Inspiration for Kobe and the Rest of Us

In Their Own Words: How NBA Stars Deal With Achilles Injuries By Jonathan Abrams on April 16, 2013 12:30 PM ET

Dominique Wilkins wouldn’t wish a ruptured Achilles on his worst enemy. Where once he was the Human Highlight Reel, after his injury his game was changed forever. Elton Brand was never a highflier, but he felt the same pop that Kobe Bryant described after Friday night’s crushing injury. His game changed, too. And Chauncey Billups can relate to the struggles of returning to the game late in his career after a devastating injury. It’s a tremendous hurdle, even for an accomplished veteran and athletic freak of nature like Kobe. Wilkins, Brand, and Billups provide three case studies of players who made it back from Achilles injuries at different stages of their careers. The trio recently talked about their physical traumas and difficult rehabilitation efforts, and offered words of encouragement for the 34-year-old Bryant.

Dominique Wilkins suffered a ruptured Achilles on January 28, 1992, at the age of 32. Wilkins returned the next season, playing in 71 games and averaging 29.9 points and 6.8 rebounds. He enjoyed several more productive seasons and retired at 39.

I was literally trotting down the court. I wasn’t even running. It was really a fast walk is what it was. I heard something pop. I thought somebody had kicked me. I turned around and nobody was there. It’s a type of injury that’s a freak kind of accident. It feels like somebody kicks you or hits you with a baseball bat. And that’s when you know that you tore it — after you look behind you and no one’s there. It’s a very tough injury. But it’s also an injury he can come back from.

When I tore mine, like Kobe, it was a surprise. I tore mine completely in half. You do go through that "Why me?" attitude and "Why now?" I did go through that phase. Now, being the competitor that he is, he has to refocus his thinking. There’s a process you have to go through as far as management. What I did, I went down to the Houston Clinic, where they repaired it. It took me about a month and a half, two months, to where I could really do anything as far as just walking on it. I was [in] a cast and then they put me in a soft cast. He’s going to have to do a lot of water therapy, a lot of very, very light weights on his ankles, which will help him get his mobility back. It was a nine-month process for me, and the thing is, Kobe is a competitor. There’s no question he’ll come back as good as ever. I’m going to tell you the truth: When I came back, people had their doubts. People said I was done and [that] my career was over. Going through my rehab, literally every day for nine months, I came back and had my best all-around season of my career. It just depends on the person and how driven they are. And he’s a driven guy. There’s no question in my mind that he’ll come back as good as ever.

I didn’t feel [like I could jump the same way once I returned]. I felt like if I jumped too hard or pushed too hard off my ankle, that it would pop again. That was all mental. Once I got through that part, I told myself, You know what? If this thing is going to pop, it’s going to pop. But I’m going to play hard. I’m going to go off of it hard. I felt funny mentally. But physically, it was repaired better than ever. In fact, it was three times stronger than my other Achilles.

I did doubt [whether I could return to form], but I had people who were close to me, my family, who said, "Look, you’re a competitor, and this is a minor setback." I always believed that obstacles were put in front of you to go over or around and that’s the attitude you have to have to get back from this injury.

Elton Brand ruptured his left Achilles tendon while playing against his Clippers teammate Chris Kaman in an offseason workout in the summer of 2007. Brand, 28 at the time, played in just eight games at the end of the 2007-08 season before signing with the Philadelphia 76ers. Now with Dallas, Brand is a reliable and steady presence — and an influential locker-room figure — although his scoring has dipped since the injury.

We were playing one-on-one. Even though it’s a freak accident, I don’t think [the amount of] minutes [I played] were involved. But we went to the second round of the playoffs the year before that, and then I played USA Basketball, and then I was having problems with it during the season. Mine was bothering me before it ruptured and I actually got a shot for it to take away the pain. Nowadays, there’s studies and research saying that that will take away the integrity of the tendon. Most people wouldn’t do that these days. Things change. I got a shot in it because it was hurting, and then it popped in the summer.

[It was] just a regular dribble move, trying to go to the basket. Similar to Kobe’s, but slower, at my speed. I felt a loud bang, and it felt like someone kicked me. I went down, and you have no control over your foot. The connection from your ankle to your foot, you have no control. Everybody’s had an ankle injury. Everyone has a knee injury — most players. So you know that is something different. You know you can’t raise it. That’s what’s amazing. [Kobe] knocked down two free throws. He must have shot flat-footed. You cannot rise on your toes after you tear your Achilles. That’s one of the tests, when they touch your calf in the back and there’s no reaction. Usually, your foot would react, but if it just hangs, then they know it’s separated or torn.

[Rehab is] tedious. It’s a lot of work. We all know Kobe’s work ethic, so that’s not a problem for him. When I came back, I was explosive, for me, anyway. I felt pretty good. That summer, the atrophy kind of set in, and I didn’t have the strength going on from there. But when I first got back, it was pretty good. It was probably eight months.

