Transforming patient information into patient understanding.

A very brief course in Greek Mythology.  Achilles was a mighty Greek warrior who had only one weak spot.  It was his heel.  An arrow pierced his heel during a fierce Trojan War battle.  It caused his death.

A very brief course in Orthopaedic anatomy.  The achilles tendon is the largest and strongest tendon in our body.  It connects the large calf muscles to the heel bone (calcaneus).  The achilles tendon is able to withstand tremendous forces.

Common Injury

The achilles tendon is the body’s most frequently ruptured tendon even though it is the biggest and strongest.  It takes quite a pounding during sports or running.

Weekend Athletes

Achilles tendon ruptures are especially common among men age 30 – 50 who play stop and go sports like tennis, basketball and racquetball.  It is even more common among weekend exercisers who do too much too fast.  They fail to warm up before exercise and run more miles than usual. Running on a different surface can cause a problem too it seems.

Why Does It Rupture?

It would be impossible I think to rupture a normal achilles tendon.  You could never apply that much force to it in any of our activities.

An insidious wear and tear process begins without warning in the tendon itself that weakens it and leads to rupture when sudden stress is applied.  It’s sort of like osteoporosis of the tendon, in a sense.  When it weakens enough and the stress applied is just right, it just goes – BOOM.  You never knew anything was wrong with it before it ruptures.

Symptoms

I have taken care of hundreds of ruptured achilles tendons and almost all of the patients (90% men) say they were running, jumping or twisting somehow and felt an intense, sharp, sudden pain in the back of the ankle or calf.  No one ran into them or was even near them.  It just happened – BOOM.  They can’t walk right because when the achilles ruptures you have no power in your foot.  It feels floppy.

It would be hard to ignore, but I have had a few men come in a few days later because they thought it was a bad ankle sprain.  It wasn’t.

Doc, What About Tendinitis?

Sometimes in the fortunate few, a person will begin to have soreness or pain in the area of the achilles tendon which becomes worse with exercise.  Rarely the pain may actually improve with exercise.

Again this condition is also seen mainly in men.  It comes on typically following a change in training habits.  Pain may range from annoyance to significant disability.  The pain can be where the tendon attaches to the calcaneus or two inches above this in the area of the body of the tendon.

Evaluation

In either case, rupture or tendinitis, it is something I should be checking to determine what the correct diagnosis is and what the best treatment may be.

If you will please join me next week, I will be covering treatment of achilles tendon rupture and achilles tendinitis for you.

It is a privilege to be able to write these articles for you and have them published in the Gratiot County Herald.

This is my 83rd consecutive article!  I’ll let you know soon when each and every article will be on my office teaching website  www.orthopodsurgeon.com,  which takes you to Your Orthopaedic Connection.

Our goal is simple – To help people return to more pain free, functional lives.  I specialize in you.

Good health.  Good life.  All the best to you.

Be well.

Dr. Haverbush