Winter has finally thawed and you have eagerly laced up your sneakers ready to bring your workout outdoors. Nothing beats the sun on your face and the refreshing breeze as you hit the courts or the running path. Enjoy yourself this spring, but play smart and make sure you are properly warming up and stretching because the rate of injuries tend to increase during the spring, especially for the Achilles tendon rupture.
According to Dr. Steven Raikin, director of foot and ankle service at the Rothman Institute and professor of orthopaedic surgery at Thomas Jefferson Medical College, over 30% of Achilles tendon ruptures happen in the spring.
The Achilles tendon is located behind the ankle and connects the heel of the foot to the calf muscles. It is responsible for the push-off of the ankle. "It is the largest and strongest tendon in the body," Dr. Raikin explained.
A rupture occurs when the tendon tears, usually due to a sudden jump or planting of the foot or chronic repetitive damage. But what may surprise you is that professional athletes are not the most at-risk group for this type of injury.
"People in their middle ages are most susceptible," he explained, "particularly men, around 45, who are weekend warriors."
"In the winter, people are much less active so the tendons tend to tighten. Like warming up your car in the morning, it is harder to get your body going. People tend to head out without stretching enough."
In a study he co-authored with David N. Garras and Philip V. Krapchev in Foot Ankle International in 2013 called "Achilles Tendon Injuries in a United State Population," Dr. Raikin and his co-authors found that the most common sports associated with Achilles tendon ruptures were basketball, tennis, football, volleyball, and soccer, but more so on the community level not in professional sports. 83% of the ruptures analyzed were sustained by men while only 17% occurred in women.
To keep from being sidelined this spring from injury, he recommends that you stretch your calf muscles more. "Many people mistakenly thing they can just stretch right before heading out for a game or a run, but you need to do it 3-4 times a day, just for 5 to 6 minutes."
There have always been questions about whether stretching is good or bad for you, but Dr. Raikin recommends stretching on a daily basis whether doing exercise or not. He explained that this should be augmented with a pre-exercise stretching program combined with the warming up of the calf muscle. Post exercise stretching can be done as part of a cooling off, but probably is not necessary - and does not decrease the rupture risk of the Achilles, which usually occurs during activity.
Two easy stretches he suggests are:
Runner's stretch against a wall: Step your right foot forward and lower into a lunge. Place your hands against the wall, leaning forward. Switch sides.
Achilles stretch: Stand with one leg (the non stretching leg) firmly on a step, while the leg you are stretching hangs half way off the step. Slowly lean back (without bouncing) onto your stretching leg, pushing the heel downwards. Once a good stretch is obtained, this position is maintained for 10-20 seconds. Each leg is stretched independently.
If you feel a "pop" sensation in your heal or experience a lot of heel pain, you might have a rupture. To get back to playing at your full strength again, it can take 11 months to year, so make an appointment to see your physician if you are in pain.