As we mentioned yesterday during our breakdown of Kirk Cousins’ Achilles tendon tear, this week on the blog has been deemed “Achilles Week.” We are going to spend the week looking at a number of different aspects of Achilles tendon tears and their management. Today, we’re going to explore some of the risk factors that can increase an athlete’s likelihood of a partial or complete Achilles tendon rupture.
Achilles Tendon Rupture Risk Factors
An athlete’s Achilles tendon rupture risk profile is an intricate interplay of numerous factors. While some of these elements are within our grasp to manage, there are others that remain beyond our control. We encourage you to proactively address the controllable factors while maintaining an awareness of those elusive elements. Here’s a glimpse into the factors that shape your risk profile for an Achilles tendon tear:
1. Age: Achilles tendon ruptures are a possibility at any age, but they tend to strike with greater frequency in adults in their 30s and 40s. The accumulated wear and tear on the Achilles tendon, coupled with ongoing physical activity, renders it more susceptible to rupture.
2. Obesity: To put it simply, the more you weigh, the more stress is exerted on your Achilles tendon during certain movements. Excess weight further strains the tendon during routine activities such as standing, walking, or simply going about your day. This heightened stress expedites tendon degeneration and amplifies the risk of rupture.
3. Field Surface: Athletes are exposed to a heightened injury risk when performing on surfaces that offer limited force absorption. For example, a grassy football field provides better shock absorption during sprints and landings, in contrast to a hard basketball court where the force is directly transmitted to your feet, ankles, and Achilles tendon. Such surfaces increase the likelihood of damage or tears during swift movements.
4. Steroid Use: Research has highlighted the profound impact of steroid use on the strength of the Achilles tendon. Steroid injections and oral steroids can disrupt the alignment of collagen fibers, which provide stability and strength to the tendon. They also elevate the risk of collagen necrosis, which is the degeneration of collagen. Weakened or damaged collagen fibers substantially heighten the risk of Achilles tendon tears.
5. Gender: Men face an approximate fivefold greater risk of experiencing an Achilles tendon tear compared to women.
Dr. Silverman wanted to touch on a sixth potential factor for Achilles tendon rupture, and that’s diet.
“The Achilles tendon, named after the formidable warrior Achilles from Greek mythology, is indeed intriguing to consider. According to the myth, Achilles’ mother immersed him in the River Styx but held him by his ankle, resulting in this particular area of vulnerability. Yet, if we delve deeper into the origins of Greek mythology, it often sought to provide explanations for natural phenomena. It’s evident that people, dating back to at least the time of the Greeks, have experienced Achilles tendon ruptures.
Additionally, historical records indicate that the first significant city-states whose inhabitants primarily relied on grains for sustenance were the Greeks. When we combine this historical context with our understanding that grain consumption elevates blood glucose levels, which, in turn, can lead to tendon glycosylation and subsequent degeneration, we might arrive at a reasonable hypothesis. This hypothesis suggests that a diet high in sugar and grains could be a contributing factor to the risk of Achilles ruptures.
This concept gains further support from observations in patients with diabetes. Diabetes patients often exhibit a higher degree of tendon degeneration compared to individuals without diabetes. It’s worth noting that patients with diabetes are more likely to be overweight, typically falling into the Type 2 diabetes category.
In essence, while it’s essential to refrain from making definitive claims, there appears to be a noteworthy connection between dietary factors, especially sugar and grain consumption, and the risk of Achilles tendon degeneration and ruptures. Patients with diabetes, who often follow diets with high sugar and grain content, seem to be particularly susceptible to these issues.
By exploring these intriguing connections, we can better appreciate the intricate interplay between diet, health, and the occurrence of Achilles tendon injuries.”