5 Weeks In From ATR
Well I will start off saying that I have never written a blog before in my life, but since finding this site, after weeks of reading journals and websites regarding achilles injuries, and reading a few blogs on AchillesBlog I decided to write my own and share the next year of my life with fellow Achilles suffers..
A bit of background about myself, I love the game squash!! Have done since I got exposed to it at the tender age of 15 growing up in South Africa. I do however believe that the reasons for my ATR was solely down to me (obviously) due to the negligence of realising that I am not a young man anymore (between the age of 18-30). When I was playing at an incredibly high standard I would always make sure my shoes were right for my feet and that I was warmed up before I went on the court and warmed down sufficiently enough when I came off it.
I recently moved to Basingstoke in the United Kingdom due to my job and decided that after 5 years of not playing any squash due to studies, moving around the country jobs wise etc, I wanted to get back into it. Foolhardily bought myself a pair of squash shoes for £30 (on special) instead of getting my feet properly measured etc, which I always used to do.
Joined a squash club and was just about to join the club team and start getting back to the level I was accustomed too. Played my first league match and decided to play another one the following week. The following week came and played my league match, finished it well within the alloted 40 minutes and myself and my opponent decided that seeing as we had another 10 minutes left will just have a knock about to use up the time. As i pushed of to run for the ball, I heard a POP!!! It sounded as if someone had dropped a ball on the floor behind me and I looked around. Instantly I knew that I had ruptured my achilles. I hopped off the court and collapsed outside the court, telling my opponent I had just ruptured my achilles. I knew I had, the searing pain in the leg, the sound it made all added up to, in my mind knowing this was it for me competitively for 12 months.
The guys and girls that work at the leisure centre, were fantastic in how they dealt with me, BUT!!! When it comes to injuries they did not have a clue. They applied an icepack to the back of my leg (which at the time was the right thing to do), but when they asked me what happened I told them my achilles just ruptured, they were on the phone to my girlfriend saying that I had damaged my ankle and that I was telling them I had ruptured my achilles, but they think it was a bad sprain. I know my body and I know what had happened, also I have experience in seeing ruptured achilles injuries in my time playing squash. So from that point of view I was a little miffed to say the least.
So my girlfriend and good friends of mine came to pick up from the centre and take me straight to A & E. Going there I had heard some horror stories (waiting times, no doctors, no staff etc), but in all honestly my experience was excellent. Yes I waited for about an hour and a half, for the night doctor to see me, but the nurse had checked my injury, confirmed my fears and gave me some awesome pain killers, within half an hour I could not feel any pain and had a stupid grin on my face.
Saw the doctor eventually, he did the Thompson test on me, and put me in a temporary cast, gave me some crutches, to which I got a quick crash course on how to use them. I got an appointment for 2 days later at the fracture clinic to see the orthopaedic surgeon.
I decided the next day to go to work, as I had only been in my new job for 4 days, so I had to make the effort. Needless to say that I work in a laboratory as a QC Chemist and the alarm bells were ringing with HR and the Health & Safety representatives with me being in a lab. By the afternoon my leg was aching and my boss allowed me to go home and rest the foot.
The following day was down to the hospital to go and get some expert advice on what to do next. As it was a Saturday morning, it was rather busy, the hustle and bustle of people all around me and me on crutches (I have never been on crutches in my life) was a receipe for disaster.
Doctor asked me to lay on my stomach with leg slightly over the edge of bed/seat. he cut of my bandages and removed the temporary cast. He then proceeded (to which I can only describe as sheer agony) to feel his way around the injury. His thumb digging into the achilles, obviously sizing up the extent of the damage. He then gave me the two options, giving the pros and cons of both, and recommended to me the option of non surgery. He also told me the rupture is higher up than the usual ruptures he has come across. I honestly thought I would only get one option - go under the knife.
I chose the non surgical route for one option only, work. With me only being there for 4 days I did not want to be off long term. The fact that for the first 2 months if you go sick you do not get paid for the days you are absent, it was a no brainer for me. Plus I had to support my family, that I was driven to do. We could not live on one salary, it was impossible. So off to plaster room to get my foot set, toes pointing as much to the floor as possible and had a cast put on up to the knee.
So the Monday I am back in work, as I arrive to go up to the 2nd floor I get collared to have a meeting. They suggest that I do not go back in the lab until I am ready (no crutches), they organised me a desk on the ground floor in an office and in fairness have given me other work since then to keep me ticking over. I cannot fault them one bit, they have been brilliant so far.
So anyway now that long winded introduction is out of the way, lets get down to brass tacks and discuss the past 5 weeks to the date of this ATR injury.
I got my first cast put on (my stepson chose a blue colour cast, at least he did not choose pink), on the 15th January and was told “no pressure whatsoever”. See you back here on the 31st January to change the cast, (colour of your choice etc) and raise your foot up, they said.
The next two weeks was to prove extemely difficult for me. I have always been active, whether road running, squash, any other sports for that matter I was always doing something. To go from that to where I was/am now was difficult for me to comprehend. Going up and down on stairs on my backside was tough. Not being able to shower, could not do any chores around the house, the list goes on and on. I have been lucky enough to get lifts back and fore to work since my injury, by people who live locally I work with, and most importantly I have a bloody good woman who has gone above and beyond for me, without ever complaining once.
So the 31st came around and back to hospital to get the cast changed, cast was removed, my foot elavated to a position which “was comfortable” and new cast put on. Doctor then came and saw me with my medical notes(file) and said to come back on the 21st Febuary (which happens to be my birthday) where he will do a few tests to see how it is healing and then either put me in a boot, or if it is not healing sufficiently, put another cast on. I hope it is a boot next as it is the girlfriends choice for a colour cast and she said it is going to be pink, just to have a bit of a laugh, and make me squirm….Great!!!
