AchillesHeel
Sunday, June 15, 2008
 
So, my tendinitis just about gone. Eventually it got bad enough that I went to my doctor and asked what to do. She hooked me up with physio therapy sessions that lasted for six weeks (or so). Each session consisted of massage, ultrasound and then ice with electrical stimulation. I was also given some simple exercises to do, including standing up on both tip toes and then putting all the weight on the effected foot and coming down slowly.

At times during the treatment, it didn't seem that I was getting anywhere. If I flexed the foot enough, the tendon still screamed out in anger. However eventually, I started to notice my ankle less and less. Now, the pain is gone, but there's a bit of residual stiffness.

During treatment, I almost stayed away from sport. I did continue surfing, and found that my leash tugging at that left ankle was one cause of discomfort. The therapists also had me doing 20 or 30 minutes of 60 RPM cycling on the stationary bike, and now I am back to riding out in the open a bit.

Perhaps what brought this all on was that I suddenly started cycling 12 miles per day on a commuter run, without cycling shoes. In fact, much of the time I was in my street shoes (when I wasn't in flip-flops riding down to surf). Now, ecxept for the surfing runs, I have proper cycling shoes and clip-in pedals, which keep my feet better aligned. The shoes are also stiff enough to give support to the arches.

So, this episode has been a little warning that the ankle is a complex machine and needs some looking after. Now I'm looking for exercises that I can keep doing to strengthen that area.
Friday, April 04, 2008
 
Tendinitis continues. I am now trying to avoid physical activity for a week or so to see if I can get the tendon back to normal. Taking NSAIDs, wearing sandals, and avoiding dorsifexion.
Friday, March 07, 2008
 
Michael,

Glad to hear that the blog is of some use.

Funny you mention it, but I have just recently had my first trouble
with the tendon since the original recovery. Nothging serious, but
probably related to a combination of a longer cycle route to work (12
miles round trip) and continuing attempts to teach myself to surf. I
wear the surfboard leash on the left ankle, and it gets an almighty
tug when the board is caught in a wave.

The end result is a bout of tendonitis that I am going through at the moment.

In summary, though, I have done everything after recovery that I did
before, though I am more injury prone--probably as a combined result
of age and the strength imbalance in the calves.

Good luck with your recovery, and thanks a lot for the feedback on the blog.

Do you mind if I post this e-mail exchange as a brief update on the blog?

Jeff

On Fri, Mar 7, 2008 at 2:56 PM, michael cantlon <> wrote:
> Hello Jeff,
> Thank you very much for your excellent achilles
> recovery blog. I've been following it day by day to
> see how my recovery compares with yours and reading
> ahead to see what I can expect in the future. I am at
> Day 75 at the moment and so far our rates of recovery
> are quite similar. I presume you are back to "normal"
> now and are able to do the things you did before your
> injury. I snapped my tendon playing indoor soccer.
> Like you, I am (sorry, was) involved in a lot of
> outdoor activities and have a few goals set for later
> in the year. I live at the base of the Blue Mountains
> near Sydney Australia so I'm itching to get back into
> bushwalking again. Patience!
> Thanks again
> Regards
> Mike Cantlon

Thursday, August 12, 2004
 
When I first saw my physio back in February, I told her that my goal was to go mountaineering and backpacking in August. The first installment of this was last week, in Zermatt. There, after two days of good training hikes, I climbed three alpine mountaineering routes. Two of the days were 6-hours of good mixed climbing, including crampons on glaciers, ice and rock; and 'big boots' climbing on rock. I found that I favoured my left foot when climbing ice or steep snow in crampons, especially front pointing, but that didn't cause any problems.

I was worried before the trip that my heel or my calf would simply give out half-way up some desperate route, but fortunately that didn't happen.

On the last day, before leaving Zermatt, my friend and I climbed from the village straight up to Unter Rothorn, 1500m of ascent in three hours.

