Case 25: Non-operative treatment

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one year ago today …

February 19th, 2010 · 5 Comments

Exactly a year ago I ruptured my left achilles tendon in a basketball game. What a year!
I feel I need to update those interested in my journey with some results, good news and some not so good news. Thus, here we go:

I was one of the very first ones, at the highly celebrated sports clinic at my university, to go through the non-operative procedure with the PRP (Platelet Rich Plasma) injections. I can’t say I am completely happy with the results. I can run, jog, walk, swim, play most sports. I can’t jump, lift myself up with on the left heel, or come down the stairs smoothly (or without a handraili). The issue is that my tendon healed long! I have recovered full muscle strength, but eh, that isn’t just doing it. On top of that ,there is a consistent and constant pain every morning for about the first half hour.

On that note, I highly recommend everyone to take physio therapy very seriously. At the beginning the clinic I went to was just a cash drain. They did nothing substantive. The second clinic I went to (after the 5th month) they were fantatic, attending, caring, results oriented, scientific and methodical.

Overall, I am glad the year is over. Just mentally I am at ease. I wish everyone on this site, and all those sharing our pain, a smooth recovery.

Thank you all for your support!

Tags: Uncategorized

5 responses so far ↓

  • 1 tomtom // Feb 19, 2010 at 11:58 am

    mazmouza - Thanks for the update. Sorry to hear you are still struggling with the elongated tendon. As you may remember, my tendon healed long as well. I’m now just shy of 7 months post op from a procedure to shorten the tendon. I’m just curious if you are considering having the tendon shortened, or if you’ve accepted that the tendon will always be long. Have you visited with the doctor lately to get his/her opinion?

  • 2 mazmouza // Feb 19, 2010 at 4:06 pm

    Hi tomtom,
    I was just reading your entries.

    I haven’t decided what I should do. I am seriously considering getting a second opinion. So I have to start searching for good surgeons in the Toronto area.

    I’m curious to know how you feel about this, beyond what you have already mentioned in your entries.

  • 3 tomtom // Feb 19, 2010 at 6:42 pm

    mazmouza - You situation is very similar to where I was at 1 year post rupture. I was getting around okay, but wasn’t back to normal due to my weakened calf. It was about this same time that I realized a shortening surgery was becoming a reality. I waited another 6 months hoping that changing up my gym routine might do the trick. In hindsight, I kind of wish I would have opted for the shortening surgery sooner.

    That said, I didn’t take a second surgery lightly. I knew there was/is no guarantee that I’ll get back to normal and that I would have to start the recovery process all over again while opening myself up to the possibility of wound complications.

    In the end there were a couple of things that helped me make my decisions. First, I’m relatively young (36) and I’m hopeful that I’ll remain active and competitive for many years to come. I also didn’t want to be asking the “what if” questions 20 years from now. Second, I was concerned about other body parts (knees, back) having to compensate for a weakened calf. In some ways I looked at the second surgery as preventative surgery.

    I think you would be wise to seek a second opinion. It doesn’t commit you to anything, and it might be helpful to hear a medical professional lay out the options. Feel free to bounce questions off of me as well at any time.

  • 4 normofthenorth // Feb 20, 2010 at 1:11 am

    Mazmouza, I get a chill whenever I read your stuff, because I’m having the same UWO-based immobilization-plus-PRP protocol that you followed. On the other hand, at 10 weeks in, mine seems to be going well, and I THINK my tendon length seems right. Hard to be absolutely sure before the walking-straight-barefoot stage, but I think I’m already getting a normal amount of heel lift (still 2-footed!) from my new AT.

    I’d love to give you some tips on finding a good AT surgeon in Toronto, but when I searched around in early December (initially looking for surgery — which I’d had on the other AT 8 years ago), I was shocked that it was so hard to find one!

    John Murnaghan at the O&A hospital on Wellesley street did my first AT, but when I tracked him down, I was told he’d given up on “feet”. I struck out with several other leads, too.

    Then I went to the Univ. of Toronto Sports Med. Clinic (same as I did 8 yrs ago) and they referred me to Rick Zarnett at Sports. Med. Specialists. He’s presumably a fine surgeon (chief surgeon of the Toronto Argonauts pro football team), but he told me that he’d stopped doing ATR repairs since learning the results of the UWO study, 4 months earlier. So I was talked out of surgery by a surgeon(!).

    OTOH, he might do an AT-shortening operation, if you decide to go for one. He’s probably worth calling about it. (Tell him I sent you, if you like. I’ve seen him twice now, and he’s answered a lot of questions.)

  • 5 2ndtimer // Feb 20, 2010 at 6:04 pm

    mazmouza,
    Sorry to hear you are disappointed in your recovery. I have a feeling no solution is perfect.
    It is good if you can do most sports - but having half an hour of pain daily is discouraging.
    I had pain in the tendon when I was walking after the conservative treatment, but my flexibility was better.
    After the re-rupture and surgery the pain in the tendon has disappeared, however my dorsiflexion is much less than in the good foot. That makes jumping and leaning forward a bit uncomfortable. I can walk fast, and jog a bit, jump, too, but I lost a lot of muscle strength with the 2 periods of immobilization. I am just a few days shy of the original rupture, and hope that by the summer, when the anniversary of the surgery comes that will improve a bit.
    However I still get pain in the front of my foot when I walk a lot, and no one could explain why. I guess surgery does mess up things a bit.

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