The Ruptured Achilles Tendon Recovery Blog

Day 1: How my life changed in an instant Monday 7th April 2008

2008-10-31T15:26:00.004+09:00

All squash players have heard stories about other squash players that snap their Achilles tendon. Of course this always happens to the other guy and nothing can prepare you for when the "other guy" becomes you !!

It was a Monday night and I am playing Division one pennants. I was up against one of my arch enemies (and I mean that in the nicest possible way) who over the years I have had some fantastic hard games against. I remember the last hit we had - it was so hard I could hardly walk for 2 weeks after the match !!

So here we were again locked in an epic battle. I lost the first game but then won the second in only what could be described as one of the hardest games of my life. I remember coming off the court and thinking to myself I was entering uncharted waters with regards to my fitness levels. You could say I was stuffed.

Lucky for me my opponent was also tired and I won the next game fairly easily and was leading 4 - 0 in the fourth game.

And then it happened.

I was stretching for a back hand shot when i felt my Achilles snap. The feeling was exactly like all the "other guys" describe it. Like someone whacking you behind the calf with a squash racket or someone whipping you behind your leg. For me the best way of describing it is imagine having a big thick elastic band strapped inside your leg and then someone cuts it !!

Amazing enough there was very little pain. I remember thinking to myself this should hurt more than this !! One other good thing was my calf muscle did not wrap itself up into my leg as I have heard stories of. In fact because it didn't do this I was hoping it wasn't actually torn but only sprained. And then I felt down to the spot my beautiful Achilles should be - it wasn't there - just space :( I knew then my life had changed in an instant.

So what happens next?

I have never snapped an Achilles before so I wasn't really sure what I should do. The first sentence i spoke was "can someone please phone an ambulance". This just blurted out as I was waiting for excruciating pain to happen and I figured the ambulance drivers would be best placed to administer pain relief. But this was put on hold when the pain didn't eventuate and I had a chance to collect my thoughts.

I bum shuffled myself out of the court, elevated the leg, iced it and started to go through my options.

When anything like this happens the first thing you think of is getting to the emergency department ASAP. Lucky for me I had a good mate that was willing to drive me to hospital so I was bundled in the car and off we set. As we were driving there I had a change of mind. I was in no pain and knew the hospital emergency dept would just strap it up and tell me to find a specialist tomorrow. So I asked him to drive me home.

Lucky for me we live next door to a doctor and she strapped me up and sent me to bed with pain killers.

Lesson Learnt: Squash is a unique game especially designed to snap the Achilles Tendon!.

Day 2: Visit Specialist

2008-10-30T16:43:00.001+09:00

For a guy that has just snapped his Achilles I slept fairly well. I remember waking up the next morning and hoping this was a bad dream. Well I hoped !!

Beautiful neighbour next door was meanwhile on the phone and had somehow got me an appointment with a sports orthopaedic specialist that afternoon.

Lesson Learnt: always be nice to your neighbours - you never know when you may need their help.

Meanwhile, wifey had found me some crutches and I was mobile again.

So off I trot ( I could wish) to the specialist.

I was due to see him at 2.20pm which was in 10 minutes time and there were still 5 people in front of me. Gosh I thought, this guy is so far behind. I made it in by 2.20pm !!!

I will now verbatim our conversation.

Hi, I am Dr XXX what seems to be the problem.

Me: I think I have snapped my Achilles playing squash.

He looks at it.

Doctor: Yes you have. I can do surgery tomorrow afternoon.

Me: Great.

End of consultation and a bill for $130 - that took all of 3 - 4 minutes!

Having said that I felt confident that he was going to be a good doctor and had full faith and confidence in him.

This is the test they do for a ruptured Achilles Tendon. It wasnt done on me as it was so obvious i had snapped it.

Day 3: The Operation

2008-10-29T20:20:00.003+09:00

Well I rolled up into the hospital and was shown to my bed. Had a beautiful view of Perth from my window and it felt like I was in a 5 star Hotel :)

At about 1.30pm they came and wheeled me away to the pre-op waiting room. It was packed with patients waiting patiently for their surgery. They couldn't find a spot for me so I was tucked away in another room. The result of this was when it came my turn to go in the orderlys had trouble finding me !!

I got wheeled into a massive surgery, had a cursory hello from my surgeon (who i didn't actually see !!) and then they put me to sleep.

An hour or so later I woke up in post op and was then wheeled back to my room.

Within an hour I was back to my normal self, having a cup of tea and starving hungry !!

The nurses were great and looked after me very well. I had pain at a 4/10 level and that was easily nipped in the bud with a pain killer and 2 panadol.

