Physio, Re-rupture, and the Worst Summer of My Life

So as I stated earlier my doctor prescribed “gentle ROM - dorsiflexion and calf strengthening”.  The physio I went to had me do stretches with one of those elastic bands for a while, very light leg presses (only at the clinic) with my right leg spotting, and of course he stretched the tendon out. Everything seemed to be going extremely well, after a few days of stretching I was able to somewhat walk and with continued practice my walking got better along with my ROM. Naturally there was also ultrasound treatment/shockwave therapy, new stretches, and some other light strengthening.

Then about two weeks into my physio/rehab process sometime around the end of July, DISASTER. My physio had me start doing some calf raises/heel raises and though I was concerned at first, when I did the exercise at the clinic I had my right leg spotting as well as my arms and it seemed fine at the time. So  he said I could do these at home along with all the other exercises he showed me. He also stated try and do it for a minute or as many reps as I felt comfortable with. Of course this ended up causing my re-rupture, on the second time doing it at home. After bringing my foot up without any pain I heard another snap/rip/unusual loud sound from my left leg and I knew right away what I had done but hoped it was something else. My heart sank.

Now I don’t totally blame my physio entirely because I was doing this exercise at home so I certainly take responsibility for it. However I do maintain that I was doing exactly what my physio showed me but that it is possible I may have over did it. It was one of those moments that was very hard to remember because I was in shock so everything seemed to go so quickly. Yes in hindsight it seems or was COMPLETELY idiotic to do calf raises but you have to understand my state of mind at the time. I am fairly young and this was my first major injury ever, so I guess  through my naiveté and eagerness to get better quickly my attitude was to trust the experts and do whatever they say as that will help me get better.  On the flip side I was also very fearful to stray away from anything the doctor or physio said thinking that it would lead to a possible re-rupture.

In the end I believe I was done in by several things. The initial protocol my doctor treated me with combined with his vague/loose physio prescription, my physio’s failure to understand how the doctor’s “conservative” protocol may affect my rehab process, my failure to do in depth research, and as mentioned earlier my naiveté.  In the end I lost the two months and half of progress and I am now back to square one.

3 Responses to “Physio, Re-rupture, and the Worst Summer of My Life”

  1. There’s another ATR web-site online that I think is linked on the main page here — something with “family” in its name — that quizzed all their re-rupture bloggers on HOW they re-ruptured. They had a sample of maybe 2-3 dozen, IIRC. The leading cause was tripping and falling, then maybe getting your foot stuck under something. But a sizable minority just said “Physio”!!

    Heck, the whole rehab thing is a lot like walking a tight-rope: go too slowly, and you’re not just wasting time, you’re potentially making the final healed leg weaker and MORE vulnerable! Go too fast, and POP!

    I had a similar experience, though much less serious. I was much farther along in recovery from my first ATR — around 17 weeks post-op, and JUST FINALLY able to walk normally in bare feet. My PT literally paraded me up and down the length of the U. of Toronto Sports Medicine Clinic in my bare feet, showing off my great recovery. I was 58, no spring chicken, and I was walking properly much sooner than the few undergrads I’d met who’d ATR’d at about the same time, so we were both proud.

    Then we went back to her PT station, and she did her things, and got me to do various stretches and exercises. Toward the end of the session she said “Now do some 1-legged heel raises.” I told her I wasn’t ready yet, because (following my rule of thumb for strength-building exercises) there was no way I could do 8 “reps” of them. “So just do as many as you can,” she said.

    That was Wrong In So Many Ways!! But I fell for it. First of all, if an exercise is too strenuous, it’s too strenuous. If it’s so strenuous that you can only do ONE rep, then you definitely should NOT do it, even once!! Secondly, nobody should ever tell a competitive aggressive athletic person (like me) to do As Many of ANYTHING as he can, because I’ll DO it!!

    I cranked off maybe 3 or 4 heel raises, grunting and groaning and sweating — but feeling no pain. The pain started soon afterwards, right at the back of my heel, where the AT attaches to the bone. It was much more pain than I had when I tore the AT, or even after surgery, and it didn’t fade. It was a whole MONTH before it went away, and I was finally walking normally barefoot again!

    So PT is great, and PTs are great, BUT. . . Like OSs and the rest of us, some are better than others, and they have Good days and Bad days, hours, moments, etc. One PT’s Bad Day — and my near-miss failure to rebel, even though I KNEW BETTER — cost me a full MONTH in my ATR recovery!

    Like me, I’m sure you’ll be taking PT and other “expert” advice with a bigger “grain of salt” this time — and probably for the rest of our lives!

    Have you communicated with that PT since? I think it would be a favor to his or her future ATR patients to do so — in the nicest possible way, but firmly and clearly.

  2. I am sorry to read about your re-rupture…. I find it surprising how different the protocols are. Do I get it right that after 7 weeks of cast you were wearing the boot and still in the boot when started leg raises? You re-ruptured 3 weeks after getting out of the cast?

  3. I have talked to my PT since norm and the jist of what he said was that the re-rupture was likely going to happen anyways (meaning he didn’t think it healed properly) and that it was better it happened in a controlled environment versus once I’m back on the rugby pitch where I could suffer potentially more severe injuries as a result.

    Now as much as the latter part of his explanation made sense to me, it still sounded like bs as if he was saying I didn’t do anything wrong. Anyways I simply told him I thought he was a little aggressive in his rehab approach and should take that into consideration for future clients. Whether he listens is another story but I know I will be looking for a new PT when the time comes.

    2ndtimer, that is correct. When I re-ruptured I was wearing my boot when I went outside of the house but in the house I would practice walking normally without it.

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