Professional and recreational athletes alike are subject to injuries of the Achilles tendon, the strong band of tissue that connects the calf muscle to the heel. If this tendon is stretched out too far, it may tear, rupture, or degenerate, causing pain in the ankle and lower leg so extreme that it may be impossible to walk.
Achilles tendon tears are often the result of sports injuries, particularly one those that occurs during repetitive athletic activities, such as jumping, pivoting, or sudden accelerations during running. Achilles tendon injuries are not only seen in basketball players and other professional athletes, but are common in “weekend warriors” who suddenly become active without proper physical preparation. Most often, tendon tears and ruptures require surgical repair. Tendon tears most often require surgical repair. The flexor hallucis longus, or FHL, tendon, which runs from one of the leg bones to the rear of the ankle, is most commonly used to reconstruct and augment the Achilles tendon.
If the Achilles tendon is stretched beyond its normal limits, it may tear or rupture. When patients rupture an Achilles tendon, they experience severe pain and swelling near the heel of the foot and are unable to walk normally or bend their foot. Although frequently resulting from the same stresses that cause Achilles tendonitis, an Achilles rupture is a far more serious injury.
The peroneal tendons, located along the outer edge of the lower leg provide stability and function to the ankle joint. Inflammation and tears of the peroneal tendons are common sports injuries, typically due to repetitive stress. They frequently occur in basketball, volley ball and football players, runners (particularly those who run on uneven surfaces), and in gymnasts. Pivoting motions are often responsible for the development of such injuries. Those with high arches or heels that turn slightly inward (hindfoot varus) are at greater risk.
When surgical repair or restoration of the peroneal tendon is required, there are two surgical options: retinaculum repair or groove reconstruction.
Lisfranc injuries occur when the midfoot suffers a fracture or torn ligament. This frequently occurs in football and soccer players, as well as anyone who stumbles over the top of a downwardly flexed foot.
Any Lisfranc injury involving a subluxation of the joints, in which the bones are moved out of their normal position, requires surgery. The primary goals of Lisfranc injury fixation are to realign the joints of the midfoot. Fixation devices may be used to secure placement until healing is complete.
While Hallux rigidus, meaning “stiff big toe,” can occur in anyone as a type of degenerative arthritis affecting the joint located at the bottom of the big toe, it is a common problem with athletes who put a great deal of stress on the big toe. Often referred to as “turf toe” in athletes, the condition causes the toe to stiffen and become painful, eventually causing severe mobility issues. As the arthritis worsens, bone spurs develop along the top of the big toe joint. Cheilectomy is a surgical procedure to remove the bone spurs, so relieving pain and improving flexibility so normal athletic activities can be resumed.
Because athletes are more prone to ankle injuries, even those requiring surgical intervention, than their more sedentary peers, it is important for them to understand the benefits of arthroscopic surgery. Arthroscopic surgery is less invasive than traditional surgery and allows the doctor to view and repair joints without making a large incision.
Ankle arthroscopy requires only a small incision. During the operation, the surgeon uses small instruments guided by a tiny camera to transmit images onto a video screen. The procedure can be used to remove bone spurs, to repair osteochondral lesions, to remove scar tissue or to relieve symptoms of arthritis. There are many advantages to arthroscopic surgery over open surgery, including: less pain, less scarring, less bleeding, and shorter recovery time. For athletes, this can mean less time without training and less time off the field.