Wifey and the boys came in to visit me that night and it was a relief that everything went well and I was back with my family again.

That night I slept ok up until I had to go for a pee. For some reason I couldn't pee into the bottle laying down on the bed so I had to stand up ( I must have some genetic trait that my water works don't work if I am laying down. Note to self: remember to ask my brother can he pee laying down). Lowering my leg onto the floor caused a huge amount of pain to shoot through my leg - but at least I was able to pee. Laid awake in pain for a while until I relented and called for more pain killers from the nurse.

Lesson Learnt : If you can only pee standing up, don't play squash

Below are some videos of an Achilles surgery. Don't click them if you are squeamish.

Day 4: I leave Hospital

2008-10-28T10:20:00.002+09:00

Spent the whole morning waiting for the specialist to arrive to discharge me.

At 11am he rolls up, sticks his head around the curtain and tells me everything went ok and then walks away !!! I call him back "when am I supposed to see you again"? He looks at me strangely and says its all in the anaesthetist report I was supposed to have. I call him back again. "How long does my cast stay on". "Six weeks" he says and then like a shadow that has seen sunlight - he disappears.

I still have so many questions to ask him. I would actually like my cast off in 3 - 4 weeks and go to a boot like the one below so I can actively participate in a rehab program. I am very conscious of the need to have some flexibility in my ankle if I am to ski in 13 weeks and the longer I stay in a cast the more my calf muscle will atrophy.

Lesson Learnt : Don't expect your surgeon to be enthusiastic about your ideas for a quick recovery.

Day 5: The Wheelchair

2008-10-27T16:37:00.001+09:00

Well its been a couple of days since the surgery and I am having to come to grips with a lack of mobility. For a person that I am sure some people think is ADHD, this is a shock.

I have a 5 kg cast on my leg - itself is a health hazard. If I hop around on one leg my other calf feels like it will snap in sympathy so I have to be careful to minimise trying the hopping. Likewise the lump on the end of my leg can generate quite a bit of momentum so I am mindful of snapping my knee !

I have tried crutches, and they certainly have their place, but with them comes a slip hazard. So for me, what is working best is a wheelchair.

Lucky for me wifey found a local hirer so now I have "wheels".

I thanked wifey that she was saving my sanity by allowing me to be mobile again. She replied " no David, I am saving my OWN sanity" !

Lesson Learnt: Don't sit around moping - get yourself mobile again

Day 10: Back to work

2008-10-26T15:56:00.001+09:00

Well my cast has been on a week now.

I have found it easier to use a wheelchair instead of crutches so I am motoring around the neighbourhood.

Everyday I try to have a mini workout by wheel chairing up to the local shops and back again.

One thing I have learnt about myself is that my upper body strength has alot to be desired. Even going up a small hill in a wheelchair makes my arms burn !!

I have decided the cast has to come off ASAP. I hate it. It is like having a bag of potatoes strapped to your ankle. I see my surgeon in about 2 weeks time and I am going to try and have him let me go straight to a boot. At least that way I will be able to stretch my calf muscle and hopefully alleviate all the muscle waste in my lower legs. I wonder what the surgeons response will be !! I hope he will be receptive to my plight.

I have been in to work for 2 days this week. I got a lift from a work colleague and she dropped me off at the building where my meeting was at that morning. After my meeting I then had to wheel chair back down to the building I worked at. Its about 500 metres all down hill thank goodness. The only problem was I got burns on my hands trying to slow the wheelchair down on some parts of the wheel chair path.

Lesson learnt: wheel chair paths are built by architects that never bother to test out the path they build.

Next week I am catching public transport - now this is really going to test me !!

Day 14: The cross trainer

2008-10-25T15:15:00.001+08:00

The foot is feeling pretty good now. I can flex it slightly in the cast and have no pain.

For the first time in 2 weeks I did some exercise. Nothing flash just some core strength work and some upper body weights.

I also did a light theraband stretch of my injured Achilles and that felt good too.

I am starting to feel confident I will make the ski trip in 12 weeks :) The only downer is I spent quite a bit of time reading up on other blogs from individuals with the same injury and most of them have taken 6 - 12 months before they have made a full recovery. I am hoping that my high level of fitness before the injury and motivation to do high levels of physical therapy will get me over the line.

Now if you have ruptured your Achilles I would not recommend the exercise below !!

Footnote: I am writing this six months after I did the above. This was stupid and dont try this at home !

Day 16 - I am driving again

2008-10-24T15:46:00.001+08:00

Well it has been exactly 2 weeks since the surgery.

