What Does an Achilles Tendon Tear Look Like?

You have probably read several articles and heard on the news multiple times about someone famous tearing their Achilles tendon.  This is no simple fete.  The Achilles tendon is the largest tendon in the leg and the force it takes to tear it has to be significant.  Often it is a force that causes the foot to come up towards the leg sharply, causing tremendous stretch of the tendon.  When this occurs, you feel a pop in the back of your leg and often describe it as being hit by a baseball bat or getting shot with a gun.

I have many curious patients who have these types of injuries and they always want to know what it looks like.  So in a recent surgery to fix this rupture, I took a couple of pictures.

In this picture, the stringy thing in the center of the incision is the ruptured Achilles tendon. You can see how large the tendon actually is and there is an obvious tear straight across the tendon.  Also note that there are multiple tears running longitudinally along the length of the tendon.  This gives it the "horse tail" appearance that we often use to describe the tendon after rupture.  

This picture shows how traumatic a rupture can be with significant bleeding and trauma to the tissues.  In this particular case there was also a large bone spur present prior to the injury which caused the tendon to be thicker than normal.  For this patient, the majority of his tendon was degenerative and there was minimal healthy tendon available for use.  So in this case, the tendon was replaced with a graft.  But in cases with healthier tendon, often repair can be done by just sewing the two ends back together if it is repaired quickly.

Recovery for this traumatic event is lengthy, but once healed this patient will return to digging holes, climbing trees, running or anything else they feel comfortable doing.

Kobe Bryant is Out for the Rest of the Season After Suffering a Torn Achilles Tendon

The Laker fans are crying this morning after their star, Kobe Bryant, suffers a torn Achilles tendon last night. Kobe felt a "pop" and stated he thought someone kicked him during a routine cut to the basket last night. He took a time out, then returned to make his free throws on one foot. He watched the rest of the game from the locker room. He is having an MRI this morning to plan for surgical repair of his torn tendon.

Several times in the last few weeks, it has been discussed whether or not this was the last season for the 35-year-old Laker. The Lakers are holding onto the last playoff spot by the tips of their fingers and it seemed like Bryant was playing them into the playoff with sheer will and determination. What will happen to the Lakers now? They are one game up on the Jazz for the last playoff spot with two games to go.

Will Kobe come back next season? Good question. He has the will and determination, but this is a devastating injury that often takes up to a year to recover from. That would put him out most of the next season as well. At 35, this could be the end. This is the same injury that ended Dan Marino's career to name just one of many stars who's bodies betrayed them before their mind had given up the game.

For more on Achilles injuries, Achilles tendon surgery. If you have chronic Achilles pain or suffer an injury like Kobe, contact us for help! The doctors at Foot and Ankle Associates of north Texas in Grapevine and Keller, Texas are here to help!

Ryan Howard Has Torn His Achilles Tendon

If it isn't hard enough to take a loss that exits your team from the MLB postseason, first baseman Ryan Howard of the Philadelphia Phillies ruptured his Achilles tendon. With two outs, Ryan hit a ground ball to second base resulting in an easy play at first sending the Cardinals to the NLDS. What was out of view of the play was the injury that occurred to Ryan as he tried to advance to first base. As he planted his foot to advance he crumbled to the ground. Several attempts were made to get back up and run but he was just unable to push off of his left foot. He described his injury as follows.

"I was trying to run, and I just felt this pop," said Howard. "The whole thing just went numb, like it was on fire. Just tried to keep going, and went down. It literally felt like I was on a flat tire. I tried to get up. Couldn't go." He also said, "[I] didn't have any pain. I think it was flexed trying to come out of the box. It felt like the bat hit it."

Ryan had been suffering from Bursitis near his Achilles tendon and had been given a cortisone (steroid) injection in the area to reduce inflammation and pain prior to the playoffs.

It was almost like Ryan Howard had read the textbook on Achilles tendon injuries by the way he described his injury. Ironically many people who injure this tendon describe the injury like being hit with a baseball bat, then loose the ability to flex at the ankle and can have a burning sensation. An MRI has confirmed the diagnosis of rupture.

Achilles tendon ruptures occur when one plantarflexes the foot rapidly, which is a downward force at the ankle, or when a rapid force is applied to the foot forcing it upwards while flexing the calf muscle simultaneously.

The motion alone usually does not cause the injury, but usually involves one of the following problems

1) Overuse of a diseased tendon, or overuse in people with a weak calf muscle. Your typical Weekend Warrior.

2) Use of a group of antibiotics called fluoroquinolones. Usually just taking the medication is not enough, a rapid ankle movement is needed as well.

3) Finally, the use of cortisone(steroids) near any tendon can result in rupture. Cortisone temporarily inhibits the normal healing process of the tendon.

In Howard's case, his injury is probably a combination of a diseased tendon and injection of cortisone in close proximity to tendon.

Howard is in for a long recovery. In a complete rupture of the tendon, surgery is required to repair the tendon and recovery will likely take 6 or more months.

Unfortunately for Ryan and the Phillies organization, don't expect to see Howard rounding the bases at the start of the next MLB season.