It Happened to Misty May-Treanor, Don't Let it Happen to You!

It has been a rough early fall for Misty May-Treanor, Olympic Beach volleyball champion. She was in the preliminary rounds of "Dancing with the Stars" when she ruptured her Achilles tendon in practice. She had successful surgery on her tendon and hopes to be back to competition soon. Many people have asked "If such a terrible injury happened to such a conditioned athlete, how can I prevent it from happening to me?"

The Achilles tendon is the largest tendon in the human body. It is a large ropelike band of fibrous tissue in the back of the ankle that connects the powerful calf muscles to the heel bone (calcaneus). When the calf muscles contract, the Achilles tendon is tightened, pulling the heel. This allows you to point your foot and stand on tiptoe. It is vital to such activities as walking, running, and jumping. An Achilles tendon rupture is a complete tear through the tendon, which usually occurs about 2 inches above the heel bone.

The Achilles tendon can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Certain illnesses and medications can also increase the risk of rupture.

Rupture most commonly occurs in the middle-aged male athlete (the weekend warrior who is engaging in a pickup game of basketball, for example). Injury often occurs during recreational sports that require bursts of jumping, pivoting, and running. Most often these are racquet sports and basketball, but any forceful push off can cause a rupture. Most ruptures are obvious and the person experiences a sudden and severe pain may be felt at the back of the ankle or calf—often described as "being hit by a rock or shot." The sound of a loud pop or snap may be reported. Initial pain, swelling, and stiffness may be followed by bruising and weakness. The pain may decrease quickly and smaller tendons may retain the ability to point the toes. Without the Achilles tendon, though, this would be very difficult. Standing on tiptoe and pushing off when walking will be impossible. A complete tear is more common than a partial tear.

Tendon strain or tendon inflammation (tendonitis) can occur from tendon injury or overuse and can lead to a rupture. Most likely, although not reported, Misty May-Treanor had a minor chronic tendonitis from her volleyball competitions and then aggravated it with the strain of dancing. "Dancing with the Stars" training has been reported to be significant and quite taxing even to the athletes that are competing!

How can I prevent this happening to me? Treat any tendon symptoms before they lead to rupture! Call your doctor if you have any signs of minor tendon problems including pain with activity, swelling and problems with standing on your toes. Tendon strain or tendon inflammation (tendonitis) can occur from tendon injury or overuse and can lead to a rupture. Prevention centers on appropriate daily Achilles stretching and pre-activity warm-up. Maintain a continuous level of activity in your sport or work up gradually to full participation if you have been out of the sport for a period of time. Good overall muscle conditioning helps maintain a healthy tendon.

What should I do if I think my Achilles tendon is injured? Any acute injury causing pain, swelling, and difficulty with weight-bearing activities such as standing and walking may indicate you have a tear in your Achilles tendon. Seek prompt medical attention from your doctor or emergency room. Do not delay! Early treatment results in better outcome. The majority of people return to normal activity levels with either surgical or nonsurgical treatment. Most studies indicate a better outcome with surgery. Athletes can expect a faster return to activity with a lower incidence that the injury will happen again. Return to running or athletics is traditionally about 4-6 months. With motivation and rigorous physical therapy, elite athletes may return to athletics as early as 3 months after injury.

Remember that your Achilles tendon is needed for almost all activities! Treat it right and see your podiatrist if you have any symptoms of Achilles tendonitis to avoid an Achilles tendon rupture like Misty May-Treanor!