Achilles Tendon Rupture – Young Adult Female Volleyball Player

• Main Authors: Botterbusch, Katie M, Vicencio, Lisa A, Seamans, Abigail G, Stamatis, Andreas, Dr.
• Format: Text
• Language: unknown
• Published: TopSCHOLAR® 2021
• Subjects: Serotonin Toxicity; Tendinopathy; Sympathetic Nervous System; Ultrasound; Clinical Exercise Physiology; Health and Physical Education; Medical Education; Sports Sciences; Iceland
• Online Access: https://digitalcommons.wku.edu/ijesab/vol2/iss13/88; https://digitalcommons.wku.edu/cgi/viewcontent.cgi?article=4785&context=ijesab

CASE HISTORY: A 25-year-old professional volleyball player, who was playing in a game in Iceland, was transitioning off the net back-pedaling and pivoting as she felt something pop in her right calf. Initially, the athlete denied having any pain but was unable to plantarflex her foot or weight bear. At the time of injury, she was taking Sertraline (HCL 50 mg), Trazodone (50 mg), Wellbutrin XL (Bupropion HCL) 150 mg, Adderall (5mg) and birth control. PHYSICAL EXAM: The athlete was evaluated at an emergency room, where a Thompson squeeze test was performed and determined positive for an acute Achilles tendon rupture. The athlete was placed in a soft cast and was scheduled to be treated nonoperatively. DIFFERENTIAL DIAGNOSES: Acute Achilles tendon peritendinitis, medial gastrocnemius tear, calf muscle strain or rupture, posterior tibialis stress syndrome, posterior tibialis tendon injury, and peroneal injury. TESTS & RESULTS: Approximately one week after her initial diagnosis, she made arrangements to return to the US and to be re-evaluated by an Orthopedic surgeon. During the evaluation, the athlete reported pain over the Achilles tendon. Objectively, another positive Thompson squeeze test was performed. There was swelling over the Achilles tendon and a definite defect on the distal ⅓ of the tendon. There was no pain over the insertion point at the calcaneus or calf pain. An Ultrasound Duplex Doppler scan was performed to confirm the initial diagnosis and assess for deep vein thrombosis (DVT). Gray scale, color and imaging of the deep venous system of the right leg was performed from the level of the common femoral vein down to the level of the popliteal vein. There was no echogenic clot seen within the venous lumen. The veins tested exhibited normal compression and augmentation properties with color flow demonstrated within the tested veins. There was no evidence of DVT in the right leg. Evaluation before surgery showed obvious edema over her Achilles and a definite defect on the distal third of her Achilles. ...