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This. Get MRI, know for sure then figure it out. High probability that failing Thomson test means tendon is not there/connected to your foot or not functioning properly/severely torn which all equal surgery for fastest recovery. With surgery there will be no doubt that it will be stronger than your healthy one (if rehabbed properly). Get PRP injection with surgery.Quote:
Originally Posted by rod9301
Thanks for all the responses. I found a specific sports medicine doctor who works with the German National Ski Team. I have an appointment when they open Monday (hope my American Insurance covers most of it). Looking to get an MRI and if it is fully ruptured have surgery. I appreciate the heads up on PRP injections sierraskier. Looking at my boot in front of the window as it is currently dumping......
I got the open surgery done on 12/29, and I've been on bed-rest/leg-elevation 20+h/day since. First post-op checkup is 1/7. Getting around (poorly) on crutches. Had to go on disability for work. Assuming there aren't any issues with the incision, I'm looking at another 10-14 days of this before they transfer me into a walking boot. Once the swelling stops being an issue, I can begin rehab and return to work.
Some interesting things:
PRP/Stem Cells: I asked about PRP and stem cells, and my surgeon said that those treatments are only indicated when the injury is not treated with the open surgical approach. She told me that those treatments are about bringing healing blood cells to the area that wouldn't normally get there, but that when you do the open surgery, the body brings blood to that region in order to heal the incision and that the benefit to the tendon comes as a side effect of that. She did say that if there were subsequent issues with rehab, etc. (i.e. much later, after the incision was fully healed) that we could reconsider those treatments then.
American Health Insurance in Europe: You definitely want to communicate frequently and proactively with your insurance company about what is and isn't covered when you're in a foreign country. Every plan is different, but my experience has always been that emergent care is usually covered, but nothing else. I would be *very* surprised to hear of a US-based insurance plan that covered an Achilles repair in a foreign country. You may find that health care providers who are used to single-payer systems will treat first and worry about billing later, which is psychologically nice, in the moment, but can be a real surprise later. Be proactive. Ask ahead of time how much each thing costs, and communicate every cost you can't pay yourself to your insurance provider. The good news is that self-paying for health care in single-payer countries can actually be pretty reasonable. (Digression: Years ago, I broke my thumb in Curacao, a Dutch protectorate. I saw a GP, then saw a radiologist/got an X-ray, then saw an ortho guy, and the total bill was $36. This would be totally inconceivable in the US.) A self-pay MRI in the US is anywhere from $500-$3,000 so unless you have that kind of money lying around, get your ducks in a row before you accept treatment.
Had my first followup appointment yesterday. Good news: my incision is healing nicely (and looks pretty gnarly). Bad news: I had misunderstood the remainder of the recovery process. Yes, if all goes well, at my next followup (a week from now), I will transition from a cast to a boot, but not a "walking boot." I'll still be unable to put any weight on it, I'll still have to use crutches, and I'll still be expected to elevate my leg 'as much as possible', for another two weeks after that. So my laid up time after surgery time will actually be at least four weeks, not two, as I originally thought.
Will post updates when I have them.
Had my second followup. Out of the cast and into a boot, but as mentioned, that just means easier bathing. Boredom is reaching situation critical. I have watched "all the TV shows" and I have developed my ability in Call of Duty: Ghosts to an improbable level (still can't compete with the 12 year olds screaming racial/homophobic epithets over the party chat, but a lot better than I was.)
Really the saddest thing is looking at the ever-increasing difference in tone between my good and bad legs. The bad leg is withering away -- I can now get my fingers all the way around my thigh right above the knee. My good leg on the other hand, has decided to go all "BEEFCAKE 3000" from doing twice the work. I imagine half of the ensuing PT will be dedicated to correcting this imbalance.
My surgeon remains ever-positive and tells me that I might be able to get out skiing for a few days late in the season, depending on weather and my rehab.
Update from earlier: I elected to have the surgery done on 12/30 over here in Germany. They said everything went well and commented on how healthy the tendon looked. I was immediately placed in a boot but told not to put any weight on it. My boot was placed at a 30 degree angle for the first two weeks and on 1/15 they adjusted it down to a 15 degree angle. I already had two PT sessions which pretty much consisted of a lower leg massage to get the blood circulating. My PT also recommended doing upper body exercises to get the heart rate up and blood circulating to my tendon.
