Wednesday, April 6, 2011

All you wanted to know about Achilles injuries.

What Really Happened to David Beckham and Can It Happen To You?

On Sunday March 14, 2010, the world’s most elite soccer player lost his chances of entering The World Cup due to a sports injury. This injury was an Achilles tendon rupture, often a career-ending injury for soccer, tennis, football and basketball players.

The Achilles tendon is made up of fibrous tissue bonded together in a ropelike manner. The tendon connects the heel bone to the calf muscle in each individual. It is the largest tendon in our body and is capable of bearing large amounts of weight. The function of the tendon is to pull the heel off the ground and allow the toes to push off the ground in order for us to make a step as the calf muscle tightens. The ‘tendon’ is actually a combination of the three muscles of the lower leg, often called the gastrocnemius complex. The ‘tendon’ is the terminal attachment of the Soleus Muscle, as well as the Medial and Lateral Gastrocnemius muscles. The action of the tendon/muscle group is necessary to allow walking, running, and different activities such as participating in sports. Once an interruption (tear) is made through this band of fibers, a simple task such as walking becomes unbearable. This condition is known as an Achilles tendon rupture. Bruising, swelling, redness, inflammation, pain and sensitivity in the back of the affected leg are just a few of the symptoms to mention that result after a rupture. Patient may also hear a sudden pop as the injury occurs. Often, patients relate being hit with a 2x4 or feeling like they were shot in the back of the leg!

The chances of a rupture increase as the tendon grows weak. This weakness can occur due to aging, medications such as corticosteroids (and some drugs known as Quinolones) as well as conditions like arthritis. With that said, it is important to know that tendo Achilles rupture is most common in middle aged men, especially those known as “weekend warriors” who play an extensive amount of recreational sports such as basketball, soccer, surfing, etc. after a long time of no activity. A sudden fall, a sudden push-off of the foot with the knee straightened can all result in injury.

It is important to seek medical care as soon as the injury happens. Podiatrists are trained to diagnose an Achilles tendon rupture by some important and simple clinical testing techniques. An MRI or ultrasound are then ordered to verify the rupture and determine the level at which the rupture has occurred. Once a rupture is confirmed, surgical and nonsurgical treatment plans are decided by the physician. Both are a long term course of treatment that can last about 6 months. Immobilization, casting, and physical therapy are some standards to achieve the ultimate goal of treatment which is restoring the original length and strength of the tendon.

A word of advice from your sports podiatrist: always RICE after any injury. To RICE is to Rest, Ice, Compress and Elevate the site of injury.

Unfortunately Beckham’s injury crushed his hopes for a chance to win at the world cup and is causing him to miss a big portion of the MLS season. We all wish him a full recovery to return to the sport that he loves most.