Thursday, September 11, 2014

Achilles Tendon Injuries and the NFL.....Should these guys do more YOGA?

After this first week of the NFL football season, you can't help but notice the amount of Achilles tendon injuries that were reported.  In our podcast last night Dr. Henne and I discussed this topic and I said I thought maybe some of these injuries could be prevented. Dr. Henne thinks I'm crazy because I said maybe these guys should do more stretching or even yoga.  This is a very elementary way of thinking, I know, but sometimes children have the best ideas!

The Achilles tendon in the largest tendon in your body, and a part of the body we treat all the time.  For fantasy football purposes, I wanted to make this simple, as far as, that not all Achilles injury claims are created equal.  But that prevention really does come down to proper conditioning and stretching.

Insertional Achilles tendonitis is more of a chronic problem over time.  The Achilles inserts or attaches at the posterior middle third of the calcaneus or heel bone.  When the Achilles is tight, it pulls on the periosteum of the bone(I always describe this as a thin clear membrane around the bone that I liken to saran wrap).  The tendon tents up or pulls on the periosteum and this area gets inflammed and over time a bump or exostosis will form,  This is an injury the player can still play on with little risk of rupture, just mainly a lot of pain. This is also more of a chronic problem that can get better and flare up very easily.

Non-insertional Achilles tendonitis is a different beast.  These type of injuries typically take place anywhere from 2cm to 8cm above the insertion of the tendon on the heel bone.  This is commonly referred to as the "Water shed zone", a term meant to denote less blood available to this area.  So of course, if there is less blood flow getting to the area to heal a tear or strain, it takes longer for the player to get better.  This injury is usually more of an acute injury and players tend to struggle with this once they have had it throughout their career.

Both of these injuries truly stink to have, but depending on the treatment regimen the outcomes do not have to be career ending.  An Achilles tendon rupture is an injury that becomes a surgical procedure for athletes of this caliber.  Repair and recovery are not always the same from individual to individual and if your fantasy football player has an Achilles tendon rupture, or two of the main guys on your fantasy football defense have this, it's time to drop them and get someone new.  This is not an injury you come back from easily.

I have my patients with insertional and noninsertional Achilles tendonitis stretch as part of their treatment but stress to them that continuing to stretch will prevent this from coming back in the future.  I believe Achilles tendonitis, whichever kind, truly just stems from a muscle imbalance.  Our calf muscle is so much bigger than our anterior(front of the lower leg) muscle group.  They are meant to be antagonist, but the calf wins out being stronger, bigger and more powerful.  Look at your own calf and then look at these guys legs tonight.  They are huge, they need that power, but I wonder how much stretching they do to help this muscle and Achilles from doing damage to it self.

Good luck to everyone who has players tonight!

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