About my ATR

Hi to all 143 fellows in AT problems here! Seems I’m the oldest so far meaning that I am already two years (and some days) since the accident and surgery. I reckon this initiative is pretty new, some months as I believe, because I did not find such support when I was at home two months dealing with the ATR.

My ATR happened on July 13th 2006, while playing tennis, going for a very fast ball to the net. The snap happened when starting the quick run - which never happened, I was stopped in place and broke down. I thought my shoe slipped, because I felt no pain but a strange sensation (my heel hitting the ground, I saw the mark on the field, which was odd considering that the start run should be with the toes not with the heel on the ground). I hardly walked to the side and I was ‘hoping’ for a sprain injury, resting assure no fracture could have happened, which was right, only there was a rupture, of the AT, which I never thought it could happen.

The diagnose was quick, ATR, surgery needed, programmed in one week, one week I stayed at home in a temporary cast, then on July 20th 2006 the surgery. I had a very good doctor (he was with me from the moment I went to see what it was, I was very lucky he was also a orthopedic surgeon, doing hips replacement and all, being a surgeon in the ER main hospital of Bucharest, repairing people from car accidents, so it was very good, though young, like around 40).

The surgery went great, except that I was on the operating table on July 19th but anesthesia aborted because I eat a piece of bread in the morning before coming to hospital, so I had to leave home for another night of anxiety before surgery. On the 20th all went well, good nurses, good anesthesia (spinal, yuck), legs were unwilling to freeze, but finally after half an hour they were limb so the surgery went on for another half and hour or such then the closing and the cast. Senses back in some hours and I was in recovery room for one night. Pretty hard but I was able to go to toilet with crutches. I was beginning the month of crutches.

Another four days in a nice reserve, nice nurses, permanently filling my antibiotics and stuff going in my vein, I had I guess more than 5 liters of something dripping 24/24 into my veins, but it was for my own good. Doctor checked on me daily and telling it’s going great. Then bye bye hospital and went home, where I set up my crib - the couch that became my friend for two month, the laptop, the TV.

As you know, normal jobs seems very difficult when having to keep one foot in the air and you walk in crutches around the house. I had developed my technique for bathing, arranged chairs around the house (one in front of the fridge), I arranged the couch for a long stay with the leg upper than the body. It was summer and I had no air-con in the room at the moment but I never suffered of heat, it was a mild summer I guess.

I had to make the daily heparin (subcutaneous injection) for anti blood coagulant. This is very important especially during the summer time and when you stay longer period not moving (in a cast). This is to prevent deep vain thrombosis - blood clogs forming there and going up the blood stream to the lungs or brain . If you don’t do heparin you should ask your doctor. It can’t be bad for your health, just a little expensive.

I changed three casts, moving gradually the toes from high angle until the last one of 90 degrees. The wound healed good, meaning very clean, the only thing I was thinking was about the tendon inside to recover well. The scar didn’t look nice (nor today), it was dark red (doctor telling me it’s working) and from being lower than the skin (like a fine ditch) beginning to look cheloid (the scar line little higher than the skin, the line being dead skin - like in burn scars). After removing the final cast I have applied more times a day a lot of cremes that were supposed to soften the skin and avoid cheloid scar. But they did not have a great effect, the scar looks today almost like it looked in August-September 2006, so I gave up having a pretty scar and concentrated on recovering the leg.

Walking without crutches was painfully, with my last (3rd) cast, going around the home. Each morning the first step was a great pain, then started to dissipate. Then after removing the last cast it was all difficult again, as without cast you put your tendon and muscled attached in working, so you can’t really walk immediately after putting the 2 shoe. I have started the recovery, going to a specialized small center, where I did psychical exercises, electrical and laser stimulation. Electrical are a must as they twitch you muscles gently without your weight. Then the pretty painful psychical exercises to gain back the strength in leg muscles. I was though very careful (too careful I think) with my tendon.

