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My Achilles Heel – The Irony of the Achilles Tendon Rupture

Posted July 28, 2009 6:00 AM by ShakespeareTheEngineer

For most of my life, I've played physically brutal sports such as rugby, football, wrestling, and lacrosse. And for the most part, I have been free of major injuries during my career. Ironically, my first major one, rupturing my left Achilles tendon, came about during the most non-violent of situations. In this multi-part blog series, I will be detailing the injury, repair, and rehab of a complete Achilles tendon rupture, which I suffered on a play so innocent, most of my team thought it was nothing more than a mild cramp. At 33, is a complete comeback a pipe dream? By the end of this series, we'll know.

A True Bang-Bang Play

While playing two-hand touch rugby during practice, I started to accelerate from almost a stop to full-speed. In two steps, I caught the ball and I felt someone fall on my left calf (or so I thought). It caused me to fall to the ground, slipping on wet grass. I then turned to see who had caught me from behind. When I didn't see anyone, I realized that the hit was really a pop and I must have either strained or ruptured my Achilles tendon.

White's Anatomy

The Achilles tendon is located between the middle of the calf muscle and terminates at about the base of the heel. Whitish in color, it is generally around 15-cm in length and, in the average person, thins as it approaches the ankle (to about 4 cm) before bellowing out again in a somewhat asymmetrical hourglass shape. This connective tissue is considered to be the strongest tendon in the human body.

Rupturing the Achilles tendon is often referred to as "The Sniper's Shot" because of how it feels, and because the tear can sound like a gunshot to other people. In fact, long-time New Hartford High School track coach Tom Wells said he once mistook a rupture as a starting gun going off a second time indicating a false start.

Generally, an Achilles rupture is considered to be one of the most painful injuries an athlete can endure. Symptoms range from moderate to severe pain, to an inability to bend the foot. If the event is a complete rupture, the injured person will not be able to move the toes upward at all.

A Game of Risk Factors

Most often, an Achilles tendon rupture is the result of poor conditioning, a health condition, or inadequate support of the lower leg. In my case, I fit several of the caution areas, but realized this too late. As I reviewed the risk factors and evaluated my own case, I learned that rupture can stem from overuse (no), running on hills or hard surfaces (no), tight calf muscles (chronically bad), poor stretching habits (on that day), weak calf muscles (no), worn or poor-fitting shoes (no), and/or flat feet (extremely). Little did I realize I was so at-risk of getting this severe an injury, and as always, an ounce of prevention would seemingly have been worth four months of cure.

The Thompson Test - A Pain in the Calf

It was on the drive to the ER when the real pain set in. Since the Achilles connects to the calf, I wasn't in that much pain until I started experiencing muscles spasms. This wouldn't normally be an issue as I am used to pain, but I elected to drive myself to the hospital as the pain wasn't that bad when it happened, so that made it more tricky. Spasms were such an issue that when it came time for medication, muscle relaxants (Valium, in my case) were more important than pain killers. The pain also decreased greatly once my foot was in a splint that stopped me from having to support its weight with my calf, which suffered some trauma, as well.

Both doctors that I saw, one that night in the ER and my orthopedic surgeon the following day (as it was deemed that I should been seen immediately), performed what is known as a Thompson Test. Laying face down with my foot hanging over the edge of the bed, the doctor squeezed my calf to see if my toes would point. I can't tell you how hard each had to squeeze to test, but I will tell you that I almost tore the mattress in half each time they did it. And from the last time my calf was squeezed to the scheduling of my surgery, only ten minutes passed. That is what kids call an Epic Fail.

Related Readings (please note that hyperlinks will not work until future blogs are posted):

Part 1 - My Achilles Heel - Achilles Tendon Rupture
Part 2 - To Cut or Not To Cut? Not Even a Question!
Part 3 - Sew Happy Together
Part 4 - Casting Call
Part 5 - The Process of Getting a Handicapped Parking Permit
Part 6 - The Orthopedic Boot(y) Call
Part 7 - I'm Going to Rehab
Part 8 - Preparing for the Breast Cancer Run
Part 9 - Results from the Breast Cancer Run

Resources:

http://www.mayoclinic.com/print/achilles-tendon-rupture/DS00160/DSECTION=all&METHOD=print
http://en.wikipedia.org/wiki/Achilles_tendon
http://en.wikipedia.org/wiki/Orthotics
http://en.wikipedia.org/wiki/Achilles_tendon_rupture


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#1

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 8:44 AM

Initial reactions after reading this: OMG, ouch, ewww, and ow (again).