I was waiting out the front of my house for my boss to pick me up when I thought that I would see how my leg would go on the brake and accelerator of my own car. To my surprise the little bit of flexion I had with the cast was more than enough to comfortably and safely drive.

So when boss arrives I proved to her that I can do the pedals ok and she gives the ok to drive. So now I am back on the road again thank goodness. This must be what it feels like when a young kid first gets their license. Its great to be mobile again :).

Day 18 - Exercise

2008-10-23T15:52:00.001+08:00

I may not be able to run but I see no reason why I cant exercise the rest of my body.
So I have bought some weights and an exercise mat and started doing upper body strength and abs. The only silly thing I did was single calf raises on a step with my good calf lifting my whole body ! I wouldn't advise this - I think I have pulled a muscle in the only good calf I have left !!

I see my surgeon in 2 days time to hopefully remove this cast. I am going to try and get him to let me wear a "boot" so I cant start some more intensive physical therapy (eg massage) on my Achilles. My guy feeling tells me he will want ANOTHER cast put on my foot so as to keep me less mobile. Lets see how I go !

Day 22 - the visit to the specialist

2008-10-22T21:18:00.001+08:00

Well I rolled up at the specialist with the "boot" in my back pack and high hopes of the surgeon letting me wear it out so I could start exercising my calf and Achilles.

Unfortunately he had other ideas. He cut off my old cast, looked at my boot and said "that boot has the foot an an angle of 90%. Your foot still has to be at 45%" and then proceeded the put ANOTHER cast on my foot !!

However, I had him trapped for at least 5 minutes so I fired questions at him. Here is what I learnt:

* The new cast with my foot has to stay on for another 2 weeks eg that will make 4 weeks in total. Then I can go to a boot for 4 weeks and then a shoe with heel lifts (wow, I always wanted to wear stilettos to work :)
* The operation took 1 hour. It took so long as it is a tricky process for the anesthetist as I had to be turned on my stomach which has implications for my breathing. This explains why my throat was slightly sore from the breathing tube they must have put in.
* He used "invisible stitches" so they don't have to be removed.
* The cut is about 4 cms and whilst he was in there he cleaned up some pre-existing tendonitis I also had. In his words I "got 2 operations for the price of one". I knew some good would come of this :)
* The stitches he used to join the 2 ends of the Achilles will stay there till the day I die. He described the strength of the stitches as being like that on the cords on venetian blinds eg extremely tough (except when my kids get a hold of them!)
* He thinks my Achilles will be stronger when it has fully repaired and he has never had a re-rupture (mind you I doubt if he would confess if he had one!)

I am fully back at work now on crutches. My next post will be in 2 weeks when I have the boot. I will film what the scar/incision etc looks like.

PS Its snowing at the resort I am planning to go too - I wonder if I will make it?

Day 36 - the cast comes off !

2008-10-21T20:02:00.001+08:00

Well I went to the specialist again and finally after 5 weeks my cast comes off and I have to wear a boot now for the next 2 weeks.

I asked the specialist could I see a physio or something and he said NO !!!

So now I am in a boot and not feeling very happy that I cant start any physio work that will enable me to start recovering quick enough to get ready for the ski trip.

Day 37: Boot goes in the bin !!!

2008-10-20T20:16:00.001+08:00

I hated the boot ! Made me walk around like darth vader. I know I was supposed to wear it but I have decided that if I am going to ski in less than 9 weeks I need to move things along.

So I tried just a normal sand shoe with gel heel lifts and it felt much better. Of course I am walking with a limp and have no real flexion in my foot (which forces u to walk with your foot turn slightly outwards) but its better than that restricting boot. I am hoping that by limping around the action alone of doing this will stretch the Achilles.

Plus, I can still drive :)

Day 39

2008-10-19T20:20:00.002+08:00

I have booked in to see an Occupational Therapist - against the wishes of my specialist. His name is Brett and he works here http://www.healthcentral.com.au/MtHawthornWA.html

See him next week and looking forward to it :) I know the specialist wanted me to wait 4 weeks but I think he is being way too cautious. I bet if I was a world famous footballer I would be having all sorts of physios and OT's working on me !!

Day 40 - rode 20 km on my bike

2008-10-18T20:22:00.000+08:00

I jumped on my mountain bike and hey presto - it felt great.

Suprisingly you can ride pretty well with very little ankle flexion.

Did a solid 20km over bush tracks and was very releived to be getting back on the road to my fitness.

See the OT in a couple of days.

Day 42 - Off to the OT

2008-10-17T20:25:00.004+08:00

Oh my gosh - I have never felt pain like this.