In the evenings, my Achilles was 'present' but not 'painful.'

I still can't stand on tiptoe, but I can lift the heal a bit farther. Perhaps a few days of backpacking next week will bring it around to full strength.

Day 243 Summit of the Breithorn



Monday, July 19, 2004
 
Wow. Something--my training, a walk along the canal or just a twist--has given me a fierce left-sided backache this week. Perhaps it's a sign of poor biomechanics resulting from the weak calf? I've been doing some hard runs on the treadmill in preparation for my trip to Zermatt in a week. Running (though bad for the joints) seems to be the thing that gets my calf working.

Tuesday, July 06, 2004
 
At my son's school sports day today, I ran into a guy who's a personal trainer. He knew about my Achilles and asked how it was going. I complained about the lingering weakness in the calf muscle, and he suggested doing some more prolonged calf raising and lowering exercises--particularly lowering the heel below floor level, leaving it for 20 seconds, and then raising it as far as I could.

I still can't stand on my left tip-toe, and I won't consider myself 100% healed until then.

Monday, June 28, 2004
 
I signed myself up to play a game of competitive 6-a side footie tonight on the astroturf, but the game was a walk-over. Instead we did an hour of 4-on-4 messing around. It didn't seem to bother my heel, although my calf was weak and I didn't play particularly well after such a long lay off.

Sunday, May 02, 2004
 
Day 152

Is my tendon becoming a barometer? For no particular reason, my left lower leg felt quite weak today as I walked around an amusement park with Ethan and Karen. I hadn't exercised particularly hard last week, so I can't explain it.
Saturday, April 24, 2004
 
Day 144

I went back to weight training today, including a full set of leg exercises: press, curls and lifts. I also used a standing calf machine, loaded with 10 kg on my shoulders. This is essentially a heel raise with extra resistance. Perhaps that will help me get back the remaining calf strength which has been so hard to recover. I can lift my heel off the ground, but I can't stand on my toe.

By the way--thanks to those who have given positive feedback about this site. It's nice to know that I've given something useful back to the Internet after all these years!
Monday, April 19, 2004
 
Day 139

Another two games of indoor five-a-side footy, including a good crunching left-footed tackle. I feel quite confident in the repaired tendon. Now I just have to get full strength back in the calf. At the moment, I guess that I can lift my heel about 3 cm off the ground (standing on only my left foot). I'll pronounce myself healed when I can stand on tip toe, like I can on the right.

When I do exercise the tendon a lot, it seems to niggle me in my sleep; when my body's quiet I can feel the injury.
Tuesday, April 13, 2004
 
Day 133

Another hike on Monday, and a long day geocaching today, and my tendon doesn't feel bad. I wouldn't say that it's painless, but it certainly hasn't stopped me from enjoying the days out.
Sunday, April 11, 2004
 
Day 131

We walked along the canal tow path today, and up onto St. Catherine's hill. Perhaps it was two miles all told; certainly it was the longest trail walk I've had since my injury.
Monday, April 05, 2004
 
Day 125

MAJOR MILESTONE!

Today l played two 15-minute games of 5-a-side football in the sports hall. It felt great to be twisting, turning, tackling and passing. l felt confident, the tendon was painless, and it's only four months from my injury.
Thursday, April 01, 2004
 
Day 121

I went to my physio today off the back of three 30-minute workouts in the gym. Yesterday, l did 30 minutes on the treadmill to try some real running. Today the tendon feels fine. I'm surprised.

The physio session concentrated on exercises in the gym. l did lunges from both legs, with standing or landing foot on a partly inflated rubber ball. And the Physio also had me complete an exercise involving two elastic exercise bands, deep knee bends and a wobble board. l finished of with five minutes on the stair master.

The physio thought l didn't need to come back any more... at least until my calf is back to full strength.

