Torn Tendon in the Foot: Causes, Symptoms and Treatment

The anatomy of human foot is quite complex. There are 26 bones and 33 joints in the foot. The forefoot contains five toes and the longer bones, known as metatarsals, while the midfoot contains three cuneiform bones, the cuboid bone, and the navicular bone.

The ankle and the heel bone constitute the hindfoot. The ankle bone is known as talus bone, while the heel bone is known as calcaneus, which is the largest bone in the foot.

Tendons are the strong, connective tissues that attach muscles to the bones. There are basically four types of tendons in human foot, two peroneal tendons (peroneus longus and the peroneus brevis), anterior tibialis, posterior tibialis, and Achilles tendon. 

Out of these, Achilles tendon is the largest tendon in the body, and is located on the back of the foot, above the heel. It connects the calf muscle to the heel bone. Achilles tendon is more prone to injuries than the other foot tendons. In fact, it is one of the most common areas of tendon rupture. However, a tear can occur in other foot tendons as well.

As the foot bears the weight of the entire body, while standing or moving, the tendons of this area are subject to considerable stress. In general, tendons can sustain a tear due to direct trauma or injury, injecting steroids into the tendon, and advanced age.

As we age, there is a gradual decline in the supply of blood to the tendons, which can weaken them and make them more prone to tears.

Strenuous physical activities and high-impact sports, which require repetitive motion, can increase the risk for torn tendons. Laceration of the tendons is another factor that can cause a rupture. Sometimes, longstanding tendinitis can also weaken the tendons and make them more susceptible to tears.

Achilles tendon in particular, can sustain a tear due to landing awkwardly on the feet (after falling or jumping from a height), which can cause the ankles to bend backward (dorsiflexion of the ankle).

There are a number of signs and symptoms, that you can experience with a ruptured tendon. Some of the common symptoms of this condition are:

✦ Pain
✦ Swelling and bruising
✦ Inability to move or walk
✦ Inability to bear weight on the foot
✦ Indentation above the injured tendon
✦ A snap or popping sound at the time of injury 

A ruptured tendon is usually detected with the help of physical examination and X-ray of the affected area. MRI and ultrasound are carried out, to find out the severity of the rupture, i.e., whether it is a partial tear or a complete rupture. As with any other injury, the severity determines what course of treatment would be required for a ruptured tendon.

If there is a partial tear in the tendon, then physicians usually recommend rest, or immobilization of the foot for a few days to promote healing. The affected foot is usually immobilized by placing it in a cast.

Crutches can be used during this period to move around, without putting pressure on the torn tendon. The recommended period of immobilization is then followed by physical therapy, that aims at slowly restoring the movement of the foot and strengthening the associated muscles.

Surgical repair of the torn tendon is generally required, if there is a complete rupture. After the surgery, the foot is placed in a brace or an immobilizing device, for a few weeks. During this period, the affected individual is advised to use crutches to move around.

Physical therapy is then initiated, to gradually restore the normal range of motion and increase weight bearing. The healing time and prognosis of tendon rupture depend on several factors, including the severity of the rupture, and age and overall health of the individual, prior to the injury.

Younger and otherwise healthy individuals can recover faster after the surgery, compared to an elderly person.

✔ Ice application helps a lot in reducing the swelling and pain associated with a ruptured tendon.

✔ Never use ice directly on your skin. Instead, put the ice cubes in a plastic bag and wrap them with a towel to apply on the affected area.

Here are some of the precautionary measures, that can be taken to avoid tendon injury and prevent the recurrences of ruptured tendons in foot.

✔ Avoid the factors that increase the risk for tendon rupture.

✔ Before doing any strenuous physical activity, be sure to prepare the foot tendons for it with the help of stretching exercises.

✔ Always wear shoes that fit properly, and provide adequate support to the heel and the foot, while running or participating in any sport activity.

Torn foot tendons should always be treated on time, as any delay in treatment can lead to scarring and shortening of the tendons. So, if you experience severe pain and swelling after a foot injury, or hear a snap or pop during the injury, and if you have not been able to move or bear weight on the foot, then seek immediate medical attention.