Pain in Achilles tendon and Midfoot

Patient

Q: About a year ago I was playing basketball and while driving to the basket, when my left heel hit the ground I felt a pain shoot up my Achilles tendon, but also in my mid foot. So as I went to jump off my left foot in that same step, I lost all vertical and strength. I kept playing because I could still put all weight and pressure on just that leg so I figured I didn't tear the tendon. I stopped playing and running for a few months after that to rest. Now, nearly a year later, I have played basketball a few times and I still have almost no vertical just jumping off that foot and after I run or play, I have some pain in the tendon and mid foot. The only thing I can think of is a combination of a partially ruptured Achilles tendon that hasn't healed and a Lisfranc injury. Any other possible scenarios and advice?

Doctor

A:   You were complaining about recurrent pain in region of Achilles tendon radiating up to mid foot. Lisfranc injury or fracture, is fracture of mid foot, which is rare in football players, as it requires twisted movement on a flexed forefoot, which is rare movement in football. Moreover, these injuries are usually open wound injuries and can be easily diagnosed by a X-ray. This is a rarest possibility in your condition. Other option of Achilles tendon tear can be seen in sudden forced flexion movement of foot, but this condition is usually extremely painful, which also may not be option in your condition. Third one is Achilles tendinitis, which is quiet common in sports person, who involve in lot of jumping. This could be an option in your condition, as the pain is moderate to severe, usually associated with pain above ankle and in mid foot. Compression therapy, heal pads, physiotherapy exercises will help the condition. Pain killers and steroids can be helpful. Visit a physician at the earliest, as you are in risk of tendon rupture.

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