Freak Accident

[Oso]

this sucks ass


the guy i've been sparring with who was going to do the toughman this coming weekend injured his achilles today.

he was having a go with one of my students and in the process of shifting/stepping forward to punch something 'popped' loud enough to be heard throughout the room and he had to stop.

it appears as if he has torn his achilles at least partially :(:(:(

he had warmed up well with jump rope and bodyweight squats and abs and had done some light stretching but....

i'd never examined his ankles before but there was a very visible difference to the way the back of his ankle looked compared to the other and he could not point his toes on that foot.

He's definitely going to the doc.

anyone experience this type of injury?

[cjurakpt]

not personally, but I've been involved in the rehab aspect; although I can't say for certain, it sounds pretty much like you've got what you thought you got, between the pop and the visible deformation and inability to plantaflex (toe point); he's going to be on the sidelines for a while, depending on what the course of treatment will be (surgical repair vs. healing on its own - I'm gonna guess the former in this case based on the description of the presentation); obviously he's gonna need rehab after the fact to get range, strength etc. back; make sure he finds a good place for that, one that focuses on sports rehab...
sorry to hear about it...no fun...

[Oso]

thanks, i was hoping you were hanging about.

he was pretty down and trying to make less of it than it seemed to be (imagine that) so I was trying to make sure he was going to go see someone soon.

it was really weird, he and I had done 3 rounds at full contact and he was running through everyone in the school at a much lighter level (everyone else being a student of his or mine) before we went again. So, he wasn't stressing it hard or anything...i had my eyes on him when it happened...he was just moving forward fairly casually.

he's relatively young at 33 so he can come back from it. He's had plans for this toughman and for a trip to europe to do some fighting in June. I feel bad for him.

[herb ox]

I've heard that rupture of the Achilles tendon happens most often to men in their early 30's - it would seem to affect the more athletic type given the type of strain placed on the tendon while exercising. I have suffered from a tendonitis of the Achilles for about two years now - there's a palpable swelling about midway down the tendon where I believe microscopic tears have caused scar tissue to build up.

I attribute this to not warming up properly and neglecting to stretch my gastroc regularly - I'd often jump into practice (literally) using a 'light' form to warm up. Problem is, in the system I've studied, there's a lot of low stances, reverse bows, and jumps from a sweep. Only recently have I realized these were the techniques that were aggrivating my tendon. After analyzing my form, I realized I was 'cheating' on these techniques by launching from my toes, rather than digging my heel into the ground, thus placing enormous stress on the tendon while it is in its most extended, stretched position. This was further exacerbated (IMHO) by the abundance of right foot stomps in Northern Shaolin.

Needless to say, I'm re-evaluating my technique - after 10 years of practice, I feel like a perpetual beginner... maybe that's a good thing.

peace

herb ox

[Oso]

herb ox: i'd basically agree except that I saw him warm up. pretty thorough and complete, imo.

[kwaichang]

I have treated a number of Men who have ruptured their Achilles, " I was watching Troy as I read this" anyway rehab is not that big a deal with this just slow progression and mke sure he gets scar massage to release any scar tissue otherwise he will have decreased Power and ROM "range of motion". Good luck to him. KC

[BoulderDawg]

Sometimes things just happen for no reason.

It seems like about once every two years or so I'll through a period of severe back pain for 2-3 weeks where I can barely stand or walk. Usually this comes on without warning and for no reason I can see. I might be bending over the sink and find that I cannot straighten back out.

[Charles T Rose]

I dont believe injureis happen for no reason.
Something somewhere in the bio-mechanical chain was off and overcompensation may be the culprit.
It could come from a previous injury that seems un-related, it could come from a mis-aligned hip,knee,pelvis or ankle.

Back spasms,which I also suffer from,can be traced back to anywhere between the neck to the ankles.

[Judge Pen]

That's horrible news to hear. This is one injury that I fear will happen to me (along with the shoulder).

Let him know that I'm wishing him a speedy recovery. He's a tough guy, I'm sure he'll be back stonger than ever.

[The Willow Sword]

Massage would be Contraindicated at this point. With such a fresh injury its best of he get options as to how to quickly heal the Achilles tendon. After surgery is done to reattach or the even longer process of the tendon trying to heal itself, there will be, in any case, some limited Range of motion and the PT is definately the way to go and THEN the Massage(light) would be beneficial. I would reccomend that the whole leg be worked on massage wise, especially the gastroc and the soleus(AFTER Surgery and the initial PT).

Ouchie,,TWS

[SevenStar]

Has he seen a doc yet?

[Oso]

he had an MRI done this afternoon...he said he'd call me tomorrow when he got the results.

**** stubborn fighty guys...he's worked the past two days on it.

I think he said he wrapped it but that he couldn't miss work. i know how it is but I wish he would have stayed off of it.

i'll post any developments.

[Oso]

just talked to him.

the tendon is almost completely torn in two...which is what it certainly looked like.

he's going to be scheduled for surgery soon.

he said something about a special 'boot' for post surgery.??? cjurakpt?

[cjurakpt]

Sometimes things just happen for no reason.

It seems like about once every two years or so I'll through a period of severe back pain for 2-3 weeks where I can barely stand or walk. Usually this comes on without warning and for no reason I can see. I might be bending over the sink and find that I cannot straighten back out.

there are a number of very logical reasons why this happens (what you describe is actually not that uncommon, I've seen it many times), as well as a couple of ways that you might actually be able to "see it coming" before your symptoms hit you and avoid the whole episode, but then again, what the heck do I know, obviouus fraud that I am...:rolleyes:

[cjurakpt]

I dont believe injureis happen for no reason.
Something somewhere in the bio-mechanical chain was off and overcompensation may be the culprit.
It could come from a previous injury that seems un-related, it could come from a mis-aligned hip,knee,pelvis or ankle.

