Back in the Saddle: My 14-Month Injury Hiatus

Back in the Saddle: My 14-Month Injury Hiatus

Page Type Page Type: Article
Activities Activities: Mountaineering

The Misfortune

Serious injury. Nobody likes to be majorly injured but for those of us used to an active lifestyle, it can be particularly traumatic from a mental standpoint. These are my personal reflections after having spent 14 months on the sidelines after a mishap at Joshua Tree.
Getting Ready at JTLast climbing--the day before the injury


I begin with the underwhelming story of how I got hurt. If you’re going to get seriously injured, ideally it should happen doing something like climbing a hard route or rescuing someone in dramatic fashion. Not me. I was climbing at JT with the California Mountaineering Club the weekend of December 5-6, 2009. We had had a good day of climbing on Saturday although it had been pretty windy and cool. Come Sunday morning, I had breakfast and decided to warm up for the day by taking a running start at and bounding up an 8-foot boulder near the campsite. I hadn’t been able to make it quite all the way to the top of the boulder so I decided to make maximum effort. I ran at the boulder hard and planted hard with my right foot on a tiny ledge on the boulder. CRAAAACK!! It was a loud sound and I felt the band that is my Achilles tendon separate. I landed on the ground and could put pressure on my foot if I rested back on the heel. Fortunately, I felt no pain. I knew what the injury was and confirmed it by sticking my finger into the gap at the back of my foot where the tendon had completely separated.

I told my buddies I would not be climbing today although I did not tell them how serious the injury was. They all encouraged me to try to “walk it off” but I knew that was futile. I took my leave and made the nearly 2 hour drive to an emergency health facility covered by my insurance.

Orthopedic Decisions

I first went to the emergency room. When I found out there was a “wellness” clinic I decided to go there as I figured I would be referred to an orthopedic surgeon quicker than waiting around in an emergency room. The Family Medicine doc who examined me gave me unwarranted hope when he told me it was a partial tear. But I suspected this was not the case and I turned out to be right.

I saw an orthopedic surgeon in short order. He put me in a cast and explained that surgery was an option, but that the tendon would also fully heal without surgery. He told me-and numerous other orthopedic surgeons I consulted confirmed—that the evidence is not entirely solid that surgery is the better option. They said the literature tilts in the direction that there is a less likely chance of reinjury when going the surgical route, so they advise athletes to go with surgery. Since I was not a college or professional athlete, I figured to forgo the surgery.

A week later when I saw the surgeon again I told him of my decision not to have surgery. I passed up an opportunity to have the surgery done that very afternoon. That weekend I decided to run my decision by my close friend and running buddy who lives across the street. He is a family medicine and sports medicine doc. He said if it were him, even as just a recreational athlete, he would go with the surgery without hesitation. I value his advice and it caused me to have second thoughts about my decision.

By Monday, I had changed my mind and called my surgeon to tell him I had decided to have the surgery after all. Alas, his schedule was by then fully booked past the period within which the surgery on a torn Achilles tendon should be done (within 10 days or so of the injury).

Fortunately, there are six docs who live right across the street from me. Again, fortunately, one is an orthopedic surgeon. So I went to Brad and explained my situation. Long story short, Brad set up surgery for me at his facility with his boss as my surgeon.

The Mental Hit

Snow Shoeing near Wrightwood, CAI was depressed about not being able to do things like this.

In the midst of all this I was struggling with the dark thoughts that I would not be climbing, or canyoneering, or running, or hiking, or even getting to go to the boring gym, for a long, long, time. Average time to heal an Achilles tear is 12 months. YRMV and I later talked to people who did not get to full healing for over 2 years! And I was dreading being in a cast and having to get around on crutches. It was a depressing time. Plus, as a litigation attorney, I had the extra challenge of getting around in a courtroom.
View Toward North face of Mt. Baldy from Grassy HollowMt. Baldy from Wrightwood area. I was missing scenes like this.

Surgery and Complications

Back to the surgery. It seemed to go fine. My surgeon, a wonderful personality named Bill, put me in a boot instead of a cast. This is a major advantage because you can remove the boot when you want. Still, it is miserable being on crutches. I took some falls during this time including one time when one of the crutches snapped in half. I was certain that I had reinjured the tendon and went to the emergency room but it turned out to be ok.

MY COMPLICATIONS began during the first week after surgery. Some abscesses developed along the scar line. They looked ghastly and they oozed. My running doc friend put me on antibiotics immediately. I went back to Bill my surgeon and he was optimistic the abscesses would heal soon. They didn’t. They oozed yucky stuff all the time, although it wasn’t pus, and I had to carefully bandage my foot each day.

