Reduce the Risk of Achilles Tendon Rupture

Ugh. Achilles tendon ruptures.  They affect elite athletes and weekend warriors alike, especially men.  Certainly, they happen to females too, and a couple of recent studies have found increases in both sexes (Huttunen et al, Am J Sports Med 2014; Lantto et al, Scand J Sci Med Sport 2015).  Recent data has shown incidence is lower in women than in men, with the range being up to nearly seven times that of women (Vosseller et al, Foot Ankle Int 2013).  The “prototype” is usually a working guy who is still trying to “live the dream” playing rec league sports.  They work all week huddled in front of a computer then try and leg out a triple in softball at the “beer league” Thursday night and they rupture their Achilles tendon.  Inevitably, patients always ask “is there anything I could have done to prevent this?”  Prevention is always a tough question because really no injury is absolutely preventable, but there are definitely some things you can do to reduce the risk of having this painful injury and long, boring rehab.

5 Ways to Reduce Risk of Achilles Tendon Rupture

1. Don’t get out of shape.   Certainly, this injury happens in elite athletes.  For most of the population though, many guys are moderately active, but really don’t exercise consistently.  Then, they sprint down the court playing basketball at the gym and…well, you know the rest of the story.  Regular stretching and strengthening is a good start.  The American College of Sports Medicine recommendations for physical activity haven’t changed much in a few years, but here they are.
2. Run fast every now and then. OK, so you’ve stayed in shape.  But, do you ever actually run as hard during workouts as you do during rec league games?  If your Achilles isn’t used to being as explosive as you were back in your high school heyday, it’s not accustomed to that type of loading.  Therefore, make sure you do some sprint workouts from time to time so your Achilles knows how to be explosive when you ask.  Don’t like to run fast or got bad knees?  Consider jumping rope quickly.
3. Stay hydrated. Again, for most guys that come through the door with this injury, they work all week.  They drink loads of coffee (or caffeinated sodas).  Caffeine is a diuretic, which makes you have to urinate.  Furthermore, as we age, our tissues stiffen and lose water as part of the aging process (think beef jerky vs. filet mignon).  If you lose water, you lose elasticity.  You need that elasticity, like a rubber band, to be explosive when you decide to leg out that triple in softball.  It’s a recipe for disaster.  Here’s a good link from the Mayo Clinic on how much water you need per day.  If you’re a coffee or soda addict, at least drink one of those and chase it with the same amount of water.
4. Stretch your calves. Your calves basically are comprised of two main muscles – the gastrocnemius and the soleus.  Stretches for them are pictured below.  Stretch every day, 30-second holds, repeat twice each side.  Similar to what was described above, we have to maintain the elasticity in our tissues.  Staying flexible gives your Achilles a suitable range of motion from which to work from.  The more it’s able to extend, the more explosive it can be.  Think about stretching a rubber band – the farther you pull it, the farther it goes when you release.
   
   

   Gastrocnemius stretch. Keep the knee straight, heel stays on the floor. Bend the front knee until you feel stretch in the calf.

   
   
   

   Soleus Stretch. Bend the back knee, keeping the heel on the floor.

   
    
5. Warm up. Sorry dudes, this isn’t high school where you show up and get after it.  Your joints and muscles have some “tread” from years of playing sports and well, age.  Maybe you let yourself go a little too and aren’t the Adonis you once were.  Try and show up a little early and go for a light jog.  After breaking a sweat, do things like walking lunges, “butt kickers,” high knees, skipping, shuffling, cariocas, or jumping jacks to further loosen up your tissues.  Other guys may make look at you funny or make fun of you, but you’ll be laughing when their calf after Achilles surgery is as small as their thumb due to muscle atrophy.  It’s 15 minutes of time that may save you a surgery.

As we stated, no injury is 100% preventable.  You may already be doing all of these things right and still have an Achilles rupture, like many elite athletes that get these.  Yes, sometimes, “stuff” happens.  However, why not put yourself in the best position to succeed?  Give these 5 things a try and hopefully, we won’t need to see you for post-operative PT anytime soon.
It would be a privilege to serve you and partner with you in your care, give us a call!

Tags: Achilles tendon, Achilles tendon rupture, Kansas City, Overland Park, Physical Therapy, prairie village, SSOR