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.  

Losing Weight Workouts without Foot Pain

The optimistic visions of the New Year are contagious. Lofty goals are being set and we all aim high in January. Still, many of us hold back. We paddle through a long list of excuses on why this year is not the year. Weight can be a huge aggravator for foot pain. Losing weight helps foot pain, but how do you lose weight when you can barely walk without pain?

In a survey done by the American Podiatric Medical Association, 72 percent of Americans says they do not exercise because of foot pain. First, foot pain is not an excuse and will not be accepted as one in my office! If you are having foot pain that is keeping you from healthy activities then something is wrong and you need to be treated. There are a variety of reasons that you may be having foot pain. Common conditions like plantar fasciitis require treatments such as cortisone injections, physical therapy, and night splints. Occasionally surgery is needed but this is a last resort.

The first thing to evaluate is your shoes. Not just the shoes you exercise in but all of your shoes. Most of us wear bad shoes or none at all. Whether it is dress codes or personal style, we do not give our feet enough room or support. We also love to kick the shoes off. Yes, walking barefoot around your house can be very bad for your feet! Some of us need extra support all of the time. Your shoes should be wide enough, long enough and have support in the arch area. Some athletes have trended towards the minimalist shoes or barefoot running. Is it ok? For some people, yes it is ok, but this is not for everyone and is only for the elite athlete with impeccable foot structure. Very few of us have the foot type that can bare the abuse.

Next is to evaluate the type of activities you are doing. Some sports or work outs have a higher impact on your feet than others. Swimming and biking have very low impact on the feet and are great alternatives if you are struggling with your feet. Other activities put a greater demand on your feet such as running on a treadmill or blacktop. You must also evaluate the consistency of high impact activities. Alternating between low and high impact activities will keep you doing what you love but also keep you on your feet!

It is that time of year to be optimistic. You will cure your foot pain, get back to the gym and lose the weight! First find the source of the pain, seek treatment, and stay focused. It is easy to find excuses and the foot is an easy target. Don’t let your feet get the best of you. 72 percent is an unreasonable amount of Americans struggling with foot pain.

Losing Weight Workouts without Foot Pain

The optimistic visions of the New Year are contagious. Lofty goals are being set and we all aim high in January. Still, many of us hold back. We paddle through a long list of excuses on why this year is not the year. Weight can be a huge aggravator for foot pain. Losing weight helps foot pain, but how do you lose weight when you can barely walk without pain?

In a survey done by the American Podiatric Medical Association, 72 percent of Americans says they do not exercise because of foot pain. First, foot pain is not an excuse and will not be accepted as one in my office! If you are having foot pain that is keeping you from healthy activities then something is wrong and you need to be treated. There are a variety of reasons that you may be having foot pain. Common conditions like plantar fasciitis require treatments such as cortisone injections, physical therapy, and night splints. Occasionally surgery is needed but this is a last resort.

The first thing to evaluate is your shoes. Not just the shoes you exercise in but all of your shoes. Most of us wear bad shoes or none at all. Whether it is dress codes or personal style, we do not give our feet enough room or support. We also love to kick the shoes off. Yes, walking barefoot around your house can be very bad for your feet! Some of us need extra support all of the time. Your shoes should be wide enough, long enough and have support in the arch area. Some athletes have trended towards the minimalist shoes or barefoot running. Is it ok? For some people, yes it is ok, but this is not for everyone and is only for the elite athlete with impeccable foot structure. Very few of us have the foot type that can bare the abuse.

Next is to evaluate the type of activities you are doing. Some sports or work outs have a higher impact on your feet than others. Swimming and biking have very low impact on the feet and are great alternatives if you are struggling with your feet. Other activities put a greater demand on your feet such as running on a treadmill or blacktop. You must also evaluate the consistency of high impact activities. Alternating between low and high impact activities will keep you doing what you love but also keep you on your feet!

It is that time of year to be optimistic. You will cure your foot pain, get back to the gym and lose the weight! First find the source of the pain, seek treatment, and stay focused. It is easy to find excuses and the foot is an easy target. Don’t let your feet get the best of you. 72 percent is an unreasonable amount of Americans struggling with foot pain.

New Jersy Nets Center Has Foot Surgery

Brooks Lopez, the starting center for the New Jersey Nets, broke a bone in his foot and is having surgery to repair it today. He is expected to be out six weeks. The bone he broke is the fifth metatarsal and is located on the outside of the foot.

This is probably one of the most common foot fractures. It usually occurs when your foot rolls over. There is a tendon, called the peroneal brevis tendon that is under tension when you twist your ankle. This causes the tendon to pull on the bone and break a piece off. Sometimes, the piece is broken off in such a way that it needs to be put back surgically. Other times, the bone breaks but is not displaced, meaning it is a stable fracture and can be healed just by applying a cast.

There are three types of fractures in this location. The base of the fifth metatarsal fracture is called an avulsion fracture. This is because the tendon yanks or avulses the bone. This fracture is usally stable enough to be treated conservatively without surgery.

A second type is a stress fracture, which is not a through and through break and not displaced. They occur usually in young athletes that put a lot of strain on the bone, thus stressing the area.

The Jones fracture is located above the base (see above diagram) and is associated with poor healing. This fracture usually requires surgery and then non-weight bearing in a cast for six weeks. Surgery consists of putting in a screw to put the fracture back. We use intra-operative x-rays to make sure the screw and bone is in proper placement. The Jones fracture is in the area of good blood supply to this bone, thus, the nutrition to the bone is disrupted in this instance. This is the reason for the poor healing, unless it is surgically corrected.

However, in basketball players, or any athlete that is required to jump or pound on their foot for their sport, the best option is to surgically repair it just by using a screw. It takes about 6 weeks for the bone to heal and afterwards, Lopez will need to get back into playing shape. So, don’t expect him to be playing for about two months which is now almost the whole season, due to the shortened schedule.