How did it come about?
I was playing soccer with some friends when it felt as if someone kicked me "hard" in the back of my right leg. It felt like my calf muscle was numb. I limped around and tried to continue playing but could not push off on my toes and after 10 or so minutes had to go and sit it out.
Recalling what I was doing at the time of the injury I remembered that I was making a hard left turn when I had a sudden pain. I did not hear anything only felt the instant pain and lack of control with my foot. It was not a great pain, I would liken it to a charlie horse in the leg.
What may have contributed to the injury is that I had not played soccer or any running field sport for a couple years, and we were playing on artificial turf, and that turf was likely the key. I was enjoying the quick starts, stops, and turns but maybe a little too much. I am not out of shape and cycle a lot, just nothing high impact like this. And yes, I had stretched and warmed up.
Diagnosis...
When my leg strength did not return the next day I decided to go to my family doctor and see what was up. He did not initially think that anything was wrong and thought that the muscle may just be traumatized from the impact that I thought it had received. But I pointed out that there seemed to be a drop off at the point where my tendon connects to my heal, when compared to my other leg you could see and feel that there was a thick pencil like tendon that went up the back of the ancle, but on the other side it seemed to just fall off to a blank area with no connection.
He sent me to get an MRI, which actually is probably not necessary, there is a simple test called a "Thompson's Test" where you lay on your belly with your knee bent to a 90 degree angle straight up in the air and have someone squeeze the calf muscle. You can test this out on your good leg and see that your foot will automatically react by moving when you squeeze. On the leg where the tendon is ruptured (torn) it will not move. Also note that it could be a partial rupture, but a partial rupture is rare, very rare according to the surgen who repaired my tendon.
I took the MRI images to the specialist / surgen who would be repairing my leg. He had less than 5 minutes with the images before I saw him, and I am not even sure that he looked at them at all. He came in and did the "Thompson's Test" on me, told me that the tendon was fully ruptured, and explained my options for recovery. This was on Wednesday March 10th 2010.
Repair Options
Surgical - Partial leg cast with the foot at a neutral angle after surgery for several weeks, every 2 weeks getting a new cast and putting the foot in a new position moving slowly to a 90 degree angle.
Non-surgical - Full leg cast, putting the knee part of the leg at a 90 degree angle so that the tendon can come back together and the foot at a neutral angle for the duration of the healing process. This process has a higher re-injury rate...
I went with the surgery as that was most common for people my age, and what the doctor recommended. Both have similar time frames as far as full recovery but you are on your foot sooner with the surgery method from what I could tell. My surgery was scheduled for Tuesday March 16 2010. (Interestingly the same day that the famous soccer player "David Beckham" would have surgery for the same thing but on his left leg.) By the way, this surgery is supposed to happen as soon as possible after the injury!
Surgery day...
The day of surgery came, March 16, 2010, and I went under at about 10:AM. I only remember being hooked up to the IV and then told that I would be moved to the surgical table on my belly for the surgery. They also said that I would have a breathing tube inserted while I was out but it would be removed before I came back around. Very soon after these instructions, I was out...
I awoke in my room and my throat was very dry and soar due to the breathing tube. I think that it took me a couple days to find my voice and talk right again. My lower leg was in a splint (Half cast) and wrapped in an ace bandage to keep it in place. I remained in the hospital until I was able to go to the bathroom, about 8:PM. Which by the way is not easy because of the medication used to put you out. I literally had to push just to get a trickle... this problem lasted for the next 12 - 24 hours but got easier as time went by. My bladder did feel like it was going to burst though and I recommend going back to the hospital if this continues to get a catheter to relieve the pressure if it gets too intense.
That night my ancle started to throb and ach intensely. I called my doctor to see if this was normal. It was 10:PM when I called. He said that I could unwrap it and re-wrap it to see if that would help. Immediately after unwrapping the pain went away. when I re-wrapped the pain would return after about 5 minutes. I tried a lot of different things to alive the pain but the pain pills were not helping and after a very long sleepless night at 8:AM I called the doctors office to see what they could do, I was convinced at this point that the cast was pushing my heel into an unnatural position.
They did not immediately think that I needed to do anything, that this was normal and wanted to see me the next day. I explained that I had little to no sleep all night because of the throbbing in my leg and could not do this another 24 hours, I needed sleep! I told them that I was VERY cranky, and that solution was not acceptable and that if they could not or would not see me that day that I would just go to the emergency room at the local hospital when I hung up the phone to get it looked at. After a short pause, they said to just come on in.
When they looked at my leg, the cast/splint was in 2 overlapping but separate sections which I guess was not normal and may be the cause of the problem. After getting a new splint put on the pain went away and did not return... I am very glad that I insisted that they looked at it, I proceeded to sleep several hours that day.
