What I believe has contributed to my ATR occurring

Posting this just as raw data, making no claims of greatness or anything like that. Long, boring post, just putting it all out there
History/Situation before ATR
  • Used to be quite active in my childhood, playing Tennis, Field Hockey, Ice Hockey, Ski, of course lots of daily bicycle (growing up in Germany, daily form of transportation), Football (the “soccer” kind), Volleyball, Sailing and various weekly sports activities in school which I always enjoyed like Handball, Basketball etc.
  • Was never much of a runner, neither very fast nor very enduring,  in all of those sports activities I focussed more on technique. I have always been on the heavy side, not in a fat but an overall strong way, 183cm/6ft and about 90kg/200lbs
  • One year, as a 16 year old foreign exchange student in California, I played “soccer” very competitively in the high school team and a separate league. We had daily practice with lots of running and endurance, I was in quite good shape during that year and became a decent runner
  • At age 18 I tore a ligament in my left foot on the stairs at home (trying to rush to Volleyball practice)
  • After end of school (Gymnasium in Germany) I slowed my sports activities way down as I had to focus on University and family
  • Family, University and eventually job became so involving that I stopped practically all sports activity
  • Around age 40 I became sick and tired of a slowly fattening, lumpy, ugly, lazy body and started back into sports, first sailing and skiing
  • Around age 45 I started Tennis again, but quickly found to my own disgust that I am miles away from where I should be in Tennis. I thought I was a decent player from my childhood but got handed my @#$ on a silver platter by whoever I played with
  • Accidentally found an extremely good and professional Tennis coach who started coaching me.  We started out infrequently a few times per month as our schedules permitted but I got totally hooked and we ended up with serious training almost daily.
  • Probably as a result of the -for my shape insane- training regimen, I developed back, leg and shoulder problems.
  • On a business trip in Japan, I came down with what seemed like a serious lower back problem, debilitating pain and immobility but was able to somewhat fix it with exercises and stretched my colleague showed me who had had the same issue earlier
  • Back at home I saw an -I think very skilled- PT, specialized in sports. He evaluated me and came to the conclusion that I am in ok shape, have no fundamental issues and can take this kind of training if I want to, however, I absolutely should add other sports for balance. He strongly suggested running.
  • I strangely started to enjoy running (I used to hate it), it was actually becoming a meditative thing quickly. I was running not very fast, but usually at least one hour about every second day. I purchased a pulse watch and took it quite seriously. Started to increase my pace and the running developed into an activity for its own sake, not just a balancing exercise for Tennis.  My favorite running area was by the waterline on the San Francisco Bay and I was starting to train for competitive runs, aiming for 10k and half marathons. Still, no great times, but definitely well within acceptable ranges for my age.
  • In a running shop I took the advice of a sales guy who said I should try “minimal” running shoes as my gait is very normal and it would be good for me. However, he said I had to watch for my Achilles as lots of people get problems with it when changing running styles like that.
  • The minimal running shoes were great, I was faster immediately and actually enjoyed running even more.  I started to develop some aches and pains in various parts of the legs but not the Achilles so I completely forgot about the note of caution of the (apparently very knowledgable sales guy, himself a very strong runner)
  • Somebody - I think it was my PT, actually said I should not change running styles like that at my age (48) but I ignored that as it felt great
  • In order to avoid injury I started some gymnastics, weights, stretching and all that but admittedly not very intensely
  • In the year leading up to the ATR I have done more sports than ever in my life, a lot of running, a hell of a lot of Tennis and quite a lot of hiking in mountains. I did a sports evaluation (spiro-ergometry) which showed that I am ok but should do more low intensity endurance work. I followed that strongly by deliberately running slower at a much lower heart rate. There had been only few days in the entire year  with less than one hour of sports, e.g. when I had a cold or after falling when running during a business trip in LA
  • Before Tennis practice I usually warmed up for an average of 10-15 minutes including stretching some light running
  • When I went running, I started out very slowly and only gradually increased the pace. Sometimes even stopping in the beginning for stretching and in between when I felt aches and pains
  • My job consists of a lot of traveling world wide, telephone and of course the computer, so basically not a lot of movement during work

