Aug 30 2011

The story so far (Part 2)

Published by joelh1978 at 23:13 under Re-rupture

When I first felt the pop at the back of my leg after trying to get on my bike I tired convincing myself it was just a bit of scar tissue popping off. Unfortunately this was not the case. A friend helped me find a local MRI facility that day and by late that night I already had confirmation from my surgeon that I had completely ruptured it again.

A week later I was back in for surgery but this time it was to be a more complex procedure. I was given a donor tendon to bridge the gap and then the new join was wrapped in facial tissue obtained from my lower leg. Rather than a handful of small incisions like last time, I now have a 30cm long scar running about 3/4 the way up the side of my leg. In my personal opinion this scar looks a lot cooler than the the previous ones from the percutaneous surgery :-)

At work I had discovered I had over 400 hours of sick leave saved up so this time I decided to milk the situation and took 2 weeks off to recover. I was in a splint similar to the one I had last time but instead of 2 weeks in the splint I spent 5 weeks in it.

I just went back into the boot last Friday. It felt good to be able to wash it and move it a little for the first time but I discovered the surgery hadn’t quite gone to plan. While I was in the splint I had felt a little bit of pain on the side of my foot from time to time. The surgeon had told me he was going to use part of my hamstring to wrap up the tendon but with no incisions in the area I assumed he may have used some tissue from my foot instead.

When the splint came off I realised that wasn’t the case. Instead, a large part of the side of my foot is numb. I think there may have been some nerve damage from surgery but I don’t think it’s anything to worry about. It may heal with time but even if it doesn’t it won’t slow me down.

I’m now 5 weeks out from surgery and I’ll be NWB at least until late next week when I see the surgeon again.

6 Responses to “The story so far (Part 2)”

  1. ryanbon 06 Oct 2011 at 06:32

    Joel, when you ruptured the second time, what type of shoes were you wearing? Road cleats (which, when standing, raise your toes up, stretching the Achilles), Mountain cleats (which are flatter, as they are designed for walking), or regular athletic shoes?

  2. joelh1978on 09 Oct 2011 at 13:51

    When I did it I was wearing a pair of slip-on shoes. I had removed my clip less pedals and put the regular ones back on so that I didn’t have to wear my road cleats.

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  3. rosethornon 02 Feb 2012 at 09:11

    Joel-

    I have a section of hamstring wrapped around my Achilles tendon as well, but it is cadaver tissue that was pre-ordered for my surgery.

    I am curious about what Ryan has asked as well since I am also a cyclist!

  4. joelh1978on 04 Feb 2012 at 12:27

    Yeah I have cadaver tissue too. I’m not sure where it was from. I assumed it was tendon tissue but it could have been anything I guess. My surgeon also used some of my own tissue from just below my calf.

    I don’t think the re-rupture had anything to do with the shoes I was wearing. I think it was more a combination of the results from the first surgery and also trying to ride too soon after surgery. It’s been over 6 months now since the second surgery and I have only been on an indoor bike. With any luck I’ll be back on my road bike in a month or two. I’m still hoping to do a 200k ride in October.

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  5. normofthenorthon 08 Feb 2012 at 03:18

    The aggressive push-off cyclists normally use to get going can certainly re-rupture a healing AT. Heck, we’ve had people do it pushing off into a surface dive in a pool, which seems lots gentler to me.
    I returned to urban cycling while still in a boot, then returned to the boot for cycling (& other high-risk situations) for a while after I was otherwise in 2 shoes. This time (ATR #2) my left was the “bad”, so it was the foot on the pedal for that scooter-like push-off. That has risks, too, but they can be minimized by placing your foot forward on the pedal.

    Alas, when we first return to pre-ATR activities like cycling, it helps to examine them with an engineer’s eye, to limit the max tension on the healing AT. It doesn’t know or care how common a high-tension “move” is for a normal healthy person, it only cares if we pull on it too hard. The rule of thumb is that the vast majority of re-ruptures happen before 12 weeks post-whatever, but it’s just a RoT, not a guarantee.

  6. Joelon 10 Feb 2012 at 14:59

    Hrm, some of my replies haven’t been getting through.

    As for what shoes I was wearing when it re-ruptured getting on the bike. They were just a pair of slip on shoes. I had replaced my clipless pedals with regular pedals so I didn’t need to wear my regular bike shoes with cleats.

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