Shaq tore his.  So did David Beckham.  And this week, as the world watched at the 30^th Olympic Games, Chinese hurdler, Liu Xiang ruptured his.  If you’ve been watching coverage of the London games or regularly watch Sportscenter, you probably know I’m referring to these athletes’ Achilles tendon injuries.  All three of these men were virtually gods in their sport when an Achilles tendon injury brought them down to the level of mere mortals, unable to even compete.

It comes as no surprise that the Achilles tendon itself derives its name from a demigod (half god, half man).  Greek mythology tells the story of Achilles, son of the goddess Thetis.  Thetis dipped Achilles into the River Styx to protect him after she received a prophecy of his death.  His mother held him by his heel as she dipped him into the river.  The protective water didn’t touch his heel, making it more vulnerable.  During the Trojan War, Paris killed Achilles by shooting a poisoned arrow, striking Achilles in his weak heel.   

The Achilles tendon connects the two large muscles of the calf, the soleus and gastrocnemius to the heel.  The two muscles come together to create the Achilles tendon, the largest and strongest tendon in the body.  The tendon itself extends from about midway down your calf to the back of your heel, about 6 inches (or 15 centimeters).   It functions to lift your heel up and point your toes down.  

So, if the Achilles tendon is so strong how is it so vulnerable to injury (hint: the answer is not found in Greek mythology)?  A lot is required of the Achilles, especially in activities that require a lot of running, jumping, and kicking.  When the tendon is overworked it can become inflamed (tendinitis) and tiny tears may develop.  This leads to the formation of scar tissue (tendinosis), which makes the tendon less flexible.   In some cases when the inflexible tendon is stretched it snaps or tears.   If you’ve seen the video of David Beckham’s tendon rupture you know that a rupture can be quite dramatic.  The rupture is often accompanied by a loud pop, and I’ve had several patients tell me that they thought that they had been shot in the back of the ankle when their tendon snapped.   Any of these Achilles tendon injuries are painful, but a tear or rupture can be nearly disabling, leading to the inability to even walk normally. 

Treatment of an Achilles tendon tear or rupture can be either nonsurgical (casting) or surgical (open repair, followed by casting).   There are hundreds of studies that support either treatment approach.  All of the above athletes underwent surgical repair because this approach usually ensures the fastest return to activity and has been shown to be more durable.  At Advanced Foot and Ankle Care our doctors, including myself, are all well equipped to discuss your treatment options and create a plan tailored to your needs and goals.   We will have you back shooting like Shaq, bending like Beckham, and leaping like Liu in no time. 

Hillarie Amburgey, DPM