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Beckham's injury explained

2010-03-15 17:30
London - David Beckham's torn Achilles' tendon may end his chances of playing in the World Cup, but the injury is hardly surprising - especially for an elite athlete.

The Achilles' tendon, which connects the calf muscle to the bone in the heel of the foot, is the most commonly torn tendon in the body. The tendon is usually torn when the leg is straight and the calf muscle contracts.

It typically takes several months for athletes to fully recover.

"With Beckham, you never say never, but if it's a complete tear, it's very unlikely he'll be fit enough for the World Cup," said Jonathan Rees, a sports medicine expert and spokesman for the British Association of Sport and Exercise Medicine.

"With early surgery, Beckham might get back into training in three months' time, but that wouldn't give him enough time to be match-fit for June."

Doctors said if the footballer had only partially torn his Achilles' tendon, there was a slight possibility he might be ready to play in South Africa.

"If it's only a partial tear, you can start rehabilitation earlier and be much more aggressive," said Dr. Victor Khabie, chief of orthopaedic surgery and sports medicine at Northern Westchester Hospital in New York and a former assistant team physician for the Los Angeles Galaxy team.

That could potentially cut Beckham's recovery time in half, he said.

"There's a small chance that (Beckham) could be ready, but it's still not a great chance," Khabie said.

Tearing the Achilles tendon can happen even without a major incident, particularly in athletes whose bodies are under the continual stress of physical training. Beckham has had little time off, playing for the Los Angeles Galaxy of Major League Soccer and then going on loan with AC Milan in Italy.

The injury is most common in tennis players, football players, basketball players, and runners. A study published earlier this year found that one third of National Football League players who hurt their Achilles' tendon never returned to playing professionally.

In Beckham's case, he was on his own in the centre circle before he began hopping on his right leg, grimacing in pain during AC Milan's 1-0 victory over Chievo Verona on Sunday.

"With the Achilles' tendon, you can have a lot of wear and tear happening over your career so the tendon itself is weakened," Rees explained. "The final event that tears it can be quite innocuous."

Beckham was in tears after the injury and was carried off the field on a stretcher. Khabie said that was consistent with the pain of a complete tear.

"It feels like someone kicking you in the back of the heel very hard, and if you are in severe pain, it's likely the tendon has snapped," he said.

People who tear their Achilles' tendon have major swelling and are unable to put any weight on their ankle or foot. Beckham generally kicks the ball with his right foot.

Certain medications increase the risk of tearing the Achilles' tendon, like antibiotics or medicines to reduce inflammation like corticosteroids. It is not known whether Beckham was on any such treatment.

Doctors typically fix torn Achilles' tendons with surgery. After the operation, patients are outfitted with a cast or brace to help the tendon heal, for about six to eight weeks. That makes Beckham's chances of playing in June at the World Cup unlikely, experts say.

Khabie said Beckham would likely want to be fully recovered before resuming play, since reinjuring the tendon could end his career entirely.

"It might put him out of the World Cup, but he could be back to form in about a year or less," Khabie said.
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