Overall recovery seems to be going smooth. I am still supposed to place zero weight on my foot but find myself occasionally putting light pressure on it while on my crutches. My wound has completely healed and tendon feels pretty smooth (which I am told is good). On 1/29 I go back to my Orthopedic doctor and get my boot placed down to 5 degrees. Then after two weeks I am told I can start placing pressure on my leg while in the boot for an additional two weeks.
It has been difficult but I am surprised at how mobile I am and the lack of pain I feel. I look forward to continue progressing but am trying to take it slow. Next week the PT guy said I should be fine if I want to go swim in the pool but to be very careful getting in and out and don't move my foot past a 5 degree angle. I also have been trying to eat as healthy as possible but have been pretty week at cutting alcohol from my diet (I'm living vicariously through my friends ski stories at the local Apres bar). I try to stay as hydrated as possibly with some water between beers though.
Hope everyone who is gimped out this winter is doing well and staying in high spirits. It's hard but even harder if you have a bad attitude about it.
I had another follow-up yesterday, 4 weeks post-op. Much to my surprise, my doc wanted to take me from 30deg to 0deg in one appointment. I didn't quite make it all the way to 0, (we settled on 10deg for now) but I'm now allowed to put full weight on it, and will be starting PT later this week. The doc also pointed out that because "recovered", to me, is defined as "skiing again", that I have further to go than most people (because of the dorsiflexion inherent in ski boots), and that I'll likely need to push myself a bit more than usual to get all of that dorsiflexion range back sooner. They encouraged me to continue using crutches (at least one) for a while as a "safety net", telling me that while I'm allowed to put full weight on the leg, the boot and muscular imbalance is going to make walking awkward, and they wouldn't want me to take a fall and get further injured.
They're clearing me to return to work on a limited basis next week. The limited part is primarily on account of swelling. I have been elevating my leg since before the surgery to control swelling, and I've observed that (at this point) I can make it about 3 or 4 hours of "not elevated" before the swelling makes life uncomfortable. Naturally, actually using the leg will pump more blood through it, which gives the body more of an opportunity to pull fluid away from the area, so I'm hopeful that the swelling will become less of a problem soon, although they also warned me that some folks experience some (usually manageable) swelling at lower leg surgery sites for the rest of their lives.
Anyway, walking on the leg is definitely very weird. Just hobbling around the house a bit here on the first day, it didn't take very long to get to the point where I had to lie down and take some Advil. I'm guessing PT is gonna be a blast. :) This morning, on day 2, it's still weird, but I'm enjoying the finer things in life... you know, like being able to make a cup of coffee and actually carry it to the table for breakfast!
Hope @smitty3063 is progressing too!
Figured I'd post an update, since I'm here at Snowshoe in West Virginia, playing Call of Duty and drinking scotch in the room while everyone else I'm with is out skiing. (Although, when they come back and tell me of 50min singles line waits, I kind of wonder who has the better deal.) I hobbled out yesterday to watch my 3.5yo nephew take his first runs on the magic carpet, etc. There was the question of, "Why isn't uncle Ian skiing with us?", and the adults trying to explain that although I hurt myself skiing, he would be OK, but he did really well. Today he did his first full top-to-bottom run. I give it a year before he's one of those midget cannonball kids.
As for the gimpiness, I've started PT, but the guy explained to me that the first half of PT is usually about re-training you to do the "daily life" stuff (bending over and picking stuff up, bathing yourself, etc), and that I appear to have that all worked out on my own, so we're doing once a week for the first two weeks, enabling me to tack the extra sessions onto the end when I'm actually returning to "athletic" conditioning.
I also figured it'd be worth sharing this pic of my moderately gnarly incision scar:
https://www.tetongravity.com/images/...776__forum.jpg
@smitty3063 hope you're doing well.
It's been about a month since my last post, so I figured I'd check back in...
