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  1. #1
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    Ruptured Achilles - Anyone have experience?

    I ruptured my achilles tendon skiing last week. I just got home from the Dr. and I am a little bummed out. No skiing, no Cycling, and basically no high impact activity for a year. I pressed him on the cycling thing and he said I could start in about 9 weeks using platform pedals, bike paths/mellow trails, and I have to ride with a custom orthotic device that imobilizes my ankle to prevent any sharp/sudden impacts to my achilles. When I pressed him about the skiing he wouldnt budge.

    I am thinking about getting a second opinion because of two things. I asked about physical therapy and he told me I was on my own. I asked if I would need xrays or an MRI and he said no. I asked what if something else is wrong? His response was nothing else is wrong.

    What do you think? Anyone with first hand experience?

  2. #2
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    Quote Originally Posted by rug wheelie
    I ruptured my achilles tendon skiing last week. I just got home from the Dr. and I am a little bummed out. No skiing, no Cycling, and basically no high impact activity for a year. I pressed him on the cycling thing and he said I could start in about 9 weeks using platform pedals, bike paths/mellow trails, and I have to ride with a custom orthotic device that imobilizes my ankle to prevent any sharp/sudden impacts to my achilles. When I pressed him about the skiing he wouldnt budge.

    I am thinking about getting a second opinion because of two things. I asked about physical therapy and he told me I was on my own. I asked if I would need xrays or an MRI and he said no. I asked what if something else is wrong? His response was nothing else is wrong.

    What do you think? Anyone with first hand experience?
    Get a second opinion as fast as you can. Unless sci-fi x-ray glasses have become available lately how can he/she or anybody start talking about ruptures etc. You should have an MRI or a diagnostic ultrasound done asap to find out the degree of rupture and then you decide what is the course of action: rest, physio, surgery. Up to about 50% partial thickness tear is not too serious of an injury provided you are not heavy. A few physio sessions for strengthening and proprio work is a good idea. Splints and casts are useful in the begining but passive movements out of the cast a few times per day is also indicated depending on the degree of the tear. That's why I said run for a second opinion.

  3. #3
    Having a nice day!
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    Here is a thread from February that you might find helpful

    Achilles Tendon Rupture

    You can read what I previously said about when it happened to me. I guess every doctor is different, and rehab times kind of depends on if you go the surgical route or not. I went the surgical route and was back riding trails, albeit a little gingerly, after about five months. No lingering issues, other than mental. Based upon what you said and my own experience, I think I'd get another opinion.

  4. #4
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    As I understand it...

    I'm the guy who started the last thread in January. While it never hurts to get a second opinion, my understanding is that if you have a positive Thompson's test then you've got a complete rupture. This is according to my surgeon who didn't want to see my ultrasound, other than to humor me. Thompson's test involves lying on your belly and bending the injured leg 90 degrees at the knee. The calf is then squeezed and if your foot doesn't move you've got a rupture. If you are going to get a second opinion do it now because if you need/want the surgery the sooner the better. I was told no more than 10 days after the initial injury. I had my surgery 4 days later. Now 3 months down the line things are going well, but no outdoor biking for another 3 months. I was still on crutches at 9 weeks and only starting walking well in shoes 2 weeks ago. I'm no doctor but I don't see how you could ride outside flat pedals or not at 9 weeks. I would think, based on the advice I've gotten that you'd be asking for a re rupture, not so much from the pedaling but rather from sudden stops and the resulting trauma from your foot hitting the ground. I did rent an exercise bike and am riding it no resistance 15 minutes a time, twice a day. It is amazing how much the calf on the injured leg can atrophy. I have a physical therapist (they are called physiotherapists in Australia) and she is great, so I don't understand why you should be on your own in that regard. Good luck and keep us posted.
    Last edited by aussieklein; 04-16-2007 at 11:58 PM.

  5. #5
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    I didn't have a complete rupture, but I had a tear years ago when I ramped up my running mileage too fast. It was miserable! No impact stuff (running, MTB) for many moons. I was very bummed.

    Whatever the final verdict is, do follow the PT's rehab recommendations - even if it is a unbearably long time to nurse it, get that healing done right the first time. Don't risk re-injury on that one; it's no good!

