Achilles Rupture Recovery

< last edited Nov 18th – still a Work-in-Progress >

After rupturing my Achilles, I returned home somewhere around 7pm on a Sunday evening. The treatment at the hospital had been excellent, I felt at the time (and still do, at 4 weeks post-injury). Nevertheless, although I’d been told the next step would be to get an MRI done and, on the basis of that, one could decide whether an operation was necessary or not, I had been given essentially no information on the subject whatsoever. Kinda par for the course, I find, with most doctors in general and hospitals in particular – they’re there to ‘treat’ you, not educate you.

Now, over the period of quite a few years before the rupture, I had tendon problems on and off – a couple from running (both knee and Achilles, both sides), also from climbing (golfer’s elbow – like tennis elbow but on the inside instead of the outside, also both sides). As a result, I learned a few things over the years … kind of enough to know that I knew practically nothing about the subject, but still, more than absolutely nothing … things like:

• Tendons take WAAAY longer to adjust to new loading than muscles: once I learned this, it was easy to understand why most tendon problems happen … when one progresses at the speed of the muscle growth, it is pre-programmed that you will have tendon problems of one kind or another, whether feet, fingers, legs, arms, whatever. Amazingly, a sports doctor I consulted about taking up sport again around the age of 45 never mentioned this … would have saved me a lot of problems;
• Their blood supply is WAAAY worse than muscles – once you do damage them, they take absolutely fricking ages to mend (my first case of golfer’s elbow took around 9 months to be banished from the world);
• You also need to load them for them to get better (just resting them is generally the worst thing you can do) … but not overload them … and seemingly pretty much no one can tell you where the border is. You’ll only know when it’s too late, perhaps even a lot too late. So best take it easy, but do SOMETHING rather than nothing;
• What a ruptured Achilles tendon was, what the signs were – hence I’d recognised it straight away (one good reason I didn’t end up being one of the ‘walking wounded’, i.e. not knowing and not going to the ER until weeks or even months down the line – seemingly surprisingly common);
• A certain doctor dedicated decades of his life and his team’s time to, amongst other things, severing rats’ Achilles tendons … these would grow back inside days, without any treatment, to the point where the rats would be running around again like nothing had happened in no time at all.

So, that evening, it seemed most sensible to get researching – whilst it was (and still is) clear to me that no one becomes an experienced doctor overnight by spending a few hours googling, it seemed the best thing I could do was arm myself with a little bit of knowledge with regards to treatment options for a ruptured Achilles; self-educating had helped me in the past to deel with my multiple cases of golfer’s elbow, as well as other things – not that it made me an expert, BUT it can put you in a position at least to know what questions to ask instead of being completely helpless in the hands of someone who, worst-case, is absolutely the wrong person to be treating you but you simply aren’t aware of it.

In any case, I couldn’t sleep at all; going for a walk in the evening (as I had enjoyed many times before in such cases) was also not happening … so why not? My starting place was looking for white papers on the topic … I also carried on collecting over the next few weeks, and these, below, are the ones I made a record of:

My most pressing subject at the beginning was: what are the differences between operative and non-operative treatment?

As I progressed along the non-operative timeline, I learned that, seemingly worse than a re-rupture would be an elongated ‘healed’ tendon … this lead to the question in my head: does an elongated tendon really correlate to a significant deficit in functional outcome? (coupled with: can one recognise it as it’s happening / what does one do to avoid it?)

Now, I’ve collected these links; I also think it makes sense to read them otherwise I wouldn’t have collated them. HOWEVER, please don’t forget that these are all statistic-based ‘experimental processes’ with external motivations behind them; YOU, dear reader, are a single person … and these statistics just don’t really apply to you as a single person (the knowledge in general is of course relevant).

On top, there’s the old adage: never believe a statistic (or study) that you didn’t fake yourself. Yes, I’m cynical … but I have my name on a couple of white papers and have seen what it can be like ‘behind the scenes’; in other cases, some data sets on graphs I’ve seen look like a blunderbuss fired at a barn door from 50 paces … and yet somebody drew a handful of lines ‘through’ some of those points as if those points clearly defined an accurate mathematical formula; in some cases, those lines form the basis of the summary of a white paper … and that summary is typically what is then communicated around the world as a ‘fact’. In our particular injury case, there are a few prime examples such as:

• Folks going down the non-operative path are more likely to experience a re-rupture;
• Those opting for surgery will have a faster and better return to sports, particularly the explosive performance part of those sports.

At the moment (just 4 weeks into this ‘ride’), I still don’t really have a clear view of enough to make a call even for me, let alone put it into text here for others to read, BUT what is clear is that the simplified regurgitation of individual statistics is very easy to swallow for people, and thus will be readily accepted as a concrete truth. This is the basis for ‘fake news’, Donald Trump style (him issuing such, rather than him being correct when he calls others out for issuing such ‘fake news’). So, my word to you, dear reader, if you are really interested in knowing ‘the truth’ (which doesn’t really exist, there are just different versions of some kind of light grey / dark grey data), be skeptical of such numbers, at the very least, and at best, look for the motives behind any ‘proof’ of the one or the other type of treatment, problem, whatever.

What I can say with absolute surety: there are no ‘clones’ in this world that we know of, where anyone (read any two cloned copies) has (have) gone through _exactly_ the same healing process so as to be able to provide _absolute_ proof of any healing theories. Rather, every single statement you will come across is based upon some statistical ‘evidence’ gleaned from some physical process (paid for by some body (not somebody) – don’t forget this) that some system has ‘parred down’ into some kind of data set which can be put into a white paper … and some people are REALLY hot on getting their white papers published for a whole bunch of reasons.

No conspiracy theories. Just a healthy degree of skepticism on my behalf. Put another way: I’m ‘just’ asking you to question any statements thrown at you in an easy-to-swallow package which is supposed to point you in any particular direction. Your choice, whether you just swallow the red or the blue pill; or whether you ask who is manufacturing those pills, what’s in them, why you are supposed to be swallowing them, what’s going to happen if you do (or don’t!), etc. etc. etc.

Anyway, whatever happens, whatever your thoughts: I wish you all the best with your recovery; I also hope you will garner plenty of positive things from this long healing process as I am doing … really: yes, it’s a shitty injury, no two ways about it, BUT it has plenty of positive ‘side effects’ if you’re open to seeing and acknowledging them. Good luck!