6 Month Follow-Up (and questions)

I haven’t posted in a very long time, but thought I’d give some follow-up on my case and get some feedback from others.  I ruptured my right Achilles’s tendon back in September and surgery.  Uneventful recovery and I’ve been back on two legs since November-ish.  I’m back at the gym and finally have the green light to run again.   However, I still have significant heel pain by the end of the day.  I notice this is especially the case when I’ve taken a long walk or exerted myself physically with my legs.  I’m a little worried that this may be a chronic occurrence and that running might worsen it.  I’m curious what others may have experienced.

Also, a question.  Does anyone know if the quinine in tonic water may contribute to ATR?  I know the quinolones have been linked and the two are chemically similar, but I can’t find anything definitive in the net.  My favorite drink is (I mean, used to be) G&T.  I’m an odd because I really like the taste of tonic water and often I would just have the tonic water w/o the gin.  But I’m wondering whether my consumption of quinine predisposed me to injury.  I’d appreciate any info (and cites!) that others might have.

3 Responses to “6 Month Follow-Up (and questions)”

  1. 1 normofthenorth March 10, 2014 at 11:46 pm

    1) “Heel pain” near the AT insertion point (back top of the heel) is very different from hp on the bottom of the heel. The former is likely AT related — either a “real” pain caused by over-stressing that insertion, or a “referred” pain from higher up the AT. The latter, when it doesn’t go away after the early days of FWB & 2-shoes (when most of us had it) is more likely something like plantar fasciitis, which I think is +/- = “heel spur”, a common athletic malady with its own prognosis and treatments. In either case, I wouldn’t encourage “working through the pain”.

    2) Quinine has been consumed in large quantities for a long time, mostly to prevent or (sort of) cure malaria. I’ve heard that it can cause heart palpitations, but if Google doesn’t link it to tendon tears, it might be because it’s innocent. OTOH, this double-ATR guy used to drink more than his share of tonic water, too, though I think I stopped a decade or more before my first ATR. It’d be interesting to see if our little ATR club here happens to be a bunch of tonic-lovers. . .

  2. 2 reasonsformoving March 11, 2014 at 8:17 am

    Hi Normofnorth,

    Thanks for responding. My pain seems to be more at the back top of the heel and I suspect that it’s related to the injury. I’m just surprised that it has endured this long. My fear is that it will continue indefinitely.

    As for the quinine, yes I know that it was used in much larger doses in the past. But that was for acute treatment I believe. I wonder whether chronic “low levels” may be damaging. Perhaps we’ll never know as I doubt anyone is doing research on the topic. Nonetheless, I asked a friend who knows organic chem inside and out and she said the two are very closely related.

  3. 3 normofthenorth March 11, 2014 at 2:09 pm

    I think your fear is probably justified. I describe a serious setback (a whole painful month back in the boot!) I suffered from overdoing during my first-ATR rehab. My pain was where yours is. I backed right off until the last hint of pain was gone, a whole month. I was active (especially late in the month), but it was all in a hinged boot, which eliminated all pain. I was afraid that if I “pushed through”, or even if I tried to “walk the tightrope” and keep the pain down to a low level, that it might become chronic and permanent. I don’t know if I was right, but I do know that I’ve never had that pain again and it’s been over a decade now.

    One of the guys here said that that spot is susceptible to referred pains from elsewhere in the AT region. I’ve had a few referred pains diagnosed in the past, in other parts of my body, and it is shocking how convincingly the pain shows up remarkably far away from the source of the pain. “Listen to your body”, but “Don’t believe everything you hear!”

    As for the quinine, my understanding is that gin and tonic was invented and became popular in the British Empire because those moderate chronic doses of quinine were thought to be helpful against malaria. We don’t have “Big Data” looking for a link between g&t’s and ATRs, but the association with quinolone antibiotics is now crystal clear. (If you haven’t looked at the discussion of that link here, there’s a link on the Main Page.) I haven’t researched any of this, and I have no idea if anybody understands the biochemical mechanism of that association; if so, they would know whether the quinine in tonic is a risk or not. (You might even be able to email one of the authors!) I’d guess not — just as science has shown that aluminum pots do NOT increase the risk of Alzheimer’s, despite the prevalence of aluminum compounds in some Alzheimer’s lesions — but it’s just a guess.

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ATR Timeline

  • Name: reasonsformoving
    Which Leg: R
    Status: FWB

    251 wks  6 days Post-ATR
    251 wks  2 days
       Since start of treatment

  • reasonsformoving has completed the grueling 26.2 ATR miles to full recovery!
    Goal: 365 days from the surgery date.
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