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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