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Elite Care for an Elite Runner: Repairing a Ruptured Achilles Tendon

Doug Escher made quite an impression when he first went to see Dr. John Kennedy, an orthopedic surgeon at Hospital for Special Surgery, in 2006. A retired police detective from Garden City, New York, Mr. Escher came to Dr. Kennedy with Achilles tendonitis and an amazing record as a marathon runner.

Orthopedic surgeons at Hospital for Special Surgery are accustomed to treating professional athletes, but Dr. Kennedy and his colleagues marveled at Mr. Escher's accomplishments. A former elite runner, at age 38 he ranked 47th nationally. He had been running marathons on and off for about 30 years. At one time, he could run a mile in 5 minutes and 44 seconds. At age 60, he ran a 26-mile marathon in 3 hours and 10 minutes, which many younger athletes would struggle to match.

He continued running until age 61, when Achilles tendonitis stopped him in his tracks. "It was very painful," Mr. Escher says. "It's a condition that often affects runners."

The Achilles tendon is the largest and strongest tendon in the human body, connecting the calf muscles to the heel bone. Remember Achilles, the hero in Greek mythology who was only vulnerable at his heel? The tendon can withstand forces of 1,000 pounds or more, but it is also the most frequently ruptured tendon in the body. Achilles tendonitis is a common overuse injury that causes pain and inflammation.

Mr. Escher came to HSS on the recommendation of a fellow runner who was very pleased with the care he had received from a sports medicine specialist. Mr. Escher originally saw the same doctor, but she recommended he see Dr. Kennedy, who specializes in sports injuries of the foot and ankle.

As is the case for many runners, Mr. Escher's tendon had degenerated from wear and tear. After his doctor visit, he went home with a prescription for physical therapy, orthotics and medication to reduce the inflammation. He also took it easy for a while and was hoping to get back to running. But then he ruptured his tendon in a freak accident. One day when he was out with his dog, his pet suddenly dashed over to another animal. When Mr. Escher jumped up to go after him, his already weakened tendon snapped like a rubber band.

"Mr. Escher's tendon was compromised to begin with, and that type of sprinting action is often the final blow that causes a rupture," Dr. Kennedy says. "Many people who rupture their Achilles tendon say it feels like someone has kicked them in the back of their leg. They may be able to walk after, but they could not stand on their toes or engage in athletic activities."

This time, Mr. Escher needed surgery. Dr. Kennedy repaired the tendon by suturing it back together. Recovery after such an operation is generally slow, requiring a cast and rehabilitation to build back muscle strength, but Mr. Escher was willing to do what was necessary to get back to running.

He says he was very happy with the care he received, and although he lives on Long Island, he never considered going anywhere but Hospital for Special Surgery. "For a lot of people on Long Island, it's an inconvenience to go into Manhattan. As a runner, I wanted to put myself in the best hospital with the best doctor possible," he explains. "At Special Surgery, you have the doctors who know the most about the least common conditions. I liked the idea of seeing a very specialized doctor who treats very specific injuries."

He was well on his way to running again, but recently developed Achilles tendonitis in his other foot. Dr. Kennedy recommended treatment with a specialized laser that promotes healing and reduces inflammation. Once that tendon is healed, Mr. Escher plans to start training again so he can resume running.

"We see a lot of elite runners, but we were particularly impressed by Mr. Escher," says Dr. Padhraig O'Loughlin, an orthopedic research fellow who works with Dr. Kennedy, and a marathon runner himself. "The most impressive thing about Mr. Escher is he's always so positive, nothing gets him down. The whole office is rooting for him."

The doctors expect Mr. Escher to get back to running this summer. Dr. O'Loughlin says he hopes to join him his first time out.

Repairing a Ruptured Achilles Tendon, an Elite Runner's Story