First blog second rupture

By way of background, I ruptured my right Achilles in January 2009 (35 at the time) playing football and had a successful recovery. Was in a cast for two weeks, then the boot for another four. Walking normally soon after that and in the gym, etc by about 4 months. Probably never got 100% of the strength back but about 90% and enough for me. Was very happy to ditch the crutches but kept the boot which was handy as…

On 11 July (two and a half years since first atr) went and snapped my LEFT Achilles. Was playing tennis this time. When it happened initial thought was that someone had hit a tennis ball and it had hit my ankle but a fraction of a second later I immediately knew what I had done. Was very depressed knowing what I had done and knowing exactly how long it takes (albeit I know my last recovery was on the shorter side).

Three and a half weeks on and have had the surgery (the next day with the same surgeon I used last time - I had to say whilst repeat business shows I was happy with what he did last time, I was not pleased to be seeing him again). Again, cast for 2 weeks and now fwb in the boot with one wedge which I think can probably come out now but I am seeing the surgeon on Wednesday so will leave it for him to confirm.

Few thoughts having had this experience twice:
- the first time I ruptured I stupidly walked on it for about a week. I knew it was something serious but was in denial - lesson learnt the second time and got it sorted immediately. This meant the surgery was much easier and neater.
- first time I was also naive about recovery and not until the day of the surgery did I acknowledge I would have to have time off work (genuinely thought that it would be cut me open, stitch me up and off I walk in the boot). If I had taken a bit of a look at a site like this I would have been better placed but was a bit of a lacking in the doctors who assume a bit too much about the common sense of a patient like me. The shock of knowing how long recovery is can be pretty upsetting but I think short targets are useful (eg I will be in the boot in 2 weeks, I will be walking at 3 weeks and I will loose the boot by week 6). longer term targets are also useful to keep us going. My first one was to be skiing the next year and this time it is to be quicker and better than last time. It is important that these are realistic though as depressing to keep missing your targets.
- whilst we all have plenty of time to research in the 1st few weeks and knowledge is power, everyone’s case is different so do not take anyone else’s story or guidance as your protocol. When you mention to anyone that you have ruptured your Achilles, they or someone they know also did that and was walking normally in 2 weeks or never walked again. Everyone loves to exagerate or pretend they know more than they do. You have to learn to listen to the right people.
- whilst my Achilles probably had a weakness, I didn’t properly stretch, etc when I ruptured the second time. Massive lesson learnt (even if it took two ruptures to instill), if I do get back to sports this will be my mantra. All people reading this approaching activities, please listen to the physios. They do know what they are talking about. Whilst there are always cases of rerupture, there always has to be a balance of quality of life vs precaution. Don’t give up the things you love but use the knowledge you gain to prevent it happening again (yes, a lesson I should have learnt the first time).

Anyway, more than enough from me for now. Wish everyone out there a speedy and successful recovery.

6 Responses to “First blog second rupture”

  1. Greetings from a fellow “both sides now” ATR guy — though it took me 8 years after the first to tear the second.

    If you read the latest studies on pre-sports stretching, I think you’ll find that it is consistently detrimental to strength and performance, and probably also negative for avoiding injuries! Having non-sports stretching-exercise sessions may be beneficial, but stretching as part of a pre-sports warmup seems to be a Bad Idea, based on the evidence I’ve seen.

    There’s a good NYTimes article (online) from 3-4 yrs ago that summarizes the evidence up to that point. I think the evidence that pre-sports stretching hurts strength and performance, may have come more recently.

  2. Found a more recent blog on NY TImes:
    http://well.blogs.nytimes.com/2010/09/01/phys-ed-does-stretching-before-running-prevent-injuries

    Seems to be contrasting opinions still but I never used to stretch pre-sport (warm up but not stretch) and stretching was for post exercise.

    I think a big factor for me was being generally in worse condition than I was 3-4 years ago and suddenly playing tennis. Whilst I have got moderately “gym fit” since 1st rupture, level of fitness was much less and hadn’t really been playing the higher impact sports.

  3. Hi Markuk, so sorry to hear about your left rupture. it is my biggest, worstest fear. You made the comment but left it open to interpretation…Just confirming that you believe that pre-sport stretching is important? I tend to agree with you. I am hesitant to even think about returning to tennis at the same level i was playing before because I am nervous about rupturing my other (right) tendon. Well, you are well informed about what is in store for you in the next few weeks, no doubt, you are wiser since you’ve been through this before. Best of luck to you!

  4. Hi Polly,
    In truth, I wouldn’t like to guide anyone one way or the other given that professionals seem to be in dispute but personally think warming up which includes gentle stretching must help. I think it is the intense stretching (to the point when you feel a resistance) that puts the body under stress. But that said, what does Mr Two Rupture here know?

    At the end if the day, these ruptures happen and I think I either was very unlucky or I had a pre-existing problem. I do not believe anyone should give up what they enjoy because of a what if. I could have kept myself fitter but people in a much worse state of fitness than me will pick up a racket or kick a football for the first time in years and not get injured. All we can do is follow general good advice (maintain a good level of fitness, keep weight down, build up to any intense sport, warm up properly, etc) and live our lives. I hadn’t played tennis in years so I will not miss it if I don’t play again but I like to ski so it will not stop me doing that.

  5. The stats on ATR patients rupturing the other side — one study linked from this site says ~200 TIMES the normal risk, with only 4 yrs of follow-up, IIRC!! — suggest that many of us have a pre-existing condition that makes ATR unusually likely.

    The dominant theory used to be that there’s a blood-flow “watershed” zone a few inches above the heel — and presumably more extreme in us higher-risk folks — where the blood stagnates, so the tendon is slowly starved and deteriorates. I think I’ve seen a recent study or two that calls that theory into question, but SOMETHING seems to make a “tear here” line on our ATs.

    “By design”, every tendon in our bodies is significantly stronger than the muscle that pulls on it — or we’d be tearing tendons every day or two. But members of this club have legs that somehow broke that rule, at least on one side.

    I’m a big fan of “living our lives”, including returning to the activities we love, even if they present a risk of an other-side ATR. (And I say that after I LOST the bet myself!) Mind you, there are very few decisions that are as properly personal and “there’s no wrong answer” as that one. Lots of people live wonderful lives without explosive athletic activities. . .

  6. I consider (or considered after this injury) myself to be pretty fit, playing sports 3/4 times a week. I’ve never done a traditional warm up with stretches as to me, you would need to cater that stretching to the specific activity you’re doing. Instead I have always spent the first 5 minutes easing myself into that activity as the only thing guarenteed to use all the bits that I need to use is that activity itself!

    I did read somewhere recently, but can not for the life of me find it again, that a good a warm up as any is to do a 5 minute quick walk as this will warm up sufficiently all the major parts you need.

    Personally I’ll stick to my way of warming up.
    I don’t believe my achilles went due to some pre-disposed weakness. For me I believe it was down to pushing my body way past its physical limits when exhausted.

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