The OT worked on my calf for 20 mins. The ankle is still quite swollen so he is pushing the fluid (which is like a thick paste) from my ankle up thru channels in the back of my calf and into a little drain that sits just behin the knee cap.

It was amazing watching him move this fluid (called oedema) about. If I wasnt seeing this guy, this fluid would just be sitting there no doubt extending the period of my recovery.

I have booked in to see him twice a week.

IMPORTANT IMPORTANT IMPORTANT

(now click on "older posts" to read the rest of my recovery over the last 12 months)

Day 49

2008-10-16T21:52:00.001+08:00

Off course I am still limping around. Still haven't got enough flexion in my calf to be able to stride properly.

I am still riding 20km every day and loving it.

Have started working out in the gym. Mainly doing upper body, arms and abs.

Can use a X-Trainer now quite comfortably. Have about 40 days before I go skiing - am I going to make it ???

OT work is still very painful. When he works on moving the oedema fluid around and away from my ankle it is so painful I am dripping with sweat by the time he has finished. I keep on telling myself it is worth it and that when I am skiing on the slopes I will look back at this time as being well worth it.

Day 60

2008-10-16T13:01:00.001+08:00

Walking much better with only a slight limp.

Am doing heaps of stretching of the calf and heel raises.

The Achilles tendon itself is quite thick as collagen has formed around it as part of the repair process. It fact I would say my injured Achilles tendon down near the back of the ankle is about 4 or 5 times thicker than my uninjured Achilles.

Still cycling heaps and working out in the gym. Starting to think that just maybe I will be skiing :)

My OT cannot believe the progress I have made. He tells me he has never seen anyone make such a great progress.

Why do I think this has happened ?? Well in my unmedical opionion I think its because I got mobile much earlier than my specialist was suggesting. Now please dont take my advice. If you have ruptured your achilles you need to listen to your specialist. Just because this has worked for me does not mean it will work for you.

By the way. I have not been back to the specialist since Day 36. Quite frankly what other advice can he give me?? I am on my own now controlling my own destiny.

Going to see a good OT was the best decision of my life.

Day 70

2008-10-15T10:11:00.000+08:00

Walking without a limp now.

Even went for a short slow run it felt that good. However, wont be doing this again for a while as it aggravated things the next day (ankle was sore for 2 days)

However, when I was on the run and warmed up the calf muscle it felt REAL good :))

Day 71

2008-10-14T22:14:00.000+08:00

I forgot to say on day 70.

My flexibility is much much better with the calf muscle. Easily have enough flexion I think to ski. Just a little bit of pain around the ankle where the achilles joins the heel.

Day 94 - Only 10 days to go till I ski !!!

2008-10-13T22:18:00.000+08:00

Only 10 days to go until I am going skiing. And boy do I have some good news.

The achilles feels great. I have (I hope) enough flexion (eg bend at the knees) to ski. I still have a little bit of pain down near the ankle but I dont think this will be a worry.

Still riding my bike heaps and working out in the gym.

Started to do alot of wobble board exercises on my bad ankle to get all the nerves operating correctly.

Still seing the OT but there is no pain there when he works on me (thank god)

Ankle is no longer swollen but the achilles tendon itself is very fat and hard from the build up of collagen. I am not sure if this will ever get back to its normal slim shape??

And, the best news of all is the place I am sking in (called Falls Creek) has had the most amazing snow falls. In my 18 years of skiing there this is the best season I have ever seen :)

Day 97 - one week to go until l Skiiiiiiiiiiii

2008-10-12T17:13:00.001+08:00

Video update on my progress:

Flexibility Test:

Stretches I have been doing

The rehab I have been doing:

I did it !!!! Skied after 14 weeks

2008-10-12T17:11:00.000+08:00

Well, I have just returned from the best skiing trip I have ever been on.

We had the best snow seen in Australia probably for ever according to the locals. I have to agree. With a base of over 1 metre, 27 cms of fresh snow falling the night we arrived and then a full week of sunshine - it doesnt get any better than that :)

How was my achilles?

Fantastic. No pain and I skied for 5 days solid without any trouble - even on the black runs.

Well it looks like all that stretching and OT paid off as you can see from this video.

Day 111 - I have been slack

2008-10-11T19:46:00.000+08:00

Well its almost a week since I have come back from skiing and my Achilles has been a little sore and tight. After the excitement of the best ski trip of my life I have fallen in a hole and forgot about stretching my calf - now I am paying the price !

To try and get myself back on track I just went for a light run (approx 700 m). It actually felt fantastic. I could run with my normal gait and a full stride and only had a small bit of pain on the lower left anterior side of my heel - just below where the cut finished.

