The News Herald (Willoughby, OH)
Achilles tendon at risk from increased vigorous activity
DEAR DR. ROACH >> I ruptured my Achilles tendon playing basketball seven years ago at the age of 49. I was able to recover and continue playing. My question has to do with others who have suffered from this: Why do so many young people appear to tear their Achilles? I can think of a handful of guys I know who have recently done this, and all of them are in their 20s or 30s. I don’t remember this happening when I was at their age. Is there an increase in the number of young people tearing/rupturing their Achilles at such a young age? And if so, what is this attributable to?
— F.H.
DEAR READER >> There is indeed an increase in the rate of rupture of the Achilles tendon. Experts have attributed this to increased vigorous physical activity. Competitive sprinters, decathletes, soccer players, jumpers and basketball players all have a greater than 10% lifetime risk of tendon rupture. The most common age for this to happen is 3040, and it’s about five times more likely in men than women.
A class of antibiotics, which includes ciprofloxacin, is associated with increased risk of tendon rupture within a month of taking it. Surgical consultation should occur immediately after tendon rupture, although not everyone will need surgery.
DEAR DR. ROACH >> About seven years ago, I was diagnosed with hemochromatosis, and my ferritin level was in the thousands. A liver biopsy showed no damage from the excess iron, and after having regular blood tests and phlebotomies, my ferritin level is now down to an acceptable level.
After relocating to a new state and finding a new hematologist, my ferritin count is now down to 250. The normal range is 24 336 nanograms per liter.
The doctor wants me to have another phlebotomy, as she states that the ideal range for someone with hemochromatosis is 100 or below.
My 250 reading is the lowest I have ever been since I was diagnosed, and I can’t find any info verifying the 100 or below recommendation.
— D.M.
DEAR READER >> Hereditary hemochromatosis is a disease of iron absorption. Normally, the body absorbs iron very efficiently when the body’s iron levels are low, and doesn’t absorb much or any when the iron level is where it should be. In hereditary hemochromatosis, iron is absorbed at the highest possible level by the body all the time. This leads to iron overload since the body has (almost) no way of ridding itself of extra iron.
The “almost” refers to women with menstrual periods, which does get rid of some iron. Women typically develop symptoms of HH later than men, but it is possible for menstruating women to develop iron overload.
Contact Dr. Roach at ToYourGoodHealth@med. cornell.edu.