Everyone Has An Achilles Heel with Foot and Ankle Surgeon, Dr. Ebonie Vincent, DPM
Achilles Tendon Injuries and Repairs
Let's talk all things Achilles tendon and who better to get some insight on this topic than a brilliant colleague of mine Dr. Ebonie Vincent, DPM. Dr. Vincent is a highly trained and sought-after foot and ankle surgeon located in Orange County, California. Before we bombard Dr. Vincent with numerous questions on how she saves the day with these injuries, let us dive into some knowledge; the anatomy, who's at risk, the symptoms, and how it could affect you!
Your Achilles tendon stretches vertically down the back of your lower leg. It's a band or cord-like structure that connects your calf muscle to your heel bone. It assists in your foot and ankle movement when walking, running, and jumping. It helps in the push off phase of walking. When you think of what your Achilles tendon does think of pushing your foot down on a gas pedal and back up or standing on your toes.
Achilles Tendon injuries are common in athletes (runners, basketball players, gymnasts, dancers, and weekend warriors (you know most of us that take up some form of exercises in between busy work schedules, family and social life). Tasks and activities that put a lot of stress on one's feet and repetitive overuse movements can also cause Achilles tendon injuries.
Types of Achilles Injuries:
Achilles tendonitis: This term is used when the tendon is inflamed. Symptoms may include pain in the lower leg and heel, severe pain in the heel with physical activity, achy pain in the calf, nodules or bumps along the tendon and pain, swelling and stiffness in the area of the Achilles tendon. Unfortunately, if left untreated Achilles tendonitis can progress to Achilles tendonosis which is degeneration of the tendon resulting in small micro tears in the tendon or Achilles tendon rupture (a partial or full tear).
Risk Factors:
-A sudden increase in repetitive activity too quickly
-Poor footwear
-Running on an uneven surface/ground
-Not properly stretching before and after exercise
-Weak calf muscles
-Repetitive uphill running
-Flat feet
-Activities that involve rapid acceleration or deceleration
If you are experiencing heel pain or Achilles tendon pain, visit your primary care provider, podiatrist, or chiropractor (not sure which one? It's okay they all can refer to each other if need be!) for a proper diagnosis, advanced imaging, (if needed) and a treatment plan. Treatment may include rest, ice, physical therapy, orthotics, over the counter anti-inflammatory medications, strengthening and stretching exercises, soft tissue mobilization, and the use of therapy modalities like ultrasound. Recovery of Achilles tendonitis can be reasonably quick, BUT what happens when you have been diagnosed with a partial tear or a full rupture?! Let's ask the specialist.
Dr. Lina: Hi, Dr. Vincent! Thanks for joining us. Who's usually at risk for an Achilles tendon tear?
Dr. Vincent: Hi, of course! Not always but in many cases, it occurs in an active sports person in their 30's or 40's, but I have also noticed it in other age groups when they perform a sporting activity that involves a quick change in direction on their feet.
Dr. Lina: What are some of the symptoms of an Achilles tendon rupture/tear?
Dr. Vincent: Believe it or not it's possible to have no symptoms, but more commonly the individual may feel or hear an audible pop or snapping sensation, inability to walk or push off during walking on the injured foot, pain in the calf and immediate swelling around the tendon and heel.
Dr. Lina: For a patient that has an Achilles tendon rupture, what surgical procedure do you usually perform?
Dr. Vincent: Depending on the patient and location of the rupture, I usually perform what's called a PARS procedure. The PARS procedure allows for a small minimal incision (no more long vertical scar) where the actual tear is located. The sutures used, secure the tear to the heel and anchors the Achilles tendon into the heel, to reinforce the correction. With this procedure, it is less likely to re-tear the tendon.
Dr. Lina: What's the recovery time with this procedure? How often do you see the patient after this procedure?
Dr. Vincent: The patient is usually back on their feet or able to bear weight (ability to put body weight on the injured foot) in about five weeks. I see the patient every week post-operation and then once every three weeks after the patient has begun physical therapy.
Dr. Lina: What do you expect from a chiropractor or a physical therapist rehabbing the patient after this procedure?
Dr. Vincent: I would like them to focus on improving the dorsiflexion motion with the patient and strengthening of the gastrocnemius and soleus muscles, basically strengthening the calf muscles.
Dr. Lina: Do all Achilles tendon tears require surgery?
Dr. Vincent: Not all, but if not surgically repaired the risk for re-tearing the tendon in the future increases.
Dr. Lina: Lastly, do you have any tips on how to prevent Achilles tendon tears?
Dr. Vincent: Be mindful that steroid injections into the ankle joint to reduce pain, can weaken the surrounding tendons like the Achilles tendon. I never recommend cortisone injections into this area. Talk to your doctor, but certain antibiotics can also weaken your Achilles tendon. Make sure you are stretching your calf muscles before and after activity but also participating in exercises that strengthen your calf muscles. Also, increase training intensity gradually/slowly and be mindful of uneven running surfaces.
I agree. Those are some useful critical tips! Dr. Vincent specializes in minimally invasive surgical techniques, reconstructive foot, and ankle surgery, diabetic limb salvage, and sports medicine. Dr. Vincent currently practices in Orange County, CA, so look her up. Dr. Vincent is knowledgeable and friendly, with a fantastic bedside manner. She has co-authored several research articles and was a former Division I collegiate volleyball player. She's definitely someone I would recommend to my foot and ankle surgery candidates. You can also find more info about her and her procedures at HERE! Thanks, Dr. Vincent for helping me spread some knowledge and being a part of Dr. Lina Colleagues and Friends!