Friday, July 10, 2015

Achilles Tendon Injuries

Achilles tendon and calf muscle tears are problems that have recently become near and dear to my heart. This, much like tennis elbow is the source of many athletic midlife crises. The Achilles tendon is actually a combination of three separate tendons. The Gastrocnemius is the big, bulbous muscle that gives the calf muscle shape. The Soleus is a flat muscle that sort of resembles a fillet of sole, and the Plantaris is a very small muscle that does not seem to provide any substantial function.  The tendons of these three muscles come together to form the thick heel cord that is the source of many problems. 

Unfortunately, as we age the healing process is not quite enough to support the constant pounding that the Achilles tendon receives.  When an injury occurs, it is typically described as a feeling of being kicked in the back of the leg.  Typically these tendons are injured during an explosive events such as jumping, landing or starting a "sprint".  The typical age for this type of injury is between 40 and 50 years old and occurs predominantly in male patients. Up until recently, the recommendation was almost universally for surgical repair.  The rationale behind this was to decrease the rate of rerupture.  Now, with more advanced rehabilitation techniques, we are able to spare many people the pain of surgery.  In the highly athletic population however, there is still the belief that surgical repair improves the strength and function in the long run.  The recovery from any type of Achilles tendon rupture is quite long.  It frequently takes 6-12 months to completely recover from such an injury and requires intensive rehab.

-J Fallon