The Injury Itself

May 6th, 2013  Tagged

I’m 30 years old. I work a job where I’m standing/walking 95% of my day. I’ve played sports my entire life and consider myself in good shape, not overweight at all.

On April 18th, I was playing in an adult league soccer game. In the 2nd half of the game I simply stepped forward getting ready to jog in front of me, that’s when I heard the loud pop of the opponent kick with all his effort the bottom of my shoe. I was pretty angry, and as I was dropping to the ground, I turned and saw the opponent about 10 feet away. I was probably the most confused I had ever been in my life.. and then I knew what it was. I had ruptured my left Achilles.

My team carried me off the pitch thankfully, They held my foot in place so it were not to move. Once the injury took place, I never tried to put weight on it or move it all that much, and I believe that helped pain-wise. The pain wasn’t all that bad compared to some people I’ve seen on these boards or had heard about in the past. As some others feel, it was sort of the ‘numb’ feeling although it did hurt from time to time. I waited until the game ended, they carried me to my car and put me in the backseat so I could lay down and be driven to the doctor.

I arrived at the doctor, I told them I ruptured my Achilles. We did x-rays, then the Thompson Test. The Thompson test showed zero response and that’s when it became official. The Thompson test ’squeeze’ brought the pain on, not pleasant for me.

That was a Thursday night, I was then scheduled to see a specialist the following Monday the 22nd. I spoke with him on the 19th, and he advised elevation, ice and nothing more until I saw him on Monday.

I did a little bit of research and realized how long this ordeal could take… but stayed in a good mood about it all.


9 Responses to “The Injury Itself”

  1. kellygirl on May 6, 2013 11:22 am

    IKWYM, the research sure makes it sounds daunting. After the initial shock, I had to adopt the attitude that it is what it is. It made me feel much better and less alone reading so many of the blogs of people who have and are currently going through this. So, thanks for sharing. I am looking forward to reading what course of treatment you will pursue. Good luck.

  2. normofthenorth on May 6, 2013 2:59 pm

    Hattrick, you’ve triggered a question that’s been nagging at me for a while: The Thompson Test is the best simple diagnostic to confirm an ATR. But might it do harm?? In any ATR treatment (op or non-op), one of the initial challenges is to draw the two torn ends toward each other and “close the gap”. Surgeons just grab them, and the “equinus” ankle/boot angle closes the gap for non-op patients. And the good (& surprising) news is that the (limited) evidence suggests that large ATR gaps heal non-op just as well as smaller ones.

    But… Most of us who’ve been through the ATR “mill” know that one of the WORST parts of it is that our calf muscle is all balled up tight, and there’s no safe way to get it extended again! And hoe does the Thompson test work? The squeezed calf (Gastroc) muscle contracts involuntarily. On the “good” leg, that moves the foot — and when it’s over, the foot moves back and the calf and AT return to their former, relaxed/extended position. But on the ATR leg, the calf contracts and pulls the top ruptured half of the AT farther up the leg, and there’s no non-surgical way to put it back! (”You can’t push a rope!”)

    So doesn’t that mean that the post-test Gastroc is even more balled up than before?? Maybe more chance of healing long (esp. non-op?), or making the surgeon work too hard to dig out the top tendon end, etc? Should ATR patients be refusing the test?!? Back in the “surgery is best” days of my first ATR (2001), one sharp sports-med surgeon told me that he never bothered testing for an ATR if the patient told the stair-walking story that I told him — I couldn’t walk up a step until I splayed my toes out to the side so my heel fit on the step. This OS would just achedule the ATR-repair surgery, then and there!

    That’s unusual, and the Thompson Test is a fine diagnostic
    – maybe as good as MRI and UltraSound! — but it’s staring to make me nervous…

  3. hattrick30 on May 6, 2013 3:08 pm

    normofthenorth,

    Very good question. I’m no expert and obviously have not thought about that yet..

    My separation was 5cm per an MRI. I never moved my foot at all post injury. Could the test have moved it further? Perhaps, but I’m no doctor.

    Also.. my tear was up at my calf muscle as well, which really made for a painful ‘test’. They squeezed exactly where the tear was in my opinion. I’m someone who can endure a lot pain, but the test pain bothered me quite a bit for several hours.

    I’ll post an update to where I am currently soon.

