Pop Goes the Tendon

Lateral view of the human ankle, including the talus (Photo credit: Wikipedia)

The Achilles tendon is a tough fibrous cord which attaches the calf muscles of the lower leg to the heel bone. When overstretched, the tendon can become inflamed and sore. This is called Achilles tendonitis. In many instances home treatment is successful when done under a doctor’s supervision. If further damage occurs to the tendon, small tears may begin. These tears are also called ruptures, and may be partial or complete. A rupture results in sharp pain and the inability to walk normally. Sometimes there is an audible “pop” when the tendon first ruptures. Other symptoms include:

• Pain and swelling in the heel area, and pain may be severe.
• Unable to bend foot downward.
• Inability to raise up on toes.
• Popping noise when injury first occurs.

Rupture of the tendon usually occurs near the point where the tendon attaches to the heel bone. Ruptures are most frequently caused by increase in physical activity, traumatic injury like falling high up or stepping into a hole.

Men between the ages of 30 and 40 present the greatest risk for Achilles tendon rupture. Also, the likelihood is increased if you participate in recreational sports that involve running, jumping and quick starts and stops. There are also certain types of medicines that can increase the risk of tendon rupture.

Because an Achilles tendon rupture affects your ability to walk, you should seek immediate treatment. Dr. Blaakman has certain tests he can perform to determine if it is your Achilles tendon and the degree of rupture. He may order additional tests like an MRI so he can view the extent of the damage. This is a painless test that creates a computerized image of the tissues in your body.

Both non-surgical and surgical treatment methods are common. Younger more active people may choose surgical repair to try to get back to their routine quicker, while older individuals may choose non-surgical methods.  Non-surgical methods may work equally well, but probably take a bit longer to heal and run a greater risk of the injury recurring. You would be required to wear a boot or cast for a period of time while the tendon mended itself.

Surgical correction is done through an incision, whereby the tendon is sewn back together. As with any surgery, infection is a possible risk. Regardless of the treatment method, a rehabilitative time of 4-6 months is necessary during which time you will undergo muscle strengthening exercises and physical therapy.

Exercises that strengthen the calf muscles can help prevent a rupture. Also alternating activities to avoid overuse is important as well as gradual increase of duration and intensity of exercise. If you have tendonitis or an Achilles rupture, contact Dr. Blaakman at (877) 941-3338. Don’t wait for things to get worse. A little help from Dr. Blaakman and you’ll be right back up and running in no time.

References:

http://www.mayoclinic.com/health/achilles-tendon-rupture/DS00160/DSECTION=prevention

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Haglund’s Deformity-A Walking Nightmare

Image via WikipediaHaglund’s deformity, sometimes referred to as the “pump bump” is a bony protrusion in the heel area, which is thought to be caused primarily by pressure from shoes, although there may be other factors involved. Between the bone and the Achilles tendon is a small sac of lubricating fluid which allows for easier movement. A prominent heel bump can squeeze the soft tissue between the bone and the shoe. This can cause inflammation and a build-up of tissue that creates even more pressure.

The most notable symptom of Haglund’s deformity is pain in the back of the heel. The tissue that thickens in this area and forms a callus type buildup doesn’t usually impede function or interfere with walking, but the bursitis, which causes swelling and inflammation, can create a great deal of pain when shoes are worn.

Diagnosis of Haglund’s deformity can usually be made visually, but our office will probably want to get x-rays to have a better picture of how the heel bone is shaped, and rule out other possibilities that might cause your heel pain.

Treatment can be either non-surgical or surgical. However, much of that depends upon your diagnosis.  Below are some non-surgical options, which include, but not limited to:

    •    Taking over-the-counter medications - such as Ibuprofen to reduce swelling and discomfort.

    •    Icing the area – you can use a towel between ice and skin, and apply it  to the inflamed area for 20 minutes, then wait at least 40 minutes before applying again.

    •    Exercising – this will help relieve tension in the Achilles tendon.

    •    Heel lifts or heel pads – these may help relieve pressure and lessen irritation.

    •    Changing your shoes – wearing a backless shoe will help to avoid irritation.

You can find more information by clicking here.

If non-surgical treatments fail to provide relief, surgery may be required. Dr. Blaakman will determine what course of treatment best suits you.

If you have swelling and pain in one or both heels, call our office at (877) 941-FEET (3338).

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