Partial rupture of the Achilles tendon during a simulated fire ground task: Insights obtained from a case report for the prevention and reporting of musculoskeletal injury

Background: In this case report an incumbent firefighter partially ruptured his right Achilles tendon during a study of the physical demands of firefighting. Methods: Kinematics and kinetics of the lower limbs and trunk were collected while the firefighter performed two simulated fire ground tasks. From this unexpected event, two insights were obtained that should be considered in all future injury prevention and reporting efforts. Findings: (i) Consider the full anatomical linkage the right ankle and knee kinematics leading up to the onset of injury trial were comparable to all preceding repetitions. However, there was a notable difference in the left knee starting position before the initiation of movement of the 37th hose-advance trial. (ii) Consider the cumulative load the task in question comprised forward and backward phases. A marked difference was observed in the frontal-plane ankle moment during the return phase of the trial preceding the injury. Additionally, the magnitude of the left side vertical ground reaction force was comparable across all trials, suggesting that loads experienced by the right limb were also similar. This would indicate that the tolerance of the Achilles tendon and not the magnitude of the loading was altered. Interpretation: The unfortunate injury captured in this work provides insight into the complexity of characterizing the pathways of injury. It is recommended that future injury prevention and reporting efforts consider individuals physical demands (at work and in life) and document the nature of loading (i.e., frequency, duration, magnitude, type) when considering the mechanism for injury. Crown Copyright (C) 2013 Published by Elsevier Ltd. All rights reserved.