Tendons are strong connective tissues that link muscles to bones, enabling movement. They also absorb some impact, helping to prevent muscle injury. While robust, tendons can tear due to sudden, forceful movements or through gradual wear and tear from overuse and repetitive motions.
Signs at the Moment of Injury
When a tendon tear occurs, individuals often experience immediate sensations. A sudden, sharp pain at the injury site is a common indicator. Many people also report hearing or feeling a distinct “pop” or “snap” at the moment the injury happens. This sensation can be likened to a thick rubber band breaking under tension. Following the pain, there is often immediate weakness in the affected limb. This weakness can manifest as an inability to move the injured area or to bear weight on it, depending on the tendon involved.
Developing and Ongoing Symptoms
Beyond the immediate onset, a tendon tear often leads to a progression of symptoms over hours or days. Swelling around the injured area is a common response, as the body initiates its healing process. Bruising may also appear, sometimes spreading away from the injury site.
The injured area becomes tender to the touch, with pain worsening upon direct pressure. A visible deformity or gap can be observed where the tendon has retracted, indicating a complete tear. Stiffness and a grating or crackling sensation, known as crepitus, may also be present when attempting to move the affected joint.
Common Tear Sites and Their Specific Signs
Understanding the unique signs associated with tears in common tendons can help identify the injury.
Achilles Tendon Tear
An Achilles tendon tear, at the back of the ankle, causes difficulty pushing off the foot and an inability to stand on tiptoes. A noticeable gap may also be felt or seen just above the heel.
Rotator Cuff Tears
Rotator cuff tears, affecting the shoulder, cause pain during overhead movements and weakness when attempting to lift the arm. Difficulty sleeping, particularly when lying on the affected side, and a popping or clicking sound with arm movement may also occur.
Bicep Tendon Tear
A bicep tendon tear, usually in the upper arm, can lead to a visible bulge resembling a “Popeye” muscle. Weakness in bending the elbow or rotating the forearm (turning the hand palm up) is also reported.
Patellar Tendon Tear
For a patellar tendon tear, below the kneecap, it may be impossible to straighten the leg or bear weight on it. A visible indentation or the sensation of the kneecap moving higher than normal can also indicate this type of tear.
First Aid and Medical Consultation
Upon suspecting a tendon tear, immediate first aid measures can help manage symptoms before medical evaluation. The RICE method (Rest, Ice, Compression, and Elevation) is recommended. Resting the injured area prevents further damage, while applying ice can reduce pain and swelling. Compression with a bandage helps limit swelling, and elevating the limb above heart level promotes fluid drainage.
Seeking prompt medical attention is important for an accurate diagnosis and appropriate treatment plan. A healthcare provider will perform a physical examination to assess the injury. Imaging tests, such as X-rays, MRI, or ultrasound, may be ordered to confirm the diagnosis and determine the extent of the tear.