Jock Doc

Don’t wait to treat Achilles tendon injury

Q. Last week I was playing tennis and running for the ball I felt a pop behind my left heel. It hurt a lot and I had to stop playing but I was still able to walk.

I went to the emergency room and they took X-rays. They said I had a sprained ankle and if it was not better in a week I should see an orthopedic surgeon. It still feels weak and I went to an orthopedic surgeon who said it was not a sprain and that I tore my Achilles tendon and needed surgery. I am just a recreational athlete and really do not want an operation. Are there alternative treatments?

There are three large muscles in the calf that come together to form the Achilles tendon that attaches to the heel. There is an incredible amount of force on a very narrow tendinous band that can take up to 5 to 7 times your body weight while running or jumping.

When a complete tear of the Achilles tendon occurs, you would end up with significant weakness on flexing your ankle, which would not only result in difficulty with running but even with walking and activities of daily living. Although in certain countries such as Sweden, many Achilles tendon tears are treated non-surgically, as a general rule surgery is the preferred treatment in the United States as it results in a faster rehab and more normal function and strength.

Most patients who rupture their Achilles tendon are recreational athletes who do not warm up and stretch properly before the activity. Most are male between the age of 35 and 50. If you are not comfortable with the diagnosis, I recommend you seek a second orthopedic surgical opinion. However, I do recommend that if surgery is performed that it be performed within the first couple of weeks of injury as this makes the surgical procedure considerably easier and the results more likely to be successful.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to

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