Torn Achilles

[CJ]

I have fixed a lot of Achilles tendons over the last 23 years. I can tell you this, if I had a ruptured Achilles tendon with a 3 cm gap I would not be treating it conservatively. For me that’s 100% surgical repair. if the tendon doesn’t heal with the ends approximated under physiologic tension, you’ll never be able to produce the force through your ankle that you could before the rupture. With all that being said, I wish you well and hope nothing but the best for you!

My initial thoughts, as well. 3 cm is a very large gap, will immobilization in plantar flexion even close that gap? And how much slack will ultimately be in the tendon if the distal and proximal ends aren't matched up perfectly?

 

[CJ]

If I recall CJ didn't you do this almost the same way?

Don't they have a term for this Weekend Warrior injury?

Mine was Crossfit. Even more embarrassing than doing it while playing softball.

 

[snake]

Here….
FINDINGS:

Diffuse Achilles tendinopathy with complete rupture located approximately 10 cm above the calcaneal attachment.

Tendon gap is approximately 3 cm.

Everyone has a different tendon length but at about 4" up, you still have a tendon to tendon connection. That's good if you do opt for surgery.

I just don't see how a 1" tendon gap is going to connect back together but then again, I'm no Dr.

Hope for the best regardless of which way you go.

 

[A1c]

My initial thoughts, as well. 3 cm is a very large gap, will immobilization in plantar flexion even close that gap? And how much slack will ultimately be in the tendon if the distal and proximal ends aren't matched up perfectly?

Yes, you would have to be plantar flexed with your toe pointed like a ballerina immobilized in a cast for at least one month then slowly over the next month or to bring it out of that extreme plantar flexion with serial casts. It can heal that way and it is an option for a non-surgical candidate. However, the scientific literature shows that non-surgically treated Achilles tendons do have a higher rate of re-rupture than ones repaired surgically. This is concerning to me especially with someone who’s really active and can generate a lot of force through their Achilles tendon. In other words, athletic individuals in my opinion would be significantly more prone to re-rupture after healing from conservative treatment for an Achilles tendon rupture.

 

[CJ]

Yes, you would have to be plantar flexed with your toe pointed like a ballerina immobilized in a cast for at least one month then slowly over the next month or to bring it out of that extreme plantar flexion with serial casts. It can heal that way and it is an option for a non-surgical candidate. However, the scientific literature shows that non-surgically treated Achilles tendons do have a higher rate of re-rupture than ones repaired surgically. This is concerning to me especially with someone who’s really active and can generate a lot of force through their Achilles tendon. In other words, athletic individuals in my opinion would be significantly more prone to re-rupture after healing from conservative treatment for an Achilles tendon rupture.

And it also seems like a whole lot of extra time vs having the procedure.

To your point, I can't recall any athlete opting to NOT have the procedure performed after this injury.

 

[buck]

Last year a buddy of mine on the first run of the ski season completely tore his tendon all the way through. The Dr.s told him the chance to complete recovery was the same whether he got the surgery or not. I was a little surprised to hear that, but they have more experience than me. It took time but he is back to how he was. I guess the next ski season will be the real test.
As a side note i have always worked the uninjured appendage when doing recovery to keep the surgically repaired side to keep the nerves stimulated so there is less atrophy.

 

[CJ]

Last year a buddy of mine on the first run of the ski season completely tore his tendon all the way through. The Dr.s told him the chance to complete recovery was the same whether he got the surgery or not. I was a little surprised to hear that, but they have more experience than me. It took time but he is back to how he was. I guess the next ski season will be the real test.
As a side note i have always worked the uninjured appendage when doing recovery to keep the surgically repaired side to keep the nerves stimulated so there is less atrophy.

How in the fucking hell does one tear their Achille's in a ski boot??? The ankle is pretty much totally immobilized.

 

[buck]

How in the fucking hell does one tear their Achille's in a ski boot??? The ankle is pretty much totally immobilized.

Probably the same way he tore his hamstring having sex with his wife a year earlier. Getting old is a bitch. Things get stiff, where you don't want them to and brittle!

 

[CJ]

Probably the same way he tore his hamstring having sex with his wife a year earlier. Getting old is a bitch. Things get stiff, where you don't want them to and brittle!

No, I literally mean that it should be impossible.

If you can't stretch the tendon, or even move the joint itself, how is that injury even possible?

 

[buck]

No, I literally mean that it should be impossible.

If you can't stretch the tendon, or even move the joint itself, how is that injury even possible?

If you look ankle injuries are common when skiing. So, if the ankle can be twisted i am sure the Achillies can be damaged as well. Tendons can be torn and damaged just from the amount of force a muscle is putting upon it. I have had tendons tear without undue stretch, just from the force the muscle applied.

 

[BigChief1]

Where to begin….. Overall feel like shit and a bit depressed. Was finally close to being where I wanted and getting to throw some calories to grow. Than this shit. Diet has been complete crap the past few weeks. I kept an eye on overall calories but mainly eating junk.

Somehow only gained 2lbs but look like crap. Started back to the gym last week limping around in a boot focused on just upper body. Still a bit painful and found myself just going through the motions.

Today was the best I have felt since the injury. Did chest this morning and got after it. Surprisingly I haven’t lost any strength.

Have a mri coming up on the 24th to make sure it’s healing. Feels like it’s healing anyway. Swelling and bruising has went away as well as the serious pain.

Meal prepping today to get the diet back on track. As u can imagine I’m just on regular trt. Plan of attack is currently to stay on trt until I’m completely healthy. Then I’m gonna run a long cycle to get back on track. Nothing too serious but I’m planning a 20 week blast of 300mg test and 200mg EQ while eating in a 200 cal deficit. In the past I’ve done really well in maintenance or slight deficit. So fingers crossed

 

[BigChief1]

Went back to the doctor yesterday. Good news is everything is healing nicely. Doctor said I’m ahead of schedule!

Also said I have a shit load of scar tissue and still quite a bit of swelling. Got into a bit of a bitchin match over physical therapy. One thing that definitely sux about living in the sticks is everything is far away. I told the doctor I’m not driving almost 2 hrs 3x a week to go to physical therapy. We reached a compromise about me going once to be shown the exercises. Then I will do on my own and report back in a month to see progress.

My mobility sux at the moment. But I’ve been cleared to Introduce some leg work back into my routine. Nothing serious but certainly better than nothing. Mentally feeling much better. Next doctor visit is October 22 and if goes well I will be released to return to work. That’s all for now…….