Road to Recovery and Rehabilitation; Achilles Tendon Rupture- Post Surgery and Swelling
How did it happen?
The thought of, "it'll never happen to me", will (almost) never cross my mind again. Back at the end of May during a basketball league game, I ruptured my right Achilles tendon. A motion that I had done time and time again caused my Achilles to fully tear. I remember it vividly. I held the basketball at baseline and faked a pass to the right. The defender side-stepped and I had a clear path to the basket. As soon as I took that first step, it felt like someone threw something at the back of my heel. I was certain that this was what happened and gazed back to see who had thrown the object. There was nobody. A referee ran up to ask what happened. "Did it feel like someone kicked you in the back of the leg?" Only after four shifts of working as a new Fire Captain, I would be off for several months on an injury, a rupture right Achilles tendon.
Doing some research, there are several factors I believe contributed to my injury. Here are some that I feel were applicable to me:
- There was a period of inactivity then rigorous exercise. I had spent several months studying for my promotional exam. My workout regiment was interrupted and I found myself exercising considerably less. As soon as the testing process was over, I pushed myself harder to get back into shape. The week prior to the injury, I did two workouts a day, climbing stairs, doing box jumps, and an assortment of Crossfit-type exercises. In hindsight, I did not allow my body to slowly work back to its original state.
- I did not adequately warm-up and stretch. My calves were probably tight from the workout the day before. Although I had more time prior to the game, my warm-up and stretching was not adequate to my body's condition. You need to feel out the condition of your body. That morning should have told me that I needed to warm-up and stretch for a longer period of time.
- I slept only 4 hours the night before the injury. As a firefighter, you are on-call 24 hours a day. The night before the injury, we had three calls between the hours of midnight and 8 a.m. It is important to allow your body to rest and recover at night. An ample amount of sleep is vital for a healthy body.
- My new basketball shoes were not properly fitted for my feet. I bought these shoes a few weeks prior to the injury. I noticed during games that the ankle support built into the shoes placed pressure on my Achilles. Something told me that this did not feel right, but I failed to act and the injury occurred. It is vital that you wear proper footwear no matter what sport or activity you are engaged in.
- My diet and lifestyle lacked important discipline. I ate relatively healthy and stayed away from things that research showed to be bad for an individual. There were two things that I noticed prior to the injury. My caffeine intake was considerably more, but my water intake significantly less. I had three to four cups of coffee a day without fluid replacement. Since caffeine is a diuretic (causes you to urinate frequently), I was probably dehydrated. I also coupled this with an occasional diet soda, another diuretic. Diet soda and many of the sugar-free alternatives however, have a compound that can be dangerous for anyone, phosphorus. This draws the calcium away from your body and causes it to be more prone to injuries when consumed at a certain level. For example, a recent body scan of a firefighter in my department showed his bone density similar to that of a seventy year old. He was only forty. He easily consumed six diet sodas a day on a consistent basis. He recently injured his right shoulder. Since water is vital for life, drink more of it and minimize the intake of caffeine.
I was taken by some friends to a local hospital and treated in the emergency room. With some pain medication and a walking boot, I was sent home to rest. I called early the next morning to make an appointment with an Orthopedic/ Sport Injury doctor the emergency room had suggested. I was examined later that afternoon and the doctor performed a few clinical tests. My options were then laid out in front of me.
- Open Surgery. This had the best prognosis and recovery time. (4 to 6 months) The chance of re-rupture was minimal. (approximately 5%) The risk with this was associated with the surgery itself with possible complications from infection, and anesthesia.
- Percutaneous Surgery. This was the second best option. This procedure is done with several small incisions rather than completely opening up the area of injury. The prognosis, recovery time, and re-rupture probability was slightly worse, but still better than the traditional method. The same complications of surgery was applicable.
- No Surgery. The recovery time (6 to 12 months) and chance for re-rupture (40%) was significantly more. Your Achilles tendon was casted in place from foot to groin to allow for healing. This did not have the same complications from surgery.