That's a major milestone.
Sunday, March 21, 2004
 
Day 110

I ran a couple of races with Ethan last night on the way to the Indian, and felt good with it. I remember in December wondering when I'd be able to do that again: run without thinking.
Thursday, March 18, 2004
 
Day 107

Back to the physio today, so it's a good point to do a progress check.

In the gym, I've been doing 15 minutes or more on the stair climbing machine. I don't experience any difficulty while I'm doing it, but after several consecutive days of exercise, the tendon bothers me a bit. I just have the feeling that if I went hiking for a whole day, it might be difficult to get out and do it again the second day. Not such a good sign for backpacking trips.

I can keep the wobble board balanced for a few seconds now, although because it is a small diameter board with a sharp balance point, it's still a challenge.

Most impressively, I can lift my left heel off the ground about half an inch now without hopping. So I am making progress.

I would say, however, that progress is slower now. Without the discipline of doing the ankle exercises twice a day, I am counting on general exercise and trips to the gym, so I don't feel that I'm progressing.

The physio decided to concentrate on the tendon today, and massaged it for 10 minutes or so. There was no pain during the massage, and it felt pretty comfortable immediately after I left the appointment. She also did some work on my calf muscle, which certainly had some hot spots.

Back in two weeks.
Sunday, March 07, 2004
 
Day 96

I was on my feet all day today, and by the evening my tendon was certainly letting me know about it. When I have worked it to excess, it swells and burns a bit. At these times, my left foot still looks swolen in comparison to my right.
Thursday, March 04, 2004
 
Day 93

Finally, I have achieved full dorsiflexion of my left ankle!

This was one of the milestones that the physio was looking for, and since I have ready access to a gym during the week, she has decided that I should only have physio appointments every two weeks now. She did have me do some balance exercises, lunges and a bit of stair climbing today, just to fill out the time. I no longer need to do the specialist exercises, other than the heel lifts and using the resistance band.

I think that the next major milestone will be an ability to stand on my left toe. If I 'hop' a bit, I can get the left heel off the ground, but that's all.
Tuesday, March 02, 2004
 
Day 91

As usual by mid-week (between physio sessions) my leg has started to feel more recovered. Some days there seems to be a cumulative effect to the strengthening of the calf, and everything just works more freely.

I'm also using a small wobble board in my office, mostly for entertainment. It's about 24 inches in diameter, and I'm lucky if I can balance it for 2 seconds, but it's a workout for the brain and the ankle.
Sunday, February 29, 2004
 
Day 89

Perhaps that long workout on Friday wasn't such a good idea; my achilles has been giving me slight pain all weekend. I'll back off to 15 minutes!
Friday, February 27, 2004
 
Day 87

Since I have the all clear to use the stair machine, I did 15 minutes on it today; and I felt so nicely warmed up that I went on to do 15 minutes on the elliptical trainer, too. This was the best workout I've had since my injury.
Thursday, February 26, 2004
 
Day 86

Physio today.

My foot still isn't dorsiflexing as far as its partner, so we start out with some assisted stretching. I asked about ultrasound for the scar material, and Julia said that she doesn't do it as routine. My scar isn't bothering me, and she thinks it feels compact, so no ultrasound indicated.

Then out to the gym for a jog on the trampette and some balance work. It turns out that I am crabbing my toes for balance when I step forward, so I had to practice walking properly on the ball of my left foot, with the toes straight. I also got to do some work on the stair machine, and I can start to mix that into my workouts at the gym.

She didn't give me any more specific exercises, since my gym work covers the muscles that are in need of building up.


Saturday, February 21, 2004
 
Day 81

What's worse than Chelsea getting beat away by Arsenal in the FA Cup last Sunday? Chelsea getting beat by Arsenal at home in the Premiership this Sunday.