It's amazing that when you're playing a sport that you love, it's easy to forget the dangerous possibilities associated with it - especially if you're doing a lighter version of it, like two-hand touch.

I'm sorry to hear about your injury. I sincerely hope that it doesn't put you out of the game forever. Thirty-three is young, so best of luck in your healing process!

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#2
In reply to #1

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:05 AM

Thanks, Sharkles. Surprisingly, it didn't really hurt that bad. I wouldn't recommend this injury to anyone. The ER doc said for athletes, it is "the one not to get", but what are you going to do other than work hard on rehab?

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#4
In reply to #2

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:23 AM

Injuries are no fun at all. They are something that every athlete dreads but at some point most will experience to some degree.

But it could have been much worse, you could have fallen asleep on the couch after a binge of pizza, chicken wings, and dorritos, rolled over and fell off only to split your head open on the coffee table and lose an eye in the process.

That said, moving forward I wish you the best of luck with your recovery and hope you can return to what you enjoy soon!

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#7
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Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:32 AM

That is true. At least it was being physically active that did it. I guess that's something.

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#12
In reply to #1

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:47 AM

"Initial reactions after reading this: OMG, ouch, ewww, and ow (again)."

You said it.

This post is equal parts fascinating and frightening. To think that the Achilles may be damaged by running is making me rethink my steps as I walk.

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#15
In reply to #12

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/29/2009 12:59 PM

I understand what you mean, but in truth, this comes from explosive, 0-60 type motion. Joggers, although they may have tendonitis from lots of mileage, should have limited concerns about this. Unless they have tendinotis and really push it, that is.

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#3

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:11 AM

Ouch, this sounds painful! I have some idea of the seriousness of this injury because I have had some experience with its equivalent in horses. Even when it's not a tear it can mean months of layup. A tear or rupture can result in putting the animal down, depending on some different factors. Luckily humans understand they need to cooperate and can adapt to crutches.

Hope you are well on your way along the road to recovery.

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#8
In reply to #3

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:33 AM

Luckily humans understand they need to cooperate and can adapt to crutches.

My wife might disagree. She asked the doctor twice about putting me down, I think.

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StE - "For 'tis the sport to have the enginer/Hoist with his own petard" -Hamlet Act III, scene 4, 202–209 - Please note that I have returned to school so responses to blog comments will no longer be immediate. Thanks to all who comment on CR4!
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#11
In reply to #8

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:37 AM

Come to think of it, I wasn't very content on crutches, either! Maybe it's time for me to write a blog entry about my experience. I drove myself to the ER too. BIG mistake.

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#16
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Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/29/2009 1:04 PM

That sounds like a great idea. Personally, I want to know why engineers have not come up with a better alternative. They are about the same basic design as they were during the civil war, with the exception of a hand grip and the move to aluminum from wood for most places.

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StE - "For 'tis the sport to have the enginer/Hoist with his own petard" -Hamlet Act III, scene 4, 202–209 - Please note that I have returned to school so responses to blog comments will no longer be immediate. Thanks to all who comment on CR4!
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#5

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:24 AM

"That is what kids call an Epic Fail."

Ouch! So what would you say is worse-- pain from the injury itself, or having to hobble around on crutches for weeks of recovery? I sympathize, as I spent part of one summer on crutches and it was no fun at all!

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#9
In reply to #5

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:34 AM

Definitely the loss of independence. Thankfully, TechOutReach is good at fetching coffee.

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#6

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:28 AM

This story made my calves cry and beg me not to do something like this to them. Maybe I will stretch next time I play softball...

I hope you the best of recoveries.

I liked your punch line in the end. Haha. Epic Fail.

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#10
In reply to #6

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/28/2009 10:35 AM

And make sure you have quality footwear. Sneakers need to be changed every three months (of regular use) or 300 miles.

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StE - "For 'tis the sport to have the enginer/Hoist with his own petard" -Hamlet Act III, scene 4, 202–209 - Please note that I have returned to school so responses to blog comments will no longer be immediate. Thanks to all who comment on CR4!
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#23
In reply to #10

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/31/2009 3:59 AM

Sneakers need to be changed every three months .

