Wednesday, February 27th, 2013...8:57 pm

Injury, diagnosis and early days…

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I ruptured my left Achilles tendon on Feb.13, 2013.  I am a reasonably fit 36yr old librarian and mom of three.  I love to run, do yoga, pilates, swim in the ocean, play volleyball, etc…. Before the injury I had slowly been getting back into shape after ‘putting on a few’ while completing my Masters degree.  For 8 months, I had been running regularly and slowly getting back into shape (or so I thought), so all the references in the literature to thirty-something "weekend warriors" being most susceptible to this injury hits close to home.

The injury took place at a fitness class doing resistance wind sprints (i.e. the runner and a partner have a large elastic around their hips with the partner resisting while the runner tries to sprint and pull them along).  I had been doing yoga, skiing and trail-running that week as well.  Maybe a little too much at once?!?

Like many others, I initially thought I had been booted hard in the calf/Achilles region from behind.  Apparently this is a common assumption based on how the rupture feels.  I immediately raised the leg on a large exercise ball thinking that this was just a bad kick and would result in nothing more than a bruised, swollen ankle.  Once the intense heat and pressure subsided, I tried to stand up to stretch it out but it felt like someone else’s foot attached to my leg.  My calf muscle immediately cramped and I was back on the ground.

That night, I kept the leg elevated and iced it until (after calling the nurse hotline) we decided to go to the ER to check it out. The doctor ordered an ultrasound for the next morning, which confirmed a complete rupture at the musculotendinous junction (where the tendon inserts into the calf muscles) with a 1.3cm distance between the tendon and muscle.  My GP sent the ultrasound to the orthopedic surgeon on call at Lions Gate Hospital in North Vancouver, Dr. Alan Baggoo, and told me that he had confirmed the radiologists’ diagnosis, but that I was not a candidate for surgery due to the location of the rupture. He said that I should be sent back to the ER to have the leg casted in an equinus (pointed toe) position.  The day after the injury, Valentine’s Day, I was back in the ER getting a massive cast on (up to the top of my thigh)!! Not the most romantic Valentine’s Day evening, but definitely memorable!


  • Most surgeons avoid operating on high ATRs because the muscle doesn’t hold sutures as well/strongly as the AT. Fortunately, a good modern fast non-op cure like seems to work as well on hig ATRs as low or medium ones. Slower older-fashioned protocols do NOT work nearly as well, though, with much higher rerupture rates — and they’re a bloody nuisance too and probably cause more muscle atrophy too. So make sure your Doc and PT don’t send you down the slow road. If they want to, either educate them (e.g. with the CANADIAN UWO Study (free on this site), or trade them in on professionals who’ve been keeping up with the evidence. (The UWO Study was only published in 2010.)

  • Also, like many of us, you’re finding some excuses for self-blame during your spare-time “Why me?” moments. Forget it! Of course being active and pushing our legs hard puts us at risk of ATRs, but that’s a wonderful thing to do and way to be, and it’s about the only clear evidence-based risk factor (other than taking fluoriquinolone antibiotics). Even warming up and stretching pre-sports doesn’t seem to lessen the rate of ATRs, at least not enough to show up in the statistical analyses that have been done so far. Many of the same “moves” that make us fitter and healthier and buffer and happier and longer-lived, also put us at higher risk of rupturing an AT. David Beckham and all the other elite athletes that have joined this club didn’t get in by doing something wrong, but by doing something right!
    It’s a bummer, a serious setback, a frustration and a nuisance, sure. But if our species/society really understood what it is and where it usually comes from, it would bring credit and honor to us all, like a medal! So hold those crutches high — except when you’re putting your weight on them, of course! :-)

  • Thanks Norm, for the encouragement and all the great info. I’ve definitely been looking into this and just posted about my non-operative path. Your comments and contributions have helped me understand that this is the scenario that is inevitable for my situation, and that I can still have a great outcome without surgery provided that the rehab model is in keeping with current research.

  • ….’morning jdrg
    I’ve been reading your addictive posts for an hour now, clicking on the links you provided too! We are neck and neck with the injury & however our recoveries are going to be slightly different. I had surgery Feb. 15th on my ATR and you’re non-op.
    *Splint for two weeks NWB w/ crutches
    *Feb. 26th …Stitches out, BOOT on, 24×7 even have to sleep with it on! (can air out leg while resting) still NWB w/ crutches (so clumbsy $^%$^% crutches, grrr)….Hubs bought me a LIFE SAVING Knee Scooter (on ebay) , allowing me to scoot around with so much more freedom. Truly, I only used it for two weeks. We will allow others to borrow it when needed! We live in a 55+ snowbird park in AZ.
    *Mar. 4th…began PT! 3x a week! Boot off, make big circles with ankle, move toes up & back, try as I might, and begin to trace the alphabet . SO HARD TO DO! Then I recieved foot, ankle, calf massage 20 minutes straight!! mmmm Then 15 min. TENS unit, and done.
    *April 9th…2nd post op, boot off and into TWO shoes!! FULL back shoes, no flip flops for a month. Then only to wear inside house and poolside.
    *6-8 more weeks PT 3x week
    *Water aerobics, eliptical, treadmill, upper body cardio, walking (yet listening to my body saying, thats enough for now)
    *RICE-ing still very appropriate
    *Vit. E while massaging scar
    *prepare for our family cruise May 11th!!!
    I’m one HAPPY ATR recovery 60 year old retiree who snowbirds with hubs in Bullhead City, AZ
    (Summers in Spokane, WA / at cabin too Spirit Lake, ID)
    Happy Healing
    and Dennis…….thank you thank you for this blog!! I’m so addicted to it. I happened upon it, because I googled: “I thought someone kicked me in the ankle, and didn’t say I’m sorry”…… BAM, up came ATR Blog xoxo

  • Thanks Sandizona. It’s lovely to read your cheery comment. Way to go working so hard on the recovery. Yes, it sounds like we are on a similar timeline though I’m non-op and a little behind you. 60yrs? You are inspiring, and obviously one young-hearted, healthy woman.
    I’m just now FWB so not in 2 shoes yet although I feel like once I got over the mental hurdle to fully bear weight, things have progressed quite a bit (my sweet shoe helps too :). It sure is nice to be at a more active recovery phase though isn’t it? Just getting on the exercise bike and out to the gym has been wonderful!!! I completely agree that the physio massage is great too. Mine was a bit painful initially - breaking up all the scar tissue and releasing the build up of ‘gunk’ I suppose - but it feels better every time and my lump is almost gone now. Keep at it. Your attitude alone is addicting.

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