Not much to say about my achilles, however, it got me to the ground on time and supported me through the high and low points of the match. I've started to worry about the scar tissue. Have to ask the physio about it.
Thursday, February 19, 2004
 
Day 79

Now I've been to the physio four times. We have concentrated on getting the joint mobile, and between sessions I have been working with the calf muscle and with the small muscles in the foot. The physio sessions consist of manipulation to get the foot dorsiflexing completely, followed by some balance work to strengthen the calf and foot, and now some jogging on a mini-trampoline.

We haven't done any work on the scar tissue on the tendon itself. Should I worry about this? Some people have mentioned that we should be doing deep tissue massage or ultrasound to reduce the scarring. The tendon is fat and wooden.

At the moment (and for the last few days) I have a pain across the top of my foot. The phsyio manipulated this a bit on Thursday. It feels like a persistant bruise.

I have been using the stationary bike at the gym, at around half the resistance I normally would, and I have been riding my bike the mile between home and work with no ill effect. The physio cleared me to work on the ellipical trainer, too.

The strength has not yet returned to my calf. I cannot stand on the left leg alone and get to tiptoe, although I can raise the heel if I 'jump' a bit. Probably, to look at me walk, you would not detect a limip, but running I am still favouring the left.

Sunday, February 15, 2004
 
Day 75

What's worse for the recovering achilles than walking to the station, taking the train to London, standing for 90 minutes, taking the train back to Guildford, then walking back from the station? Doing it to watch Arsenal beat Chelsea (again).

I found that such a lot of exercise (not much by my normal standards) tired me out, though my heel didn't give my any real trouble throughout.
Thursday, February 12, 2004
 
Day 72

Kicked a soft football around with some 7-year-olds in the schoolyard today. Probably shouldn't have, but it felt good. Nice to make some movement other than walking or trying to stand on tiptoes.
Wednesday, February 11, 2004
 
Day 71

During physio today, I got to see how stiff the tendon still is. Walking down alternate stairs, when my right (good) foot is going to a lower stair, I still can't keep my left foot firmly planted. I have to lift the heel much earlier than I would "normally."

After the stair torture, I got to do some work on a balance board, which I find stimulating and interesting. Also a few steps of jogging on the mini-trampoline.

Swelling is still pretty marked.
Sunday, February 08, 2004
 
Day 68

Running.

I've used the gym four times this week, just riding the stationary bike.

Yesterday I did notice that my heel hurt a bit, and last night I had some moments of heel pain while sleeping, but today I thought my foot was more mobile than ever. Walking down stairs isn't so painful, and resting my foot while driving (plantarflexed) seemed almost natural.

I was even able to run a few steps to keep up with Ethan and to catch a Tube train.

I still can't lift my body weight on my left toes at all.
Tuesday, February 03, 2004
 
Day 63

The physio said that the swelling would be the last thing to go away, and that I shouldn't worry about it.

She worked my ankle agressively, presumably to break up some of the scar tissue, and added a couple of new exercises to my list. They're typical ankle and calf exercises, including use of a resistance band.

The best of the exercises is to stand on on one leg (the bad one) and do various tasks, such as bouncing a ball or passing an object around my body and under my idle leg. This is a good mental and physical challenge, and I can feel it strengthening my ankle. Try it with your eyes closed.
Monday, February 02, 2004
 
Day 62

Return to the gym.

I returned to the gym today. After a gentle stretch (including some of my physiotherapy exercises), I got on a recumbant stationary bike and did 15 minutes of gentle cycling. No problem. It was good to be back at the gym--I haven't been away for this long for more than seven years.

I have noticed that the most uncomfortable thing I do is walk down stairs. As the good right (good) foot leads down to the step below the left, the left is dorsiflexed with some real pressure from the leg. That hurts.