THIS WENT ON FOR A YEAR. Actually, the tendon itself healed fully in half the time such injuries usually do. Mine healed in 6 months. So 6 months after injury I began doing some simple hikes. But the abscesses were still there and on one 7 hour hike the pressure from my hiking boot on the scar mashed the scar into hamburger. Now I had really done it. A plastic surgeon I consulted said I had set myself back to day one and that I should not expect to get back outdoors for another year at least from that time. Talk about depressing news!

More Time in the SP Forums

All during this time my usual steady pace of contributing TR’s and other pages to SummitPost came to a complete halt. That was frustrating. I began to spend more time in the forums discovering how nasty the exchanges can get within the SP community. But I even felt guilty about visiting the forums thinking that I really didn’t deserve to be talking about mountaineering and climbing subjects since I wasn’t doing any myself.

A Reluctant Second Surgery and Results

BACK TO MY LACK OF HEALING. So now I was approaching a year since my injury and my wound still had not closed. My ortho doc referred me to a plastic surgeon who advised against another surgery to see what was wrong because it would involve having to graft an artery and tissue from another part of my body. Not encouraging. My doc then brought in several other orthopedic surgeons to examine me. Three of them said the same thing. I ‘d had a bad reaction to the suture material (called Fibrewire) used to sew the tendon and the sutures needed to be removed. None had ever done this with an Achilles injury and they couldn’t opine on how difficult it might be.

My doc Bill was against the idea of going in to remove the sutures. What if he had to mangle the tendon to get all the sutures out? That would clearly mean reconstructing an Achilles tendon with the attendant complicated surgery and complicated healing. We decided to wait some more. But at the one year anniversary of my injury, my wound was still open and I could not wear shoes. Not a good situation. Finally, my doc and I decided we had no choice. Despite his lofty credentials and extensive experience, he had never done this procedure and I could tell he was nervous about it.

On December 16, 2010, over a year after my injury, I went under the knife again. When I woke up, Bill told me with a big smile that the procedure had gone smoothly and that the sutures had pulled right out. Now to see how the healing went. WITHIN FOUR DAYS MY WOUND HAD COMPLETELY CLOSED after having been open for over a year. I was on crutches only two weeks this time and within 4 weeks could walk in my boot. Praise the Lord! I was really healing.

About two months after the second surgery I began climbing back into the saddle. First, my son and I did a great snowshoe hike near the Wrightwood ski resort in the San Gabriel Mountains. I tested my foot further with a canyoneering outing in Bailey Canyon in the local mountains. No problems. IT FELT SO GOOD TO BE BACK OUTDOORS. My third outing was another canyoneering venture rappeling the thunderous waterfalls below Mt. Baldy in southern California. Next, I went skiing at Mammoth,CA. Then I did a snow climb of the Mt. Baldy Bowl in southern California in good order. Now I knew I was fully back.
Canyoneering Bailey CanyonMy first outing in 14 months. Canyoneering in Bailey Canyon


Content on the Summit of Mt. BaldyContent on the summit of Mt. Baldy Mar. 5, 2011

Mt. Baldy Bowl at DawnBaldy Bowl at dawn Mar. 5, 2011

View from Baldy BowlView from Baldy Bowl Mar. 5, 2011

Final Comments

The tendon still feels very stiff and after exercise it hurts and gets a little puffy. But full range of motion is back and I can put any amount of pressure on it. My doc said don’t worry about any discomfort, just judge the healing by what I’m able to do. By that standard I’m fully back in the saddle.

That’s my story. CONCLUSIONS? MORAL OF STORY? I don’t know. Certainly nothing can prepare you to be incapacitated from your favorite outdoor activities. The dark, deflating, withering moods are inevitable. All you can do is understand that there is light at the end of the tunnel, all this shall pass, and take advantage of all those free weekends by spending more time with loved ones. My final thought is that I hope there is no one out there reading this story who is going through a similar experience. If there is, all I can say is HANG IN THERE. THE DAWN WILL BREAK.
Ready for Skiing DayMy first skiing at Mammoth, CA mid-March, 2011

My Daughter and ILots of down time? SPEND MORE TIME WITH LOVED ONES. Me and my daughter Alicia at Mammoth, CA for a ski weekend,March, 2011



Comments

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Greg Enright

Greg Enright - Apr 24, 2011 2:36 pm - Hasn't voted

Great Story

Amazing how that jump up the boulder changed your life. Interesting how quickly you healed after the sutures were removed. I love the Moral of the Story: I don't know.

Augie Medina

Augie Medina - Apr 24, 2011 10:16 pm - Hasn't voted

Re: Great Story

thanks for reading and commenting Greg.

