Week one done

There is no doubt that ATR recovery is a huge test of patience.

Life with your feet up is not all it is cracked up to be. I am a very active person and it is so hard to not be frustrated by the crutches and inability to do simple tasks. Taking it one day at a time!

I have been doing lots of research on recovery, my last rupture was pre-Google. How things have changed.

My foot is currently cast at 27 degrees. I wasn’t given any other info at the time other than the casting would be changed progressively and a boot used at some point. Is 27 degrees too close to neutral?

I also am still getting some swelling- will keep the chunky old leg elevated as much as I can so that this hopefully passes soon.

Happy healing!

15 Responses so far »

  1. 1

    normofthenorth said,

    August 28, 2014 @ 3:32 pm

    Make 100% sure you don’t go slower than those 3 protocols! Slow non-op doesn’t work any better now than it did 100 years ago.

  2. 2

    jimb0san said,

    August 28, 2014 @ 3:35 pm

    I’m sorry to hear that this is your 2nd rupture. was it the same foot? And hang in there. i was in your shoes just a few weeks ago.

  3. 3

    herewegoagain said,

    August 28, 2014 @ 4:05 pm

    Norm- I am Canada, my last ATR was repaired in Australia.
    I will not meet an OS until my 2 week appt. so hope to have some more answers then. The ER staff mentioned that a boot could be an option at a later date and this would be the doctors decision. There was very little info given and when I asked for more detail on the recovery outcomes (surgery v non) I was told it is now regarded as the best choice (but I had no choice). Living in a small town I didn’t really have any other options, and fortunately it seems like the best way to go. So- I have a Vacocast on the way and printed out the protocols to take. Worst case is I put myself in the hands of a PT and manage my own recovery. Feel OK about that, I had a really tough time learning to walk again last time which I am sure was due to being immobile for so long.

    Jim- other leg! Now I will have a matched set.

    Thanks!!

  4. 4

    davidk said,

    August 28, 2014 @ 5:17 pm

    I’m starting to see a connection between Canada and double ATRs! :-)

  5. 5

    nosport45 said,

    August 28, 2014 @ 6:34 pm

    Good luck. Time will soon pass and sounds like you’re in the right frame of mind. Keep us posted. Take care

  6. 6

    normofthenorth said,

    August 29, 2014 @ 3:42 am

    Cute, davidk! We’ve had a smattering of 2-timers around here for a long time, from lots of places. Have you seen the (non-Canadian) study (linked from this site’s Protocols and Studies page) that shows that first-time ATR patients have a ~200X greater risk than the public at large in the first few years of tearing the other AT? So lots of people do it much quicker than these two Canadians.

    I’m in Toronto, where ATR treatment is all over the block, from OSs who push surgery hard, to others who have stopped doing the op (including mine for ATR #2), and everything in-between.

    In addition to making sure your OS sees the 3 best modern protocols, he should also see the whole Wallace study from Belfast. Wallace’s simple technique of matching the initial immobilization angle to the needs of the torn AT seems like a breakthrough in non-op treatment, and his great results bear that out.

  7. 7

    Greg baker said,

    August 29, 2014 @ 8:08 pm

    Why do you think we have a greater risk of rupturing the other one? I tried to find some research on it but there doesent seem to be anywhere. My doctor told me I have a 40 percent chance of rupturing my other one, so i think my sport playing days are over and I’m only 21 years old. I wish there was concrete research on this with empirical evidence on why this is so I could make a decision about my future.

  8. 8

    herewegoagain said,

    August 29, 2014 @ 8:52 pm

    Greg, I am not sure how much research has been done on rupturing both achilles. I do know that I have met lots of people over the last 15 years who have had an ATR, none of them had done it twice. I have had 15 years of fun skiing, rowing, running and biking before this second hit. Get more info from your doc and think about a pro-active preventative plan from a good PT. No-one should ever think their sport playing days are done!

  9. 9

    normofthenorth said,

    August 30, 2014 @ 1:45 am

    There’s some decent empirical evidence, but it answers What, not Why. Look in the Studies and Protocols page linked from the Main Page, and look for “Contralateral”. That’s the study that shows the What, I.e. the elevated risk after 1 ATR.

