Weekend Dr. Achilles Tendon Rupture

Weekend Doctor

By DR. THOMAS F. VAIL

You may have heard recently that “Jeopardy’s” Alex Trebek ruptured his Achilles tendon while chasing a burglar down the hall at his San Francisco hotel.

On July 27, Trebek was using crutches before opening the final round of the National Geographic World Championship. He explained that a female burglar broke into his hotel room at 2:30 a.m. July 26, while staying at the downtown Marriott, when he and his wife were sleeping.

Awakened by the intruder, he chased her down the hallway, but his Achilles tendon ripped, causing him to fall and bruise his other leg in the process. He had surgery last week.

Rupturing or tearing of the Achilles tendon is a common condition. This typically occurs in an individual who sustains the rupture while playing sports or perhaps from tripping. There is a vigorous contraction of the muscle and the tendon tears.

The patient will often describe the sensation as someone or something has hit the back of the calf muscle. Pain is suddenly present and, although it is possible to walk, it is painful and the leg is weak.

While it is possible to treat this ruptured tendon without surgery, this is never ideal since the maximum strength of the muscle and tendon never returns. Surgical correction of the ruptured tendon is necessary.

The surgery is performed in order to regain the maximum strength of the Achilles, as well as the normal pushing-off strength of the foot.

There are two types of surgery to repair a ruptured Achilles tendon:

• In open surgery, the surgeon makes a single large incision in the back of the leg.
• In percutaneous surgery, the surgeon makes several small incisions rather than one large incision.

In both types of surgery, the surgeon sews the tendon back together through the incision(s).

Surgery may be delayed for about a week after the rupture to let the swelling go down.

After either type of surgery, you will likely wear a cast, walking boot or a similar device for six to 12 weeks.

At first, the cast or boot is positioned to keep the foot pointed downward as the tendon heals. The cast or boot is then adjusted gradually to put the foot in a neutral position, not pointing up or down.

Many health professionals recommend starting movement and weight-bearing exercises early, before the cast or boot comes off. Your total recovery time will probably be as long as six months. Walking and exercise are very important after the surgery and a careful physical therapy program will be required.

In general, both open and percutaneous surgeries are successful. More than 80 out of 100 people who have surgery for an Achilles tendon rupture are able to return to all the activities they did before the injury, including sports.

If you suspect you have an Achilles injury, make an appointment as soon as possible with a podiatrist.

Vail is with Advanced Footcare Clinic, Findlay. Questions for Blanchard Valley Health System doctors may be sent to [email protected], or to Weekend, The Courier, P.O. Box 609, Findlay, OH 45839.