Achilles tear in ski crash?

[Shorty_J]

I didn't take it politically, and you might be right about the differences in the healt-care system. I really love that my health-care is free, but our system is so far from perfect. I have thought many times about how much better treatment I would have got for this in the US.

My recovery is hit and miss. 2 steps forward, one step back.

The calf muscle is still very weak and it's really difficult for me to even make the muscle fire through a full range of motion, so it's being slow to build back up. That whole leg is weak, but it already was before the injury.

I'm skiing again, which is GREAT! I still can't really do much in the way of any cardio. Even riding a bike is kind of tough because I can't push my right toe down has far as I can the left. I'm pretty sure the tendon is lengthened to the point where I never will be able to, and I'm also pretty sure that part of the reason for that is going non-surgery... since I'm relying on my body growing accross the gap, rather than re-connecting the tendon to it's original length.

It's been 9 months, so I guess if I put in perspective that I can do light weight with my legs and I can ski, that overall I'm doing pretty decently in my recovery. Obviously, I'd like it to be faster, but what can you do?

[XXX-er]

How is your recovery coming shorty? When I blew mine, they didn't even mention a non-surgical option. It was simply, "how soon can you have surgery." Difference between U.S. and Canadian healthcare? (don't mean that last bit to be in anyway political.) Is there a difference in treatment/outcomes if one has a "tear" (I know they come in degrees) vs. a full rupture?

Trying to get the lowdown for when I blow my other one.

My bud who got the surgery was dealing with a surgeon in Northern BC who gave him the 2 options, explained the pro's/con's and then told him he should quit beating the shit out of his body

So the same universal HC, perhaps a difference between province of alberta vs BC but I doubt it and besides those fucking Albertans over in Mordor got lots of money

I am probably ^^ being political?

[waxman]

shorty j what r u doing for rehab? have you checked out the athlete factory?
the are great at bringing back athletes from injury and/ot making you better/stronger/faster

[Shorty_J]

I am probably ^^ being political?

Ha ha... you tell me?

shorty j what r u doing for rehab? have you checked out the athlete factory?
the are great at bringing back athletes from injury and/ot making you better/stronger/faster

I stretch it when I think of it, try to do some simple single leg exercises on the bad leg, some massage... but mostly I just walk around on it.

[waxman]

well if you are interested in the new year PM me and i'll see if i can get you a couple sessions

[AdironRider]

Im a little late to the party but I had a partial rupture 3 ski seasons ago now on the first day WROD. Came to a hard toe side stop on the snowboard and felt it jab at me, but no violent fall or anything. I actually waited tables on it for a couple weeks but when I got back on the board it was screaming.

I went with Dr. Jost here in Jackson and went with non-surgery. If I recall correctly it was due to it being a partial rupture and not a full blown tear, which probably wouldnt required surgery.

Based on her recco, while I am at increased risk for retearing it, the recovery time would be shorter and due to my timing I didnt want to lose two full ski seasons.

The most important thing to remember with an Achilles is it just takes time. Lots of it. I was in a boot for 3 months, crutches for another month still after that, then a walking boot for a couple weeks. PT religiously for 6 months total. Even after all that, it still took the better part of a year before it wasnt an issue. To this day it still feels tight, but honestly stronger than the other, non torn one at this point.

So I wouldnt be opposed to going the non-surgical route. Cheaper, shorter recovery time, etc. That being said, I would not be taking these skiing after 6-8 weeks as the rule but more the exception. I know in my healing process I wasnt even close to that kind of activity until after I was fully out of the boot and done 6 months of PT. Did it suck? Oh yes, but Im glad I had patience with the issue and its paying dividends now. Dont rush back or you'll never be the same.

[Shorty_J]

well if you are interested in the new year PM me and i'll see if i can get you a couple sessions

Definitely interested... I'm always up for anything that will help this along. Thanks!

[KBP]

My doctor recommended surgery for faster recovery and small chance of recurrence. 10 months post surgery I'm back on skis with 10% loss of strength and some neuropathy. Hoping time is on my side.

[Shorty_J]

My bud who got the surgery was dealing with a surgeon in Northern BC who gave him the 2 options, explained the pro's/con's and then told him he should quit beating the shit out of his body

So the same universal HC, perhaps a difference between province of alberta vs BC but I doubt it and besides those fucking Albertans over in Mordor got lots of money

I am probably ^^ being political?

Read this quote today and thought it seemed relevant...


‎"We don't stop playing because we grow old, we grow old because we stop playing." - George Bernard Shaw


I'm going to continue to beat the shit out of my body until I can't anymore.

[ill-advised strategy]

I am back on newer krypton pros, which I love, but I still have the feeling/fear that I could bend the boot in half under extreme conditions.

Once I cratered into an unexpected cat track in flat light and hit my head on my ski without releasing from my bindings in a pair of daleboots. I was like "ok, definitely too soft." I had a muscle strain that could easily have been a ruptured achilles. Soft boots seem to come with that risk.

