Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A tendon is the fibrous tissue that attaches muscle to bone in the human body. The forces applied to a
large tendon may be more than five times the body weight. In some rare instances, tendons can snap or rupture. Conditions that make a rupture more likely include the injection of steroids into a tendon, certain diseases (such as gout or hyperparathyroidism), and having type O blood.
Although fairly uncommon, a tendon rupture can be a serious problem and may result in excruciating pain and permanent disability if untreated. Each type of tendon rupture has its own signs and symptoms and can be treated either surgically or medically depending on the severity of the rupture and the confidence of the surgeon.
The four most common areas of tendon rupture are as follows:
A group of four muscles -- the vastus lateralis, vastus medialis, vastus intermedius, and the rectus femoris
-- come together just above the kneecap (patella) to form the patellar tendon.
Often called the quads, this group of muscles is used to extend the leg at the knee and aids in
walking, running, and jumping.
This tendon is located on the back (posterior) portion of the foot just above the heel. It is the site of attachment of the calf muscle (gastrocnemius muscle) to the heel of the foot (the calcaneus bone).
This tendon is vital for pushing off with the foot (this motion is known as plantarflexion). The Achilles helps you stand on your tiptoes and push off when starting a foot race.
The rotator cuff is located in the shoulder and is actually composed of
four muscles: the supraspinatus (the most common tendon ruptured), infraspinatus, teres minor, and subscapularis.
This group of muscles functions to raise your arm out to the side, helps you rotate the arm, and keeps your shoulder from popping out of its socket.
The rotator cuff tendon is one of the most common areas in the body affected by tendon injury. Some
autopsy studies have shown that 8%-20% have rotator cuff tears.
The biceps muscle of the arm functions as a flexor of the elbow. This muscle brings the hand toward the shoulder by bending at the elbow.
Ruptures of the biceps are classified into proximal (close) and distal (far) types. Distal ruptures are extremely rare. The proximal rupture is at the attachment of the biceps at the top of