The Ankle Bone is Connected to the…
TCR is happy to announce the addition of Joseph Hecht, M.D. as a guest contributor to the site. You may recall his detailed insights in the comments as "Cubster" on the various medical woes that our team has suffered throughout the years. He's a board certified orthopedic surgeon with over 20 years of experience, currently running a private practice just outside of Chicago, in Munster, Indiana. He'll be providing us with insight on the various ailments that will undoubtedly befall the boys in blue as the season progresses.
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Cliff Floyd, the most recent Cub addition will immediately fit in with the Cub tradition as he’s been a walking wounded athlete much of his career. His current malady for which he had surgery last October is Achilles Tendonitis. Recent Cubs surviving this Epic Malady include the “Marks” Grudzielanek and Prior, although neither of those athletes needed surgery for the condition.
From Greek Mythology and Homer’s Iliad come the origin of the concept that the Achilles tendon is the weak spot of many a legendary hero.
Thetis (Achilles Mother) held the young Achilles by the heel and dipped him in the river Styx; everything the sacred waters touched became invulnerable, but the heel remained dry and therefore vulnerable.
I don’t believe Cliff Floyd’s mom’s first name is Thetis although she might have listened to a song or two from the band Styx.
But seriously folks, this stuff hurts…
Achilles Tendonitis is an overuse syndrome. During running the tendon can transmit up to ten times the body weight. So doing the math:
Cliff Floyd at 6 foot 4 inches and 230 lbs.; 10 x 230 = 2300 lbs
Makes me want to slowly stretch my ankles…
Consequently, the Achilles tendon is subject to inflammation, degeneration and even ruptures. Achilles tendonitis simply put is inflammation and degeneration. More specifically it is categorized by the specific location where the inflammation occurs, either in the tendon itself or at the location where the tendon inserts into the heel bone (aka calcaneus).
Basic initial treatment is rest, anti-inflammatory medications, shoe modifications including arch supports or heel lifts and stretching exercises followed by modifications in the ballplayers training program.
In a pitcher, we all know that much of their velocity comes from the legs and the Achilles transmits the added leverage that the mound gives to that push off. Longer legs and bigger calf muscles mean more force being transmitted across the tendon. No wonder our prodigy pitcher with this problem has the nickname “calf-zilla”.
The tendon itself has a limited amount of blood supply and there is an area about 1-2 inches above where it inserts into bone that has even less vascularity, making that area susceptible to microscopic tearing of the collagen or fibrous tissue that makes up the tendon.
When the condition becomes chronic, usually not responding to treatment for over 6 months, surgical treatment is considered. The surgical approach is to remove the damaged fibers of tendon and if necessary supplement or reinforce it with a nearby tendon.
When the inflammation occurs at the location where the tendon inserts into bone, the treatment is almost identical but if the problem is chronic enough there can be spur formation (which is what Floyd cited as the problem yesterday), which usually takes years to develop.
It is not the spur that is painful but the inflamed tendon adjacent to the spur that is the source of the pain. Treated surgically, the tendon is split, the spur is removed and sometimes the tendon needs to be reinforced with a graft of supplemental adjacent tendon. Recovery can take 3 months or more.
So, hopefully, Jim Hendry and his medical staff are doing some serious medical homework if they really expect to get more than 97 games and 332 at bats like the Mets got from Floyd last season. Well, maybe that’s the point(keep your expectations low), one Matt Murton just might be thinking.
Welcome to the Chicago National League entry, Mr. Floyd, where we are no strangers to the disabled list either.
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