This reminds me of the joke about Athlete's foot...
The Doctor said...
'put on a clean pair of socks every day'
By the end of the week I couldn't get my shoes on...
Del

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#24
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Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/31/2009 9:12 AM

Del,

This place wouldn't be the same without you. You just create an irreplaceable atmosphere that I get a kick out of almost every day.

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StE - "For 'tis the sport to have the enginer/Hoist with his own petard" -Hamlet Act III, scene 4, 202–209 - Please note that I have returned to school so responses to blog comments will no longer be immediate. Thanks to all who comment on CR4!
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#13

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/29/2009 8:02 AM

Last fall while surveying stockpiles at one of the mine sites I worked at half of the pile gave way. Once I felt the pile starting to slide I jumped about 6 feet to the nearest berm in the process I felt a pop in my lower calf muscle of my left leg. My leg really didn't hurt at first just didn't function properly. After hobbling close to a mile back to my truck and making a run to the nearest hospital's ER they did the Thompson test on my leg. I passed the test the Dr said and only had strained my calf and I could go home. Next day still not able to walk, my company sent me to the company Dr. I went for a MRI and found out that my calf had been nearly torn in half. I also found out that I had numerous blood clots through out the area, and had to spend over two weeks in a hospital with my leg up with IV to get rid of the clots. The sent me home and said the could not risk doing surgery because of the clots. After 12 months and weekly therapy sessions I can walk now without a cane. It's just amazing how such little things can do so much damage to your body.

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#17
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Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/29/2009 1:05 PM

That's is unreal. Thanks for sharing the story. Thankfully, no clots, but I also had to take daily injections in the abs to help prevent them post-op. No fun, there.

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#19
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Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/29/2009 3:33 PM

I got to take commoden thank goodness. I had the shot's in the beginning in the stomach they felt like fire for hours. The Drs must have gotten tired of torturing me so I ended up with the pills. How often do you have to have blood tests? Mine where three times a week. I did that for six months, I look like I had a bruised up pin cushion.

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#20
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Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/30/2009 11:03 AM

Thankfully, after my stint in the hospital, I didn't have to submit to blood tests. They felt that the damage to muscle was limited enough that once I was "out of the woods" t I wasn't enough of a risk of developing clots to warrant continual blood testing, just preventative medicine.

From the sounds of what you went through, I was much luckier than I realized. The ab shots only lasted 12 days.

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StE - "For 'tis the sport to have the enginer/Hoist with his own petard" -Hamlet Act III, scene 4, 202–209 - Please note that I have returned to school so responses to blog comments will no longer be immediate. Thanks to all who comment on CR4!
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#21
In reply to #20

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/30/2009 11:13 AM

The thing that sucks now is that my daughter (5 years old) is starting soccer this year and I volunteered to be her couch. My doctor doesn't want me to run around especially short sprints. So now I have to try and couch without running around with the kids I'll just make the best of it.

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#22
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Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/30/2009 11:19 AM

Luckily, this happened one week after my coaching season ended, because I am very active at practice, be it demonstrating moves, skills, or techniques, or just playing opposition.

I would normally recommend player coaches, but five years old is a little young. I would try deputizing some parents or see if you can't contact some older kids from the middle or high school to come help out on occasion.

Finally, I am a big fan of the Positive Coaching Alliance. They have some ideas about spreading the load of coaching & team management responsibilities that might be useful for you. Their site is: http://www.positivecoach.org/

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#14

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/29/2009 8:48 AM

I've got little to no cartilage in these knees, and torn-up biceps & a bad back....but in no way would I ever trade a minute of my many years in football away - I don't regret a thing....

33? I say go get at it while you can....you'll heal and if your having fun, that's what it's all about - best of luck on your recovery & rehab...you'll be fine I hope

That stretching in PT is a PIA!

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#18
In reply to #14

Re: My Achilles Heel – The Irony of the Achilles Tendon Rupture

07/29/2009 1:12 PM

Thanks for the well wishes. As beat up as my body is, I wouldn't trade away any of my former sports seasons. I might change my mind, when I am 60, but they have been far to valuable in so many ways.

The body heals. I have faith in that.

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StE - "For 'tis the sport to have the enginer/Hoist with his own petard" -Hamlet Act III, scene 4, 202–209 - Please note that I have returned to school so responses to blog comments will no longer be immediate. Thanks to all who comment on CR4!
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Previous in Blog: The Death Race: An Endurance Event for Mind AND Body   Next in Blog: To Cut or Not To Cut? Not Even a Question! (Achilles Tendon Rupture – Part 2)
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