Pop goes my Achilles………
Well on the 1st August 2010 I thought my athletic career came to a screeching end 
Now for a quick intro on my life, well I’m an elite 26 year old female high-jumper (Olympian) and I ruptured my Achilles tendon while training for the 2010 Commonwealth Games.
I was walking back to do another rep when all of sudden i hear a ”POP” and I came tumbling down to Earth with a thud :( YES i did it walking!!!. I knew straight away it was going to be serious and it was either my Achilles or calf muscle on my right leg and it just happened to be my take off foot as well.
I could walk straight away after i did and just had major pain in my calf and couldn’t push through my toes. Being a Sunday I was taken to hospital ASAP where I was diagnosed with a partial tendon rupture and when straight into a half plaster cast, front slab to prevent tearing the tendon all the way through and was informed I would require surgery straight away if it was required. So I hobbled home on crutches and waited till Monday.
Monday 2nd August 2010
So Monday Came and went where i saw a family friend and doctor who booked me into an MRI on Tuesday and an appt. with an Orthopedic surgeon on the Wednesday. He then continued to look at my Achilles and removed the front slab of plaster, he then preformed the Thompson test from where my leg went from bad to worse. There was no movement what so ever, meaning it was a full rupture. There i left on my crutches after the surgeon informed him i can continue to weight bare on it, till i saw as once it’s ruptured you can’t do any more damage on it and that there was no such thing as a partial tear :s
Tuesday 3rd August 2010
It’s MRI time!!!!! Results confirming my nightmare: Recent complete tear of the Achilles tendon 8 cm above the insertion with intra-tendinous gap of approx. 1 cm. FML
Wednesday 4th August 2010
Appt with the surgeon who also is a sports surgeon and does the Australian cricketers (I knew I was in great hands). I was presented with two options surgery and non-surgery. Non-surgery would take longer to heal and the chances of the tendon repairing longer then usual was an extremely high factor, meaning I wouldn’t be able to generate the same power and strength through it, also making it slower. Being on my take-off leg and being a jumper i wasn’t going to the take risk and further more there was a 20% chance of a re-rupture.
Surgery would mean a 2% chance of a re-rupture and the tendon repairing to it’s full strength in 12 weeks. I was also informed should i have the plantaris tendon, they will use that to repair it, making it stronger and aid in a quicker recovery. However not many people have this tendon, it also doesn’t serve a purpose in the foot. We also have one in the wrist.
Surgery would also mean plaster cast and crutches for 2 weeks after surgery then a boot for the following 6 weeks, along with daily injections for 15 days to prevent blood clots. Surgery booked for August 13th.
Stay tuned………
normofthenorth said,
August 26, 2010 @ 7:11 pm
Athlete, what I posted to you before you started your blog still applies:
“Jumper, I think you just took “the prize” from Misty May-Treanor, US Olympic Beach Volley Ball gold medalist, who tore one of her ATs while practicing for the TV series Dancing with the Stars!
If you have the time and inclination, start a blog of your own here, and we can all “pile on” with questions and suggestions and such.
I’m one of the more compulsive (a) bloggers and (b) evidence/study finder here. I’ve assembled one huge page here on studies comparing surgery to non-op protocols — at bit.ly/achillesstudies .
Part-way down (search for “Japan”?), I link to a recent report from two Japanese surgeons who seem to hold the Gold Medal on fast recoveries from ATRs. They reportedly did not use a tendon graft, just lots of strong sutures. (Then they skipped the cast and boot completely — details if you find and follow my link, or ask here and I’ll find it.)
I’m a big fan of the new-fangled NON-op rehab for most of us, including serious competitive non-elite athletes, like the one that produced results as good as surgery in the large recent study I cite, from U. of W. Ontario. But if I were David Beckham or you, and Hell-bent for the fastest complete recovery possible, I think I’d fly to Japan for this fancy surgery. If Beckham recovered as fast as their AVERAGE patient, he could have played for England in the recent World Cup!
I haven’t seriously studied the relationship between grafting — like your surgeon’s use of your plantaris tendon — and recovery time. But from my casual reading, from memory, it’s far from clear that grafted repairs heal faster, on average. Several bloggers here have been told by their OSs that they have to take MORE time (longer NWB or immobilized or pre-PT or in equinus) because their repair was more complicated than average.
