Posts Tagged ‘achilles tendon’

The Best Treatment for an Achilles Tendon Injury

Achilles Tendon InjuryAn Achilles tendon injury can affect your ability to perform the activities you enjoy and even your ability to walk. That’s why it’s important to talk to your doctor if you experience significant pain in your Achilles tendon, which connects the muscles on the back of your calf to your heel bone.

Types of Achilles Tendon Injuries

There are two common types of Achilles tendon injuries:

  • Achilles tendinitis: A gradual onset of pain, often from overuse. It can usually be treated with rest and rehabilitation.
  • Achilles tendon tear or rupture: A sudden injury that may feel as though you were hit or kicked in the back of the ankle. It usually affects your ability to walk properly and may require surgery to repair the rupture.

It’s crucial to know which type of Achilles tendon injury you have because treatment is very different for each form. If you suspect you have a torn Achilles tendon, seek treatment from a doctor specializing in sports medicine or orthopaedic surgery.

Achilles Tendon Injury Diagnosis

Your doctor will likely be able to tell if you have an Achilles tendon rupture from a physical exam by feeling the gap in your tendon. To know more about the severity of a tear, a magnetic resonance imaging (MRI) scan may be recommended.

Achilles Tendon Repair

If you have a torn Achilles tendon and are an active individual, surgery may be your best option. Sometimes a ruptured Achilles tendon can be treated with a brace, cast or splint that keeps your lower leg from moving. However, surgery decreases the chance of your tendon tearing again and requires a shorter recovery time. Your surgeon may wait a week after your injury to perform the surgery to allow swelling to decrease.

There are two forms of surgery to repair an Achilles tendon injury. Both involve your surgeon sewing your tendon back together through an incision.

  • Open surgery: The surgeon makes a single large incision in the back of the leg.
  • Percutaneous surgery: The surgeon makes several small incisions rather than one large incision.

Depending on the condition of the torn tissue, the repair may be reinforced with other tendons.

Rehabilitation for an Achilles Tendon Injury

Rehabilitation, especially physical therapy to strengthen your tendon and leg muscles, can also be helpful in treating an Achilles tendon injury, whether you require surgery or not. Most people can return to daily activities within four to six months, while high-impact athletes may need up to a year to heal before returning to play.

Achilles Tendon Ruptures and Repair

achilles tendonThe Achilles tendon connects the muscles in the back of your calf to your heel bone. There are two basic variations of Achilles injuries: Achilles tendonitis, and a complete tear. It’s important to know whether the Achilles is torn or not, because the treatment is very different: a torn Achilles may require surgery; Achilles tendonitis probably means rehab and rest. While tendonitis is a gradual onset of pain that tends to get worse with more activity, an Achilles tear is a sudden injury, and it feels as if you were hit or kicked in the back of the ankle. A tear usually affects your ability to walk properly.

Because an Achilles tendon rupture can impair your ability to walk, it’s common to seek immediate treatment. You may also need to consult with doctors specializing in sports medicine or orthopaedic surgery.

Tests and Diagnosis

During the physical exam, your doctor will inspect your lower leg for tenderness and swelling. In many cases, doctors can feel a gap in your tendon if a complete rupture has occurred. Achilles tendon rupture can be diagnosed reliably with clinical examination, but if there’s a question about the extent of your Achilles tendon injury then your doctor may order a magnetic resonance imaging (MRI) scan.

Repair

The best treatment for a ruptured Achilles tendon in an active individual is typically surgery. While an Achilles rupture can sometimes be treated with a cast, splint, brace, or other device that will keep your lower leg from moving, surgery provides less chance that the tendon will rupture again and offers more strength and a shorter recovery period. Surgery may be delayed for a period of a week after the rupture, to let the swelling go down.

There are two types of surgery to repair a ruptured Achilles tendon and both involve the surgeon sewing the tendon back together through the incision(s):

  • Open surgery – the surgeon makes a single large incision in the back of the leg.
  • Percutaneous surgery – the surgeon makes a number of small incisions rather than one large incision.

Depending on the condition of the torn tissue, the repair may be reinforced with other tendons.

Rehabilitation

After treatment, whether surgical or nonsurgical, you’ll go through a rehabilitation program involving physical therapy exercises to strengthen your leg muscles and Achilles tendon. Most people return to daily activity within four to six months, though high-impact athletes may take up to a year to return to sport.

About Dr. Labib

Sam Labib, MDSam Labib, MD, is a sports medicine fellowship-trained surgeon and director of the foot and ankle service at Emory. Dr. Labib started practicing at Emory in 1999. He is an Associate Professor of Orthopedic Surgery.

He has lectured both nationally and internationally at many orthopedic meetings. His research has been published in several journals, including the JBJS, Arthroscopy, Foot and Ankle International and the American Journal of Orthopedics as well as numerous video presentations and book chapters. Dr. Labib is Board Certified in orthopedic surgery with additional subspecialty certification in Sports Medicine Surgery.

For the past 5 years, Dr. Labib has been nominated by his peers as one of “America’s Top Doctors” as tracked by CastleConnelly.com. Dr. Labib has a particular interest in problems and procedures of the knee, ankle, and foot. He is the head team physician for the athletic programs at Oglethorpe University and Spelman College, and an orthopaedic consultant to the Atlanta Falcons, Georgia Tech and Emory University.

Related Resources

Preventing and Treating Achilles Tears

Brandon Mines, MDYou may know that Chamique Holdsclaw, one of my former Atlanta Dream players (not to mention one of basketball’s most gifted female athletes), suffered an Achilles tendon injury this year. While this injury is common with basketball players, it is most prevalent in men ages 35-45. They’re often the “weekend warrior” types—so the injury is more likely to happen when they overdo it, and when they don’t have a good stretching regimen.

There are two basic variations of Achilles injuries: a bad sprain, and a complete tear. It’s important to know whether the Achilles is torn or not, because the treatment is very different: a torn Achilles means surgery; a strained Achilles means rehab and rest. Some people with Achilles tears are misdiagnosed with sprains, only to find out later that they have Achilles tears and they’ve missed the window to have it fixed. (An Achilles tear should be repaired within four weeks of tearing it.)

Here’s the difference between an Achilles strain and a tear: a strain is a gradual onset of pain that tends to get worse with more activity. An Achilles tear is a sudden injury, and it feels as if you were hit in the back of the ankle—the tendon actually pops and tears in a sudden fashion. Most people who have this tear will actually say, “Somebody must have kicked me me because I felt it in the back of my heel/ankle.”

If you’ve suffered an injury like this, it’s important for you to see a sports medicine doctor immediately. You can also take our Ankle Quiz.

If you’re healthy and uninjured, be sure to do everything you can to keep it that way. Here’s are some tips to prevent Achilles injuries:

  • Exercise regularly; in other words, don’t jump into a game of full-court basketball after not working out for a year.
  • Wear shoes with a lot of support.
  • Warm up and stretch for 15 minutes before playing.
  • Stretch and stay warm during breaks in the action.

Do you have any questions about the prevention or treatment of Achilles tendon injuries? If so, be sure to let me know in the comments section.

About Brandon Mines, MD:

Dr. Mines has been practicing with Emory since 2005 and specializes in family practice and sports medicine. His areas of clinical interest include ankle, shoulder, hand, knee, sports injuries, upper extremities, and wrist. Dr. Mines holds organizational leadership memberships at the American College of Sports Medicine and the American Medical Society of Sports Medicine.