I was in a boot for a few weeks, then started the rehab. But that’s when the atrophy and stuff starts to set in. [Kobe’s trainer] Tim Grover told me about a machine that he could buy directly for this type of thing, and this was six years ago.

Kobe is the greatest of my era, and if anybody can get close to 100 percent, he will find a way.

Chauncey Billups tore his Achilles in February 2012 at the age of 35. Billups returned in November, but a variety of injuries have limited him to only 20 games this season.

I feel bad for him, of course. I don’t like to see anybody go through that, especially him. He’s a friend of mine, so it sucks for him. But it is what it is. And as I told a lot of people, with somebody like him, and I kind of felt the same way, I’ve pretty much accomplished everything I wanted to accomplish playing this game. He’s done that, too. You look for different challenges, and you don’t want a challenge like that to come about. But it happened. This is a big challenge for him, as it was for me. He’s going to be perfectly fine. He’s going to get back to playing at a high level next season, at some point, and be able to prove to everybody his toughness and his will.

All the reasons why I wanted to come back were inside of me, not what I was hearing from everybody else. I understood what they were saying. I don’t really have anything to prove anymore, and I’m an older player. It would maybe make sense if you didn’t know me. And I understood that. But at the same [time], that’s just not how I’m built.

AirCast to VacoCast Pro Achilles

On day 24 went from Hard Cast to Aircast

On day 35 went from Aircast to Vacocast Pro Achilles (aka Vacoped)

You may have read earlier that my bracing center refused to order me a Vacocast because my OS “prescribed” me an Aircast.

After reading more about the Vacocast on achillesblog.com I became more resolved to get one. While initially stymied when calling the Canadian distributer for Vacocast as they didn’t want to sell retail.  I sent an email request  to www.well.ca and was amazed when the cast was on my doorstep 2 days later.

My physiotherapist was game (initially “but don’t tell your OS”)  and now believes I am having a better recovery than I would have had otherwise.  I have pretty good insurance so I suspect they will pay for it.

I immediately felt more comfortable with the Vacocast and practically ditched my crutches once I started using the new cast. I really enjoyed the increase in mobility and it felt to me that there was less atrophy happening.

Here are the adjustments as made/when.

Day 35 - Vacocast set to 2.5-3

Day 41 - Vacocast set to 2.0-3

Day 46 - Vacocast set to 1.5-3

Day 50 - Vacocast set to 1.0-3

Day 55 - Vacocast set to 0.0-3

Day 57 – started 2-shoes around the house!

Day 62 - Vacocast set to -0.5-3 (Dorsiflexion for first time in boot that I was still wearing outside and in public)

Day 64 – started 2-shoes outside!

Weird Achilles Dreams

Yippee-Ki-Yay!

I am water skiing, and I am good!

Not only that, I am barefoot water skiing!

And I am doing it on my local neighbourhood lake!

And I am being pulled by a Miami Vice-like cigar boat!

And I am about to look really cool doing one on those throw-the-tow-rope and step-gracefully-onto-the dock finishes.

I step up on to the dock and OUCH!

I have RE-RUPTURED my Achilles tendon!

I reach under the blankets to touch my Achilles tenderly, thinking “How could I have been so stupid?”

I realize I am safely in my bed and start to chuckle.

  • I don’t water ski.
  • My neighbourhood lake is really just a  large pond.
  • there has not been a motorized boat on it since 1950.

I guess this injury is on my mind.  :)

How about you?

Anyone else dreaming about their ATR?

Day 24 - Hard Cast Removed and into Boot

Middle of my 4th week and a glorious Monday.  Hard cast removed.

Although my OS approved via email that I could have the cast removed at hospital on the Friday before.  The hospital would have nothing of it without formal orders, and an email on my blackberry would not suffice.  It was a bit of a drag as I had unfortunately got the inside of my cast a bit wet on the Friday morning leg-out-of-the-shower shower.  Note to newbies….get real shower protection immediately.

Very weird sensation as they cut the cast off - seemed like a small reciprocating saw that is imminently going to slice into your leg.

Assumed my ankle had somehow adhered itself to hospital bed as I looked at what appeared to be a dead-fish foot.  It was only when I lifted my lower leg  off the bed with my hands did I realize that it was only an adhered-to-bed sensation.

Was put into Aircast boot with 3 wedges.  BTW, The bracing centre would not order me a Vacocast because the OS specifically prescribed the cast used in the UWO protocol.

Went home and celebrated with the longest shower of my adult life.  :)

Nitroglycerin Patches to Speed Recovery?

I am a non-op/UWO Protocol and I get my hard cast off in 2 days and into a boot (Yay!)

