The Philles gave up an early home run in the first inning that ended up being the only run scored in the game. The Philles were able to get just three hits all night. In the final inning, Howard came to the plate with two outs, and a chance to tie the game. Howard connected with a weak ground ball, and sprinted toward first to attempt to beat out the throw. A few steps out of the batter's box, Howard suddenly began to hobble, then fell to the ground, clutching his ankle. An MRI two days later confirmed the diagnosis of a ruptured Achilles tendon.
Achilles Tendon Ruptures:
An Achilles tendon rupture occurs when the tendon snaps just behind the ankle joint. The rupture almost always occurs a few centimeters above the heel, where the tendon is weakest. When an Achilles tendon rupture occurs, the muscles can no longer point the toes downward, and the strength of the movement is lost. Muscle spasm, swelling, and inflammation can cause acute pain, but the longer-term issues relate to the strength of movement of the ankle.
Cortisone Injections in the Achilles:
Injecting cortisone around the Achilles tendon is very controversial. Injections into the tendon are known to increase the likelihood of tendon rupture, and injections into the surrounding soft tissues may have similar effects. Usually, if an injection is considered, a lengthy period of rest to avoid tendon ruptures will follow the injection.
Achilles Tendon Repairs:
Surgical treatment is accomplished by suturing together the torn ends of the ruptured tendon. As is the case with Howard, surgery is delayed to allow swelling to subside. The surgery itself is not complicated, but there are potential complications of surgery that can be serious. The most concerning surgical complications are infection and healing problems.
Having Cortisone Shots for Achilles Problems:
Most doctors feel that cortisone should be used in this area as a last resort, following months of traditional Achilles tendon treatment. Furthermore, many doctors will recommend that after an injection of cortisone anywhere around the Achilles, that people rest the tendon for weeks, or even months, to ensure an Achilles rupture does not occur.
Rehab After Rupture:
Typically the tendon takes about three months to heal, but normal motion and strength are seldom seen before 6 months from the time of surgery. For a professional athlete like Howard, it may take even longer to fully recover from the surgery.