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Achilles Tendon Ruptures – What You Need To Know

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Most people know that the Achilles tendon has something to do with the back of your ankle, but I sat down with orthopaedic foot and ankle specialist Dr. Marvin Brown to find out a bit more.

What is the Achilles tendon and what does it do?
The Achilles tendon is the thickest and strongest tendon in the body. A tendon connects muscle to bone and the Achilles tendon connects the calf muscles to the back of the heel bone. This tendon allows you to point your foot, helps to bend your knee, and makes it possible to internally rotate your ankle.
When you stand up, you exert a force 3 times your body weight through this tendon and your feet. Walking increases that force to 4.5 times your body weight and running increases it even more to 9-12 times your body weight. This amount of force is what can lead to an Achilles tendon rupture.

What is an Achilles tendon rupture?
An Achilles tendon rupture is a break or disruption of the connection between the calf muscles and the heel bone. The most common area for the tendon to rupture is just above the heel bone, where there is poor blood supply to the tendon. Often, a patient who suffers an Achilles tendon rupture has already experienced symptoms of tendon degeneration, whether they realized it or not. Prior degeneration, of course, makes the tendon more vulnerable to rupture.

What are the symptoms someone would experience with an Achilles tendon rupture?
When someone ruptures this tendon, they often feel as if something hit them on the back of the leg. They hear a loud pop and have pain with walking and with pointing their foot. They will also notice they cannot feel a tendon on the back of their leg just above the heel. Instead of a taut, cord-like structure, it will feel soft. When an Achilles tendon rupture is suspected, a medical provider will perform the Thompson Test – which involves squeezing the calf muscle with the patient laying on their stomach or sitting with their legs free from the floor. If the foot does not point when the calf muscle is squeezed, it is considered a positive test for Achilles tendon rupture. Note: Achilles tendon ruptures can sometimes be misdiagnosed as ankle sprains if the tendon rupture gap is disguised by bruising and swelling. It is recommended to seek evaluation from an orthopaedic specialist if you think you may have an Achilles tendon rupture.

How do Achilles tendon ruptures occur?
Most Achilles tendon ruptures occur when a sudden explosive activity – such as forceful push off at the start of a sprint or falling onto the foot, resulting in a violent upward flexion of the foot – stretches the tendon beyond what it can hold. If the Achilles tendon ruptures without a sudden, explosive activity, there are likely other contributing factors – including degeneration of the tendon due to age, a change in training, or possibly a previous injury that was left untreated.

How soon do you need to seek medical attention for an Achilles tendon rupture?
It is best to seek medical attention immediately after you suspect an injury to your Achilles tendon. The sooner proper treatment is started, the better for the long term healing of the tendon.

If you have an Achilles tendon rupture, will you definitely need surgery?
This can be a point of controversy among orthopaedic surgeons. There is evidence to support both arguments, however both the patient’s preference and level of activity are always considered when making a decision about a surgical or non surgical approach. Unfortunately, re-ruptures are likely with both approaches, though more likely with non surgical treatment.

How is an Achilles tendon rupture treated?
If surgery is deemed necessary, then a tendon repair would be performed. This involves knitting the torn tendon back together using sutures. Achilles tendon repair is usually performed in an outpatient setting and may be done either as an open repair or a minimally invasive primary tendon repair, depending on the case.  

For non surgical treatment, there are two possibilities:

  • the patient can be kept non weight bearing and casted with their foot pointed for two weeks before starting weight bearing
  • the patient can begin weight bearing early on in a boot with a small amount (3cm) of heel lift

Keeping the foot pointed down allows the ends of the tendon rupture to begin healing. Once weight bearing has begun in a walking boot, another centimeter of heel lift is removed every two weeks until the patient is able to step with their ankle at neutral and the tendon is healed. The patient would also have early rehab exercises to encourage good range of motion in the ankle. After eight to ten weeks of walking with immobilization, they would begin formal physical therapy and walking in a sturdy tennis shoe.

Describe the rehabilitation process following treatment for an Achilles tendon rupture.
Both surgical and non surgical patients begin early range of motion. The surgical patient would remain non weight bearing for six weeks following surgery, but ankle motion would be initiated after the skin had healed. Studies have shown us that the sooner patients with tendon repairs move the ankle joint, the better they do in the long run. Movement helps keep scar tissue from forming and encourages blood flow to the area for healing. The surgical patient will begin formal physical therapy at around 12 weeks once they are full weight bearing. The non surgical patient will typically be able to begin formal physical therapy at around 10-12 weeks after the start of treatment.

Dr. Marvin Brown is an orthopaedic surgeon with TSAOG. He is board certified by The American Board of Orthopaedic Surgery (ABOS), fellowship trained in conditions of the foot, ankle and lower leg, and sees patients aged 1 and up. Dr. Brown has a special interest in total ankle replacement, complex foot and ankle fractures, ankle arthroscopy, tendon reconstruction, and ankle arthritis. He is fluent in Spanish and has appointments available at our Central location.