Sum: Long term potential factors

  • I often rest my feet on the wooden bar connecting my desk’s feet about 30cm above the ground. The situation is such that when I do that, the AT gets to rest on the bar. The bar is rectangular and only about one inch deep/wide so it bends the AT’s somewhat sharply. I always found that very relaxing but potentially it acts as a strain of the tendon which doesn’t seem like it feels/displays any pain
  • The minimal running style and change from previous heal-strike style with strongly cushioned shoe
  • Sudden, strong increase in activity in a short time frame
  • A massage therapist had told me only about 1 week before the incident that my calves are very tense
  • My left ankle suffered a torn ligament injury 30 years ago
  • My left leg had another injury about 10 years ago when it was hit by a falling engine in a mechanic’s shop
  • I had a muscle tear in my right thigh about 6 years ago which still causes some painful discomfort, potentially causing strange movements at times
  • I learned after the ATR from histology of the torn tendon that “unspecific pre-existing damage” was visible on the tested pieces
  • I found after the ATR when in my hospital bed that massaging my good AT, it was actually very sensitive or even hurting slightly, something I had never noticed before probably because I had never paid attention to the AT’s before
  • My Dad had ATR also playing Tennis when he was a few years younger than I am now
  • When I was a baby, there was a scare about babies dying in their sleep from choking when sleeping on their backs, so I was put on my belly.  I still basically can only sleep like that.   The feet are quite angled downwards when sleeping in that position. I started to “hang” the feet outside so they can be more at right angle many years ago and find it hard to sleep in beds (traveling) where I can’t do that. All this could have a direct impact on the AT’s I guess

The day of the ATR

  • Business trip to completely different climate
  • It had been a stressful day at work, I was running way late, stuck in traffic
  • Cold day (around freezing)
  • No time to warm up, came a few minutes late and just jumped into the game (didn’t happen until 40 minutes later, though)
  • I had not done much running or other sports for a few days due to bad winter weather
  • Different playing surface (carpet with sand) from what I am used to (concrete court)
  • I don’t like doubles as there is very little activity/running most of the time, then very sudden, explosive moves
  • I don’t like playing indoors, somehow I don’t feel get enough air, warm up properly
  • Before the ATR, there had been a few rallies which had been very intense with a lot of explosive moves and running

While probably not a single item on my long list above is exactly and individually to blame for the ATR, I do believe that most of them probably contributed in one form or another, that’s why I listed all that. Interested to see comments.

2 Responses to “What I believe has contributed to my ATR occurring”

  1. Hi niewneon, not in quite as much detail but here are some of the factors I think led to my initial rupture.
    - I sprained my left ankle about six years ago, playing basketball (my ATR is my left leg).
    - I have always played basketball, to a competitive level when I was younger but for the last couple of years I played just once a week at pick up sessions.
    - I was fairly active otherwise, a bit of running (including a half marathon) and activity in the gym on a fairly regular basis.
    - During Summer 2013 I joined a basketball club again and began training two to three times a week plus running and other gym activities. This was definitely a step up in intensity of activity for me.
    - My initial injury happened in September 2013 after about 90 minutes of training, towards the end of a session which included sprinting and lots of cutting. No pain at all in my tendon prior to the injury.

    So some similarities - a previous injury and returning to higher levels of activity after a less active (but not inactive) period.

    I have been thinking about this because I am thinking about what level of activity I will get back to after this injury (or multiple injuries in my case, unfortunately!)

    I know the standard is 6-12 months before your achilles tendon is ready for sport and higher levels of activity, but I am also conscious that I will have work to do to build up the rest of my body before getting back to any high intensity sport, to avoid any other injuries. I’m not at all sure about going back to basketball, we’ll see. I think I will start with swimming and take it from there.

  2. 90 minutes into the game. That certainly does not sound a lack of warm up. If anything tiredness and pre-existing injuries which progressively became worse
    as you kept banging on it?
    Is our “Achilles heel” the fact that those tendons practically don’t create any pain even if they are hurt?
    My muscle tear a few years (right thigh) hurt like crazy, I was literally sweating of pain sitting on a plane hours after that had happened.

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

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