breaking ankles again by 2016

Partial Tear? Need Advice Please

Hello all - I’ve had a bit of a setback unfortunately with my right (non-surgery) achilles.  As I described in my earlier posts, back in October I ‘tweaked’ it a bit while playing basketball and it was sore and tender for months afterwards, though I was able to continue with my normal activities, including basketball, after a period of resting for 2-3 weeks (but still walking, etc.).  My PT had looked at it afterwards and didn’t find any indication of acute injury so wasn’t too concerned.  The morning soreness never completely went away, but it did gradually improve, and I’d say as of a few weeks ago it was more or less behind me.  As I’ve said before, this is an injury that I have suffered maybe 6 times in my past over the years, and it never was bad enough to warrant a doctor’s visit, and always (eventually) completely went away, without having to limit my activity much.

Then I was playing basketball a few weeks ago, and towards the end of the game when I was rather tired and playing defense aggressively on an 18 yr. old kid about twice as quick as me, I felt a similar acute pain in the achilles, but maybe twice as intense.  I pulled myself out and was able to kind of ‘walk it off’ but it was definitely sore and caused me to walk with a slight limp.  I knew it wasn’t a full tear, but was concerned it could have been a partial.  I had a 5 day skiing trip planned for the next day, and so I iced it that night, woke up rather sore with a limp, and hoped for the best.  Luckily, by the time it came to put on my ski boot, though I couldn’t walk completely normal, I felt more or less normal with the ski boot on, and was able to get through the whole week skiing without much limitation.  I of course iced every night, and every day it got a little more normal - by the end of the week I was walking without any noticeable issue, except it would be sore and stiff each morning.  I had a week off from basketball after that, so basically took it easy that week, then decided to give basketball a go this Monday.  I got through the game okay, but was definitely playing 70% effort, and had a slight limp at the end.  Still, I could run and jump (at least at 70-80% effort) without any issue.

Today I got into the VA podiatry department after taking the rest of the week off, in the hopes that they would do an MRI.  As I sort of suspected, they wouldn’t be able to get me in for an MRI for another couple months, and as such advised me to stay off it and wear a boot for 3-4 weeks.  Thompson test showed no issues, and plantar flexion strength is good, so they aren’t sure exactly what the issue is, but indicated it could potentially be a partial tear and the best way for it to heal is to isolate it for 3 weeks in a boot.  I did convince them to do an ultrasound test, but they won’t be able to get me in for that until next week, or maybe later.

For those of you that have gotten this far, my questions are:

  • Has anyone had a similar injury to what I’m describing, and if so have you ever had a diagnosis and treatment for it?
  • For those of you that have had a diagnosed partial tear, what did it feel like when it happened, what could you do afterwards, and what was the diagnosis and treatment?  I realize that a 90% partial is different than a 10% partial, but that is the data I’m trying to get.  It’s a fact that I don’t have a 90% partial, but I could have a 10%, and also could have a 0.1% or 0%.
  • Any general advice on whether to wear the boot or just do what I’m doing, and be careful, assuming it will heal on its own without completely shutting it down?  I’m motivated to not go the boot route by my desire to finish both the bball and ski season, as well as a surf trip I have planned in about 3 weeks.  If I knew for sure it was a partial tear, I’d hop in the boot right away, but I don’t want to do that if it’s just some minor injury that will heal without such drastic measures.  I’ll know more with the ultrasound, but that still leaves me a week or two to decide on boot or no boot.

Thanks so much for those of you that can weigh in on this!  The good news is that my left achilles feels great!

April 1st, 2016 at 3:45 pm

3 Responses to “Partial Tear? Need Advice Please”

  1. pozaicer Says:

    hi Grumpy Old Man

    a friend of mine had a partial tear whilst running and he recovered fully within 4 months, short period in the boot (around 4 weeks) then PT.

    I’m on a different route to yours as i did a full ATR and i am non-op.

    i understand your sentiment and empathise with you, however i wouldn’t push myself like you are. personally i would consider how much ‘pleasure’ i would get from finishing the bball and ski seasons versus the risk of totally being immobile again and start from scratch, my personal take would be to stay put in the boot till the studies are carried out as every further bit of damage will only worsen a brighter outcome. at the end of the day you can still enjoy the landscapes and the company, i definitely wouldn’t do bball or surfing as these leave out the tendon completely exposed to damage, perhaps gentle skiing will allow you to scratch that itch?

    i hope you are not grumpier by my personal opinion! and happy healing!

  2. richard407 Says:

    Im Infantry in the Army and my first partial was in Iraq in 2010. They just gave me motrin and I continued on. My second partial was in 2013, I just wore a boot for about 10 weeks or so. I already had a surgery date when I fully ruptured it in june 2015. One of the things that I did was supposedly keep micro-tearing in between all of them. It just made it build so much scar tissue ended up needing a tendon graft. I wish they fixed it the first time.

  3. skelonas Says:

    Yikes, thanks for the advice pozaicer and Richard. The fact that you were able to continue on, Richard, and it just led to much more serious issues down the road I think has sufficiently convinced me. Obviously the ultrasound will give some insight, but I’m curious how your experiences with the injury felt both as it happened and afterwards (both what you described as partial, and the microtears). Also, did they do any kind of tests at any point to see what it looked like and what degree of partial tear it was? I’m concerned that the ultrasound may not show anything, when in fact there is damage. If it is an actual partial tear, it certainly isn’t a big one.

    In any case, I’ve been wearing the boot, and did lightly ski this weekend to keep me sane, but that puts less strain on it than walking so I think I’m okay there. I just let my teammates know that I’d be sitting the game out tonight, so hopefully I can get things looked at this week to make a decision for the playoffs and surfing. Believe it or not, I’ve already imagined myself surfing while wearing the boot, but probably smarter to stick with clamming that weekend if I’m still boot-bound.

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