    Godspeed on your recovery....

    Cheers, Chris

  6. #6
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    I also think you should get a second opinion. I had a full rupture and surgery to repair it.
    I can't praise the PT I went to enough with the help in my recovery.
    Good luck, learning patience is a big part of recovery.

    Dantley
    "Do or do not, there is no try." Yoda

  7. #7
    Mantis, Paramount, Campy
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    Currently Going Through That Myself

    Complete rupture that was surgically repaired March 1.
    May 1 I can get rid of my cast and begin walking and PT. The doc said I could also swim and ride. Clearly he and I have differing opinions of what riding is but just based on my physical condiditon I don't think I could ride very long. My calf is gone, 5-6" smaller than the other one and that leg can't support any weight in a normal posture.
    I was also told no high impact activity for 9-12 months. Cycling isn't high impact so I assume I'll be back on the bike full time within a month of starting rehab. I will unfortunately miss a whole summer of court sports and soccer.
    I would assume the doc is right about skiing. If I were in your shoes I wouldnt plan on hitting the slopes until 2008.
    *** --- *** --- ***

  8. #8
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    Okay guys, how did you all rupture your AT?? Just curious...and want to avoid that fate!

  9. #9
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    ruptured my achilles skiing

    I did it skiing. Second run of the day. Conditions where high alpine, 10,000 ft., natural snow, 6" new, very variable, wet and heavy. I was traversing the top of a pitch, picked my line, dropped in, made my first turn and snap. I have recently spoken to several skiers, instructors, patrolers, etc. Seems that it is not a common injury among skiers. Most examples where similar to mine - slow speed followed by an explosive effort.

    Regular stretching and warming up can help prevent this kind of injury. Age and wear & tear are big factors leading up to a rupture. Most ruptured achilles occur in athletic males between the age of 30 and 50. Achilles tendon ruptures are found more often in athletes who participate in sports involving explosive acceleration or maximal effort

    The mechanics of a rupture where explained to me as follows:

    There is a situation called an eccentric load, when a load or stress is applied to a tendon that's already being stretched. An example of this would be an athlete running backwards. This is the opposite of a concentric load, in which you are applying a load to a muscle that's being shortened, such as when you are doing toe raises and walking up a flight of stairs. What they think happens in a number of ruptures of the stop-and-start variety or the backward-to forward transition, is that the tendon has a concentric load applied to it followed quickly by an eccentric load or vice versa. Think of a quarterback dropping back to pass and then stepping up into the pocket, or a tennis player that rushes the net and then retreats for a lob over his head.

  10. #10
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    I was playing soccer with no warm up, stepped in a hole as I was trying to sprint. I knew exactly what happened before I hit the ground.
    "Do or do not, there is no try." Yoda

  11. #11
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    Thanks guys, good to know ... I've had AT soreness / tendinosis for awhile. Soccer is what started it in earnest, though i would notice the occasional soreness from the MTB. I ignored it for quite awhile because soccer after 30 is a pain inducing endeavor all around and I just thought the AT was part of the usual DOMS--big mistake. It took forever (well, 9 months anyway) to calm down to the point where I could play again. It is starting to flair up again, so I'll back off. I can't afford to rupture it and don't want to do another 9 months of inactivity ... Good luck with your recovery!!!

  12. #12
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    Had surgery for my ruptured AT on Feb 27. Was in a cast up to my knee for about 5 weeks and have been in a walking boot for the last 2 weeks. Hopefully will be starting PT in a week or two. One of the other posters noted how surprised they were by the variability in treatments for what is essentially the same injury -- I agree. It's amazing that the period of immobilization, either in a cast or a boot, could vary between 7-8 weeks or 5-6 months. My doctor was very careful about setting timelines -- I really had to twist his arm to tell me how long a particular part of the treatment was going to last.

