Treating an Achilles Tendon Tear

We are now in the thick of March Madness. While no injuries have occurred as severe as Kevin Ware’s leg break two years ago, you may have noticed his coach, Ron Hunter, on the sidelines in a leg cast.  He is healing from a torn Achilles tendon, an injury common in athletes of his age.

Achilles tendon tears are rarely due to sudden trauma. It is typically the end result of tendon degeneration occurring over many years. It usually begins as Achilles tendinosis, (when the Achilles tendon degenerates and becomes inflamed) mostly common in those with conditions like flat feet or unusually high arches. Poor shoe quality also contributes, so it is important to buy new exercise shoes every 300 miles. A less common yet more serious contributing factor called inflammatory arthropathies (psoriatic arthritis, gout, rheumatoid arthritis, etc.) may contribute.

It is important to be evaluated by a podiatrist if you experience Achilles tendon pain. At Cast a Foot Podiatry in Hempstead, NY we will be able to decipher between associated conditions such as inflammation of the tendon, insertional (middle of the tendon) vs. non-insertional (lower portion of the heel) Achilles tendinosis, retrocalcaneal bursitis, Haglund’s deformity (pump bump), or of course a full-blown Achilles tendon tear. A torn tendon can usually be felt but X-rays may be warranted to be sure. If surgery is required, an MRI may be needed to see the extent of injury.

If your tendon is indeed torn, surgery is usually the best option. Healing the tendon in a cast could take a very long time. Age, level of activity, and your own expectations all factor into the decision. Your podiatrist will work with you to find a treatment that is aggressive enough to treat your individual injury yet sensitive to your needs/requests. For example, a high-end athlete might opt for a more aggressive treatment to avoid losing function of the Achilles. An elderly person may desire minimal treatment because the risks of anesthesia outweigh the benefits of a faster recovery.


Dr. Nicole M. Castillo

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