And we’re back!

21 weeks since ATR today, and the news is amazing! I was back playing basketball last night, full tilt, and with a surprisingly on song jump shot too. No words can describe how good it feels. To add to the progress, this wasn’t just a gentle run around, but I proper training session with a team. I hadn’t played at that level for years, so even without the ATR I would have been a little concerned I was going to be up to speed, but it seems I was impressive enough to be invited back next week for a full session and am going to be a member of the squad.

My thanks go out to my amazing physio, Adrian Wagstaff and the Warr Clinic in Wokingham. He has marshalled my progress from 5 weeks post-ATR until now and has not only looked after my physical treatment but has also kept me mentally prepared for each next step - be that cycling, running, wobble boards, full weight bearing heal raises, hopping, sharp direction changes…

I am back to 25km bike, 5km runs back to back, so the basketball was the icing on the cake. My usual word of caution though - I think I am the exception rather than the rule. My ATR was very high, more like the tendon separated from the muscle it seems. That means that the recovery was very different because there is a lot more blood and soft tissue involved that ATR’s lower down ot those treated with surgery. Go as fast or slow as your professionals tell you to. And once you are healed, if you happen to be a Hoopster, I’ll hope to see you on a court sometime soon!

15 weeks - exciting times

15 weeks, physio continues and even though there are times when I feel like I am sinning by not doing my exercises, progress remains good. I am ‘running’ in that I have the all clear to go out and do a bit of walk/run alternations since when I was put on a treadmill by the physio, I wasn’t carrying the bad leg. I am doing ‘ballistic’ exercises like hopping down from a step on my bad leg and trying to keep my heal up (sometimes I even manage to do it). I am completely obsessed with my wobble board, not just for the bad leg, but also for the good one. I am that obsessed that my wobble board came with me to Japan for two weeks, and in the evenings whilst I was on conference calls I wobbled my way through them.

All in all I am so pleased with where I have got to that I am entirely convinced I will get back to basketball, and probably with better lower leg strength (or at least health) than I have had in years. I still have the target of doing a triathlon in June (one year from the ATR), but now rather than just having a target of completing the course, I am going to aim to beat my time pre-ATR for the course.

No time to Blog (for all the best reasons)

I am coming up to 12 weeks since the ATR struck, and I am in remarkably good shape. Last time I posted I was at the start of physio and cycling a bit. Since then I have been on two weeks holiday in Italy (which I spent mostly cast free), have officially been unlocked from the cast, have pseudo-cycled on a turbo about 200km, become the proud owner of a wobble board and been camping for three days, all I am delighted to say with no ill effects bar a blister the first time I put on dress shoes to go to work.

I can lift full body weight on the bad leg, am walking pretty much normally and ready for whatever the physio throws at me next. As I told him last week ‘It feels that good that if you told me I could start running tomorrow, I would go out and do it’. He told me I couldn’t do that though. Spoil sport.

So, still a way off from getting back on a football pitch or a basketball court, but making good progress. My left leg is still much smaller in the calf than my right, but the muscles are starting to remember what being a leg is all about and are coming back too.

I’ll try and get back to posting a bit. I have a two week business trip (which means two weeks of dull evenings in hotels) so I may become quite verbose in that period.

Six weeks - more exercises

You wait all week for an appointment and then two come at once. NHS trip first - not particularly inspiring since the guy I saw thought I had been in the boot for three weeks, didn’t know how the injury happened, didn’t know I had been in three weeks previous and showed no interest in my leg at all. He was all set to get a nurse to remove the heal lifts for me, but I figured that would just take time, so I took them out and handed them to him. Foot back to flat, no effects thus far, so all good. Job done, on to the next one.

Second appointment of the day was with the physio. He was very pleased with the progress since last week and gave me a whole heap of exercises to do on top of those I am doing already and the cycling. The cycling is going great - I have done 25 mins minimum every day for the last four days. Minimum resistance is tough to do because it feels so weak, but I daren’t go too hard on it. The nice thing about it though is when I get off the bike, my achilles and muscles are obviously lengthened a little as I can walk almost normally. It all tightens up again once I have been in a boot for the night, but still, it is nice to remember what walking is all about, even if it is very gingerly.

Off for two weeks on holiday on Friday, so have a swathe of appointments on Monday 15th to look forward to.

Five weeks and its physio time

Maybe it is symptomaitc of health care professionals to tell you the worst and then let you be pleased if what actually happens is better, but everytime I go to an appointment the prognosis and information I get seems to improve.

Today was my first physio appointment. I released myself from the cast and then shuffled around the physio’s office and gym with a naked, if somewhat feeble, leg.

Having had a good feel of the tendon and murmured his satisfaction with the progress he then went on to tell me that there was no reason that I shouldn’t make a full recovery and get back to basketball at some point. That was pretty much what I have wanted to hear for the last five weeks so I could have packed up and gone home then, but he had more for me.

