Kobe Bryant Tears Achilles Tendon

Could This be the End of His Career?

During the fourth quarter of yesterday’s Los Angeles Lakers game, Kobe Bryant suffered a probable Achilles tendon tear in his left leg.  Probable, because he will undergo an MRI to confirm the diagnosis.

However, a complete tear is easily diagnosed by clinical examination. A doctor will perform what is called the Thompson’s test, whereby the patient is lying on his stomach and the doctor will squeeze the calf muscle.  The foot should move up and down if the Achilles is not ruptured.  If it is, the foot will not move.

The Achilles tendon attaches the calf muscle to the back of the heel bone.  It is a very thick and strong tendon and not easy to tear, but it is still a common injury. Causes of Achilles tendon tears can be caused by overuse, such as in sports, when one does too much, too fast, and too soon.  Combine that with lack of stretching, then you have a great recipe that can lead to this type of injury.

In addition, the injury is common in professional athletes because of the tremendous force that is applied to this tendon while playing their sport.  It usually occurs as the foot is planted on the ground and then there is a quick rotation of the leg and ankle.  So, in Kobe Bryant’s case, as he planted his left foot, he quickly turned his body, causing the tendon to snap.

Bryant is 34 years old and has played more minutes per game during the month of April then in any other time during his prodigious NBA career.  This has definitely caused a lot of wear and tear on his body.

Other causes for this type of injury is wearing high heels, which causes a lot of stress on the tendon, as well as trauma to the tendon, such as a blow to the area.

Bryant will need surgery to repair this tendon, and recovery will be anywhere from 6 months to a year.  This type of injury ended careers of Dan Marino and Charles Barkley.  Hopefully, this is not the end for Kobe.

If you are having pain at the back of your heel, you should see your podiatrist.  AtFamily Foot & Ankle Specialists in Piscataway and Hillsborough, NJ, 
we see and treat a lot of athletes with this sort of injury. 

To get more information on foot and ankle injuries, get our free book, "Stop Foot Pain Fast: A User's Guide to Foot and Ankle Health.

If you are experiencing foot or ankle pain, call to get a FREE appointment at our Piscataway podiatrist office.

Big Papi Grounded With Heel Pain

David Ortiz, also known asBig Papi, the designated hitter of the Boston Red Sox, is presently sidelined with heel pain.  Heel pain should not be taken lightly.  In matter of fact, JoeDimaggio, the great centerfielder of the New York Yankees, was on the disabledlist for three months with heel pain.  The difference is that Joe D suffered from a condition called plantar fasciitis, where Ortiz has Achilles tendinitis.

Plantar fasciitis is the mostcommon cause of heel pain, but if your pain is at the back of the heel, then the usual culprit is the Achilles tendon.  The Achilles tendon is that thick tendon at the back of the ankle and attaches to the heel bone.  This tendon becomes the calf muscle.

Achilles tendinitis is verycommon especially in athletes or in people over the age of 40.  Athletes tend to torque their bodies in such a way that it puts excessive strain on the tendon.  Achilles tendinitis will also occur in people who have very high arches.  In this case, the tendon becomes shorter and tighter.  So, any strenuous activities can lead to an inflammation of this tendon.  People with very flat feet also can get Achilles tendinitis because the heel is over-pronating, meaning it is turning outward excessively, causing the arch to collapse.  This leads to the torque of the tendon, which causes the pain.

Activities that make you runon the balls of your feet are also the culprit, such as runners who run on their toes, basketball and volleyball players who are constantly jumping, and sports that require ballistic movements such as baseball and football.  The key to prevention is to make sure one always stretches before and after the activity.  Caution: Never stretch a cold muscle or joint, so always warm up first.

Another cause of heel pain at the back of the heel is a condition called retrocalcaneal bursitis.  There is a bursa (sac of fluid) between the bone and the tendon.  This structure prevents excessive friction of the tendon from the bone when it moves.  In a lot of these cases, the heel bone will be thickened in this area with a prominent “bump.”  This irritates the bursa and now you have bursitis.  The bump is also called a pump bump, because it rubs against the back of pump style shoe. 