  13. #13
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    One of the things I learned

    One of my clients is the son of a former NFL quarterback. He ruptured his AT 9 months before I did, so I contacted him right after I had my surgery seeking wisdom and advice. He told me the thing he heard again and again from his father's connections was not to stretch the repaired AT too soon. He referred to "faking it" in PT, at least early on. I didn't appreciate it until a month or so later when I ran in to about 5 people who said the same thing. Two of them learned the hard way and now are not able to push off on the repaired foot. I really watched it after that. Be careful. You can always stretch the AT out later. Let the thing heal. I'm on target to be back on the bike by mid July, about 6 months after surgery. That is as quick as anyone I've heard of. Because the AT gets so little blood it really is a slow healer and you have to expect that and respect it as well.

  14. #14
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    Update

    ...for anyone that cares...

    I was set free from my restraints May 1. I was ok'ed to ride an exercise bike and swim besides just plain old walking to regain range of motion and start re-building strength.
    I started with some work on my indoor trainer.
    About a week ago I moved on to liesurely actual rides and have logged about 100 miles.
    The tendon is still tight and my ankle still a bit stiff so that limits ride time to an hour or so.
    Doc said to remain seated at all times when riding, so bacisally no supporting my own weight with my legs.
    *** --- *** --- ***

  15. #15
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    You have to laugh!

    I ruptured my right leg achilles in April 2007. I was playing football and went from a standing position to a sprint and bang! I went for the conservative method of recovery by going down the route of non-surgical. I spent 8 weeks in various casts and then had a few appointments with PT. I was immediately using a road bike with SPDs and it was no problem and along with swimming was encouraged by my PT. The PT also had me doing various stretching excesises that were invaluable! I calculate it took me about 6 months to get to the point of full recovery. I was skiing in December and had total movement.

    Now for the bit that will make you laugh (With sympathy I hope). Feb 2008, I'm playing football again and can you beleive it, I rupture my other leg's achilles! Went immediately to hospital, now in plaster. I asked the medical team for an explanation but they couldn't explain how I have been so unlucky! It could be a genetic fault, a sporty life style may have contributed to weakness but no definitive answer. I am 36 and at the age where this injury is prone so I am careful to stretch, especially after the first rupture.

    So I have thrown the football boots and shin pads in the bin as I beleive it is the explosive sports that are likely to cause me more probs. As I said after the first rupture,skiing and biking were no probs and as they do not involve the degree of intense stress on the achilles it is these I will stay with. Guess I can throw away the tennis racket to and buy a set of dominos instead!

  16. #16
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    I had a complete left AT rupture in March of '04 and had it surgically repaired two days later. Definitely get another opinion but do it quick! It needs to be repaired as quickly as possible or it will heal damaged. I ruptured mine playing racquetball going from reverse to forward too quickly and not stretching before the game. I also have a form of fybromyalgia which didn't help the situation any. Anyway, I had the cast off by May and was riding again soon after, about 10 weeks from surgery! Of course I was riding gingerly, but I was riding none the less. It all depends on you body's ability to heal. Whatever you do, do not hit any jumps for a while, no matter how good you feel. I did it too early and almost re injured it. As far a rehab goes, work it hard. the more time you put into rehab, the better and more quickely you will heal. Another poster mentioned some nonsense about not stretching the tendon, don't listen to that BS. You have to stretch it as much as you can without pain. When the doc surgically repairs the tendon, he has to cut little slices into each end and weave them together like intertwined fingers to give it strength. This shortens the tendon's length and without proper stretching you will not regain full mobility. My injury doesn't inhibit my riding at all to this day since I didn't lose any mobility, but the ankle is not and will never again be the same. The tendon is at least twice as thick as it was before and gives me problems when wearing any footwear that goes above the ankle (ie: high top boots, ice skates, etc.) This pretty much put an end to roller hockey for me. Another thing to remember after surgery is to keep the casted foot/leg as dry as possible, especially when showering. The cast is going to be there for a good 2 1/2 months and if you get water inside you are going to have a screaming case of swamp foot. I did and it actually started to affect the healing of my incision.

  17. #17
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    A ruptured achilles is very easy to diagnose. No MRI necessary. I did mine 2 years ago, and still have not recovered completely. I had a complete rupture, surgury, and a long time in a cast (4 months). My calf muscle wasted completely away, and still has not quite gotten back to normal size. Sorry to hear about it man, that is a bummer.

    Good luck,
    Jeff

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