[ipmcc]

I recently ruptured my Achilles while skiing. I was wearing Head Raptor 115 boots. Here's the story...

It was the first day of the season, and maybe I had buckled my boots weirdly at the end of last season or something and I just could not get my left boot feeling right. It was pinching me in some non-obvious way, seemingly no matter what I tried. After a half dozen runs (and as many attempts to re-adjust the left boot) I decided to loosen it all the way (still latched, just all the buckles on the loosest setting that still grabbed any tension) and do a green trail to see if the left boot would work itself out.

About half way down this groomed, cruiser trail, off to the left, I see what looks like a stash of fresh snow. The resort had gotten 11" two nights before, and they had just opened this section of the mountain, so it seemed plausible. I tip into this section, and quickly realize that it's really a bunch of groomer detritus, and is effectively just a bunch of ice boulders covered in a thin layer of fresh snow. I made it about halfway through this crap stash, when my left ski gets caught underneath one of these ice balls. The ski stops. I keep going. My right binding released at the toe from the twisting motion, and eventually left releases, but not soon enough. I felt a *hot* pain in my left ankle, but I didn't experience any "popping" sensation, so I was hopeful that it was just a bad hyper-extension. As I was sitting there debating whether to try and ski down or not, the safety patrol showed up, and convinced me to accept a ride in, although (in the interests of my dignity) they let me ride bitch on the snowmobile instead of in a sled. While sitting there waiting for the snowmobile, we saw at least a half dozen other people bite it in this deceiving section of snow (although none anywhere near as seriously as me), and while at Ski Patrol I overheard them talking about roping it off on the radio, so I assumed the carnage was continuing after we left.

When I got to Ski Patrol ER-type-place they evaluated my leg, and they also thought that it was not fully ruptured, but this guy was just a ski patroller and not an orthopedist, and encouraged me to see an ortho guy if it didn't get better in a day or two. I saw an orthopedist a few days later, and he told me, flat out, that my Achilles tendon was fully ruptured, and that my season was over. The doctors explained the various options, and I've elected to have the open surgery. I am currently killing time (i.e. rest, ice, compression, elevation) until my surgery after the holiday. Then I'll be casted for a week at a time until they are satisfied with the healing of the incision. Then I begin "3-6 months" of rehab. The surgeon said that if everything goes well, I could *maybe* catch the very tail end of the AK ski season.

Medically, so far, I've been really satisfied with my treatment here in Pennsylvania. Mentally, I'm really bummed. I had 25 days of skiing planned for this season after saving up PTO and money for the last three years. I've lost thousands in non-refundable expenses. (Trying to sell my spot at Mustang Powder on the marketplace board currently.) It's a crappy situation, but I'm hoping for the best!

I read through all the posts here, and it sounds like there is a wide variety of experiences with this injury. Here's hoping mine is one of the easier stories when I get to the end of it.

[smitty3063]

I recently got in a decent sized avalanche in Germany. My left ski never ejected and the pressure from the snow when it settled put my foot in an contorted position. I luckily survived due to my ABS bag (highly recommend buying one) and a great friend, but had what I thought was a sore calf muscle from the strain when freed. After being stubborn for a week, hobbling around flat footed, I finally started researching my symptoms and decided to get it looked at.

The Thompson test showed that it is damaged, but I haven't gotten an MRI yet cause they said I need to commit for surgery first????. I am in a boot now and hoping that it is just a tear and not fully ruptured. Is it possible to fail the test with just a tear? I have full range of motion and little pain. Only things I can't do is lift my heel off the ground in a stand still and use the ball of my foot when walking. Really confused on my options due to my doctors lack of english, but pretty sure he conveyed that there is no difference whether I have surgery or not.

The injury occurred eight days ago. I have to decide in two days if I want surgery or not. I am 30 years old, 6'1", 210 pounds, active triathlete in the summer, put 110 on snow last year, and enjoy racket sports as well. Any recommendations?

Also, how soon can you start swimming? I need something to keep me from putting on the lbs this winter if I'm going to be holed up for a few months. Thanks in advance for any advice and I feel all your pain on having to watch it snow without being able to ski.

[rod9301]

If you failed the thompson test and you can't lift your heel, tendon is probably broken.

Commit to surgery, get mri, and then decide.

[eskido]

My ortho new immediately mine was gone, I would assume most would. If there's a question about it you absolutely need to get that MRI ASAP so you can moving on rehab.

[eskido]

With surgery, I figure your swimming in 5-6 weeks (soon as they let they let the toes down). partial tear with no surgery, I have no idea, I'd guess a couple weeks

[sierraskier]

If you failed the thompson test and you can't lift your heel, tendon is probably broken.

Commit to surgery, get mri, and then decide.

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.

[smitty3063]

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......

[ipmcc]

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.

[ipmcc]

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.

[ipmcc]

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.

[smitty3063]

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.

[ipmcc]

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!

[ipmcc]

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:



@smitty3063 hope you're doing well.

[ipmcc]

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.

[smitty3063]

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.