In terms of physical therapy, I'm pleased with some aspects, and less pleased with others. On the good side, I mostly don't notice the injury any more as I go about my daily routine. On the other hand, the calf is still very weak, and the repair site is still painful when under load. Unless I'm paying attention, my walking gait defaults to something kinda "duck footed" which takes the calf and achilles out of the motion. If I consciously think about it, I can walk with a normal gait, but with moderate pain. I certainly can't run. A week or so ago, I was crossing the street and had to jog ~25ft to get out of the way of an oncoming car, and it was very painful. Mentally, this has been a "dark" time for me. Not being able to exercise, the weight gain, and everything else; it's just a real downer. They've cleared me to ride a bike, so I got myself a spin bike to try and fight back the weight gain a little bit (I'm up about 15lbs since the injury).
Although I'm waiting to get the go-ahead from the surgeon, I feel like I could probably ski at this point, as long as I stuck to less-demanding terrain. I've put my boots on a few times over the duration of my recovery and the swelling in my ankle is still an issue, but I don't know if it would keep me off the mountain if I got cleared. They've warned me that the injured ankle may be bigger (to some degree) forever, in which case I'll need to get some boot work done to accommodate. It's been a huge year for snow here in the eastern US. My hope is that the sheer volume of snow will allow resorts to stay open later in the season. Keeping my fingers crossed that I can get a decent trip in so that the season isn't a complete zero.
It's been a few months since my last post so I thought I would give an update to my progress. I just passed my 14 week post surgery mark. I turned in the boot at the 10 week mark but was walking around my apartment and work without it since the 8 week mark. I would still use the boot when walking outside or uncontrolled areas for that two week period.
Rehab has been going pretty well. The best thing that works for me is going to the pool. I usually swim laps for 30 to 45 min. to get my heart rate up and blood flowing. I then do some stretching followed by walking in the water at about chest height, gradually walking in shallower water as my Achilles and calf gained strength. I also do calf raises and jump off on the bottom of the pool in deep water. I follow it up with some stretching in the salt water hot tub. My Achilles always feels much better after this routine. It's really funny to see all the old Germans react to me doing this in their relaxation pool.
I was approved to start biking at 10 weeks but really don't enjoy sitting on a stationary bike. Took my road bike out when we had a stretch of nice weather and my Achilles felt fine after a 25km ride. I'm looking forward to going more regularly as summer approaches. As for skiing, my doctor said I could probably go do some easy groomers but highly recommended against it. I have followed his warning and avoided the temptation somehow. My family comes to visit in May and we are planning a day of glacier skiing in Austria. Thinking it will be best to wait till then and stick to easy groomer turns.
I really don't notice the injury anymore. I am walking normally and continue to gain strength on a daily basis. Hoping to be able to start running a little before the 6 month mark and if all goes well be 100% for next season. My biggest recommendations are to eat healthy, exercise (keep from gaining to much weight) and most importantly stay positive.
Glad to hear you're doing better, man.
My progress has been much like yours except that I haven't had access to a pool. I bought myself a nice spin bike (since I had enjoyed the occasional spin class before getting injured) and have been riding every day that I'm not in "real" PT. Stationary bikes and treadmills really don't bother me like they do other folks. I just turn on the TV and go!
After clearing it with the surgeon, I got out for one day of skiing locally. Skiing itself wasn't so bad, other than being much weaker than in the past, but the dangling weight of the boot and ski while on the lifts (with no foot rests) really bothered me at the beginning of the day. After 45 minutes, the pain of riding the lift was getting pretty bad, so I took a break for a bit, and deliberated calling it a day. The pain quieted down considerably with 10 or 15 minutes of rest so I went back out, and for whatever reason, I was mostly fine from there on out. I skied about half a day before I got bored and went home (the place I went didn't have much to offer except close and cheap). I'm hoping to get out skiing for a few days early next week up in New England.
I still notice the injury every day, but it doesn't substantially interfere with daily life, it's mainly just that there's still a strength deficit. Like you, I would really like to get back to running, but they're telling me to wait another month. They have this pneumatic running harness thing that lets you run while it carries a portion of your weight. They were saying they might try me out on that soon.
