Treatment

In the younger athlete with insertional Achilles tendinopathy, nonoperative management is usually satisfactory. The usual treatment is rest, ice to reduce inflammation and pain, and stretching to maintain muscle tendon length. Evaluation and adoption of proper athletic shoe wear and the proper use of orthotics when necessary, combined with appropriate coaching instructions and observation of training regimens, frequently are necessary to alleviate the pain. Something as simple as changing the...

Case Study 1 Chronic Achilles Rupture

A 28-year-old policewoman injured her right ankle while boxing 3 months prior to presentation in the office. She was pursuing a career as a professional fighter at the time of injury. After reporting to the emergency room, she was diagnosed with a severe ankle sprain and placed into a stirrup ankle brace. At 6 weeks postinjury, she attempted to return to boxing, noting both pain and lack of push-off strength with her right lower extremity. She sought medical attention under her primary care...

Functional Rehabilitation Protocol

Following repair of the tendon intraoperatively, the patient is placed into a bulky splint in 20 degrees of plantarflexion in order to minimize swelling and maximize skin perfusion.31 The patient is non-weight bearing on the operative side and is instructed to keep the leg elevated in order to minimize wound complications. At 2 weeks, the postoperative splint is removed and the patient is placed into a removable cam walker. The goal at this time is to allow the patient to begin weight bearing...

Kush Singh and Clyde A Helms

Several different clinical scenarios warrant evaluation of the Achilles tendon with magnetic resonance imaging (MRI). However, the main reasons to image the Achilles are pain, trauma, infection, or a mass. Less commonly, an MRI may be used to screen for hypercholesterolemia. Although a diagnosis of Achilles tendon rupture is usually evident clinically, the gap between the ruptured ends of the tendon may be difficult to ascertain by physical examination alone. This gap is frequently used to...

Joseph Yu and William E Garrett Jr

Calf Muscle Tear Ultrasound

In 1883, Powell1 first reported in The Lancet on the lawn tennis leg (rupture of the medial head of the gastrocnemius). He described a 41-year-old healthy man who had sudden, sharp pain when reaching for the ball while playing tennis. Pain, tenderness, and swelling rapidly developed, but the patient was able to return to sports in 4 weeks. In 1958, Arner and Lindholm2 surgically explored five of 20 patients with tennis leg. In each case, a transverse rupture of the medial gastrocnemius at the...