New member to ATR club

September 24, 2011

I’m a new member to the ATR club, tore mine September 18.  My story is pretty similar to most; while playing tennis I felt and heard the discouraging snap on the back of my lower leg (right) and immediately had a pretty good idea what happened.  The injury has not been particularly painful outside of the initial discomfort and shock and I was pretty good about following the RICE protocol for the first 48 hours.

Less than 2 days after the event I was diagnosed by an orthopedic surgeon that sure enough I tore the achilles tendon, no surprise there.  She recommended not to have surgery because of my age (56) and stating recent studies indicate there is not a meaningful difference in length or quality of recovery between surgically repaired achilles tendons and those that are immobilized and allowed to heal on their own.  All this information in less than 15 minutes!

I was given an immobilizing boot and told to expect to wear it for 10 - 12 weeks and to return in 4 weeks for a followup.  My concern leaving the practice was the treatment seemed to be different than what is discussed on achillesblog site.

Specifically I was allowed to weight bear, my ankle is in a 90 degree position and, the decision between surgery versus noninvasive treatment is more complex than the physician led me to believe.  Net, my sense was the doc saw me as a middle aged guy who’s not going to be very active so did not give the diagnosis or treatment options much thought.

Since my initial diagnosis I’ve seen two sports medicine orthopedic specialists, one in non-invasive treatment, the other a surgeon that does ATR reconstructions regularly.  Also I had an MRI to accurately gauge the severity of the injury.  Turns out the tear is 100%; there is a wide gap (4 - 5 cm) between the two ends and more to the point it is quite high up, near where the tendon meets the calf muscle which is not the typical location the achilles tendon usually ruptures.  Leave it to me to be a statistical outlier.

For my treatment I’ve chosen surgery (and of course lots of rehab) because even the non-invasive specialist said that was my best option.  So fellow ATR club members, the deed will be done on September 27 in a Philadelphia hospital.

Perhaps the biggest takeaway from this experience to date is be your own medical treatment advocate.  Oh and be married to an amazing wife who knows the medical system and got me appointments with the right people on short notice.

Like all of you, I’m not looking forward to the next 4 - 6 weeks when I expect to be in a cast and later a boot.  Not to mention since it’s my right leg I cannot drive until I’m out of any immobilizing apparatus!  And I’m fully sanguine that daily rehab will be part of my routine for a very long time.  But given the choice to be active through my doddering old age or not than … ya do what ya gotta do.

Will update this blog when I’m a few days past the procedure.

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6 Comments Add your own

  • 1. Stuart  |  September 24th, 2011 at 5:39 pm

    It is actually unusual to do surgery on rupture that high. You may have been on the limit. The best thing you did was get another opinion. I feel you would have had ongoing problems with the treatment offered from the first doctor. Not the non-op part, just the rest. To go non-op it is best if your tendon come into contact when your foot is pointed down. That is why the foot is locked into that position for a few weeks. It sounds like you have someone who is up to date so I wish you a speedy recovery without complications. The two things to avoid are a re-rupture and healing long. The later is important in the long term and the former in the short. I feel the first doc would have had you healing long and that can only be fixed under the knife. The alternative is a strength defecit for the rest of your life.

  • 2. Mari  |  September 25th, 2011 at 7:03 pm

    M<an, I detest Dr’s like that.
    Making my mind up for me.

    Good luck, 4-5 centimeters is a sizable amount!

  • 3. ryanb  |  September 27th, 2011 at 12:10 pm

    I tore my right one 8/24. Surgery 8/26. I was driving 1 week after the surgery 9/2- though I can’t drive a stick shift yet. But, with an automatic, I just tuck my right foot in behind, and drive with my left foot. Do a little practicing in an open parking lot first. Cruise control is your friend.

  • 4. Stuart  |  September 28th, 2011 at 4:26 pm

    Your recent post doesn’t seem to allow any comment so I will put it here for you. I can relate completely to where you are but I need to tell you that you should not obsess about the future this early. Easy to say I know but if you do it can throw you into a big black hole. Trust me on that. Everything I thought and felt at that time was not true. You are very fortunate to have a surgeon who is willing and able to repair a tendon so high and so badly damaged. It may mean that your recovery will be a bit different to others here so again, do not obsess with how fast others are doing it. Given a good rehab program there is no reason why you should not be able to return to your pre-op activities if you choose. The problem at the moment is you have too much time to dwell on the injury and the future so I would suggest you occupy your time with something else. Keep your mind active and on other things. Learn something new, something very hard that takes intense concentration. Something you can do seated. Start reading or sign up for a short correspondence course. In no time you will be mobile again and life will start getting busy. In the scheme of things, this is a bump in the road but I know that it is hard to see it that way from where you are now. The first few weeks are the hardest. There are good things that come out of this injury. A bit hard to see or appreciate this at the moment as well but you will. Stay positive.

  • 5. ryanb  |  September 29th, 2011 at 10:08 am

    Like Stuart says, it appears comments are somehow disabled on your “24hr” post, so I’ll drop a comment here too.

    Don’t get too down. I’m about 4 weeks ahead of you: 9/18 was day 23 post surgery for me. Right now, I pretty much have all the essential components of my “normal” life back. I’m walking (FWB, in the boot), driving, going to work full time, doing many of the things I was before the injury. My daily schedule really doesn’t look much different than it did before: time that would have been consumed by training is now used for rehab activities.

    No doubt- we’ve both got a long road ahead of us. But I think you’ll find that you’ll figure out ways to accommodate this injury into your routine, and get things back to “normal” much sooner than you are currently expecting ;-). As I said, I’m just up the path a little ways ahead of you, and will be happy to let you know what I’m finding up here at any time.


  • 6. jjniss  |  September 29th, 2011 at 11:18 am

    ryanb and Stuart, thank you! The support available on this site is amazing. When I whimsically titled my first post about being a member of the ATR club, I had no idea how close to the truth that was.

    I’m not as down as I sounded on the 24-hours-after-surgery post. Nevertheless your advice is well taken, focus on the now, the future will take care of itself. Now if I can just get the comments to work properly on the blog …

    [WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

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