I absolutely agree that weight management is one of the hardest things about this injury. My current plan is to get on a medically supervised weight loss program as soon as I can run again. I typically lose weight in the winter (skiing, etc) and put it on in the summer (BBQs and beers) but this year I obviously gained in the winter, so I don't want to lose too much ground. I did a full course of "Insanity" before getting injured, in hopes of being in top shape for the season, and put on 10lbs of muscle doing that. Then, while recuperating from surgery, I put on another 15 of fat (plus enough extra fat to make up the weight from all the atrophy) while injured, some of which came off when I got the bike, but as I rebuilt my gimpy leg back to its former tree-trunk-like glory, it was all I could do to keep the number from going up even more. It has been a serious struggle.
Good luck with the glacier skiing!
It's been a while. The wife is working today. Figured I'd check in.
They've declared that I no longer meet the "clinical criteria" for PT (i.e. kicked me out). I can do almost everything, except, of course, lose this damn weight. Before the injury I was running 25-30 miles a week, and now I can do maybe 5 miles, twice a week, while also filling in with the bike. It's not exactly super cool. Looking forward to the ski season this year, although I've been slowly coming around to accepting that it's probably never going to be like it was. That said, I've been thinking about maybe working with a trainer to try and regain some ground.
Need a new TGR flick to get amped :)
Hope @smitty3063 is doing well.
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I am really sorry for what happened to you in that manner. A friend of mine was out on vacation with his family and did also attempted for the very first time. Did got injured very badly. As for now he takes necessary precaution measures while traveling, hiking and skeing.
I tore my right AT three weeks ago during skitouring.
We had zero sight while skiing down.
I had the feeling that the ground before me was somehow higher, but I guessed that it was a minor bump and I could ski over it.
Actually it was a real snow wall and I crashed into it before realising what was going on.
The binding indeed released (Dynafit Vertical ST at some 7)
I didn't feel much except a strain in the calf and my greatest fear was a muscle tear.
Once down I couldn't walk normally but I drove some 3h without issues.
Next day I went to an ortho which promptly failed to recognise the problem.
9 days later I went back to him and again(!) he told me just to be patient and take some pain killer.
After another week and some research, including this thread, I was quite sure that I torn the AT.
Last Monday I went to a second ortho who had no pain confirming what I suspected and scheduled me for surgery three days later i.e. tomorrow.
Today I did an MRT and discussed everything with ortho/surgeon and anaesthetist.
I was wearing Dynafit zZero4.
With stiffer boots I'm quite sure that this wouldn't have happen.
As soon as back on-line I will probably tour with the Cochise 130.
For the records: I currently live in Munich (Germany)
Good luck. You'll heal back up just fine with proper PT and motivation.Quote:
Originally Posted by PNB
BTW - it takes about 20 seconds to diagnose an achilles rupture. Any idiot who can squeeze your calf muscle can do it for you
Thanks!Quote:
Originally Posted by sierraskier
I already look forward to the next season.
Yes, I know meanwhile of the Thompson test and that's why I realized what my problem was/is and went straight to the 2nd ortho.
When I tore mine I was in flexons with a #10 tongue. Plenty stiff, but I think it's probably possible to overcome the stiffest boots resistance in certain situations.
I wonder if this is more or just the case for 3-pieces shoes - i.e. with tongue?Quote:
Originally Posted by Shorty_J
At least some models, despite tiff, are known to collapse after a given limit is reached.
TLT 5 for one.
I never heard such a thing about shoes with overlapping construction.
OP Day +2
Meanwhile I found a used bike trainer (the sort where I can put a race bike on) to help rehab ASAP and I will use the chance to learn to swim properly.
I tore my Achilles in a bd factor 130, old model, overlap, but I do think that it was kind of soft
That's bad.Quote:
Originally Posted by rod9301
May I ask, how it happened?
I'd quite love to feel sort of safe, as soon as I will ski again.
Steep couloir, on my first turn, I hit a patch of ice, couldn't hold an edge, and started tumbling backwards. I tumbled for 600 vertical feet until the slope lessened and I was able to stop.
Then a 6 mile ordeal to get to the car.
Reason for edges not holding:
I have cants under my bindings, 3 degrees on the left, 1/2 on the right.
I mistakenly switched skis before I started down.
That left me with no edge on left ski.
I remember thinking"why tf I can't turn to the right???"