    The reasons are probably partly hereditary and partly lifestyle. On average, we ATR folks are more active than most at explosive high-ATR-stress sports. Not all, but on average. And there’s probably something in our nature - geometry, blood flow, muscle-vs-tendon strength, etc? - that makes us more prone to ATRs than the average person.

    Many of us have knowingly risked it, and some of eventually ruptured the other AT. Mine, 8 yrs after #1, followed a slow rehab plus 7 great years of fun sports, including “the one”, competitive court volleyball. I’m sure glad I didn’t give it up!

    I doubt that there’s a way to drop the risk significantly. Avoiding high-risk activities would certainly postpone a 2nd ATR, but it might be worse to have one in the Old Folks Home instead of on the playing field. And most of us can choose a faster and better proven protocol (often non-op) the 2nd time, which helps a lot.
    I’ve been gradually switching over from court to beach, NOT because it’s less injury prone (including ATRs), but I don’t mind that as a freebie bonus.

  10. 10

    goldman said,

    August 30, 2014 @ 7:52 am

    Greg baker, I completely agree with herewegoagain. You should get it outta your head right here right now the thought to give up sports at 21. Just my opinion, you can choose to ignore it, but you’ll be unhappy for the next 80 years, or however long you live. Anyway, it’s not to say a 2nd (or 3rd! I read a blog on this site from a three-timer) would not completely totally suck. IT would. But it only sucks for 1% of your life. So why give up the other 99%?

  11. 11

    goldman said,

    August 30, 2014 @ 8:09 am

    oops sorry, herewego, didn’t mean to imply your life sucks since you seem to have a great attitude. Well… umm the crutches one-leg part is pretty annoying. It was about five months ago for me and that sticks in my mind. Speedy healing! -Jon
    p.s. Your blog says you injured other side with a “quick step” off your mountain bike — I guess it was pretty hard, pretty quick? I mean stepping off a bike doesn’t seem so “explosive” but I have read several blogs on this site where people describe the injury in a fashion that makes it seem like they were doing everyday activities.

  12. 12

    herewegoagain said,

    August 30, 2014 @ 11:41 am

    Jon- some parts of my life do suck. I have just looked around my messy house and predicted how out of control the grunge will be by the time I finally get back on both feet. The rest is all good! It was a quick step off the bike, not 100% sure as it all seems like a blur but I think my heel must have sunk into a bit of a hole. Probably was hard- I need to perfect some more graceful moves! Have been reading your blog, very funny! Lisa

  13. 13

    Stuart said,

    August 30, 2014 @ 4:39 pm

    Greg - was wondering what the outcome of the holiday was? Whatever life choice you make should really be your own but its a bit young to give up on it. We all live with the risk and some like Lisa and Norm have been there. This is not the worst thing that can happen to you so how are you going to minimise every risk in your life? It is only a speed bump.

  14. 14

    Greg baker said,

    September 1, 2014 @ 1:48 pm

    My vacation went well although I was limping considerably. I had to do a couple ice baths a day to control the swelling each day since walking so much was a shock to my achilles. I know everyone has the same risk but it happening while I’m so young is a scare to me and I do want to minimize the chance of my other achilles rupturing. I am not going I play competitive sports so rigorously as I used to but I also won’t let it deter me from doing the things I love to do. I wanted to learn how to surf so it’s just a thought in my head now to be mindful about it. To me, it would be devastating to have this happen again, so I just want to be mindful and conscious of what I do from here on, that’s all.

  15. 15

    davidk said,

    September 1, 2014 @ 2:36 pm

    Greg, I don’t have studies to support, but I think Norm has the right hypothesis about the greater risk of a 2nd ATR. Stated another way, it’s a bit of an apples to oranges comparison. The risk of a 1st ATR is made against the general population, but the risk of a 2nd ATR is now against a much smaller population with different characteristics–including lifestyle. My speculation is that if you used those characteristics to winnow the general population, I think you’d find that the risk of the 1st ATR is much higher–and maybe not that different from what’s reported for 2nd ATRs. I can also offer you my own experience with dealing with my ATR–at first I was devastated and thought I might need to or want to give up sports, but as I’ve recovered I’ve abandoned those thoughts. I know it could happen again, but I get too much benefit all around from the social and physical aspects of sports to quit. -David

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