David Beckham’s Achilles Tendon Rupture

By now, you've probably heard that David Beckham ruptured his Achilles tendon on March 14. So what does this mean for Mr. Beckham?

The Achilles tendon (or calcaneal tendon) is probably the most famous tendon in the body. It was named after the invincible Greek warrior from mythology whose only weak point was his heel. You will feel it behind your ankle. It's the thick, rope-like thing, and it is vital for pushing your foot down. A rupture in this tendon is the most severe traumatic muscular injury of the foot.

Without his Achilles, Mr. Beckham will be unable to walk on that leg without a boot. Furthermore, he received surgery to stitch together the two ends of his tendon. Fortunately for him, this injury is not career ending, but he will not be playing in the World Cup. He will also need to be careful, as one ruptured Achilles will make a repeat injury likely in his future.

If you think you've ruptured your Achilles tendon, you would have heard a loud "pop." A quick test for a ruptured Achilles is the Thompson test. If you squeeze the calf muscle of an uninjured leg, you should see your foot point downwards. However, if the Achilles is ruptured, it will continue pointing forward, and probably a little upwards. While your first course of action will be to seek emergency medical treatment, you should consult a podiatrist for surgery and/or follow up care.

How to Walk—things you don’t think about

Unless you are under the age of 2, you probably already know how to walk. And if you are under 2, I am impressed with your level of reading comprehension! For the rest of the reading audience, however, walking is something that comes naturally and you never bother thinking about it. Until, that is, you spend a prolonged period not using one or both of your legs. When your muscles spend weeks or months on vacation, they become weak, and this in turn affects your gait cycle, the way your legs move when you walk.

For simplicity, we'll divide the muscles into 4 groups: hamstrings (back of the thigh), quads (front of the thigh), calf muscles, and shin muscles. Here's how they participate as your foot comes down (stance phase) and then up again (swing phase).

1. Heel strike. You touch down on the ground with your heel, and your shin muscles gradually lower the rest of your foot to the ground. If they have been weakened, your foot will just slap the ground.
   
2. Flat foot, also known as Forefoot loading. Your quads and calf muscles transfer weight over the arch of your foot while retaining stability.
   
3. Heel off. Your calf muscles carry your body mass and put you on your toes. If they are not at full strength, this will be difficult.
   
4. Toe off. You continue to transfer weight onto your other foot, as your quads stabilize your leg.
   
5. Swing Phase. Your quads and hamstrings steadily propel your foot forward and the cycle continues.
   

Of course, I haven't done justice to the roles of your hips and foot muscles in keeping your legs steady (especially during Toe off). However, these are the most noticeable actions, and if you are recovering from surgery or an injury, these are the muscles you will want to exercise in physical therapy. If you experience weakness during any of these steps, and you have not had an injury, that could be a sign of nerve damage, and you should consult with Dr. Reddy or a podiatrist in your area.

Photo credit: Queen's University

Foot Pain, Stress Fractures, and 3 Ways to Prevent Them

When we think of bone fractures, we often think of athletic injuries or falls. These are not the only ways to break a bone, however. If you experience pain in your foot that arises with activity and subsides after you rest, you might have a stress fracture.

Stress fractures occur mostly in the foot and lower leg. Normally, when you are working out, the muscles of your feet absorb shock. If they fatigue, however, the shock is transferred to the bone, which will eventually chip, crack, or break. This happens when you increase the intensity of your workout too rapidly. Stress fractures will also occur if the padding in your shoes is wearing down. (Remember to replace your running shoes every 6 months!) Lastly, women should be particularly careful, because osteoporosis will increase your chances of having a stress fracture.

What do I do? Stress fractures are not necessarily visible to the naked eye. You will need an X-ray or, occasionally, CT scan or MRI. The best thing to do is to take it easy for 6-8 weeks. You can still exercise, but stay away from any activity that causes pain. This will ensure that the bone heals and you do not have a reinjury. Consult with Dr. Reddy or a podiatrist in your area for further advisement.

How do I prevent Stress Fractures?

1. Take it slow. When starting a new exercise regimen, gradually build your way up to the level of activity that is your goal. This will allow your body to get used to new stresses.
   
2. Wear comfortable shoes. Don't judge them by the treads, because the padding in the sole wears out long before the treads do.
   
3. Be sure to include Calcium and Vitamin D in your diet. This will strengthen your bones.