Tag Archives: achilles tendon rupture

Baltimore Raven Terrell Suggs Ruptures Achilles Tendon

Written by: Teresa Hall, PT, DPT, OCS

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Bad news for football fans today: top defensive linebacker Terrell Suggs of the Baltimore Ravens will likely be out for the 2012 season because of a ruptured Achilles tendon. This injury is particularly devastating to an athlete because of the prolonged recovery time, which usually means the player is out for a year.

 

The Achilles tendon is the biggest and strongest tendon in our body, connecting the two powerful calf muscles, the gastrocnemius and soleus muscles, to the heel bone. Its duty is to handle the force of the calf muscle’s powerful contraction with pushing off to run, jump, and even walk. It is usually torn when someone jumps or makes a forceful push-off movement. Less often, it can be torn by something hitting the tendon. The athlete will commonly say they felt like someone kicked them in the back of the leg when the tendon tears.

 

Achilles tears are very easy to diagnose. A clinical diagnosis can often be made by feeling the back of the leg and squeezing the calf. This is known as the Thompson test. The clinician is looking for the foot to move when the calf is squeezed. If no movement is detected, an Achilles tear is to blame. The diagnosis can also be confirmed with a MRI or ultrasound.

 

The management of a tear can be conservative or surgical. Conservative treatment involves casting and extensive rehab, and is usually more favorable for non-athletes. Athletes like Suggs will typically have an Achilles repair surgery because of the demands on their body with athletics. A surgeon will open the back of the leg and suture the torn ends of the tendon back together. The patient is then usually immobilized in a cast or boot and not allowed to bear weight for the first 4 weeks or so (protocols vary). The patient will then begin a rehab program aimed at gradually beginning weight bearing and gentle stretching exercises. Strengthening typically begins around 6 weeks post-op, with gradual increase in resistance. The athlete is usually not allowed to run until 6 months after surgery, and full jumping and sport-specific drills sometimes even longer than that. The reason the recovery is so long is due to tissue healing times and the risk of re-rupture, which would be devastating to an athlete. One study found that the re-rupture rate is about 4.5 %, which is consistent with most literature and happens more often in people less than 30 years of age.1

 

Fans will have to wait to see the outcome of Suggs’ injury and recovery until next season.

 

Is NY Knicks Wonder, Jeremy Lin, Out for the Season?

Written by: Tim Abel, PT, DPT

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As a lot of you know, Jeremy Lin, point guard for the New York Knicks, underwent surgery on his knee to repair a torn meniscus. This is really unfortunate for the Knicks because Lin was playing well, and they are fighting for the last playoff spot in the Eastern conference. Lin’s timeframe to return to action was put at 6 weeks.

 

Although you might not hear about meniscus injuries in sports as much as you do an anterior cruciate ligament (ACL) tear or Achilles tendon rupture, we see a large population of individuals both athletes and non-athletes alike that suffer meniscal injuries each year. The meniscus is a “C” shaped structure in the knee composed of cartilage. It sits between your femur (the thigh bone) and tibia (the shin bone). You have two in each knee, a medial (inside) and lateral (outside) meniscus.

 

The meniscus has many functions, the most important being shock absorption as your leg supports your body weight, but the meniscus also aides in joint stability, joint nutrition and proprioception. The meniscus is typically torn when someone is twisting, turning, or changing directions with their foot planted on the ground. Symptoms can include swelling, pain along the joint, clicking, and even locking of the knee in some cases. The treatment options for a meniscus tear are typically one of three including rehabilitation (Physical Therapy, PT), menisectomy (removal of injured portion via arthroscopic surgery), or meniscal repair (surgical fixation via arthroscopy). There is also a less common technique called a meniscus transplant, where surgeons replace the injured meniscus with one from a cadaver.

 

Factors for determining which treatment option will lead to the best recovery are the location and size of the tear. The inner portion of each meniscus is avascular, meaning it does not have a blood supply. Tears in the avascular portion are often removed instead of repaired because of the limited potential to heal. Meniscal repairs are most successful when tears are in the vascular portion of the meniscus, which is located along the outside of the meniscus.

 

Let’s hope Lin’s injury was in an area with good blood supply, because with the amount of running, cutting, twisting, and jumping in basketball, he is going to need strong, healthy knees. I personally don’t think Jeremy Lin will see any more playing time this season, especially because if the Knicks make the playoffs, they will likely face the Chicago Bulls or Miami Heat, and won’t be around for too long. Do you think Lin will make a comeback this season?

 

Reference:  Dutton M. Orthopaedic examination, evaluation, and intervention. 2nd ed. McGraw Hill; 2008.