Last reviewed: 20 Sep 2021
Last updated: 05 Mar 2021

Summary

Definition

History and exam

Key diagnostic factors

  • acute onset of symptoms
  • mechanism of injury
  • severe pain
  • swelling
  • bruising
  • palpable gap in normal position for Achilles tendon (Achilles tendon rupture)
  • positive calf squeeze test (Achilles tendon rupture)
  • positive Matles test (Achilles tendon rupture)
  • positive biceps squeeze test (biceps tendon rupture)
  • positive Hook test (biceps tendon rupture)
  • pop sound
  • deformity

Other diagnostic factors

  • previous injury
  • symptom duration more than a few days
  • limited range of motion (ROM)
  • weakness

Risk factors

  • type of sports (basketball, ice skating, soccer, contact sports)
  • anatomic variation
  • eccentric exercise
  • pennate muscle architecture and type II muscle fibers (fast twitch)
  • muscle-tendon units that span 2 joints
  • previous history of ankle sprain

Diagnostic investigations

Treatment algorithm

Contributors

Authors

Senthil N. Sambandam, MBBS, MS, MRCS(Edn)

Staff Orthopaedic Surgeon

Department of Orthopaedics

VA Medical Center

Cheyenne

WY

Disclosures

SNS declares that he has no competing interests.

Varatharaj Mounasamy, MD, FRCS

Assistant Professor

Department of Orthopaedic Surgery

Virginia Commonwealth University

Richmond

VA

Disclosures

VM is an editorial board member, European Journal of Orthopaedic Surgery & Traumatology.

Sakthivel Rajaram Manoharan, MD, MS

Spinal Clinical Research Fellow

Queens Medical Centre

Nottingham

UK

Disclosures

SRM declares that he has no competing interests.

Acknowledgements

Dr Senthil N. Sambandam, Dr Varatharaj Mounasamy, and Dr Sakthivel Rajaram Manoharan would like to gratefully acknowledge Dr Issada Thongtrangan, a previous contributor to this topic. IT declares that he has no competing interests.

Peer reviewers

Quanjun Cui, MD

Assistant Professor

Department of Orthopaedics

University of Virginia

Charlottesville

VA

Disclosures

QC declares that he has no competing interests.

Nicola Maffulli, MD, MS, PhD, FRCS(Orth)

Professor of Trauma and Orthopaedic Surgery

University Hospital of North Staffordshire

Keele University School of Medicine

Stoke on Trent

UK

Disclosures

NM is an author of a study referenced in this topic.

Use of this content is subject to our disclaimer