Response to Brendan’s Discussion Topic

Brendan has posted a fantastic discussion topic!  Here is the link.  I knew my response to the topic would be lengthy, so I thought I would write a post rather than a comment on Brendan’s page.  I’ve given a lot of thought to rupturing my other AT or a possible re-rupture over the past three months.  My conclusion - I’ll likely won’t change much, assuming my recovery continues to progress well.  If there are products available or strengthening/stretching techniques that help minimize the risk of a rupture, I will give them a try.  But, I won’t likely change my level of activity.

Being active and involved with sports is a huge part of who I am.  While this injury made me realize I’m not bullet proof (far from it) and that I’m getting older, I cannot see giving up any of the activities I did before the injury.  Life is too short to give up the things we love.  However, we can be smarter about doing the things we love. I will probably take more time in the future to stretch out prior to physical activities (at least initially until I start thinking I’m bullet proof again) and I will try to do a better job of working all my muscle groups.

My physical therapy clinic offers a running program for runners battling injuries.  I’m hopeful that I will be able to take advantage of this program toward the end of my physical therapy sessions.  The program analyzes your stride and running technique to see if there are adjustments that can be made to be a more efficient runner and hopefully avoid future injuries.  They also make suggestions for footwear to ensure any pronation is controlled properly.  Perhaps this program may find something that put me more at risk for a rupture and provide tips for reducing the risk of another rupture.

With that being said, I’m still a believer that it was just my time.  Even if I would have stretched out better the night of the rupture or wore beater footwear, I still believe a rupture was inevitable.  If it didn’t happen on January 3, 2008, it probably would have happened a month, or a year or several years later.  I have been active all of my life and I’m sure I’ve thoroughly abused my Achilles tendons over the years.  I also think genetics plays a part.  My father rupture his AT 12 years ago.  Perhaps this is just dumb luck, but I’m guess there is something in our genes that made us more at risk.  I read a few articles that mentioned some people can simply have a collagen deficiency.

Anyway, since my father’s rupture, I’ve always been more aware of my Achilles tendons.  For the last decade I’ve felt an occasionally tightness in the tendons, usually first thing in the morning or after sitting for a long period of time.  This occurs maybe once a month at most.  The tendons feel stiff until I take a step that stretches them out a little.  Usually the stretching step is the first step when going down a flight of stairs.  I’ll feel a slight pop (nothing like the “pop” we’re now all to familiar with, but one similar to cracking a knuckle) and then everything would be fine again.  Though I mentioned this to my doctor, he didn’t have much of an explanation.  It could be tendinitis/tendinosis, but there really are no other signs and definitely no pattern.  Over the years I sort of accepted the fact that I may some day experience a rupture.  Therefore, it was maybe a little bit easier for me to accept the injury when it happened.  Don’t get me wrong, I was mad as hell and still shocked when it popped, but my focus shifted quickly to rehab.

I guess I’ve also accepted the fact that there is a decent chance I may rupture my left AT someday.  If genetics and overuse affected my right AT, well than my left might not be too far behind.  The good news for me is that my father has not suffered another rupture and he remains very active, so maybe this is a good sign.

As I mentioned before, there are some things I will do to hopefully minimize the risk of another rupture, but I really won’t change my lifestyle.  There is some pain involved with this injury, but I’d feel far more pain if I started to avoid a daily run or shooting hoops or spiking a volleyball.

I hope this hasn’t come off as me believing that we’re all doomed.  Far from it.  I guess what I’m trying to say is that we’re all living proof that recovery is possible.  Some days it may not seem that way, but a few years down the road we’re going to struggle to remember if we were NWB for 4 weeks or 6 weeks.  The odds are in our favor that we’ll all recover fully and resume our pre-injury level of activity.   Just try to stay positive!

6 Responses to “Response to Brendan’s Discussion Topic”

  1. tom -
    Great post! I agree with you 100%

  2. Totally agree on staying positive Tom. I’ve had an occasional negative comment about recovery and more than my share of “cringes” about my ATR. My usual response is “you’ve forgotten how tough I am”. I’ve mentioned this before in blog comments. So my plan and expectation is to recover fully and keep doing those things that I love to do, like ski and bike. I’m confident that with a diligent PT effort we will all do the same. Interestingly, I did stop playing basketball 5 or 6 years ago (I’m 47) because I kept injuring my knees. My last injury was my right Anterior Cruciate Ligament, which disintegrated and was not surgically repaired because the knee is stable. At that time, I decided that other sports were more important to me and that I would give up basketball (other than in the driveway with my kids). That’s not to say that you 30 somethings shouldn’t continue playing higher-impact sports such as hoops, volleyball, etc. for a long time. That was just a choice I made. Maybe I could have continued playing hoops injury-free with more consistent exercise, stretching, etc.?? Nevertheless, I agree that an overall high level of health, including fitness, nutrition, and stretching is important and should mitigate risk of more injuries. Another thing I’m curious about is foot beds of some sort…see if that reduces risk of injury.

  3. Hi, im asking this question on behalf of my friend who re ruptured her achilles 3 days after coming out of her cast. she had the surgery 10 weeks ago and found this website great for helping her come up with goals. well, she’s got none at the moment and wants to know has anyone done this so soon after coming out of the cast? she’s waiting to meet with the specialist and have an MRI as there is nerve damage done this time.

  4. @Eleanor - I’m sorry to hear about your friend’s re-rupture. The first few weeks after a patient is out of a cast or boot seems to be when most re-ruptures occur. Generally speaking, the protection the cast/boot provides is gone, but the tendon is still healing. You can go to the achillesblog main page and do a search for “reruptures” to find out more details from others who have re-ruptured.

  5. [...] good blog here from Brendan about re-ruptures including some stats he’s found.  Another from Tom’s perspective.  Both good [...]

    [WORDPRESS HASHCASH] The comment’s actual post text did not contain your blog url ( and so is spam.

  6. Nice post, Tom. You’ve got a good point, perhaps I should be thankful for having 35 pain-free years of abusing my Achilles with sports and marathons. I’ll definitely look into a running clinic when I get back, too. Was probably time to check one out anyways, as my times had plateaued, and I would reliably cramp up at mile 20 - not fun.

    Genetics must play a major role. Even though 1 in 10,000 ppl suffer this injury, I would venture to guess the odds go way up if you’re heavy, tall, and/or born with the desire to push your body.

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