I took my chances and went with open surgery. I wanted and needed to return to work so I chose the best long-term option with the least amount of recovery time. The hardest part will be compliance and discipline to the instructions of the doctor and what my body tells me. I tend to push my limits. Below you will find pictures of my progress. Here is a rough timeline on my recovery:
- Weeks 0 to 2. This is post-surgery and my leg was placed in a partial hard cast from my foot to just below my knew. Much attention needs to be placed on elevating the foot and applying ice to decrease swelling. At this point, stay off your feet the following first 72 hours. After that, the doctor recommended moving around a bit to avoid complete body atrophy. You will be on crutches for the next 4 to 6 weeks so become accustomed to them. I purchased extra attachable padding to the hand grips and armpit rests after a few blisters. You will thank me for doing this.
- Weeks 2 to 4. The previous cast and stitches are removed at this point. The same portion of the leg is placed in a complete hard cast with the foot pointed downward to allow the tendon to heal. Continue to elevate and ice as needed. At this point, I am accustomed to my crutches and moving about more.
- Weeks 4 to 6. The third and final cast is placed. The same portion of the leg is placed in a hard cast, but the foot is moved closer to a 90 degree angle. This allows the tendon to stretch a bit to slowly begin the rehabilitation process. Continue to ice and elevate as needed.
- Weeks 6 to 8. Finally the cast and crutches are done! As the doctor jokingly stated, many patients throw their crutches aside and burn them. The same walking boot used at the emergency room will not be used to re-familiarize yourself with ambulating. For the first few days, crutches are still recommended.
- Weeks 8 to 16 The walking boot may or may not be taken off depending on the progress. At this point, the remained of recovery depends on the individual. The harder you work in physical therapy, the faster you will be back on your feet at 100%.
Post surgery Weeks 0 to 2
Weeks 2 to 4
Weeks 4 to 6
I have tried to help out with as many house chores as possible. If your partner complains that they cannot do anything at all, I'm telling you that you can. Hobbling on one leg, I still cook half the meals, take out the trash, clean around the house, wash the dishes, bath the little one, and do the laundry. Why do I do it? Partially to stay active and mostly to keep my significant other happy. Remember, they have to do everything else and drive you around. Keeping them happy will make your life and injury more bearable. Besides that, my partner pushed me to start doing sit-ups to stay active. She understands that being trapped at home is absolutely torture for me. I tend to mope around because I cannot do what I love such as working out. Sit-ups have greatly improved me mentally as well as physically.
You can do it at home while you are watching television. After the first week, I did one hundred sit-ups a day and added another hundred with each subsequent week. I am now at five hundred sit-ups a day. You would think at this point, there would be a washboard stomach underneath my shirt. That is not the case, but I do feel better and healthier.
After searching the internet on different websites, there are a list of things I try to take as supplements or to my diet. I am not suggesting to take these, but this is what I have chosen for myself.
- Multi-vitamin There are many essential vitamins and minerals in one tablet. Some include calcium and vitamin C, which helps the body produce collagen.
- Aspirin 325 mg The doctor suggested aspirin for its anti-inflammatory and anti-coagulatory characteristics.
- Chondroitin and Glucosamine These two supplements that are normally taken to help maintain healthy joints have also shown the same for connective tissue.
- Flaxseed Oil Omega 3 is also an important amino acid for recovery.
- Tendon, Cartilage Growing up, I was accustomed to eating foods that contained each of these items. In particular the Vietnamese dish Pho, has tendon in their noodle soup.
- Collagen Sea cucumber has a high amount of collagen. My parents have always cooked this in their soups and Chinese dishes. They have brought pots and pots of sea cucumber soup over to my place. Delicious!
I am currently in the "week 4 to 6" phase, and anxious to get back on my feet. You certainly realize how debilitating it can be without the use of both legs. I will update with my progress and any more information I learn on my healing process. Until then, I hope this information helps someone out there. Thank you for reading.
Achilles Tendon information
- Diet & Achilles Tendinitis | LIVESTRONG.COM
Diet & Achilles Tendinitis. Achilles tendinitis is a musculoskeletal condition that occurs with overuse and degeneration of your Achilles tendon -- the largest tendon in your body. The American Academy of Orthopaedic Surgeons states that there ar
- Achilles tendon rupture - Wikipedia, the free encyclopedia
Information on Achilles Tendon Rupture