Also, my foot is a bit swollen from all of this activity. I'll ask the physio tomorrow.
Friday, January 30, 2004
 
Day 59

This morning I had my first physio appointment. The physio was great; she took a thorough history, including asking me about my goals for recovery. I told her that my key objective was to return to backpacking and mountaineering this summer. Football, although desirable, is not essential. To evaluate my leg, she had me walk back and forth across the treatment room. My first trip, I held the ankle pretty rigid and hobbled along like I've been doing in the airboot and since it came off yesterday. The Physio was adamant that I should start walking normally, bending the left foot, trying to power off with the left calf, etc. When I do dorsiflex my foot, it just feels strange: stiff, weak, painful, dangerous. I think the challenge of the physio will be to work through these things at the right rate, to return strength, flexibility, comfort and confidence.

She measured my flexibility. Not much deficit (5 degrees?) in plantarflexion, but no real strength. Plenty of deficit in dorsiflexion. My exercises until the next visit are to pull the foot into dorsiflexion with a belt; to dorsiflex, plantarflex and rotate the foot agressively under its own power; to sit on a chair and do heel lifts; and to stand and do heel lifts (almost impossible at fist); finally, and most excruciatingly, to sit for thirty seconds with my feet tucked under my bottom (i.e. Japanese style kneeling).

By the end of the day I was certainly walking more freely, mainly because the Physio gave me the confidence to use the tendon.

I also drove today, for the first time in two months. The left foot doesn't have to work too hard on the clutch--most of the power comes from the leg. I guess I didn't drive too well, though, since the police pulled me over to see if I'd been drinking. Fortunately, I had not.
Thursday, January 29, 2004
 
Day 58

He walks!

This morning I went to my 8-week follow-up appointment at the hospital, and it was all over in ten minutes. The doctor palpated the tendon, had me plantarflex the foot against his hand, and told me it was time for physiotherapy. He seemed happy that I would walk out of the office and start dorsiflexing the foot immediately. He did suggest that I return to sport slowly.

It has been strange to feel the foot coming back on line. I'm moving much more slowly than I was yesterday with the Airboot on. My leg has strengthened and I could almost run in the boot, which provided the safety of solid ankle support. Now I limp around and hobble up stairs. There's no particular pain, but we'll see if that remains the case.

First physio is tomorrow.
Wednesday, January 28, 2004
 
Day 57

He hobbles! I've been hobbling around the house in the evening without the Airboot. It feels strange, though I've been very careful not to dorsiflex my foot yet. When it comes close to flexing acutely, the tendon and calf muscle feel very tight.

Tomorrow I see the ortopods, and I hope and believe it will be the last time. I am expecting to be sent away without the Airboot and crutches (unused these three past weeks), but perhaps with a walking stick. I suspect I'll be somewhat less mobile without the Airboot, since I'll be worried about protecting the tendon. We'll see.
Thursday, January 22, 2004
 
Day 51

He stands!

Today was the last wedge day, and from this morning my foot is at a right angle to my leg. In the shower I put some weight on it, with no ill effect. I'm still careful not to dorsiflex it, but this is a great development.
Tuesday, January 20, 2004
 
Day 49

I've had the foot out a bit in the evenings when watching TV. I can move it side to side, and plantarflex it, as long as I don't dorsiflex it past where it would be in the AirCast.
Friday, January 16, 2004
 
Day 45

I found today that I could lightly rest my foot on the bathtub while showering. With my leg out a bit in front of me, the foot is slightly plantarflexed, about how it is in the AirCast with the one remaining wedge. Otherwise, the duration of my showers has been limited to the time I can spend standing on one foot, and I have to exercise extreme caution when I swivel around in the wet tub.
Thursday, January 15, 2004
 
Day 44

Wedge day. Now there is only one thin wedge left in the air boot, and my foot is almost at 90 degrees to my leg for the first time in six weeks. Last night I went to a football match in London and got about easily without the crutch. I imagine that I'll need them again when the airboot comes off and I'm relying on my weak ankle. We'll see. I'm beginning to feel a bit over ripe for the beginning of physio therapy. Too bad it can't start now.
Tuesday, January 13, 2004
 
Day 42

Today I left my crutch somewhere at work and went home with out it. This is a sign of how little I need or use it now. I'm getting around fine with the air boot.
Sunday, January 11, 2004
 
Day 40.