Cheers,
Augie

Sam Page

Sam Page - Apr 25, 2011 1:21 pm - Hasn't voted

I don't know

The Oracle at Delphi said Socrates was the wisest of the wise in Athens, because only Socrates claimed not to know.

PellucidWombat

PellucidWombat - Apr 24, 2011 3:32 pm - Voted 10/10

Moral of the Story?

I'd think something along the lines of appreciating what you have since you never know when you'll lose it, and making the best of a bad situation (i.e. still appreciating what you still have!).

It's great to hear that your recovery is going well. Thanks for sharing!

Augie Medina

Augie Medina - Apr 24, 2011 10:18 pm - Hasn't voted

Re: Moral of the Story?

thanks. Yes, this is an example of needing to savour each moment because it can change in a millisecond.

Augie

Augie Medina

Augie Medina - Apr 24, 2011 10:19 pm - Hasn't voted

Re: Good to hear you're back!

Thanks Ryan. Good to hear from you.

EastKing

EastKing - Apr 24, 2011 9:40 pm - Voted 10/10

Nice to see you back!

Great report! I second PellucidWombat in that it made you even more appreciate the times that you had in the mountains. often when I am at a very scenic spot I often will absorb the beauty because I know there may be one time when I will not ever be able to see that again. Good luck in your continued recovery!

Augie Medina

Augie Medina - Apr 24, 2011 10:21 pm - Hasn't voted

Re: Nice to see you back!

Thanks for your comment. You're right about absorbing the beauty in the moment.

Augie

wyopeakMike

wyopeakMike - Apr 24, 2011 11:21 pm - Voted 10/10

Back to Baldy

Great to hear you are back at it and you are able to have the mountains heal your spirit. That must have been nice to sit on top of Baldy, I have spent a lot of time on that summit years ago and it is a great place to enjoy life. It great that the pull of the mountains can bring you back to the heights again.

Augie Medina

Augie Medina - Apr 24, 2011 11:27 pm - Hasn't voted

Re: Back to Baldy

Yep, Baldy is special no matter how many times you've been on top.

Sam Page

Sam Page - Apr 25, 2011 1:23 pm - Hasn't voted

Welcome back!

Welcome back, Augie. I'm sure your "impulse" to climb only increased during your convalescence.

Augie Medina

Augie Medina - Apr 25, 2011 2:02 pm - Hasn't voted

Re: Welcome back!

thanks Sam. That was a great Baldy Bowl morning we had.

hamik

hamik - Apr 26, 2011 2:16 am - Voted 10/10

Tear

I remember when you first posted this, and every now and then, when I saw you on the forums, I'd wonder what was going on... I'm glad to hear this turned out so well. I partially tore my own achilles tendon at the tender age of 19 from cycling overuse, and it was a long, depressing time before I could use it at full intensity again. I would definitely have benefited from this article then. Thanks for the hope for the injured out there!

Augie Medina

Augie Medina - Apr 26, 2011 3:23 pm - Hasn't voted

Re: Tear

thanks for your comment. I wondered during the year my wound wouldn't heal how it would all turn out, but I always had some foundational optimism. I figured if I didn't turn out "good as new" I would accommodate to whatever was not 100%. But I am 99% at this point.

Rick Kent

Rick Kent - Apr 26, 2011 6:54 pm - Hasn't voted

I know the feeling

Thanks for the posting. I can certainly relate to this, having gone through many of the same issues. 99% sounds pretty good to me!

Augie Medina

Augie Medina - Apr 27, 2011 6:38 pm - Hasn't voted

Re: I know the feeling

Thanks Rick. Obviously, nothing has slowed you down!

Augie

bajaandy

bajaandy - Apr 26, 2011 9:16 pm - Voted 10/10

Comparing notes

I suffered the same injury in April 2009. Reattachment surgery 12 days later. Fortunately for me, there were no complications and I was back to climbing within the year. It is so hard to communicate the mental/psychological trauma associated with injury. I know exactly what you were describing. I would be depressed, but the optimist in me kept saying "give up a season to heal so you can have many more seasons down the road". I am thankful that you got the necessary care you needed to heal and get back into the mountains. Thanks for posting!

Augie Medina

Augie Medina - Apr 27, 2011 6:40 pm - Hasn't voted

Re: Comparing notes

Thanks for commenting on your experience. Yes, without optimism one could slip into the abyss in a situation like ours.

Cheers,
Augie

SoCalHiker

SoCalHiker - Apr 27, 2011 1:43 pm - Voted 10/10

Glad...

... you're back, too. In the end it's the final result that matters. Congrats of hanging in there, surely wasn't easy.

Cheers, Guido

Augie Medina

Augie Medina - Apr 27, 2011 6:41 pm - Hasn't voted

Re: Glad...

thank you Guido. Really, really, really good to be back.

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