He asked what kind of sport I got up to normally and I listed out my usual list. ‘OK’ he said ‘do you fancy getting on a bike?’, at which he led me into another room and set me up on an exercise bike. He explained that I could cycle on very low resistance as long as I was pushing from the middle of my foot. The low resistance bit was a shame I thought as that pretty much meant no road work yet, but then he said that if I had a turbo trainer, that would be ideal, particularly if I had cycle shoes as they would keep me foot in a better position. We discussed the issuse of getting clips in and out on of pedals, but I think that if I leave the shoe on the pedal then all should be well. I don’t have a turbo trainer but had been thinking of getting one for the winter this year anyway, so any excuse to buy new toys was gratefully embraced. After a couple of demonstrations of other exercises and an assurance that swimming without vigorous kicking would be fine (I don’t kick hard anyway, and I would be swimming more for my upper body than my recovery), I strapped myself back into the boot, hopped (not quite so literally) into my automatic chariot and came home to plunder Amazon for a turbo trainer.

Couple of other bits of progress to report and maybe a word of caution. I took an executive decision to remove one of the remaining two heal lifts out of my cast on Friday. I went to work for the first time and walk-come-hobbled (wobbled?) from Waterloo Station to Fetter Lane in London - about two miles. No adverse affect on the Achilles but the heal of my foot was painful and bruised because the flat surface of the lift was small and there was no support under my arch. So I removed the top lift and now all is good.

The word of caution - I have seen a couple of folks comment that they are watching and following me. Some sage advice from the physio today about what to do and why I might be a little different to some recoveries. He noted that because my rupture is so high up it is not ‘tendon to tendon’ healing, but there is a fair portion of muscle that is healing there too. Muscle has a lot more blood in it and heals more quickly, so he suspects that might put me ahead of the curve a little. The sage advice, after I admitted to being an impatient patient, was ‘if you feel you want to go faster or try something new, you might be able to, but from now on you ask me first’. I would suggest that no matter how frustrating your protocol is, you all do the same. Every recovery pattern is different it seems, but they are different for good reasons. The last thing any of us want is a big step backward in the race to go forwards.

Heal well folks. More next week.

A good week got better

As well as the ATR (or maybe as a result of it), I have thrown my back out. I went to see my osteopath yesterday who looked at my leg and said ‘you haven’t done something stupid like ruturing your achilles have you?’. Ho Ho Ho. Anyway, it turns out she was a bit of an ATR expert, both professionally and because her ex had done the same thing three years ago. I explained where I was at and she asked if I was weight bearing. I said ‘Not yet, although I do feel I could’ and she made no further comment… until I asked her why she’d asked. She expressed the opinion that I should be, since I was in the cast, since there was no way to put any tension through the tendon, so what harm could it do? It would actually help keep some tone in my leg.

So far, so interesting, but without wanting to offend any osteopaths out there, I did want to check that advice out with a specialist before I binned the crutches and went freestyle. Fortunately, today I had an appointment with a specialist, so seized the moment and asked. His response was ‘yes, absolutely’… and then with a slight glint in his eye he said ‘are you competitive?’. That is a little like asking ‘is the Pope Catholic?’. He told me about one of his previous patients that, in a cast at four weeks, walked three miles. The challenge has been laid down.

He also told me to arrange some physio for next week. He took a good look at the injury and said it was healing well - nice movement with a Thompson Test, no ridges in the healing, all nicely aligned, so he said physio now was a good idea. Only slight downer - I asked if I could swim when I go on holiday (at the start of week 8) to which he said ‘we’ll see’. But I (literally, by comparison) skipped from his office, threw the crutches to one side and have hobbled round ever since. I even went along to Basketball this evening to say hello.

Definitely feels like a good week.

Three week check…

Three week check today - apparently I have the beginnings of an Achilles tendon growing in there! After a thorough grope of the back of my heal, the specialist declared that progress is being made, and he was pleased with how it felt. 5 mins, half of the heal wedge removed and I was back out the door.

I too am pleased, because the extra stretch on the tendon isn’t causing any discomfort thus far. I went to my son’s school sports day afterwards, but unfortunately had to leave before the Dads race. Maybe I should find something more appropriate to test progress in anyway. Also good news is that he gave me the ok to drive an automatic, so assuming my car isn’t going to fall apart (sinister noises eminating from the gearbox) then I get to do a swap with my Father-in-law, and I’ll be mobile again.

Have appointments in large supply this week - seeingmy osteopath on Thursday (all this time on crutches is playing havoc with my back!) and then a private specialist appointment on Friday.

But, in general feeling very positive. No going any quicker through the process, but at least I feel like there is progress being made.

Impatience

So I am now 17 days post-ATR and dammit, I want to make some progress! Patience has never been my virtue, so I want to be out of the boot and walking As soon as possible. I continue to be teased and tormented by the stream of runners and cyclists going past the front door - yesterday was a lovely day when I would normally have wanted to get a good hour plus in on the bike and might have tried to tag a 5k run on the end of it. Instead I was confined to barracks.

My wife has now hired me a wheelchair, but that is worse than the crutches. The only upside to all of this is that I am trying to do some core and upper body strength work, but even that just makes me want to get in a pool and swim.