After three weeks of recovery I got back to normal activities (work, yuck) with a heavy limp. The heavy limp and difficult in climbing or (especially) going down steps lasted for more than a month later. But for the following months the limp was still visible. After 6 months I was so careful with the tendon and I didn’t run. I’ve started to run on the treadmill only after 6 months. Because it was still pain I was taking it very easy.

Now I would have wanted to do more exercise. That is my main advice, once you get the ok from the doctor to stay on toes and running on the treadmill, you should use your leg as many times per day you can. I stayed at the office - wearing a band to keep the blood running there - and not moving is not good. If I would have exercised more often I’m sure I would be 99% back in shape now. Oh, and you go to the pool and swim and do all sort of exercises on the bottom of the pool, it’s more easy to walk on your toes in water than outside full weight.

I still did not run but for on the treadmill, with still some pain - and the pain is now located in the calf muscles, because the tendon in shorter and keep pulling on the muscle. Then I can’t get all down bending the knees, the tendon keeps me from doing that and lifting the heel of the ground before the good leg. I still have sore area in the upper part of the scar - probably above the stitching of the tendon. The tendon is lumpy compared to other foot, but not excessive. The scar is very visible as it is more reddish than skin color. I never played tennis, volley or football (soccer) since. I played volley during high-school years - that might be one of the cases for the tear (heavy jumping). Now I afraid to jump (did not jump for 2 years) or to play tennis. I go to the gym, I go with the bicycle, I ski - those in a heavy manner, like before. But playing football I only get the ball from side to side, I can’t risk running or jumping and having a re rupture.

If you want to ask me questions please do, I will be please to respond.

Wish you all a perfect recovery. Don’t rush, it takes time, but also don’t leave your AT ‘unattended’, give it attention but exercising it regularly. Staying with the foot down under the desk at work is bad. Moving is good.

5 Responses to “About my ATR”

  1. was it your choice not to play the sports (tennis, volleyball, tec) yours or on the advice of your doctor? i am not very far along on the recovery but i already know it is something i do not want to have to go through again. at the same time, the thought of giving up basketball, tennis, etc makes me sad

  2. Of course I’ve asked the doctor about sports, his answer was “you can play only after you warm up very thoroughly”. But probably he never played volleyball, which involves high jumping and landing on toes, exactly what stresses the AT, sudden tension is what ruptured it, and it was my own muscular power that did it, now think if you land from one meter on your toes how does this translate to the sutured place. The exact spot of the suture is hardened and not elastic. The next rupture may appear above or below that, where the tendon stretches even more than before. So to answer your question, it is my choice not to play, but I will start playing, the only thing is to be moderate. Because I always played hard, I was all around the field (tennis, volley, football), stressing every muscle (and tendon). Remember that sudden tension is the worst, so take care how you play sports involving jumping.

    Anyway, I’m going out this weekend to buy some good sport shoes (with good support on the heel - little raised) and I’m going to start running outside (not only on the treadmill) and I will post impressions here.

  3. I bent down to get something yesterday and thought, hmm, I wonder if i’ll ever be able to squat down. Can you? Can anyone yet or at all? The little things you don’t think about….

  4. I’m slowly getting to the point where I can squat. It’s a motion I just haven’t done much in 4+ months. There is some tightness in the ankle and butt is a bit small.

  5. Squat. That was the word I didn’t remember. Yes, you will be soon (4-5 months) able to squat down-that will be simple. More complicated is to squat in order to tie your shoe of the other leg, that motion is not recommended until a year rehab. But I refer also to the motion before fully squatting down, going down bending knees, with the heels on the ground. That is the motion where I can feel the sutured tendon keeping resistance.

    Remember to go to the pool and try any movement in the water, I walked a lot in my toes in the pool, and swimming slowly is excellent, gives you movement in the tendon without stress. Attention!! when entering the pool: do not use the ladder but just go both legs and hands to splash in slowly. Using the ladder going in or out the pool is not recommended during the first 4-5 months. If you tried you know what I’m talking about. Is on of the most stressing motion to the AT.

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