The main treatments for these conditions are rest, ice, and a compression sleeve.  A lot of times a heel lift will be applied into both shoes to allow for the Achilles tendon to rest.  This should only be used for a very short time, because the bottom line is that you want to stretch out the tendon, and not shorten it.  Physical therapy is an extreme necessity in most cases.

If the cause of the tendinitis is biomechanical, meaning the way the foot functions during gait,then a custom orthotic is very beneficial.  If the above treatments do not help, then there are many newer treatments and technologies out there that can help.  At Family Foot & Ankle Specialists inPiscataway/Hillsborough NJ, we employ most of these treatments.

The first one is extracorporeal shock wave therapy, also known as ESWT.  This is a non-invasive procedure that is done in the office.  After the area is numbed, the ESWT machinewill send deep, penetrating sound waves into the heel.  This will break down any scar tissue that might be present as well as to increase blood flow to the area.  The patient can walk immediately and will find relieve within the next couple of months.

In addition, the K-Laser is an FDA-approved laser for the use of pain resulting from all types of tendonopathies.  The procedure is also totally non-invasive and does not require any anesthetic.  The laser is painless and takes about five minutes.  Usually 10-12 treatments are required.  At Family Foot & Ankle Specialists, we have had wonderful results using this laser for these problems. 

The key is that if Achilles tendonitis is not treated quickly, scar tissue can result, making the treatments more difficult and increasing the liklihood of a less than optimum result.  So, you should not let the problem linger for too long.  Call your local podiatrist and get back into the game.  

Is Shaq’s 3 Month Achillies Recover Normal?

At 39 years old, Shaquille O’Neal has had quite the basketball career. This year, he has fallen on hard times. In February he suffered an achillies tendon injury and in April only 2 quarters after returning to the game, he goes out with a calf muscle injury. Is this the beginning of the end for the famous Shaq? Three months after the original injury and the Celtics are still Shaq-less.

The Achillies tendon is the largest and strongest tendon in the body and attaches the calf muscles to the heel. There are a few different achillies tendon injuries. First, the most minor injury is tendonitis. This is typically the result of overuse. Basketball players are extremely susceptible to such injuries since they frequently push off and jump off their toes. Thus, there Achillies is much over used. An achillies tendon can also become torn or completely ruptured. This is another injury commonly seen in basketball. This occurs when one pushes off or contact is made with an already contracted muscle. The tendon will tear in the weakest spot and if the force is strong enough, the tendon will completely rupture.

Since the achillies is the largest and the strongest tendon, it is also the hardest tendon to heal after an injury. Even tendonitis, the most minor achillies injury can sometimes lead to surgery! Statistics show that over 25% of all those with chronic achillies tendonitis go on to have surgery. For acute injuries, rest is the key. For low grade tendonitis, a 1-2 week rest is recommended. For higher grade injuries, a month of rest in needed for recovery. After the rest period, a slow progression back to your activities in recommended. Relative rest does not mean a break from all physical activity, but rather cease in activities that have high impact on the achillies and supplementing activities with appropriate bracing. Depending on the degree of injury will determine the level of rest needed for repair. Achillies tendon tears or ruptures often need surgical repair or a series of casting.

It is most typical for achillies tendon injuries to occur in men in their 40s. Weekend warriors commonly injure their achillies when they pick up a game of basketball after weeks, months or years of a less active lifestyle. Unfortunately, the recovery time with achillies tendon injuries is very cumbersome. Many spend a length of time in casts or in walking boots. A change of activities is necessary. This drives many crazy and anxious to get back to their activities. Many often rush the recovery and what was originally an acute tendonitis or a partial tear becomes a chronic problem.

Shaq is the oldest player in the NBA and may be now considering retirement. Achillies tendon injuries cripple a player’s season and for Shaq being near the end of his career, this may be the injury that fades him out of the basketball scene.