What activity is the riskiest for a healed ATR?

I’ve seen some rehab protocols that say jumping down (off a fence or platform) is the riskiest for a re-rupture. What about jumping up, sprinting, cutting, etc?

My injury was fromĀ backpedalingĀ and then trying to shoot forward. I’m now 7.5 months and feel pretty good. Once my calf strength returns and I’ll be able to start playing sports again, I just want to be wary of what activities I should be mindful of?

8 Responses to “What activity is the riskiest for a healed ATR?”

  1. That “backpedaling and then trying to shoot forward” is a classic way to load up your AT as heavily as possible. If it’s got a weak enough spot, that’s when it will first rupture. But virtually NOBODY re-ruptures a healed ATR. It’s the OTHER AT you should be worried about when you return to explosive and “high risk” sports like Flag Football.

    In the “Studies” page that’s linked from the Main Page here (near the top left), you’ll find a link to a study about something like “transaxle” or “transverse” (?) ATRs. They followed a bunch of healed ATR patients, and compared their risk of “doing” the other AT, with the ATR risk of the population as a whole, within just the first few years. It’s not a huge probability in absolute terms, but it’s hugely higher than the background population risk — ~200X higher, IIRC!

    The risk that one of those people RE-ruptured the HEALED AT was so low they didn’t bother reporting it. So, if you’re determined to worry about something. . .

    And BTW, nobody really knows what happens if you coddle one of those at-risk ATs. Maybe it survives until it ruptures for nothing when you’re 83, or maybe it never ruptures, or. . .? Whether you want to jump back into Flag Football or play it safer is up to you, of course. I jumped back into competitive volleyball. Eight yrs later, I did tear the other AT, but I wouldn’t have changed my decision for anything. That’s me, YMMV.

  2. wow, i didn’t realize that the other AT was THAT much at risk. i don’t want to coddle anything and plan to return to explosive sports. i just want to know what activities might be risky and then be mindful of the tradeoffs. for example, i don’t particularly enjoy crossfit because it’s a brutal workout, so would rather skip box jumps if creates more risk. point is if i’m going to risk a re-rupture or other AT, i’d rather be doing an activity that i enjoy like flag football.

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  3. your achilles tendon ruptured for a reason….. the first step is to identify why, if you can. my guess is you have a generally lack of flexibility. Muscles stay fairly strong as we age, but tendons become weaker. A flexibility routine is a must if you want to save yourself from future damage. A must! Some medications also lead to weakened tendons. Were you on medication?

    I returned to soccer at 4 months and 3 weeks after a complete rupture and surgical repair. I have played three weeks now without a glitch. I was once blessed with exceptional speed, but find myself wondering if that will ever return. I can cut and jog around just fine, but my body seems to be rejecting sprinting. My body is saying no so I am following. I refuse to give up sports and am determined to play at a competitive level. However, I would never return to competitive play without changing my body. I advise you do the same. Are you carrying too much weight for your frame? Is a lack of flexibility your problem? Medications? Poor shoes? Overpronating?

    If you return blindly back into a sport that injured you, expect the same result. Take some comfort in the fact that most athletes rupture their dominate achilles tendon. If you are right handed, your left achilles if your dominant tendon……it is your plant leg on a jump, your primary pivot leg, your only contact with the ground when your right leg is kicking. If you ruptured your non dominant achilles, you better seriously change your body before returning to sports.

    Take physical therapy seriously….do the little boring exercises….they are critical for ankle strength.

    At 7.5 months i am surprised you have not returned already. Just start slowly. your repaired tendon should be substantially stronger than your other tendon, but protect both. Strengthen the muscles in your feet and calves. Just be mindful that strengthening your calves without making them more flexible will increase your risk of another blowout. I repeat, stretching is a must. The new five finger shoes made by Vibram have increased the strength in my feet and calves substantially in just 10 days. Consider buying a pair.

    Listen to your body, prepare your body, and start slow.

  4. i think my ATR was from overuse. i was playing in 3 different flag football leagues (3 weekly games, sometimes 2 per day) on turf with cleats. plus, i was jogging 2-3 times per week. basically i was giving my body 1 day off per week. in addition, i have a stocky frame. i’m 5′8 but 185lbs and built like a running back. i could probably lose 7-8 lbs, but not much more. my tendon was really sore and i would continue to play/jog on it regardless of the pain. one day, i went for a jog and then 2 hours later showed up to my football game. by this time my tendon probably had tightened up and i didn’t warm up and the rest is history. no medications at all.

    i do supinate and am not that flexible. would yoga help here? i’ve been debating yoga for a while now. still planning to do return to PT (taking a break to strengthen my calf) so that i can participate in more advanced drills/plymetrics. will definitely check out those finger shoes. thanks grant.

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  5. yoga is a fantastic option…..in fact, yoga is starting to become a staple of offseason workouts for NFL players. You will simulataneously add strength while keeping you muscles elongated and loose. There are also many added benefits associated with the breathing control yoga promotes. Try and find a yoga partner so you can keep each other going! Your lack of flexibility is probably the key reason why your achilles tendon failed……if you can lose the weight, now would be a good time. Recovering on a lighter frame is going to be much easier on your tendon. try and stay positive, continue the push for physical improvement every week, and always try to stay ahead of the flexibility curve. when it comes to finding a top gear while running, single leg calf raises will help you the most. I have been able to run at fast jogging paces for weeks now, and am just discovering that the lifting ability of the calf in the repair leg is what is keeping my body from pushing into a new gear………..turns out our bodies do have a mind of their own. good luck and god speed.

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