Then, as I was approaching at high speed the edge of the couloir, I over rotated and lost the tails.
Probably too much information, but you asked.
Thanks for sharing.Quote:
Originally Posted by rod9301
https://www.youtube.com/watch?v=j5bIW882OR8
For the benefit of those who may not have caught the Kids in the Hall Reference. Hadn't thought of those guys in years.
I ruptured my left Achilles on March 4 while skiing Sun Valley.
I had Achilles repair surgery on March 9 in Bend, OR.
My appt to get current splint/cast off and into walking boot is scheduled for March 23.
I plan to ski again beginning next season 18/19.
This event was dominantly related to my dumb decisions. I was skiing knee deep fresh pow over dirt/rock (no base underneath pow on this slope). This occurred during my 4th lap skiing this slope, and was gonna be our last run just before taking a lunch break. I went a bit harder than my previous 3 lines and exploded on a rock mid turn at speed near the end of my run. The right ski came off instantly, left ski didn’t release and went for a ride with me over the handlebars in a forward launch face first into pow. Immediately my left ankle hurt like hell. I clicked out of left binding with my wife’s help, as I thought I had sprained my ankle or broke something.
I then found the right ski within a few minutes of crawling around in pow. I clicked back into both skis and traversed out of this pow field onto a groomer, then side slipped down to a chairlift and rode the chairlift up, hobbled over to the gondola and rode the gondola down to base area, and then filled out a patrol report once sitting in a wheelchair.
My wife picked me up in our camper van and took me to the Ketchum ER.
I got the left boot hot with the van's propane heater and removed the boot during the drive to the hospital. They took x-rays and performed Thompson test, put me in a splint while selling me crutches.
My wife drove me to Boise that night where we stayed with some friends, then home to Bend the next day. I was able to get an ortho appointment the following day, which is how I got into surgery so quickly.
The unfortunate accomplices:
Salomon Ghost 130 boots
2011 ON3P Wrenegade 181cm (113mm underfoot)
@gepmeow: I'm curious... What part of the situation do you "blame" for your injury? In my case, I was being a dumbass and was skiing around with my boots unbuckled. For instance, I'm wondering if you would say that your rear binding was set too high? Or was it just 'bad luck'?
Ian
I was skiing too aggressively through a pow field which I knew had hidden features beneath (rocks, stumps) which the pow surface would not allude to visually. There was literally no base under this pow, just dirt, rocks, and stumps.
That sucks. Good luck in your recovery.
I’ve thought about all those times that I’ve skied in marginally thin conditions and was taking a bigger chance than I might have thought.
Sent from my iPhone using TGR Forums
Bump
Saturday, 4/6, Mt Bachelor. Snowing hard, low viz and windy. Charging on hardpacked snow which turned intro a few inches of dense windpack. Got bucked, couldn't recover and went over the bars. Lost right ski. Unlike Gepmeow and others here, there wasn't intense pain - I could feel something swelling but otherwise seemed OK. Retrieved the ski, clicked back in, first turn on right leg I knew something was wrong. Toboggan to lift base, snow machine to clinic where my right leg flunked the Thompson Test.
Skis were ON3P wren 88s; boots were Lange RX130s with an incredibly tight heel pocket. Getting the boot off in the clinic was fun...
Saw the surgeon's PA this AM. Xrays say not only did I completely rupture the tendon, I managed to tear some bone off the heel when it ripped (aka avulsion fracture). I don't do anything half-assed.
That said, they think they can have me bearing weight on that leg two weeks after surgery. Instead of starting out with toes pointed down and increasing angle to 90 degrees over 6 weeks, they're gonna set the foot at 90 degrees right off the bat. Weaving in some sort of wire mesh to assist reattachment.
Gepmeow (see above) brought me his KneeRover scooter and an iWalk pegleg to assist mobility. Which is a godsend, since I'm a danger to myself and others on crutches. :yourock:
And as he did with me 13 mos ago, I loaned him a pair of skis for balance of season.
Surgery Wednesday 4/10.
Update -
Two week post op visit, got first look at their handiwork
Attachment 279911
They decided the wound was still a little too angry so won't remove stitches for another week.