So here we are 4 days away from my next appointment and wishing this would all be over soon. I know it will not be though..
My advice for any sports (squash) person, would be make sure your shoes are “fit for purpose” for your shape of foot and body and do not make the same mistake I made with regards to the shoes that I bought. I know the shoes had an impact into what happened, as well as my age, and not stretching properly.
MY ONLY FEAR is that by me not choosing the surgical route, that I will never play squash to the intensity/level I am used to. The doctor said that in his opinion ‘it is my bodies way of saying it is time for a change or to give up’. You might as well chop my legs off and stick me in a wheelchair in all honesty then. Hopefully that will not be the case……………..
If anyone reading this who has recovered from ATR and has experience regarding with what I have gone through, impart your knowledge onto me ‘O Great Ones’.
It would be much appreciated…
February 17th, 2011 at 7:32 PM
Great story, Gareth! There’s no reason you shouldn’t be back very close to 100% with the non-surgical route, especially since your Doc may be more up-to-date and informed than most, since he’s at least promising you a boot eventually. In fact, there’s no reason to wait for some arbitrary level of healing before getting the boot, since a boot can immobilize just as well as a cast. It would save NHS the cost of the extra cast, and give you some serious personal benefits, too — like being able to wash it and being able to “wiggle” it, aka “exercise”, though we’re talking about pretty gentle stuff at first.
Your Doc may also be willing to be informed even more than he already is, which would also be good for you. Especially on the non-op route, going faster (NWB-to-FWB, exercise, PT) seems to produce better outcomes, including lower re-rupture rates. EVERYBODY has always assumed that longer immobilization is safer and avoids re-rupture, but the evidence shows that the logical answer is exactly backwards! You can check out bit.ly/UWOStudyPub for the best and most recent study, and bit.ly/UWOProtocol for the (fast) protocol they used, as they faxed it to my Doc ~18 months ago. If you can convince your Doc to put you on that fast track, your life will be more convenient (and “sane”!) AND your prognosis will be better, too.
BTW, there’s no evidence that ANY of the factors you’re blaming for your injury — except age! — are to blame, and I don’t think they are. People who haven’t warmed up think they ruptured their AT because they didn’t warm up, but a large proportion of us — including you and me — ruptured AFTER playing a few games, when we were 100% warm! Stretching has recently been shown to be NEGATIVE for sports performance, and either negative or neutral for injury prevention! Good shoes that fit well are always a good thing, but I frankly can’t imagine how bad shoes would cause an ATR. They happen when we apply maximum tension on our calf muscle, to get maximum force on the floor, and maximum acceleration (often reversing direction, from “reverse” to “forward”). ALL of that is easier to maximize with GOOD equipment than with BAD!
Put another way, we tear our ATs when we’re doing exactly what we’re supposed to be doing when playing a “high-risk” sport like squash (or volleyball, which I switched to after I phased out of squash). Age is definitely a factor, and coming back to high-level activity after a break seems to be, too, but you should forgive yourself for all those other things that you imagine tore your Achilles. Stuff happens, and ATRs mostly fit into that category.
February 17th, 2011 at 10:37 PM
Thanks for the the feedback Norm, I appreciate it loads. Will take on board what you have said and take article as well with me on Monday to the hospital. I am already doing light curls and stretches in my cast and hopefully will feel the benefit in the coming weeks.
February 18th, 2011 at 10:20 PM
Alright mate. I’m from UK too and have not had the best of experiences with the good old NHS - good luck taking the protocols along, I hope you get a decent doctor willing to look at it AND more importantly take them seriously and implement them, mine didn’t want to know! I too went down non-op route and whilst like you I’m concerned I may never get back to 100% I can honestly say it feels like the best decision I could have made. I have no scar on my heel, no discomfort wearing shoes and skipped all the risk of infection/nerve damage etc, etc. The injury looks good (if you can call it that!) and has healed well, I have minimal scar tissue and although it’s early days it feels pretty strong. My treatment consisted of a cast with toes pointing down for 6 weeks then back to get cast changed - where they moved my foot STRAIGHT into neutral/90 degree position for 2 weeks and I was told I could now partial weight bear. I went back to hospital on 14th Feb and thought I’d be given a boot. To my surprise (or horror, can’t decide) I was told that was that and sent on my way (after practically having to beg for Physio). So I’ve been out of the cast and in ‘2 shoes’ for 4 days and I’m being very careful!! Still using the crutches to ‘help’ when walking but I’m going to wean off them in next 2 weeks. Hope your recovery is a speedy one and keep us posted!!
February 18th, 2011 at 11:10 PM
Hi Gareth
I too ruptured my tendon playing squash. It is not the shoe but old age I am afraid. Took a break from squash for ten years and had only return to it for four weeks when my injury occurred. My trainers were the best prince squash shoes you could buy at the time. It ruptured in a game that I was well on the way to winning.
I took the surgical approach because I was told it had a better re-rupture rate. I was told that the recover time was the same so it made sense to me.
My scar has healed well & it only hurts when I wear boots but that is getting less everyday. I have a lot of swelling but I have found that the static cycles at the gym are helping to loosen up the tendon & get the swelling down. My only piece of advice is when you are able get on the bike. Build back up all that loss muscle.
I am going to return to squash in September I hope. Going to take it easier to start with this time.
Cheers & good luck.
February 21st, 2011 at 1:46 PM
Thanks for the responses and advice guys, much appreciated. I have just returned from my appointment from hospital and orthopaedic doctor. New post on its way…
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