Last night there was pain, too. I dreamt about taking the pain killers I saved from after the operation. I woke enough to loosen the airboot and that relieved it. I wonder if I'm putting too much weight on the leg, or if I just had the boot too tight?
Saturday, January 10, 2004
 
Day 39.

I thought I should start a diary of my experience with achilles tendon rupture so that anyone else out there who has the misfortune can see what to expect. I didn't get around to starting this until today (10 January), 5 weeks after the rupture. I will, however, enter some back dated entries of the key dates.

Early this morning I had some sharp pain in the tendon. Perhaps I overdid it with the no-crutches walking yesterday. It only lasted a minute or so.
Friday, January 09, 2004
 
Day 38.

Today it seemed quite natural to move around without any crutches at all. Perhaps this is due to the heel being lower, due to yesterday's wedge removal. Still taking one crutch with me if I go any distance.
Wednesday, December 31, 2003
 
Day 29

Today I went to a single crutch. It feels natural to put more weight on the injured leg, and the Airboot stops there from being any real strain on the tendon. The Doctor wasn't clear about all of this, so I'm following my body and trying to take it easy.
Sunday, December 28, 2003
 
Day 26

Today we took a long walk at the Zoo. I let my leg take as much of the load as it would, and walked a mile or so with no trouble. It's good to feel the leg getting stronger. I'm surprised how weakened it was after two weeks in the plaster cast.
Friday, December 19, 2003
 
Day 17

Today we had to fly. At the air port (Heathrow), British Airways had mercy on me and upgraded us to World Traveller Plus, where there's a bit more legroom than pur turist class. They also laid on a wheelchair and a special transporter vehicle that lifted us up level with the plane--no steps for the man on crutches.

I had been worried about taking a seven hour plane flight with my leg imobilised. The Airboot allowed me to adjust the pressure on my leg as the cabin depressurised. I was uncomfortable, but not dangerously so. They took away my crutches while I was on the plane, so when I had to go to the toilet I just swung down the aisle using the seat backs. I was afraid to really plant my foot, but I don't think my thigh would have supported my weight anyway.

I stretched and wiggled whenever I could and did not get DVT--as far as I can tell.
Thursday, December 18, 2003
 
Day 16.

Today was my appointment to have the cast removed and the wound examined. Since we're planning to fly to America tomorrow, it's rather important that everything goes smoothly.

In the morning I called my insurance company to see if they would cover me for any physio I might need while on holiday in the States. According to the letter of their policy, they would not cover "traveling to get treatment," but the guy I talked to was very helpful and agreed that if anything was necessary he would cover it. They also validated my claim over the phone, with no paperwork at all. I guess that a ruptured Achilles isn't something they need a medical history to validate.

As it turned out, the Doctor doesn't want me to start getting physio anyway.

I waited around for a couple of hours before the technician got a minute to cut off my plaster cast with the vibrating saw. Then I had a quick exam by a Doctor (of some status), who said the wound looked good and asked whether I would like to have serial plaster casts (one per week) or a removable "air boot." I opted for the airboot, which is a high-tech plastic boot containing four inflatable chambers. Actually, it's called an Aircast Pneumatic Walker. You strap it on with Velcro and then pump up the chambers until it is comfortably snug. It can be removed for showering, and also removed to change the heel angle.

The heel angle is controlled by a set of graduated heel wedges. I started out with five, and will remove one per week, reducing heel height by about 1cm per week and gradually dorsiflexing the foot.

The Dr wasn't very forthcoming about whether I could/should put any weight on the foot, although the aircast is clearly a walking device. He was clear that I had to wear the boot in bed, in case I flexed my muscles unconsciously; and that I would have no physiotherapy until after six more weeks have passed.

Fortunately, I ran into the Consultant as I crutched out of the hospital, and he said that I should be able to put my full weight on the leg after four weeks.