Found this summary of Achilles Tendinopathy Treatment  research somewhere: #Treatment of Tendinopathy#

From the study Glyceryl Trinitrate Patches cut and placed on tendon...acts as a cellular messenger and appears to play a role in blood pressure, memory, and host defense. …appears to play a role in tendon healing after injury…

Since I was suffering from calcific tendinopathy for 2 years before the ATR, why not use the Nitroglycerin Patches per the study  and hope that it speeds my recovery?

I plan on bringing the study to my OS and ask for a prescription.

Any experience out there with this strategy?

Looking for Basketball Inspiration, When did you get back on the court?

If you search for Basketball on AchillesBlog.com you will see:

About 1,780 results!

If you do a page search on the NYC Marathon Achilles Tracker you will see:

323 of 1,749 (~18.5%)  of us suffered our ATR playing Basketball!

Clearly, there are many hoopsters among us.

Basketball has been truly the only form of exercise that I really enjoyed.

I am looking for inspiration and some anecdotal data from folks who have suffered from an ATR playing basketball.

How long after your ATR until you were able to enjoy playing another game of Basketball ?

Please share by replying.  Thanks!

Day 1 - I want to be operated on today.

See my Day 0 for prequel…I want to be operated on tonight.

Arrive back at hospital the morning after my late night ATR for an Ultrasound and visit to the Fracture Clinic to see Orthopaedic Surgeon (OS).

30 minute wait till ultrasound… repeating thought “I want to be operated on today.” , “I want to be operated on today…”

Ultrasound tech: “Are you talking to me or yourself?”

30 minute wait to see OS… repeating thought “I want to be operated on today.” , “I want to be operated on today…”

OS: Hi Dave, I want you to take a look at my 2 ankles. I suffered an Achilles Tendon Rupture (ATR) 4 years ago. Can you guess which one?

Me: Well, one of your calves and legs is much skinnier than the other.

OS: You think? (sarcastic)  My friends call it my peg leg.  The point is I am an OS, I went to the best of the best to have this operated on and if I had to do it all over again…I wouldn’t have had it operated on.  We got this great protocol from University of Western Ontario (UWO) and I have using it for the past 2 years and am happy with the outcomes.

Me: I think I still have my heart set on having it operated on today because I have been suffering from calcific Achilles tendinopathy for the past 2 years and it has been driving me crazy.  I just want you to go in and fix it all up.

OS: Dave, if I go in, I am sewing together spaghetti and now you are telling me you have bad spaghetti.   I really suggest that it would be better if we don’t operate. I am  going to put you into a hard cast for 3 weeks with your toes pointing down to shorten your achilles and then we are going to change the angle of your foot every week or so after that.

Me: (THINKING….and its magically going to heal itself?) Ummm, ok, I guess… I thought I was going to be operated on today but if you really believe this is the best course of action…let’s go for it.

OS: I do…what colour cast do you want?

Me: Green

I go home sporting my fluorescent green cast thinking…“Did I do the right thing?”

I discover AchillesBlog.com and stay up till 3am reading….boy,do I feel better. Thanks Dennis and Normofthenorth in particular.

Day 0 - Dec 20, 2012 - “I want to be operated on tonight.”

Name is Dave, Male 45 living in and about Waterloo, ON Canada

Playing basketball, men’s F division (really bad)… go from a cold start directly into a game where we are starting 4 against their 5.

5 minutes in, I am driving the baseline and thinking maybe a reverse dunk (in my dreams)…feels like someone steps on my right back heel…someone is not there…I stumble, I fall and ask for someone to give me their phone so I can call 911.

Ambulance shows up, I describe situation and the attendant assesses me with a “likely a sprain.” I know better having witnessed 2 ATRs and ask to be taken to hospital “I want to be operated on tonight”

Get to ER at 9pm and am seen by a nurse, an x ray technician, nurse practitioner and finally a doctor each for 30 seconds to 2 minutes and each over an hour apart!

I say to  each of them in turn:

  • Who is the orthopaedic surgeon on call?
  • Please call him.
  • “I want to be operated on tonight”

Nurse: “you are getting ahead of yourself”

X Ray Tech: “you are getting ahead of yourself”

Nurse Practitioner: “yes, it an Achilles tendon rupture, I will refer you to the doctor on call. But, I will tell you right now that we won’t call the surgeon tonight just for an Achilles unless there is a car accident of some sort that gives him other work to do.”

ER Doctor: “yes, it is an ATR, you also have a calcified tendon (I had been suffering tendinopathy for past 2 years) .  You can see the surgeon in the morning…it seems to go in fads whether they operate or not (What?) but given that he is a surgeon if you insist he will do it.”

Doc puts me into a Aircast and a couple of crutches and send me home at 1am (4 hours later). Told me the cast was going to be $150 and the crutches $20….still have not seen a bill and being from Canada, have never seen a hospital bill in my life.

I go home for a fitful night of sleep stealing my resolve to insist upon being operated in the morning - I have got my rights!

“I wanted to be operated on tonight”