My appeal to all of you is - tell me how quick I will be out and doing stuff. I know that physio is going to hurt, but I like the kind of pain that is going to be doing good, so I want to get to that quickly. I’m on non-surgical which I figure slows the process down a bit, but I get my heal wedge taken down to half it’s current height next Mnday and to flat three weeks after that…

Is there anythign I can be doing now? Save me before I go insane!!!

TWANG! One Achilles Tendon Rupture

Picture the scene. It is 30 seconds before the end of a basketball coaching session for 9 to 12 year olds, and a friendly game of ‘killer’ (where you have to score before the person behind you does) is drawing to a close with two Dads left in. One takes a jump shot from the freethrow line which is going left, and so as he lands he pushes off to head after the rebound, but suddenly pulls up, sits down and turns very pale.

That was me on June 10th at St.Crispin’s Leisure Centre in Wokingham. When I felt the pain I thought the guy I was playing against had taken his shot at the same time as me and had landed on the back of my ankle, I turned to actually admonish him for his aggressive play to find there was no one there. Then I assumed someone had shot me in the leg. Then I realised what had happened.

I have friends who have snapped their Achilles, which meant that when I realised my toes wouldn’t lift, I knew exactly what was afoot (no pun intended). The rest of the group came over to see what had happened, but when I said ‘I think my Achilles snapped’ no one would believe me - it all seemed so innocuous. I took my boot and sock off and found that where my lovely tight, twangy Achilles tendon had been, now there was soft, spongy nothingness.

The staff at the sports centre were great and brought my ice and called a paramedic. Apart from the initial pain (and a slight degree of shock) I didn’t feel that bad. When the paramedic arrived and asked if I wanted any pain relief, I said no, and I rated the pain at 4 out of 10.  I was bundled unceremoniously into the back of a Volvo and whisked away to Royal Berks hospital in Reading.

After a short wait in A&E, I was seen by one of the clinical nurses.  She asked me to point my toes, and I could!  She asked me to lift my toes and I could do that too!  ‘The good news’ she said’ is that it hasn’t gone completely’.  Great!  Then she had me kneel on the edge of a chair and squeezed the back of my calf muscle.  Apart from me giving her a quick education in inappropriate vernacular, nothing happened. ‘Oh’ she said, ‘the bad news is that actually, it has gone completely’.

One plastercast later and I was sent home to spend the weekend with my leg up and to come back on Monday for an orthopaedic appointment.

The weekend went by slowly, and I hopped about the house a little, arranging time off work, cancelling a trip to Moscow I was meant to go on the following week and getting chairs into place about the house so I could sit down and do things I would normally do standing up.  I was now in no pain at all, just inconvenienced by the heavy weight attached to my leg that I couldn’t put down.  I spent a lot of the weekend on the Internet reading about Achilles injuries.  Most articles agreed that surgery was the better path, and offered a better repair than sitting it out, despite the risks of infection and so on, so when Monday arrived, I was going in to my appointment ready to demand surgery.

I needn’t have worried for two reasons.  First, my consultant, John, made it clear from the outset that surgery was the primary option, and once the bullet-proof cast I was trapped in was removed, I would be sent for an ultrasound to identify where the damage was, and then we would start to make arrangements, the only reason that they wouldn’t operate on it would be if the break was right at the top of the tendon because stitching tendons back on to muscles doesn’t work.  So I went for my ultrasound (accompanied by more impromptu expletive lessons for the sonographer) and… the second reason I needn’t have worried about the research was that my tendon had snapped right at the top, so no chance of surgery anyway.

Instead, I am in an Aircast for nine weeks.  I am now ten days into my sentence and I have learnt a number of things:-

1) Aircasts are great because they are light and have a sole on the bottom, so whilst you obviously can’t walk, you can rest them on the floor when you are on crutches, rather than having to hold them in the air as you would with a plaster cast.

2) Aircasts are essentially small green houses.  I have no idea if plaster cast would do the same thing, but man my foot is not a pleasant bodypart to be around right now.  I was told not to remove the Aircast under any circumstances… but I was also given a little pump to inflate and deflate the air pockets and a spare sock to go under the cast.  How do I change the sock without removing the cast?  The combination of sock changing and the vague aroma of gorgonzola means my foot is getting a fairly regular (albeit very gentle) wash.

3) crutches and escalators don’t mix.  If you put the sticks on to a moving staircase, they have this not-entirely-surprising habit of setting off without you.

4) Runners and cyclists are evil, psychological villains.  They run and ride past my house, taunting me with their upright, bi-pedal parambulation.  They know they are doing it.  Evil.  This was compounded on Sunday by the staging of a local triathlon (that I came 35th in two years ago) where the cycling route runs past my front door.  It was torture.

5) Aircast plus gout is not good.  Not sure if this is as a result of the foot being in a cast, but I have had a first bout of gout in three years.  Pressure from the cast on my big toe is excruciating.  The ATR is still causing me no pain at all (as long as I keep all weight off of it of course) but the gout…. yowsers!

6) Lego Star Wars may be targetted at children, but Dads can become addicted to it too.

I’ll keep this blog updated with progress, obsessions, irrational ATR related hatreds and general pathos for as long as it takes.  But I can state now, this time next year, it’ll be me cycling past my house doing that triathlon.  That’s the target.

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