Out I went, with this plastic ski boot on and my two crutches. At least I've moved into another phase.

I brought the plaster cast home, because that's the done thing.
Friday, December 05, 2003
 
One important early purchase for me was the Limbo, a well-sealed plastic cover for the plaster cast. This is especially important if you aren't going to be in an air cast, but will stay in plaster for a couple of months. With Limbo, I could linger in the shower for as long as I could stand on one leg--much better than a sponge bath or bathing with one leg hanging out.

Try to buy here.



Thursday, December 04, 2003
 
Day 2: Surgery. New plaster cast from below the knee. IV. Painkillers before bed, but not much pain.

Surgery. Everything went pretty much like clockwork today. The routine at the hospital is to wake us all at 0630, even thought we don't have anything to do. It fits in with the nurses' schedule, I guess. I couldn't eat or drink anything, so kept playing chess on my palmtop and reading my book. Doctors came in an marked my (left) leg with a comforting arrow.

Just after noon they rolled me downstairs. I waited briefly outside the operating theatre. They rolled me in, plugged in the general anesthetic and the next thing I knew I was swimming up to consciousness in the recovery room. May have revealed innermost secrets and fantasies to nurses. Who knows?

There wasn't much pain after the surgery, although I was still pretty much under the influence of the anesthetic. Then I took some pain killers when offered by the nurse. After this I didn't have any pain killers at all.

They let me eat dinner, which was nice. I did suffer the typical consequences of a general anesthetic, including sore throat and croaky voice. (As well as calling people on the phone and not remembering it the next day.)

Wednesday, December 03, 2003
 
Day 1: Bang! Trip to hospital. Plaster cast from below the knee. No food after midnight. Crutches or wheelchair.

Went down to the gym today, like I do most every day. On my way to the locker room, I was pulled in to make up the numbers in a game of netball. Changed quickly, warmed up quickly and got into the game. Our team was two people down, so we had a lot of running to do. Managed to stay in the game, though, only one point behind at half time. Switched ends and lost another point. Just getting ready to start again, and went to sprint foward. Heard the sound of a book hitting the floor, felt someone kick me in the left calf, and fell over forward. Everyone laughing, as it seemed I tripped over my own two feet. Looked around for the space debris that hit me, then began to understand that the event was entirely internal. Reckoning that something bad had happened, dragged myself to the edge of the court.

I didn't have much pain or swelling. We elevated the foot and put an ice pack on it. I was a bit shocky, just from knowing that I'd done myself a major injury. I was pretty certain straight away that it was the tendon. I had a bit of a knock from playing football the previous Friday, and anyway "Achilles heel" has such a fine history.

Friends helped me up to a car and to the hospital, where I waited a while for a diagnosis. After a couple of hours, a nurse practitioner gave me the Thompson Test and decided it probably was an achilles rupture. Then I waited a few more hours for a jr. dr. to confirm it. She explained the possible treatments: surgery to sew the tendon back together, or just let it heal. In both cases, a plaster cast for months and a six-month return to sports. She took pains to explain that the surgery is only slightly better statistically than the more conservative approach, but admitted that if it were her, she would have the surgery. I had Karen call her brother (a doctor in the States) and he called some friends, and they also recommended the surgery.

Opting for the surgery meant a couple of nights in the hospital. There was no time to activate my private health insurance, so I was in an open ward with five others, about which the less said the better.

Before sending me up to the ward, they put a temporary plaster cast on my leg, from below the knee. Of course they also put in an IV and attached me to a drip, so I was reduced to total immobility and had to be shunted around in a wheel chair. I could move on crutches, but only if someone dragged the IV stand behind me.

The worst thing was not being able to get on the internet and learn more about the injury. It turns out I had the classic experience: middle aged man playing sport requiring lots of jumping hears bang, feels kick, ruptures tendon. Not much pain. Not even total immobility of the foot.


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