Tendons are resilient, fibrous cords that connect muscles to bones. They enable movement by transmitting muscle contractions to the skeletal system. Tendons also absorb some impact during activities like running or jumping.
A tendon tear occurs when these strong tissues are stretched or divided, either partially or completely. This injury can cause significant pain, swelling, and limit proper joint function.
Understanding Tendon Tears
A tendon tear involves damage where the tendon fibers are disrupted. This differs from a muscle strain, which affects the muscle or its junction with the tendon. Tendon tears are classified by severity, ranging from mild to severe.
Partial tears, or incomplete tears, involve disrupted fibers but the tendon is not completely severed. A complete tear, or full-thickness tear, means the tendon has entirely separated from its attachment. These injuries can occur acutely from a single traumatic event, or develop gradually due to repetitive stress or degeneration. Common locations include the Achilles tendon, rotator cuff, and patellar tendon.
Immediate Steps and Diagnosis
Immediately following a suspected tendon tear, follow the RICE principles: Rest, Ice, Compression, and Elevation. Rest involves avoiding use of the injured area. Applying ice helps reduce pain and swelling. Compression helps control swelling, and elevating the injured area above heart level reduces fluid accumulation.
Seek medical attention if pain is persistent, severe, or if there is difficulty moving the affected joint. A sudden pop or snap followed by pain and loss of function suggests a tendon rupture and requires immediate evaluation. Diagnosis typically involves a physical examination to assess symptoms, range of motion, and identify any palpable gaps. Imaging, such as ultrasound or MRI, confirms the diagnosis and extent of the tear. Ultrasound offers real-time imaging, while MRI provides detailed views of soft tissues.
Treatment Pathways for Tendon Tears
Treatment for tendon tears depends on the tear’s severity, location, and individual factors. Non-surgical approaches are often considered first for partial or less severe tears. Conservative treatments include immobilization using braces or casts to allow the tendon to rest and heal. Pain management, including anti-inflammatory medications, reduces discomfort and swelling. Physical therapy focuses on gentle movements to maintain range of motion and prevent stiffness.
Surgical intervention is necessary for complete tendon ruptures where the tendon has fully detached. Surgery may also be recommended if conservative treatments fail or for active individuals requiring full strength and mobility. Surgery typically involves reattaching the torn tendon ends to each other or back to the bone. In some cases, a tendon graft or transfer might be required if the torn ends cannot be brought together.
Rehabilitation and Long-Term Recovery
Rehabilitation is fundamental to healing a tendon tear, restoring strength, flexibility, and function. Physical therapy begins with gentle range of motion exercises to prevent stiffness and promote mobility. As healing progresses, strengthening exercises rebuild muscle and tendon strength. Proprioception exercises improve balance and coordination, restoring full function and preventing re-injury.
Tendon healing timelines vary; mild injuries may heal in weeks, while severe tears or those requiring surgery can take months or over a year. A repaired tendon is weakest in the initial weeks post-injury, with strength gradually increasing over months.
Proper nutrition supports long-term healing. Protein is essential for tissue repair and collagen synthesis, a primary component of tendons. Adequate vitamin C is crucial for collagen production, and zinc contributes to tissue repair. Preventing re-injury involves proper warm-up routines and a gradual return to activity, avoiding sudden increases in intensity or volume.