Tendon rupture – causes, complaints & therapy

In the case of a tendon rupture, there is a jerky tearing of the tendon. Especially in the context of a sudden overload, it is not uncommon for this type of injury to occur. In the human body, tendons form the connection between muscle and bone and are therefore crucial for the transmission of muscle power.

In the case of a tendon rupture, a bang-like noise is usually heard, and severe pain and swelling also occur. Often there is also a dent in the area of the crack. Functionality is limited; the affected muscle is no longer or only partially mobile, it can no longer be actively stretched and bent. In the case of a partial tear or tear, severe pain also occurs, but the muscle can still be moved.

Causes

A tendon tear occurs predominantly during sports. Finally, the tendons transfer muscle power to the skeleton.

However, since they consist of tensile collagen fiber bundles, they are only slightly stretchable, so that the tendons cannot withstand strong loads such as a kick or impact at maximum tension, are overstretched and finally rupture.

Previous damage to the tendons such as tendonitis or tenosynovitis increases the risk of tendon rupture. In addition, the risk of suffering a tendon tear increases from the age of 30, as a degenerative change reduces the elasticity of the tendons and they are therefore more susceptible to overstretching and tearing.

In certain sports such as running, tennis, football and skiing, the risk is also higher, as the Achilles tendon, which is prone to injuries due to the limited blood flow, is particularly stressed here. Jerky movements, twists and bruises can thus lead to tendon tears under exaggerated loads. The extensor tendons of the finger joints are also often affected by tendon tears in sports such as handball and volleyball.

Symptoms and course

Typical symptoms of a tendon rupture:

• Pain of movement

• Swelling

• Bruise

If it comes to a total tendon rupture, those affected often perceive a loud bang. The noise is usually accompanied by a very strong and stabbing pain. As a result of the pain, those affected are noticeably impaired in their ability to move. The tendon rupture is clearly visible through swelling and bruising. With a partial rupture of the tendon, the initial pain subsides relatively quickly. In addition, the impairment of the ability to move is not as pronounced as in a total tear. Externally, only a slight bump can be seen on the skin.

If it comes to a tendon rupture, the course of the disease depends largely on the chosen therapy. For example, mobility can be fully restored as part of an operation. Despite extensive therapy, however, it can lead to recurring pain in the affected area.

Diagnosis

A tendon tear or tendon rupture is usually diagnosed by the accident doctor. Patients report a sudden, stabbing pain after mechanical force has been applied. When the tendon was torn, the patient could usually even hear a whip-like crack. Typically, it is a sports accident caused by a hit, kick or overstretching. With such a development history, the doctor already has a suspicion of a tendon rupture. He tries to confirm his assumption by palpation (scanning).

Depending on the location of the tear, the gap can already be felt in the course of the tendon. In addition, it is found that the patient can no longer move the affected limb in one direction. Either the ability to bend or to stretch is no longer available. In addition, a hematoma (bruise) has developed, which is also externally visible depending on the localization. A clear sign of this is severe swelling. The patient complains of pain anyway.

The symptoms are not always clear because the tendon rupture is not complete in all cases. Imaging diagnostic procedures are therefore necessary, especially in the case of a partial tear. A sonography ( ultrasound examination ) can provide reliable indications of a partial tear of the tendon. X-rays in different planes are often more precise . In addition, if necessary, magnetic resonance imaging ( MRI , MRI, NMR) can show important details.

Complications

A tendon tear should always be treated medically. Otherwise there is a risk of serious complications. Such a tendon rupture is usually caused by an unusual or excessive load. Severe pain then occurs immediately, so that normal movement in everyday life is no longer possible. If you do not visit the doctor at this point, there is a risk of serious and serious complications. The tendon rupture can become inflamed, leading to the formation of an abscess. An abscess is a cavity that fills with pus. If the pus fluid gets into the bloodstream, there is even a risk of blood poisoning.

In some cases, an operation is necessary. In rare cases, infections or wound healing disorders can occur. Sticking together or shortening of the tendon sheaths can lead to restricted freedom of movement. This may necessitate another operation.

The affected person is often given a special splint so that the damaged joint can be immobilized. Too early loads should be avoided completely in the first three weeks. It should be clarified with the attending doctor when unrestricted loading is possible again.

treatment and therapy

Tendon ruptures should be treated immediately after the injury according to the PECH rule: the affected area must be kept still and cooled immediately to counteract swelling and pain. Applying a moderate-tension pressure bandage may also help. In addition, the affected part of the body should be elevated to also relieve pain and swelling.

If a tendon rupture is suspected, a medical examination must also be carried out. Functional tests and X-ray examinations allow conclusions to be drawn about the exact injury. If the tendon ends are close together, an operation does not necessarily have to be carried out, as they can grow together on their own.

However, in the case of more complicated injuries, in which bone parts have also been torn out, or in the case of competitive athletes, an operation is often unavoidable.

The tendon stumps are sewn together using a specific suture technique. The affected area is then fixed with a splint or plaster cast for four to six weeks.

Also, depending on the extent of the injury, anti-inflammatory drugs are prescribed to prevent inflammation and chronic sequelae such as chronic tendinitis.

Physiotherapy can be started very quickly after the operation in order to promote the healing process. However, it is important that the tendon is not fully loaded for a period of up to four months after a tendon tear and that the training is only increased slowly.

Prevention

A tendon rupture can be effectively prevented by intensive warming up and a subsequent cool down and appropriate stretching exercises . In this way, the tendons become more elastic, more flexible and finally stretchable. This makes them less susceptible to overstretching or ruptures (cracks). Elastic bandages or tape bandages (bandage made of plaster tape) can prevent unwanted and unnatural movements. This supports and stabilizes the tendons during sports and protects against excessive strain and tendon tears.