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Achilles Tendon Injuries

Q. I recently had a complete rupture of my right Achilles tendon during a championship match 12-11-05. I had surgery for this (using a fiber wire) to reattach both ends 2 days after this injury. What are my chances of getting back into competitive playing again… or do I just have to take it easy from now on?

A. Sorry to hear of your injury. You should consult the physician who performed the surgery to gain information regarding the strength of the repair, the status of the torn tendon at time of surgery and also evaluate the success of your rehabilitation carefully. It is important that you re-gain full range of ankle motion (especially ankle dorsiflexion – moving your toes toward your nose) before you even attempt to do functionally demanding activities.

Additionally, ensuring that your entire lower limb (hip, knee and ankle) have strength levels equal to the uninjured side is important. It may also be of benefit when you first return to activities that you wear a small heel lift in your shoes to take stress off the repaired Achilles tendon. However, you must wear the lifts in both heels or you will simulate a leg length difference. Orthotics may also be indicated based on your foot type, but this can be evaluated by your physician.

Many patients who have had an Achilles rupture do return to full activity following rehab. Unfortunately, this is a common tennis injury due to the rapid multi-directional movements inherent in the game of tennis.

Q. I'm a 50 year old weekend warrior who is in good shape, but doesn't always stretch. Over Labor Day I over did it and developed tendonitis in both Achilles tendons. You can imagine the pain and agony. I went through physical therapy and rehabilitation. I'm pretty much pain free, but still feel a little stiffness in the morning. Is it okay to get back on court with my pro and have feed me balls just to work on stroke, technique, etc? I'm dying to do something.

A. Yes, because you said that you are pain free you can begin your workouts again SLOWLY. However, also recognize that the tendonitis probably developed from a number of factors (shoes, training, foot biomechanics, weight gain/loss) and not from a lack of stretching/ flexibility. So keep that in mind. As you get back into tennis, take the time to warm-up before you play - 10 to15 minutes, until you break a sweat. Then, continue to gently stretch your calf. Lean against the net post with your foot behind you and the leg straight, hold for 30 secs and then bend your knee slightly and hold for another 30 secs. Perform 3-5 times.

Q.  I suddenly have been having issues with my Achilles tendon area. It started with plantar fasciitis in my left foot. When that finally got better and I started playing and working out again my Achilles tendon in my right foot became Inflamed and sore. Everyone I went to, just said stretch it, stretch it, stretch it. Any other good ideas or stretches you might suggest for this problem? It is becoming very frustrating. I am 48 years old and had never had any problems like this before.

A. In addition to the stretching, I would recommend having your foot structure evaluated by an orthopedic surgeon or physical therapist. Some players have very flat feet, which creates greater loads in the Achilles tendon by decreasing the efficiency of the foot during the propulsive phase of running and walking. You may be a candidate for orthotics.

Orthotics are shoe inserts that support the foot when you walk and can reduce the stresses placed on some of the structures in your foot. Also, making sure that the shoe you are using is properly fit and changed at regular intervals is very important. Ice can be effective in reducing the inflammation and pain and should be applied after playing for 20-30 minutes or after any strenuous lower body activity.

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