Back spasms,which I also suffer from,can be traced back to anywhere between the neck to the ankles.

this is one of the most insightful, accurate and correct comments I've read in a long time, and I would verify it based on my cliical experience: for example, I 've had numerous instances of clearing up low back pain by treating a shoulder, o rneck pain / headacxhes by treating the pelvis; one of my old manual therapy teachers used to refer to the body as the craniopedal complex to underscore the above...

and yes, everything happens for a reason, it's just sometimes you are clueless as to why for any number of reasons: a good theraist will teach you how to see those things coming down the pike, and how to self-manage so that you can avoid flair-ups and unecessary treatments

[cjurakpt]

just talked to him.

the tendon is almost completely torn in two...which is what it certainly looked like.

he's going to be scheduled for surgery soon.

he said something about a special 'boot' for post surgery.??? cjurakpt?

typically they put you into some sort of walking boot / cast that allows you to bear weight - the cast / boot is usually positioned into a degree of plantarflexion (toes pointing down) to give the repair a chance to heal when not on stretch, and then the angle of the plantarflexion is slowly decreased towards neutral to stretch out the area; this can be done with mobilization / rehab (the boot is removeable) - it depends a lot on the surgeon, typically they subscribe to a specific protocol that the PT's working with them follow (not to say the PT isn't involved in clinical decision making; in fact the protocol can easily be collaborative)

good luck - it's a fairly standard procedure for surg and rehab (make sure it's a sport oriented place, I imagine they'll be doing a fair amount of ploy at the back end), if he sticks with it he'll do ok, and should be able to pretty much do what he wants afterwards

[Yum Cha]

Yea, I had that happen to me in my mid 30's too. I think thats when you still have the youthful strength and reflex, but the body has begins to degenerate.

kinda sux.

I was playing basketball, did a shake and bake to a drive and thought someone had run around behind me and tread on my ankle. I felt the pop, big time.

Not much pain, at least not at first....

It happened after a good 2 hours of shooting hoops at about 6pm, all warmed up and loose. Had Surgery at 11pm (oh yea! inefficient, wasteful socialised medicine....not!) and 3 days in the hospital. Got home on the 4th day, and when the pethadine wore off, the fire started and burned for 2 weeks. Forget any walking cast, simply lowering the leg was like dipping it in napalm for the first week.

After the cast came off and the stitches came out, I got chinese medicine treatment. I was supposed to go back after a month of settling down to start physio, and the physio sent me away saying no need, as I had full mobility back. Thank you Sifu.

It took me a year before I felt secure enough to do jumping kicks off that foot, 2 years to quit favouring it psychologically.

And to add insult to injury, the nurse said, gee, most the time we get fat guys playing raquet ball with blown achillies....

Weight plays a big part, and genetics. I seem to remember something like a 16:1 ration of weight to load. i.e. every pound you carry translates to 16 lbs on the tendon. I don't feel warm up had anything to do with it.

I was warned as well, that it is quite common to blow the other one later on....

It is the sudden accelleration that does it, and guys that have fast reflexes put an extra load on the tendon.

The injury does train you to come off your toes and onto your heels, for sure.

I still reckon it was better than blowing a knee....

[Oso]

CJ: thanks for the insight. you too Yum Cha.

i had one of those walking casts when I broke the fibula in my right leg...i'm supposeing this one will be different though.

there are a large number of sports oriented clinics up here but he's about 45 min away...i'll see where he's headed. he may not have too many choices depending on his insurance...he just changed jobs.

but, my girl has worked at a private PT clinic who's specialized in sports rehab...maybe we can hook him up after surgery.

sounds maybe kinda corny but this guy has quickly became a part of our school's family...most importantly for me as a training partner and secondly, as he knocks the crap out of me, he's helped me illustrate the point to my students that style doesn't matter and being a teacher doesn't mean you're invincible.

[Shaolinlueb]

he stretched and warmed up but something contracted and pulled at the same time and muscle reflexes kicked in and it tore. thank god its not a full tear. if he was really flexible in that part it might have torn fully because his muscle ref;ex would have been greater. i wish him well and to get a good recovery. hope it gets 100% before he begins. anyone that has suffered an injury doing something they love "we always start it up before the doctor says we can." i hope he still gets to compete in tough guy later on.

[Oso]

Thanks, SL.


this has made me think about something.

All through my kung fu career, there has been a major emphasis on stretching the achilles. Much more so than even the 4 years of cross country I did in HS. The first 'style' which had the most emphasis was the tai chi/xing yi/ba gua stint I did and the second is Pong Lai.

I think that if I had to say specifically where the major emphasis on warming and stretching was in the warmup I use and teach then I would say #1 spine and #2 achilles/calf.

no conclusions yet... just thinking about it.

[Lama Pai Sifu]

there are a number of very logical reasons why this happens (what you describe is actually not that uncommon, I've seen it many times), as well as a couple of ways that you might actually be able to "see it coming" before your symptoms hit you and avoid the whole episode, but then again, what the heck do I know, obviouus fraud that I am...:rolleyes:

How dare you...dispensing helpful and credible information?!? You are a fraud, Sir!

Oh,..yeah..give me a call please...

MP