We pretty much pass it off as something that happens to Kevin Durant or Aaron Rodgers when you hear about debilitating injury to an achilles tendon. But when it happens to an adolescent athlete, rare as it is, people question how it can happen, and how do you get beyond such an injury?
By Dr. Safet Hatic, DO (Orthopedic Associates of Southwest Ohio)
Let me first say that an achilles injury doesn’t happen that often to the average adolescent, or high school athlete. In fact, it’s pretty rare.
Usually, it happens to the weekend warrior athlete, that person who’s between 30 and 40 years of age who’s playing in an adult soccer league, or plays with the work softball team, and when you least expect it…you tear, or rupture the achilles tendon behind your ankle, between the calf muscle and your heel.
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Often, pain with the Achilles tendon is what’s called acute achilles tendonitis, especially in adolescent athletes – an inflammation of the tendon, as opposed to a tear, or rupture.
An actual rupture of the tendon occurs with someone like Aaron Rodgers, where the fibers of the tendon separate, most commonly in what we call the mid-substance area of the tendon (just above the heel).
Typically, repair of an Achilles rupture is a surgical procedure, and the prognosis for the weekend warrior is quite good – that they get back to their previous level of activity. It may take six months or more for them to get there, but they will get there. It’s a little less certain in the National Football League.
Dr. Safet Hatic specializes in Foot and Ankle Surgery, and Orthopedic Surgery with the Ortodpedic Associates of Southwest Ohio.
Most of the Aaron Rodgers-type injuries are that mid-substance tear that I spoke about, and a little bit like what happened to Joe Burrow and his calf injury. Same kind of injury, in fact, except in Burrow’s case it’s not a tendon issue, but rather the calf muscle. It’s the same mechanism, but the Achilles is how you connect those powerful muscles in your calf to the heel bone. And the Achilles is the largest connecting tendon in the human body, so its a significant injury when it occurs.
It’s how you power your explosiveness, your ability to walk, to run, and to jump. That all depends on the calf muscle and the Achilles tendon. And the calf muscle is even more difficult to manage because there is no surgery that will expedite that to heal. It just takes time.
The Achilles tear, itself, is common enough, especially with adult athletes like Aaron Rodgers, Tre’Davious White (Buffalo Bills), and Kevin Durant (professional basketball). In high-schoolers, I’ve only seen maybe a half dozen in the last ten years. When you get into the demographic of 20 to 30-year olds, I would say the number is more like three dozen. But when you get into 30 to 40-year-olds, it’s every week that I see someone of that age. And when it happens it’s a serious condition.
The prognosis for recovery in the average person is very good, depending on the level of athlete. If your paycheck doesn’t depend upon it your chances of full recovery are quite good if you maintain proper health guidelines and rehab. You can definitely get you back to participation in average recreational sports.
For NFL athletes it’s a more significant injury and intense rehab to recovery. The percentage of a full recovery is not so high. At that level it can take up to a full year because there’s a far more significant athletic demand.
The good news is that techniques for repair of these injuries have evolved, significantly – the way we fix them, and the way we rehab them. Early motion, and early physical therapy, is really important now compared to what it was a decade ago. As soon as the skin heals, post-surgery, we get right into physical therapy.
From a preventative standpoint, if you want to put something in BOLD print…it’s stretching. I can’t emphasize that enough.
From young, old, and anyone in between, it’s imperative that we maintain flexibility. As an athlete, as you spend time in the weight room building that strength don’t lose sight of maintaining flexibility with the hamstrings, calves, and the Achilles tendon. That, along with hydration, being well-fueled, and good conditioning.
Be prepared, strength-wise, to participate, and you should be fine.
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