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Symptoms and Signs of Ruptured Tendon

Doctor's Notes on Ruptured Tendon

A ruptured tendon is when the fibrous tissue that attaches muscle to bone tear or rupture. Signs and symptoms of tendon rupture include a snap or pop that you can hear followed almost immediately by severe pain. Other signs and symptoms include immediate or rapid bruising, weakness and inability to use or move the affected area (the arm, knee, foot, for example), swelling or deformity of the area and the person’s inability to bear or lift weight with the affected body part. Specific injuries can produce specific signs and symptoms; for example, the shoulder’s rotator cuff rupture will not allow a person to bring their arm out to the side while a quadriceps tendon rupture results in the inability to extend the knee completely.

Cause of a ruptured tendon in most people is direct trauma to the tendon that causes it to twist and tear or to pop apart when it exceeds its stress limit. Other causes that may lead to a ruptured tendon advanced age (decrease blood supply to tendons) and steroid injections to treat tendinitis. Medications such as quinolone antibiotics (ciprofloxin, levofloxin) and certain diseases (gout, hyperparathyroidism) are associated with increased chances of developing a ruptured tendon.

Medical Author:
Medically Reviewed on 3/11/2019

Ruptured Tendon Symptoms

  • An injury that is associated with the following signs or symptoms may be a tendon rupture.
    • A snap or pop that you hear or feel
    • Severe pain
    • Rapid or immediate bruising
    • Marked weakness
    • Inability to use the affected arm or leg
    • Inability to move the area involved
    • Inability to bear weight
    • Deformity of the area
  • Symptoms associated with specific injuries
    • Quadriceps rupture: You will be unable to extend the knee completely
    • Achilles tendon rupture: You will be unable to support yourself on your tiptoes on the affected leg (you may be able to flex your toes downward because supporting muscles are intact).
    • Rotator cuff rupture: You will be unable to bring your arm out to the side.
    • Biceps tendon rupture: You will have decreased strength of elbow flexion and decreased ability to raise the arm out to the side when the hand is turned palm up.

Ruptured Tendon Causes

In general, tendon rupture occurs in a middle-aged or older man. In the young, muscle tissue usually tears before the attached tendon will tear. But in older people and in those with certain diseases (such as gout and hyperparathyroidism), tendon rupture may occur.

  • General causes of tendon rupture
    • Direct trauma
    • Advanced age: As we age, our blood supply decreases. This decreased blood supply to the tendon results in weakness of the affected tendon.
    • Eccentric loading: When your muscle contracts while it is being stretched in the opposite direction, increased stress is placed on the involved tendon.
    • Steroid injection into tendon: This treatment is sometimes used for severe tendonitis.
    • Medications: Quinolone antibiotics, including ciprofloxin (Cipro) and levofloxin (Levaquin), have been associated with tendon ruptures.
  • Quadriceps tendon rupture
    • Direct trauma to the knee just above the patella (kneecap)
    • Advanced age resulting in decreased blood supply to the inside of the tendon
    • Combination of quadriceps contraction and stretching of the muscle (eccentric loading)
  • Achilles tendon
    • Advanced age resulting in decreased blood supply to the inside of the tendon
    • Strenuous physical activity by those who are not well conditioned
    • Direct trauma
    • Unexpected forcing of the sole of your foot upward (dorsiflexion of the ankle) as in landing on your feet after jumping from a height
    • Excessive strain while pushing off with weight-bearing foot
    • Having group O blood type (This is a controversial cause-and-effect relationship.)
  • Rotator cuff tendon rupture (most commonly to the supraspinatus)
    • Lifting a heavy object overhead
    • Direct trauma
    • Attempting to break a fall with an outstretched hand
  • Biceps tendon rupture
    • Forced flexion of the arm
    • Traumatic rupture usually occurs when lifting 150 pounds or more
    • Advanced age resulting in gradual weakening of the tendon
    • May occur spontaneously

Sports Injuries Types, Treatments, and Prevention Slideshow

Sports Injuries Types, Treatments, and Prevention Slideshow

Sports injuries are injuries that occur when engaging in sports or exercise. Sports injuries can occur due to overtraining, lack of conditioning, and improper form or technique. Failing to warm up increases the risk of sports injuries. Bruises, strains, sprains, tears, and broken bones can result from sports injuries. Soft tissues like muscles, ligaments, tendons, fascia, and bursae may be affected. Traumatic brain injury (TBI) is another potential type of sports injury.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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