I hope you’re jogging at 12 weeks, as planned. For one benchmark of rehab speed with pretty good results, I’ve posted the UWO protocol here at bit.ly/UWOProtocol . It has only 2 weeks of NWB, then FWB (”as tolerated”) at only 4 weeks. PT starts at 2 weeks. For an example of how one of our own bloggers here (an ATR patient who’s also an MD) pushed his own rehab faster than almost anybody withOUT extra Japanese sutures, or a graft, or professional PT, check out achillesblog.com/doug53 .
Alas, many of our most competitive athletes here have found the psychological toll of ATR recovery even higher than average. The more active, the more competitive, and the more results-oriented you were before the ATR (for most folks), the harder it is to be immobilized, even if only for a few weeks. Of course, you will probably be working harder at maintaining CV fitness and tone in the rest of your body than most of us, and that should help physically and psychologically.
Good luck, good healing, and please keep us posted!”
Your surgeon may be an artist with scalpel and needle (I hope so), but he’s pretty sloppy with the evidence. The newest studies — FOUR of them now, all since 2007 — are showing IDENTICAL re-rupture rates from surgery and non-surgery, both in the ~2-4% range. Even the old studies, with your grandfather’s long non-surgical immobilization, seldom reached 20% re-rupture rate, though they were unacceptably high.
The results for ROM — the best easy measure of healed tendon length — are also IDENTICAL with the two approaches. In terms of STRENGTH, one of the studies showed one single measurement where the NON-surgical group was stronger, and I’ve just learned that one of the others found a few of the strength measurements better in the surgical group at 6 months, and better in just one at 12 months.
And as mentioned above, the assumption that grafted repairs heal stronger or more quickly is one that I haven’t seen documented in any studies, though I may have missed one.
The way you repeat what your surgeon told you, if it were true, there would really be no case for skipping the surgery. The current scientific evidence is lots more “inconvenient” than that simple old-fashioned story, to say the least!
OTOH, (a) what’s done is done, on with the rest of our lives, no regrets, and (b) I don’t know of any elite athletes, above the collegiate level, who have been talked out of ATR surgery yet, based on the latest 4 studies. Yet. So you’re in good company.
My own surgeon (who talked me out of surgery) is the Chief Surgeon of Toronto’s pro football team. He told me he was going to try to talk any ATR players on his team out of the surgery, based on the new studies. But one of them ruptured an AT a month or two ago, and got operated on, not by my Doc. I see my Doc again in a few weeks and I’ll ask him for details. . .
Are you in Australia?
athlete said,
August 26, 2010 @ 8:18 pm
Yes I’m in Australia
The studies are very interesting to say the least. Although the recovery rate would still be the same???? 6-12months??? I must say i’ve never heard of the plantaris tendon augmentation either, i’m very interested in seeing how it all turns out and how quickly or slowly i will return back to jumping. Off the top of your head would you know the % of rupturing the other leg? having done one already. I read articles on this site but couldn’t find a clear cut answer.
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judydeb said,
August 27, 2010 @ 4:59 am
I am so sorry this happened to you. I also went “pop” although to me it sounded more like a bang, as I made an ordinary stop and change of direction crossing my kitchen floor. I did this Aug.7.
I am a very active 53 year old and have played National Level sports. (Volleyball and Squash). My rupture was high as well and there is no option for surgery for me. I am interested that there is an option for you. If there had been an option for me I would have taken the surgical route for the very reasons you describe. Since that was not possible I am encouraged by the results of studies that indicate the good possibility of excellent healing without surgery.
In terms of you…hang in there. I find the inactivity is really hard and have developed some creative routines to get through. I do have a great respect for the healing capacity of our bodies and my sense is the training you have done for all these years will stand you in good stead.
Takecare
Judydeb
normofthenorth said,
August 27, 2010 @ 9:35 am
Gosh, you’re BOTH giving Misty May-Treanor competition for the most elite athlete who tore an AT doing the LEAST!!
JD, the latest and best results from non-surgery seem to be not just excellent, but statistically indistinguishable from the results from surgery, except for the surgical complications and the scarring, etc. I went for surgery in late 2001 (first ATR), based on “the very reasons you describe”, which were universally believed to be true back then. Since about last year, if you want to sustain that belief, it helps not to read any studies! And stay away from Orthopedic Surgery conferences, too!
BTW, the new surgical article from Japan that DID give much faster results is “Novel Approach to Repair of Acute Achilles Tendon Rupture: Early Recovery Without Postoperative Fixation or Orthosis”(!). Am J Sports Med February 2010 vol. 38 no. 2 287-292, Tadahiko Yotsumoto et al. The abstract’s at ajs.sagepub.com/content/38/2/287.abstract . (I’ve got nothing against surgery that DOES bring significant benefits!
)
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