Cast #1
After a week (May 24, 2010) in the splint they removed the wrapping and the stitches from the back of my leg and applied surgical tape to the stitched area to keep tension on the stitched area. They fitted me in my first cast still in a neutral (relaxed) position for my foot (like shown in the picture).
Cast #2
After 2 weeks I got another cast, April 7, 2010, in this case they pushed my foot closer to a 90 degree angle. The pressure was uncomfortable but after a couple hours I did not even notice any more. I am still not allowed to put any weight on my leg after getting this cast put on. Crutches sucked, and I had a vacation to Florida beach in the next 2 weeks. I hopped a lot on the beach and played frisbee and other things. Took some short walks down the beach on crutches and things like that. I had also picked up a water sock to put over my leg so that I could take showers and even get in the ocean. It worked well and was not too hard to use. The one I bought was a XeroSock that I found on Amazon. I only used it a couple times to swim but all of the time for the shower, it never failed. I recommend getting one of these things for any cast!
Cast #3
After 2 more weeks I got another cast, April 21, 2010, in this case they pushed my foot to a 90 degree angle. This cast was fitted with a kind of shoe that strapped on to the cast and considered a walking cast. I was allowed to put up to 30 lbs of pressure on the leg while walking with my crutches.
Into the Boot
After 2 more weeks, May 5, 2010, I was moved into a boot with an elevated heel. I was allowed to put as much weight on my leg as I wanted or felt comfortable doing. To me this meant throw away the crutches, and I did! However I doubt that is what the doctor would have intended me to do, but I was tired of those things and felt as if I could walk fine without them. Not without a little help for my foot though.
Right after the appointment I went home and washed my leg! It was a long time coming and felt great afterwords. I also discovered that it was impossible to just walk on my foot, particularly my heel. I had to do something to allow me to more easily take a shower. I found that a pair of Crock like sandals that could get wet were the ticket.
The heel of my foot had lost its pad, so walking on anything was very painful. I had some old Birkenstocks that had a footbed insert, I put that footbed in the boot with the lift and instantly the pain was gone and I could walk comfortably.
Stretching - at this point you are supposed to use a towel to stretch the calf lightly, you are not to stretch like with getting ready to run, thats too much tension. I use a towel to pull lightly on the foot and stretch the calf out daily or even a couple times a day from now on as the doctor instructed me to do.
No more boot, in a lifted heel now
After 2 more weeks, May 20, 2010, I did not have to use the boot anymore. This takes some getting used to. At this point I still cannot walk bare footed, I need something on that heel, its getting better but the padding is not there yet.
I visited my shoe repair man and got some custom lift inserts under the footbeds in my Birkenstock shoes (Not sandals) so that I had something comfortable to walk in with a lift. That was great!
I have jumped in and started getting to the neglected yard work while being careful not to over do it on that leg. Stairs are a challenge and I find that if I use my heel on the stairs going down its pretty easy, but to be careful not to slip or roll my ancle. I normally take 2 stairs at a time going up and climb a lot of them daily, I cannot do it except with the (right) hurt leg because I cannot push off with it. So right leg takes 2 and left only one till my right can push with the ancle.
There is not enough strength in my calf to lift my body weight or walk without a limp but thats ok, its slowly getting better. Its kind of like walking around while pointing your toes up on your leg, you just cannot push off.
My doctor says that he will not send me to physical therapy, says that I am the type that he tries to keep from doing too much, and he is right... I don't sit still and probably push things a little too much, the doctor said that he knows I am doing too much, but I try to keep from screwing up my leg again. Don't want to do surgery again!
No more lifted heel
After 2 more weeks, June 2, 2010, I took the lifts out of my shoes and have been walking around in comfortable shoes and sandals. Still cannot push off, not enough strength yet, not to mention it hurts to do so.
I will start riding an exercise bike to get some strength back, I actually have started riding it before this point and even in the boot stage to see if I could but not enough to put into those sections. I actually have a low riding recumbent trike bicycle that I can ride. It allows me to keep my feet on the pedals so that I do not have to put my leg out in an emergency to catch myself and hurt the tendon again. I feel as if it's safe and will start riding the 10 miles to work again but put most of the work on my good leg. I ride with cleats that lock my shoe to the pedal like a ski binding so that my feet can pull as well as push. I will pull mostly with my right leg but push lightly to give it some work.
Calfs - I don't like the look of my calfs, one has a large bulge where the muscle is, but the injured one is a straight peg looking leg with no definition where the muscle is, its going to take a little time for that to return. Actually its important to state that it takes up to 9 months for a full recovery, to get back to pre injury state.
