"I missed a step"

He was in his early 70's. Continued to work part time and was carrying something while going down some steps. He missed the last step and came down hard on his foot causing him to fall. Initially he was examined and told everything was OK. Four months later, He showed up in my office. By then he had a large knot just above the back of his heel in the area of the Achilles tendon. It was swollen, warm and tender to the touch. He could not lift himself up on his tiptoes on that side or even when helping with his other side. He had trouble going up and even down steps. His ankle felt "weak". An x-ray was negative but did show some evidence of calcification in the area of the knot. An MRI was ordered and revealed a partial rupture or tear of his Achilles tendon. Now he was faced with a decision.

If you are young or an active person even in advanced years and healthy, Achilles tendon repair would be indicated if the tendon is torn completely and even with large partial tears. If you don't fit these criteria, then you can be treated conservatively with options including rest, therapy and bracing which will allow you to continue to function and return to normal daily activities.

A partial rupture of the Achilles can be treated with a period of immobilization with bracing and rest, followed by therapy and return to normal activities. But a complete rupture would indicate need for a repair if possible. I have had patients who elected not to undergo surgery and treated the problem conservatively and returned to their normal daily activities and routines, but in a less active lifestyle. But if one wants to be active, Achilles tendon repair is your best option.

And what did my patient do? We put him in a custom-made brace and he will wear this for at least six months which should give the Achilles tendon time to heal. Physical therapy will be employed and he should be able to return to all his pre-injury activities.

Regardless of your age, if you injure yourself, timely treatment is important in order to get you back to your prior level of activity. Don't delay, seek professional care

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