TSAOG Seeking Patients with Chronic Hip Pain for Hip Osteoarthritis Study

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The San Antonio Orthopaedic Group (TSAOG) is currently seeking participants for the MONOVISC Hip Osteoarthritis Study.

You may qualify for the MONOVISC Hip OA Studay if you:

  • Are at least 30 years old
  • Have hip osteoarthritis that causes significant walking pain
  • Are willing to discontinue all pain medications for the duration of the study except for acetaminophen (e.g. Tylenol)
  • Have not had recent injections into your hip joint

Other study restrictions apply.

For more information, please contact Maria Lopez, Study Coordinator, at (210) 804-5901.

2016 Holiday Hours – TSAOG and OrthoNow Closures

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All TSAOG offices and both locations of the OrthoNow Walk-In Injury Clinic will be closed on Friday, December 23rd through Monday, December 26th to allow the OrthoPeeps to spend Christmas with their families.  We will resume normal operating hours at all locations on Tuesday, December 27th.

All TSAOG offices and both locations of the OrthoNow Walk-In Injury Clinic will also be closed on Monday, January 2nd.  We will resume normal operating hours on Tuesday, January 3rd.

Please note: The OrthoNow Walk-In Injury Clinic at the Orthopaedic Institute WILL be open on New Year’s Eve – Saturday, December 31st – from 9am until 1pm.

We wish you all a safe and Merry Christmas and a Happy New Year!

TSAOG Congratulates Our SA Doctors: Best of 2017

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TSAOG is so pleased to announce that 28 of our physicians have been named to San Antonio Scene‘s list of S.A. Doctors: Best of 2017! This issue is on newsstands now and features the best doctors and dentists in San Antonio, TX – as nominated by their peers.

The following TSAOG physicians made the list:

Congratulations to our S.A. Doctors: Best of 2017!

All TSAOG and OrthoNow Locations Closing Early Today – Friday, December 2nd

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a man sitting in his desk with a santa hat holding a signboard with the text office christmas party written in it

Please note: All clinic locations for The San Antonio Orthopaedic Group and the OrthoNow Injury Clinic will close today, December 2nd, at 4PM to allow the OrthoPeeps to celebrate at our annual Holiday Party!

The OrthoNow Injury Clinic at Concord Plaza will be open tomorrow, December 3rd, from 9am-1pm and all other locations will reopen with normal business hours on Monday, December 5th.

We apologize for any inconvenience this may cause. Thanks and have a fun and safe weekend!

Thanksgiving Hours 2016

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Harvest cornucopia close up with Happy Thanksgiving gift tag on dark wood background

All locations for The San Antonio Orthopaedic Group (TSAOG) and the OrthoNow Injury Clinic will be closed next Thursday and Friday, November 24th and 25th, to allow our employees to celebrate Thanksgiving with their families.

The OrthoNow Injury Clinic at 400 Concord Plaza Dr, Ste 300, San Antonio, TX 78216 will resume normal operating hours on Saturday, November 26th from 9am-1pm.

All other locations will resume normal business hours on Monday, November 28th.

We wish you all a safe and Happy Thanksgiving!

Help TSAOG Support Prader-Willi Research with One Small Step

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TSAOG’s Dr. Sergio Viroslav has a daughter with Prader-Willi Syndrome, so this cause is very close to his heart. He has agreed to share his personal story to help raise awareness:

We always felt something was amiss. This pregnancy was different than Alice’s prior one; fetal movement was sporadic and with less vigor. The ultrasound showed excessive amniotic fluid. At least the amniocentesis revealed the normal number of chromosomes.

One month to go, Alice was admitted to the hospital with a baby that wasn’t moving much; the OB had done all she could do in 1996. All we could do was wait for the lungs to mature and hope for the best.

Olivia was born 1/11/96. She weighed less than 6 lbs, her tone was low, but at least she was alive and eating.

She didn’t walk until she was three. Then this small infant who we were told had some sort of muscle or energy producing disorder began to gain weight. She didn’t particularly eat more than her siblings, though she did seem to care more about food then her older sister and younger brother.

In 2001 a visit to a childhood obesity clinic prompted the endocrinologist to check for Prader Willi Syndrome (PWS). The doctor told us not to worry. Olivia was engaging and bright. She was performing well at school, and the chromosome test was standard in working up obesity in children. We were cautiously optimistic.

As the Twin Towers were falling on September 11th we received the news. Olivia’s 15th paternal chromosome had a deletion – Prader Willi Syndrome.

Olivia is now a junior in high school. She plans to attend college when she graduates. She has friends and is active in her Temple youth group. But every day is a challenge. The pantry is locked in our home. She takes a daily shot of growth hormone to help her muscles and metabolism. She takes medicine to help her when she becomes fatigued and medicine to help her cells use insulin more efficiently. She is at the gym every day, she eats less than 1500Kcal and she can barely lose a pound. Her hunger never ceases.

That’s why we do this. We do this to help kids with Prader Willi . We do this because it’s the only way to fight. It’s the only way to find a cure. 

