptoms, such as dizziness. Watch: Whiplash Video

Whiplash injury

When the neck is abruptly whipped back and forth, it can cause a whiplash injury. A rear-end auto collision is one of the top causes of whiplash. While neck pain is the most common whiplash symptom, many other symptoms may be present, such as dizziness.

See Sources of Whiplash Pain

When dizziness accompanies whiplash, it could be due to a concussion (brain injury) that occurred at the time of the collision. Another possibility is that specialized receptors (proprioceptors) within the neck’s muscles or joints become injured. The muscles and joints in your neck are believed to have receptors that send messages to the brain. These receptors give feedback on the position of the head and neck. Along with the inner ear and eyes, the proprioceptors in the neck are believed to play a role in maintaining balance. An injury to these proprioceptors may contribute to feeling dizzy or unsteady.

Vertebrobasilar insufficiency

When one of the vertebral arteries gets compressed or inflamed within the cervical spine, it could cause vertebrobasilar insufficiency (VBI). With VBI, a reduced amount of blood reaches the brain, inner ear, or brainstem. When this happens, serious symptoms can occur, including dizziness. One type of VBI is called Bow Hunter’s syndrome, which involves temporary dizziness or other symptoms occurring when the head is turned to the side (like a bow hunter does). While this type of compression is rare, it most commonly occurs between the C1 and C2 vertebrae in the cervical spine.1 It is typically caused by a bone spur on a vertebra in the neck that pinches the artery when the head is turned.

Cervical myofascial pain syndrome

Myofascial pain syndrome occurs when painful trigger points develop in the muscles and surrounding connective tissues. When this condition is primarily felt in the neck region, it is called cervical myofascial pain syndrome. In addition to having tender trigger points than can flare up when touched or during activity, muscles can become achy and stiff, and pain can spread to the head or shoulders. While cervical myofascial pain syndrome is rare, it is estimated that about one-third of people with this condition also have dizziness. 2

Cervical myofascial pain syndrome has no known cause. Some suspected causes include previous injury, overuse or repetitive neck movements, poor posture, and/or stress. While the connection between this neck pain and dizziness is unclear, some evidence suggests that treating myofascial pain syndrome— such as with trigger point injections, physical therapy, or medication—can reduce both the pain and dizziness.3

When to see a doctor

Unexplained dizziness needs to be evaluated by a doctor, especially if it lingers or keeps coming back. A qualified medical professional can perform a physical exam and conduct diagnostic tests to help identify the possible cause of neck pain and/or dizziness. While there is currently no diagnostic test to prove a neck problem is causing dizziness, a doctor can narrow the list of possible causes and recommend treatments. Spinal injections and/or additional testing may help clarify the source of the pain and help improve your quality of life. When neck pain and/or dizziness are accompanied by other troubling symptoms, seek medical attention immediately. Some examples include persistent nausea, severe headache, fevers, chills, weakness, numbness, or bowel/bladder dysfunction.


Is Sitting the New Smoking?

In recent years healthcare news has drawn attention to the startling possibility that our desk jobs could be just as bad for us as smoking or eating junk food. The worrying thing is that avoiding periods of prolonged sitting isn’t an option for most office workers and is part of a lifestyle that is very much beyond their control.

Fortunately, it’s possible to partially counteract the effects of sitting at work with regular exercise in your spare time (BJSM, 2015). There is even some evidence to suggest that engaging in high levels of physical activity each day (60-75 minutes) can completely counteract the increased rate of mortality associated with prolonged sitting (Lancet 2016).

The average persons sits for 9 hours a day. That’s 55% of their waking hours. With this in mind it stands to reason that the way we sit may be having some impact on our musculoskeletal system. Most of us are guilty of slouching at some point but slouching is actually our body’s way of conserving energy, so if you slouch for a short period of time it could actually be beneficial. The problems start when you sit slouched for prolonged periods of time as the muscles around the back and neck are left in a stretched position. This phenomenon is called tissue creep and can eventually lead to pain when the tissue is left stretched and under load.

The average human head weighs 5kg. If you slouch and the head moves forwards the load that the neck muscles have to absorb increases to about 14kg. That’s almost 3 times as much weight simply because the head has moved forwards and is no longer balanced effectively on the spinal column. Over time this can make the neck muscles fatigue and can lead to neck pain.

Changing position regularly, taking regular breaks away from your desk and using your lunch break to go for a walk or run are just some of the ways that you can start to break up your working day and potentially improve your health!

This blog is based on a presentation given to local office employees.