User:BryceH2331/Achilles tendon rupture

Causes
== The Achilles tendon is most commonly injured by sudden plantarflexion or dorsiflexion of the ankle, or by forced dorsiflexion of the ankle outside its normal range of motion. Other mechanisms by which the Achilles can be torn involve sudden direct trauma to the tendon, or sudden activation of the Achilles after atrophy from prolonged periods of inactivity. Some other common tears can occur from overuse while participating in intense sports. Twisting or jerking motions can also contribute to injury. ==

Fluoroquinolones
== Fluoroquinolone antibiotics, famously Ciprofloxacin, as well as other quinolones such as Pefloxacin, Ofloxacin, Norfloxacin, and Levofloxacin, are known to increase the risk of tendon rupture, particularly the Achilles. Tendon rupture occurs 95% of the time in the Achilles tendon, but other tendons are subject to ruptures such as the quadriceps, peroneus brevis (or fibularis brevis), biceps brachii, and supraspinatus. With increasing concerns regarding the adverse effect profile of fluoroquinolones, the Food and Drug Administration (FDA) implemented a Boxed Warning in 2008. A revision of the Boxed Warning occurred in 2016, recommending the reservation of fluoroquinolones when applicable. People who commonly fall victim to Achilles rupture or tear include recreational athletes, people of old age, individuals with previous Achilles tendon tears or ruptures, previous tendon injections or quinolone use, extreme changes in training intensity or activity level, and participation in a new activity. ==

Sports
== Most cases of Achilles tendon rupture are traumatic sports injuries. The average age of patients is 29–40 years with a male-to-female ratio of nearly 20:1. However, recent studies have shown that Achilles tendon ruptures are rising in all age demographics up to the sixth decade of life as remaining active has become popularized around the world. ==

Corticosteroids
== Direct steroid injections into the tendon have also been linked to rupture. The use of quinolone antibiotics can cause several forms of tendinitis and tendon rupture, including rupture of the Achilles tendon. The risk is higher in people who are older than 60, who are also taking corticosteroids, or have kidney disease; it also increases with dose and taking them for longer periods of time. As of 2016 the mechanism through which quinolones cause this, was unclear. ==