If it feels ok tomorrow I will try and do 2km and report back.

Day 113

2008-10-10T17:35:00.001+08:00

Went for a 2 - 3 km jog today. Was able to get to full stride.

Boy have I lost my fitness. That run almost killed me !!! Still, the calf felt fine and just a small bit of pain around the ankle. I am going to now try jogging every second day and see how things hold up.

Day 123 - running faster now

2008-10-09T22:20:00.000+08:00

Well I have had quite a few jogs now. On the weekend went down to the local lake which has a 4 km running track around it. Thought I would just jog a 1/3 of the way around and then come back but I felt so good I went all the way around. Even started to really stretch out to a full sprint over the last 300 metres.

That night it felt a bit sore low down in the ankle but by the next morning I was ok.

The only worrying thing is my achilles tendon is still massive in size compared to the good one. It is chock full of this hard fibrous material. For example - my good achilles tendon is about 1.5 cms wide and 3 cms long down near the base of the ankle. My ruptured one is 3 cms wide and and you can feel 13 cms long of this fibrous material.

This is going to be my next battle - how the devil do I get rid of this fibrous mass !!!

Playing squash tomorrow - wont be anything too strenuous. Just a restricted game with me not sprinting forward.

Day 180 - almost a fairy tale ending !!

2008-10-08T11:28:00.000+08:00

Well I have been back on the squash court for 2 or 3 months. Playing fairly hard games but with restrictive rules. For example, I play my mate but we both are allowed 2 bounces on the court. This stops me having to do those explosive types movements that could possibly re-rupture my Achilles.

I wasn't planning on playing competitive squash again until next year which would have given me a full 9 months off but my best squash mate rings me and begs me to play tonight as his team was short of one player. He says "David, the guy you have to play is one of the weakest in the comp, you could beat him on one leg !!!" Yeah right!

Problem was my ranking was still at the same high level as when I snapped my Achilles so I had to play at number one in the team. I was a little apprehensive about playing but I couldn't resist getting back on the court. I was really missing that buzz you get when you play competitively.

So I arrive at the squash courts expecting an easy first match back but things didn't go to plan. At the last minute the team we were playing against recruited in a "new" number one and I was now playing a guy that was ranked number 5 in the State !!

I could have killed my mate !

Anyway, there was no backing out now so I nervously go onto the court expecting to get thrashed :(

In the first game I started off slowly, hit alot of errors but was actually surprised at how good and fast I was moving around the court. I lost 9 point to 5 but that was 5 points I was just happy to get !

In the second game everything fell back into place again. I was hitting the ball well and moving as well as I did before I snapped my Achilles. I was doing alot of running too chasing down his shots so towards the end of the second game I was pretty stuffed. BUT, I was leading 8 points to 6 and only needed to win one more point to take a game off this guy and complete a fairy tale comeback ! I could see my mate praying I wouldn't win. He knew if I took a game off this guy he wouldn't here the last of it and the story of my great comeback would be told over and over again by me when we sat around having a few beers ;)

But alas, getting that one point was like climbing Mount Everest. I was completely exhausted and my opponent was determined he was not going to drop a game to a guy that hadn't played competitive squash in 6 months! He ran and ran and ran and no matter what I did I couldn't fall over the line. I went on to lose the 2nd game 9 points to 8.

By the third game I was stuffed - and I mean stuffed. I was still running ok but you cant expect to perform at this level without having trained a bit harder. I lost the last game 9 points to 4.

All in all I was pleased with the way I played. I never would have dreamed that almost 6 months to the day I was back on the squash court almost as good as before I snapped my Achilles.

If I can do it - so can you :)

Day 240 post operation

2008-10-07T21:58:00.002+08:00

Please feel free to post a comment or question. You can do it anonymously if you like.

One year Anniversary

2008-09-07T22:30:00.000+08:00

Well how time flys !! I thought 12 months ago I would never be the same again but I can assure you there is hope at the end of the tunnel.

My Achilles is in no way inhibiting my sporting life. My surgeon said it would be stronger after the operation and I think he was right.

My ruptured Achilles is still about 4 times larger than my other one and I believe it will always be like this. Whilst it does feel slightly tighter I have the same flexibility levels with both calfs and I am playing at about the same level in squash as I was a year ago. In fact I am moving so fast around the court I have developed a "new" problem - Hamstring tears !! Mind you I have had problems with hamstrings for 15 years. So now my life has switched from stretching my calfs to an intense hamstring strengthening program. Gosh, when you get old the body just ain't what it used to be. But hey, I am not complaining - 12 months ago I thought my life was going to change forever - but it didn't :)