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An Outbreak of Achilles Ruptures and How You Can Avoid One

As Philadelphia sports fans, it seems that we’re surrounded by frayed and torn Achilles tendons – maybe it’s something in the water? The Phillies’ Ryan Howard (playing, but struggling), the Eagles’ Jason Peters (likely out for the season and sorely missed) and DeMeco Ryans (now back and healthy) and former Sixer Elton Brand (never fully recovered) all have been dealing with ruptured Achilles tendons and the painstaking rehab that follows surgery.

The Achilles tendon is at the back of the leg, connecting the two muscles of the lower leg to the heel bone. When it ruptures, it’s impossible to push down with your foot to take a step forward. The rehab is difficult for a variety of reasons.

“The blood supply to that area of the body is not good, and you don’t have much protective tissue there,” says Nicholas DiNubile, M.D., chief of the Section of Orthopedic Surgery at Delaware County Memorial Hospital and best-selling author of the FrameWork series of books. “Additionally, it’s a high-load area [that bears a lot of weight].”

It’s important to understand that recovery times are personal, and there’s some variety in how long it takes people to get back to what they consider “normal.” DiNubile says that the recovery time is also affected by how well the surgery goes – specifically, whether the tendon is restored to the proper length.

“A lot of it has to do with re-tensioning it properly,” he says. “These things don’t tear clean; they shred, so when you’re putting it back together it isn’t two clean pieces and you can’t always tell the length. It’s a bad injury. But they heal. It’s one of the few things that can actually be stronger [when all is said and done].”

So… how can you avoid this painful tear and the arduous rehab and maintain your position hitting cleanup on the company softball team?

DiNubile has five tips:

  • Warm-up. Especially as you age and your tendons degenerate, a gentle warm-up is essential before exercise.
  • Stretch. The Achilles snaps typically because it’s stretched too tight. You need to stretch it out before putting it under the stress of exercise.
  • Have a balanced workout. This is important. A lot of people don’t do a “total body workout” and tend to exercise the same body parts over and over. This can create imbalances in how the muscles and tendons work together, which can cause unhealthy stresses.
  • Don’t fall in love with plyometrics. Workouts based on explosive movements have become very popular and although they can be a useful training tool when done properly, especially in higher level athletes, they can be problematic in individuals over age 40 (listen-up baby boomers) whose tendons can become vulnerable due to age-related changes that occur. “A lot of people are working out harder and pushing themselves harder,” DiNubile says. “I’m not a big fan of plyometric training… maybe they’re overloading the tendon.”
  • Don’t smoke. Yes, really. Smoking, or anything that diminishes blood flow, can negatively impact an area that already has very poor blood flow.

Crozer-Keystone Health System offers comprehensive musculoskeletal care. From conservative approaches to managing pain to spine and hand services, sports medicine, and joint replacement surgery, the physicians of the Premier/Crozer-Keystone Orthopedics Partnership will determine what plan works best for you. Appointments within 48 hours; call 1-877-CK-MOTION (1-877-256-6846) or try our online appointment form

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