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Tendon rupture

While tendons — tough bands of fibrous connective tissue that connect muscles to bones in the body — can withstand a large amount of weight and stress, they can tear when pushed beyond their limits. In the case of a partial or incomplete tendon rupture, the damaged tendon remains intact and can usually be treated through more conservative means. However, if the tendon separates from the bone or splits into two pieces (known as a complete tear), surgery may be advised.

  • Types

    • Achilles tendon rupture, a tear in the tendons that attach the calf muscles to the heel bone
    • Biceps tendon rupture, a tear in the tendons that attach the biceps muscle to the shoulder bones (more common) or the elbow bones
    • Patellar tendon rupture, a tear in the tendons that attach the kneecap (patella) to the shinbone
    • Quadriceps tendon rupture, a tear in the tendons that attach the four quadriceps muscles to the kneecap
    • Rotator cuff rupture, a tear in the tendons that attach the upper arm bone to the shoulder blade
    • Triceps tendon rupture, a tear in the tendons that attach the triceps muscle to the elbow bones
  • Symptoms

    • A pop or snap patients can hear or feel as the tendon ruptures
    • Inability to carry weight on the affected area
    • Limited range of motion and/or use in the affected area
    • Pain and tenderness
    • Prompt or instantaneous bruising
    • Weakness
  • Prevention

    • Avoid physical activities in which injury, muscle strain and/or repetitive overuse of related muscles are possible.
    • Maintain strength and flexibility through regular physical activity and strengthening exercises.
    • Quit smoking.
    • Seek treatment for any medical conditions that impact the tendons and/or blood supply.
  • Diagnosis

    • Review of medical records and physical exam. Providers will discuss patients’ symptoms and medical history and examine the affected area.
    • Imaging. X-rays help highlight competing sources of pain, contributing medical conditions (such as bone spurs) and kneecap displacement in cases of patellar tendon ruptures and quadriceps tendon ruptures. MRI and ultrasounds can capture both partial and complete ruptures.
  • Treatment

    • Changes to physical activity to avoid placing further pressure on the source of injury
    • Nonsteroidal anti-inflammatory drugs to reduce swelling and provide temporary pain relief
    • Physical therapy to help increase flexibility and range of motion and to strengthen the supporting muscles
    • RICE: rest, ice, compression and elevation
    • Use of an immobilization device (such as a cast, splint or walking boot) or brace to limits patients’ range of motion, protect them from further injury and align affected areas so that the injury heals correctly
    • Surgery to reattach the ruptured tendon to the bone
  • Follow-up care

    • For cases in which surgery is advised, earlier treatment is associated with better postoperative outcomes.
    • Patients who undergo surgical treatment for a tendon rupture will require rehabilitation and the temporary use of an immobilization device, such as a cast, splint or walking boot.
    • The postoperative recovery time is dependent on the type of tendon rupture, the health of the patient and the severity of the injury.