Is a ruptured Achilles tendon the end of her sporting life?

Dear Gary,
I have a friend who is 35 yrs old, with young children, who has just ruptured her Achilles and is now in her third week of plaster. She was advised by a Specialist this week that her life will have to change now she has had this injury… his words “if you were a good tennis player before this injury then you will be a bad one for the rest of your life now”. I am enquiring on her behalf if her life will be as bad as this “expert” claimed as he has totally depressed my friend and she still has weeks left in plaster. He also informed her that she would be at great risk to snap in again if she is not very careful in the future. Can you offer any words of encouragement, advice?
Regards.
R.
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Gary comments:
There is hope - a ton of it.
As somebody who has seriously injured both achilles, including one partial rupture requiring 12 weeks in plaster, I can understand partially the distress your friend is going through right now. The good news is recovery can be complete and there are more successes than failures. I am a good example of that and so is my sister, Lorraine, who underwent at least one achilles operation and still managed to win a bronze Olympic medal. There is hope. That's for sure.

An achilles tendon rupture is a nasty, catastrophic injury and the best resources and expertise need to be mustered to ensure the fullest recovery. If it was a complete rupture, as you appear to imply, then the general consensus is that the tendon be surgically sewn back together and then immobilised for several weeks. If that has not been done for your friend, it is probably too late. This method of repair generally gives a faster and fuller recovery than placing the leg in plaster and hoping that ends meet and join back up again.

It is when the plaster comes off that the hard work really begins. Especially if the tendon was not sewn then extreme care must be taken when gradually mobilising the ankle because reinjury can happen without warning. Many years ago when I was working in the physio department of Dunedin Hospital, a young physio was giving a patient with a post achilles rupture some heel raise exercises. There was an audible snapping as the tendon snapped again. It was hard to tell who was the most upset - the patient or the physio. The lesson here is not to push things - to take one's time for a good 12 weeks or so after the plaster comes off while the tendon completes its recovery. Seek the services of a physiotherapist who has been working for several years, rather than an inexperienced Young Gun.

Recovery is probably well on the way about 12 weeks after getting out of plaster, but it is that final 10% that might take a good one-two years to be completed. The initial stages should be guided by an experienced physiotherapist who can guide your friend.

In the meantime, she is in plaster, and there are several extremely positive things she can do to aid her recovery:

Get into a gym and work out vigorously:

• It is only the bottom part of one leg that is immobilised - the rest of the body is in perfect order, so here is an opportunity to get super fit, including working on all those lose and soft bits. Being super fit will improve circulation to the injured area and ensure that she does not put on excess weight which could be a burden on her leg when the plaster comes off.

Improve nutrition and healing:

• Take some glucosamine and chondroitin which aids tendon as well as joint healing
• Take up to 4,000mg of MSM per day. Perfect for tendons and fantastic for skin, hair and nails and a natural anti-inflammatory
• Take up to 2,000mg of vitamin C per day for the same reasons as the MSM
• The same advice applies for vitamin E which is traditionally used for softening scar and for promoting healing.

All of these are available through http://www.myotec.co.nz/

The good news is that a properly treated and rehabilitated achiiles tendon is very strong. Some argue that it can be stronger. I tend to agree. My experience is that if an achilles is going to rupture again 1-2 years following the first time, it is usually the other one! (Not sure if that is good or bad news??).