“ The greatest of all mistakes is to do nothing because you can only do a little – do what you can.”-  Sydney Smith

TSAOG will be collecting donations in our clinics (where you can purchase a pair of One Small Step cut-out feet for $2) and online to help the Foundation for Prader-Willi Research work towards a cure for Prader-Willi Syndrome. All donations will go to the Foundation for Prader-Willi Research (FPWR)In fact, Dr. Viroslav is so committed to the cure that he will be matching all donations made to Team TSAOG through our campaign page at: http://onesmallstep.fpwr.org/dw/users/teamtsaog/SanAntonio2016

The fundraising for FPWR will culminate with a family friendly walk at the Tobin Center
 on Saturday, November 5th from 9am-Noon.  Please join us at this fun event to help raise awareness of this disease and contribute what you can to help work towards a cure. Register here.

 

 

TSAOG Welcomes Dr. Thomas DeBerardino

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TSAOG is very pleased to welcome Dr. Thomas M. DeBerardino to our practice! His first day is today – Friday, September 16th.

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Dr. DeBerardino is an orthopedic surgeon, fellowship trained in sports medicine. He is a retired U.S. Army Veteran specializing in arthroscopic surgery of the knee, shoulder, and hip and reconstructive procedures of the knee and shoulder. 

He will be treating orthopedic conditions of the shoulder, hip, and knee for patients aged 6 years and up and will hold clinic at the following TSAOG locations: The Orthopaedic Institute, Stone Oak, and the Medical Center.

Dr. DeBerardino’s special interests include:

  • Arthroscopic Surgery (Shoulder, Knee, and Hip)
  • Sports Medicine
  • Joint Restoration Surgery
  • Cartilage & Meniscal Transplantation
  • Complex Knee & Shoulder Reconstruction
  • Knee Osteotomies and Partial Knee Replacement

Without further ado, meet Dr. Thomas DeBerardino:

To schedule an appointment with Dr. DeBerardino, please call 210.281.9595 or request an appointment online.

To learn more about Dr. DeBerardino’s background and training, please visit his webpage.

Recruiting specialty trained orthopedic surgeons is one more way TSAOG makes your health our mission.

TSAOG Welcomes Dr. G. Lane Naugher

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TSAOG is very pleased to welcome Dr. G. Lane Naugher to our practice! His first day is today – Friday, September 9th.

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Dr. Naugher is an orthopedic surgeon specializing in sports medicine. He completed his fellowship training at Wake Forest Medical Center in Winston Salem, NC. 

He will be treating all orthopedic conditions, with the exception of the back and neck, for patients aged 3 years and up and will hold clinic at the following TSAOG locations: The Orthopaedic Institute, Schertz, New Braunfels, Westover Hills, and Mission Trail.

Dr. Naugher’s special interests include:

Arthroscopy and Sports Medicine:

  • Shoulder, elbow, hip, and knee arthroscopy
  • Shoulder dislocations and instability
  • Rotator cuff tears, including arthroscopic treatment of massive tears and revisions / repairs
  • Throwing Problems and Pain in the Shoulder and Elbow
  • Ulnar Collateral Ligament Injuries, Tommy John Procedure
  • Hip arthroscopy for management of hip conditions including FAI (femoroacetabular impingement), labral tears, trochanteric bursitis, ilitiotibial band syndrome, gluteal tendon, and proximal hamstring tendon tears
  • Knee Instability and Multiligament knee reconstructions
  • ACL , PCL Injuries and Arthroscopic Reconstruction
  • Meniscal Repairs and Transplantation
  • Cartilage preservation and restoration procedures of shoulder, elbow, hip and knee

Joint Replacement and Preservation:

  • Joint preservation arthroscopic procedures for shoulder, elbow, hip, and knee arthritis
  • Total and Reverse Shoulder Replacement
  • Total Hip Replacement
  • Partial and Total Knee Replacement

Trauma and Fracture Care:

  • Upper and lower extremity fractures and dislocations
  • Traumatic tendon or ligament injuries

Without further ado, meet Dr. Lane Naugher:

To schedule an appointment with Dr. Naugher, please call 210.281.9595 or request an appointment online.

To learn more about Dr. Naugher’s background and training, please visit his webpage.

Recruiting specialty trained orthopedic surgeons is one more way TSAOG makes your health our mission.

TSAOG Bids Farewell to Dr. Philip Jacobs

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Jacobs Philip M.

Unfortunately, TSAOG must bid a fond farewell to sports medicine specialist Dr. Philip Jacobs. Dr. Jacobs has accepted an academic position at the University of Texas Health Science Center and will be leaving The San Antonio Orthopaedic Group effective September 30, 2016.

Current patients of Dr. Jacobs will have the option of transferring their care to another TSAOG physician or any other physician of their choice. If you are a current patient with Dr. Jacobs and have any questions about your medical records or continued care, please call our main office at (210) 804-5400.

Dr. Jacobs will be missed and we wish him the best of luck in his future endeavors.

 

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