JOHN DOHERTY: Achilles tendon injuries fatal only to Achilles

2013-04-15T16:00:00Z 2013-04-16T00:03:04Z JOHN DOHERTY: Achilles tendon injuries fatal only to AchillesBy John Doherty Times Correspondent
April 15, 2013 4:00 pm  • 

According to Greek mythology, Achilles was an invincible warrior during the Trojan War. His power, it was thought, came from being dipped in the River Styx as a child by his mother. However in so doing, she gripped him tightly by the back of the heel, not allowing the water to touch him there. Shortly after Achilles conquered Troy, a cowardly Trojan — guided by an angry Apollo — ambushed Achilles, striking him with an arrow in his only vulnerable spot, and killed him.

In more modern times, an injury to the Achilles tendon has been dreaded by athletes nearly as much as an ACL tear. With good reason. Reconstructive surgery is a must, a prolonged recovery follows, and many careers have ended.

That's careers, not lives.

Most common among athletes in their late 30s, the mishap is as much a symptom of physical overuse and aging as it is an unexpected and unwelcome injury.

For Kobe Bryant, the opinion of Lakers staff notwithstanding, I suspect it is more of the former than the latter.

Tendons are poorly perfused compared to muscle, meaning they don't have much of a blood supply. Overused, they don't become inflamed — and painful — they simply and slowly wear out. Eventually, without an inflammatory process to trigger any healing, they tear. The first warning sign is often the athlete planting on his foot and then folding up like an accordion just as Bryant did.

Repaired, tendons do function again but prolonged immobilization and disuse causes massive atrophy (shrinking) of the associated muscle(s), in this case, the gastrocnemius and soleus, better known as the calf muscles.

While Bryant can expect to regain 80-to-90 percent of his strength there within a year, it will take another 12 months to get the rest.

Still, his case isn't hopeless. A look at three similarly afflicted athletes from the past may offer a glimpse of Bryant's future.

During the 1999 playoffs, New York Knick great Patrick Ewing partially tore his left Achilles tendon. His season over at age 36, he required surgery but returned for 62 games in 1999-00, averaging 15.0 points per game.

In August 2008, at age 37, White Sox pitcher Jose Contreras suffered a complete tear of his left Achilles tendon. He returned to start 21 games in 2009, compiling a record of 5-13 with an ERA of 5.42, before the White Sox traded him to the Rockies. Thereafter, he bounced around the National League as a reliever, finishing his career last season.

In October 2008, Olympic beach volleyball gold medalist Misty May-Treanor, then 31, was practicing for ABC's Dancing with the Stars. During a hop step, an audible crack emanated from the back of her left ankle. Her dancing career may have been over but the subsequent surgery and rehabilitation were good enough to get her to the gold medal stand for a third time last summer in London, at age 35.

Which is what Bryant will be next season. Consequently, I expect his recovery to most closely match May-Treanor's. That's if the Lakers manage his playing time at a more sane level than the 38.6 minutes per game he averaged this year and the 40-plus he averaged over his last seven games.

John Doherty is a certified athletic trainer and licensed physical therapist. This column reflects solely his opinion. Reach him at Follow him on Twitter @JDohertyATCPT.

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