The Achilles heel of the London Olympics

Achilles tendon injuries often have a significant impact on an athlete’s career. Depending on the grade of injury, up to 6 months of rehabilitation can be required before an athlete can return to sport. These injuries also have the potential to become longstanding and without appropriate management there is an increased risk of re-injury.

This year’s London Olympics saw one of China’s greatest athletes succumb to Achilles injury in the 110 meter hurdles event. Being the first ever Chinese track athlete to achieve world champion and Olympic champion status as well as being a world record holder, Liu Xiang fell over the first hurdle in his heat. Xiang then hopped on one foot, kissed the last hurdle and finished the race to the applause of the Olympic stadium. This is the same injury that forced the gold medal favourite to withdraw from the Beijing Olympic Games after a false start from another competitor. The Chinese champion is now scheduled for surgery in Great Britain before return home. The China Daily has quoted Xiang as saying:

‘It’s a small surgery and will not affect my life. Maybe I will be stronger after I come back. I treasure the hurdling event. I will be back. Since the hurdles are still there, I want to conquer them. The key is how I go about recovering after surgery. Just take it easy. Take care.’

But not all Achilles tendon injuries end in heartache. Take Great Britain’s World Champion triathlete Alistair Brownlee. Brownlee partially tore his Achilles tendon 6 months out of the London Olympics and underwent three months of rehabilitation under the close guidance of his sports medical team. Brownlee was placed in a boot for 4 weeks and then began underwater running on a treadmill specially built in his backyard. The UK’s Daily Mail spoke to Brownlee after his injury:

‘I felt pain in my calf and ankle. Alarm bells sounded. It’s hard to put into words just how frustrating it is not being able to train. For me it is the loss, for a month at the very least, of the thing I love.’

His brother and training partner Jonathan Brownlee recalls that during his rehabilitation his brother contemplated retiring from the sport due to his injury. However he regrouped and went on to win the World Series in Kitzbuhel just prior to the London games followed by gold at the London Olympic Games. His brother took out the bronze medal after taking out a 15 second time penalty, and soon after they became the first British brothers in 100 years to share an Olympic podium.

Previously the only treatment option for a ruptured Achilles in an athlete was surgery followed by a long period of immobilisation and slow rehabilitation. A complete rupture of the Achilles would signify the end of an athlete’s career or relegate the athlete to the lower ranks of competition upon re-entry to sport. However, surgery has come a long way in the last 10 years. Percutaneous approaches, coupled with local anaesthetic procedures now allow athletes to return home the same day. Cast immobilisation can be limited to one to two weeks allowing athletes to maintain fitness and reduce the period of rehabilitation.  The new edition of the Clinical Sports Medicine textbook discusses these recent findings and management options in its updated chapter titled ‘Pain in the Achilles region.’

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