Monday, October 10, 2011

There is a reason why they call it the Achilles

We’ve been talking about skin problems the last couple weeks, and we will return to that subject next week.  But this week something happened that has convinced me to discuss something else.

The Philadelphia Phillies are a baseball team that was expected to reach the World Series this year.  However, they were on the brink of being eliminated from the playoffs by the St. Louis Cardinals this last week.  Ryan Howard, the 1st baseman for the Phillies was Philadelphia’s last hope.  Unfortunately, he made the last out to end the game.  To make matters worse, as Howard tried to run to first base, he fell to the ground in pain.  Once evaluated, it was apparent that he had ruptured his Achilles tendon.

Achilles tendon ruptures are common and often happen with abrupt pivoting movements or when someone starts exercising after a long period of inactivity.  When it happens, the person describes the event as if they were hit in the back of their heel with a bat and they hear an audible pop.  Incredibly, they will still be able to walk, but with dramatic difficulty.  If you run your finger up the back of the heel, you’ll feel a depression or soft spot instead of the normal tense tendon inserting into the heel.  Some ruptures are partial while others may be complete.  If the rupture is bad enough, the tendon can recoil on itself like a fruit rollup.

If you try to treat a rupture conservatively, the recovery time is longer and the risk for re-rupture is very high.  For that reason, ruptures are most effectively treated with surgical repair.  Although you take on the risks of surgery, surgical repairs allow for better results long term.  You often can resume exercise sooner, the motion in the ankle is better, and overall the patients have fewer complaints.  Your podiatrist is a skilled surgeon that can perform this surgery and help you along your road to recovery.