It has just been released that Alex Trebek tore his Achilles tendon while fighting off a burglar in his hotel. Wow! So now what? Alex should be expecting surgery to fix that torn Achilles tendon and a year long recovery.
In trauma situations, the Achilles tendon can be injured by sudden forceful movements of the foot against the leg. Or blunt trauma to the tendon area can cause the tendon to tear or rupture. When this occurs, the person often feels a sharp pop or pull on the back of the calf and often describes a feeling of being shot in the leg. Instant swelling and bruising occurs with an inability to really use that foot. Without the Achilles tendon the foot has a tendinacy to "flop" on the leg.
On exam, the back of the leg will be swollen and bruised. Pain is usually not as bad as you would expect, but is still present. And there will be a gap along the leg just above the heel where the tendon is torn. In the office we do a simple calf squeeze test to check the tendon integrity. If you squeeze the calf and the foot fully points, all is good, no full tendon tear (normally). But if you squeeze and the foot just stays the same...not so good, the tendon is no longer attached.
Now we need to fix it because leaving it torn will cause drop foot and the need for long term bracing to walk. Fixing the tendon requires surgery where the 2 ends of the tendon are sutured back together. A fiberglass cast is applied to protect the tendon and there is no walking on that foot for 4-6 weeks.
Long term, physical therapy is necessary to regain strength of the calf muscle and improve confidence in using that foot and leg. This process can take about a year before the patient returns to full unlimited activity.
Job well done, Alex, on fighting off the bad guys. We wish you a speedy recovery!
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