  4. Ripraproar on May 6, 2013 3:10 pm

    Hi NOrm
    Hope your good I was coming on here to ask advice and now I’m going to ask you about the Tom test,
    Norm your view first on this please, I am going on vacation tomorrow 11 weeks non op, trying to follow Uwo as best as I can, I was wondering your view on walking on the sand would you think good to do or not to try?
    Now re the T test, your view interest me, I over the last few days do this to test after exercise , it does give me a dull pain after, would you stop doing this even at 11 weeks, I do it because its a mental thing when I get th do twinge in the tendon,

  5. Sandizona on May 6, 2013 10:14 pm

    ……Hey Hattrick (thats a hockey term not bowling, right?)
    I’m also 12 weeks post op (Feb. 15th) and am heading out on a cruise this Saturday to some gorgeous sandy beaches. I’m FREAKING out about the occassional slippery decks on the ship, and like you said….walking in the sand. My P.T. says go for it, and she said they pools would be great. Wear shoes in the water, as getting out you could slip. Both my feet are swollen now, and I have to shove my piggies into shoes. Going to wear a good fitting fit -flop quite a bit in the Caribbean!! Lets check in with each other after our vacay : ) Safe travels to you too.

  6. hattrick30 on May 6, 2013 10:36 pm

    Sandizona,

    Hattrick is a reference to 1 player scoring 3 goals, typically Soccer or Hockey. My reference is for soccer, huge huge fan and have played it my whole life.

    Ripraproar was the one asking about the sand, etc.

    Further out though, I’ll be going on a cruise, not until the first week of September though, I wonder how much at that point in time it will still be holding me back.. 4 months away, it would be about 4 1/2 months post Op for me.

  7. ryanb on May 6, 2013 11:33 pm

    Good question Norm. Logic says that the Thompson test could cause problems- but it would surprise me if it made much difference for pre-surgery folks. If the Achilles is recoiled up high, a small calf contraction is not going to move the end of the slack tendon any farther. And, if there is a small gap, then I don’t imagine a Thompson test would move it farther up than surgeons regularly deal with for a more recoiled tendon end.

    For a patient on a non-op protocol, I think it maybe makes sense to be a little more cautious. However, I suspect Thompson test contractions and calf movement are trivial compared to the typical forces and displacements that led to the ATR. Immediately after the injury, I doubt there is much risk. For a non-op patient, I’d be most cautious in the first few weeks, so as not to interrupt the process of the tendon ends finding each other and starting to knit themselves back together.

  8. normofthenorth on May 7, 2013 3:30 am

    Ryan, after I tore my first AT, I did a couple of “moves” that I think slid the top part of my AT farther up my leg. One was the first time I put “that” foot on the first step of an “up” staircase “normally”, and started shifting my weight toward it — also “normally”. I don’t recall feeling any actual PAIN, but I do recall that it was about the creepiest feeling I’d ever felt, and I’m pretty sure that was from my Gastroc contracting a bit more, with no resistance and no way “back”. (I decided I never wanted to do THAT twice!)

    Maybe that tendon-slide is a bigger deal for non-op folks than “op” patients, but I’m not sure. There’s always a percentage of operations where a nerve is damaged or other complications surface that may be partly due to rough treatment, and the deeper the AT end is buried, the harder the surgeon has to poke around to pull it out. . . Alternatively, a bigger ATR separation would generally mean a longer incision, a more invasive operation, probably higher risk of an ugly scar or a non-healing wound, etc. I’m obviously not dealing from proof or even evidence here, just logic and speculation.

    Ripraproar, I wouldn’t be compulsively doing Thompson tests to yourself, partly because they tend to be really inconclusive when self-administered, and partly because it’s like uprooting your carrots to see if they’re growing properly. Now that you’re walking and doing PT and such, all of that is better evidence about your recovery than any test.

    As far as walking on a sandy beach goes, just be aware that — depending on the consistency of the sand — it can be MUCH more of a calf-and-AT workout than the same amount (time OR distance) of normal walking. So it’s really easy to overdo and do damage, if you don’t scale back accordingly, to keep the stress on your injured and atrophied parts INCREMENTAL. And it may be best to take the second day off, even if you don’t overdo on the first, just to be extra certain. Apart from that — and the fact that the mechanics of beach-walking are a bit different from normal walking, and you’re just getting the hang of the normal stuff — I think it’s fine, and maybe even good therapy at 11-ish weeks. But of all the times and places you DON’T want to have a setback, a vacation is probably #1, so don’t get carried away! And have fun on the vacation, too!

  9. Ripraproar on May 7, 2013 5:47 am

    Hi Norm
    As always thanks
    I like the carrot analogy, ill bare that in mind, re the sand , only thinking of walking less than 30 metres or so to be near the sea, I hope to be doing pool and gym rehab on vacation, not normally what I would have in mind, but it’s hard to do back home working 12 hours a day five day week.
    Good luck everyone, I really do think this is a great community, one more positive thing to ATR

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