Was having substantial nerve pain - like getting stabbed with 1000 hot needles - so Dr gave me a gabapentin scrip. This stuff knocks you the fuck out
On the upside, they tell me there's no reason I can't start weight bearing and exercises next week. Heel was set at slightly less than 90* angle (toe to leg) so don't have to endure as much tendon stretching. I can sort of gimp around without too much pain, so long as I don't pressure the front of the boot cuff.
Wait-a-minute... So, you can get that into a ski boot?Quote:
Originally Posted by TBS
Good to see that things are progressing and that you are on the mend.
Attachment 279924
Pretty stiff flex with the aluminum stiffeners on each side, but the heel pocket isn't well formed and its kind of sloppy in the forefoot. I've still managed to overstretch the tendon a couple of times :eek:
You should try an intuition liner and a custom footbed in that boot. What’s your din?
My heel is so sore now that a liner would be agony
Will def use the footbed out of my touring boots once I’m weight bearing and the shim comes out of the boot base.
I’m guessing the din on my Achilles is <= 8.5 since my clamps were set at 9.
Glad to hear step 1 is done... PT that thing & you’ll be back to irritating lifties in no time
Quote:
Originally Posted by sierraskier
wow do I feel lucky>that's a tough spot to heal, demands surgery most times-which is not an option for everyone financially since Obamacare took costs over the handlebarsI hope your recovery goes well !!!
I did a stretch type injury too.. that can happen at low speed!
I was geekin on some steep ice , when I used to think I was bullet proof; bad choice of skis,riding the wide slight rockers>right over the tips when I fumbled one turn..it was funny >I laughed as I skid upside down.
Then my tail caught a bad angle due to the pack on my back.
Laughing went quickly to the dreaded ''no no no'' as my Calf Muscle popped.(hamstring was pretty bloody too above the knee) If I was goin faster Knee woulda went too ,I felt it almost dislocate..is what forced me to lift that ski out of the angle that was grabbing the tail, even though I was messed up by then.
Just enough strength to pull that rear tip dragging up, before my leg totally was splintered.
-yea at a freakin 5mph crash>unbelievable really ,after a few those huge cartwheels we all have done and came out o k .
I see reading ,those stiff boots I wear, saved the tendon below the calf!
I saw you can heal a muscle if its not more than 94 % torn >so fk the doctor, I had some tiny movement in there still. & I only tore upper calf because of the boots ,I imagine.
I just alternated heat /cold ,elevate.. slap a brace on, to be able to limp to the bathroom. I probably should bought crutches for the 1st few weeks of that recovery!
Totally! its basic science/our bodies joints are lubricated by movementQuote:
Originally Posted by Shorty_J
Muscles shrivel to 'death' when not used, for lack of better term.
When you work Hard all the time; Hard work becomes easy;)
Checking into this achilles thread. Outta tha cast and into the boot. My was at the insertion to the heelbone and they ground off a second heel that formed. Fkna glad to get to 50% weight bearing. OMG I have no fucking calfmuscle left!
Let the healing commence!Attachment 280602
Interesting blue lines. My guess-surgeon or asst removed half the stitches (common practice) and drew blue lines to help find the remaining stitches later, since they tend to get buried in the tissue and hard to find. If so that's a clever idea I hadn't heard of, but then I never removed just half the stitches myself. Did I guess right? Heal well.
Lines where there when the bandage came off. All stiches are out and dr applied skin adhesive to incision and layered on steri strips. I just bought a pair of runners compression socks from rei and expensed them to my FSA w dr's script [emoji12] for my upcoming cali trip.Quote:
Originally Posted by old goat
Good luck Fugi - BTW you may want to trade your knee scooter for an all-terrain model with bigger wheels.
Attachment 281110
Much easier to get over curb cuts, road imperfections, etc although easier to get a wheel off the ground in corners.
Got my stitches out Tuesday. Dr tells me I can bear 100% weight on that leg - easy in the boot, notsomuch without. Stiff as fuck, Can barely see my ankle for the swelling.
Stepped out of first shower in 3+ weeks onto repaired leg, and spent the next five minutes in agony. Ms TBS said everybody on our block learned new phrases.
2x/week PT starts 5/7
(Not) Sleeping in this boot fucking sucks