Wednesday, May 27, 2015

An Achilles Story: A Personal Account of My Own Treatment and Surgery

As it became apparent that I would need surgery on my achilles/ heel, I began to talk to other runners who already had the surgery. Together, everyone sounded like a broken record. Our stories were all very similar, so I’m writing this post in hopes that it could help another athlete in a similar situation and possibly prevent the mistakes I made.

Before the surgery, I had already been experiencing some pain for at least 5 year. The pain was barely there at first. Just a little sore when I started running, but perfectly fine once I started to warm up. I tried to get rid of the pain, but nothing worked so I just kept on running. For the first couple of years, it didn’t effect my running at all. Gradually things got worse. I started limping around when my achilles got stiff and starting a run got more and more painful, especially after a long run, mountain, or speed work. In the past two years it started to change how my foot landed and thus changed my form. For the most part this was okay, but caused some issues when trying to run fast on a hard surface. By the time I did my last ultra (Mountain Masochist in 2014) my form started to change too much and by the end of the race my entire left leg hurt. After the race I couldn’t even pick up my leg because my hip flexor was shot from running with bad form. The day after the race I tried to walk up a short little hill to get to a trail to do a short hike as Sage ran. My achilles was so bad that I literally had to crawl up the hill. Once I got on the trail I realized that I couldn’t hike as it was impossible to even walk uphill.

After the race, I took a month off running to see if it would help my achilles. The rest didn’t really help at all. I then went to doctor who gave me a cortisone shot. I wish that had never happened. I really thought the doctor was going to tell me I needed surgery and I didn’t do any research on a cortisone shot like I should have. I could run for a few weeks and then two days after winning a snowshoe race, I could no longer run as the pain was too much and wouldn’t go away. The cortisone shot weakened my tendon and did a lot more harm than good. My doctor should have known better, but I should have done my research as well. From there my doctor said to do physical therapy and dry needling for a month. The dry needling helped loosen up my calf (on top of the stretching and self massages), but I knew the physical therapy wasn’t going to help since I regularly strength train. I should have listened to my intuition as it would have speeded things up. After that I tried a couple prolotherapy sessions. At first I thought it helped, but the second time things did not get better. Still, I think it’s something worth trying if you’re experiencing achilles pain. Finally, I asked my doctor about surgery and an MRI was scheduled. It pretty much confirmed that I needed surgery.

Purple dots from prolotherapy
Over time, my left achilles formed a large "bump"

I already knew I needed surgery before I got the MRI, so I had already been looking for doctors to perform the surgery. I admit, I got lucky and knew a couple of great runner who had the surgery and was put me in contact with other runners who had the surgery as well. A couple were professional road/ track runners and had the resources to talk to doctors all around the US. Still, they had decided to go to Sweden to see Dr. Hakan Alfredson since he was the best. The runners told me they wouldn’t trust anyone else (especially the runner who had already had achilles surgery once before in the US and still experienced pain afterwords). After being upset with myself for letting 6 months of little running go by as my previous doctor tried whatever he could think of, I just wanted a doctor I felt really confident about. 9 months of no running (6 months prior surgery, and hopefully only 3 months post surgery) seems like a long time (especially as my favorite season approaches) and I wanted to make sure the healing wouldn’t take longer than necessary. Dr. Alfredson specializes in minimally invasive surgery*, which is truly wonderful. I’ll post links with more information at the end. I’ll admit, it was a huge bonus that going to Sweden for surgery was relatively inexpensive and I would have likely paid more in the US. I do know some runners who have had very successful surgeries in the US (so no need to rule that out!), but as I said, I just needed to trust my intuition at this point and wanted to minimize the healing time. Please do your research before selecting a doctor, as I have heard quite a few horror stories as well.

Right before the surgery Dr. Alfredson did an ultrasound and immediately told me more about my achilles than other doctors had in 6 months. As he was telling me what was wrong, I felt reassured I was in the right place as I stared at the signed posters of Olympians he had performed surgery on. Right after that I was given a local anesthetic to get ready for surgery. Injecting the local anesthetic was the only pain I was in the whole day, and it wasn’t much compared to all the pain my achilles had caused me beforehand. I was awake during surgery, which I actually preferred. It made me feel more confident about that the doctor was doing and he would let me know what he was going to do before he did it. It was strange as I could feel some pressure as things were being cut and hammered out but, again, nothing hurt. Honestly, the worst part was that I really, really had to pee! :) After the surgery was over I almost immediately went back to the hotel and just rested. The day after I went back to get my bandage changed and Dr. Alfredson did another ultrasound to make sure everything looked good. Here is everything that happened during surgery:

Surgery summary: Removal of subcutaneous and retrocalcaneal bursa, excision of upper calcaneus (heel bone), revision ventro-distal Achilles, scraping ventral Achilles, removal of part plantaris tendon left side.
Day after surgery

The main reason why all of this had started was because I was born with sharp heel bone and a haglund’s deformity that was digging into my achilles. Since I’m a runner the surgery was inevitable, however, I would have saved myself a lot of pain and extra damage if I would have went to a doctor sooner.

Post surgery: I’m so happy I wasn’t put in a boot for months! Though my left calf is obviously losing muscle, I have still been able to walk (with less body weight because of crutches) which I think is a great way to keep my muscles used to that movement. I’m now starting to walk short distances around my apartment without crutches. My walking is pretty wobbly, but I’ll get there.

If you’ve been experiencing achilles pain and you feel like you’ve tried everything, I hope this post has helped give you some of the information you were looking for. I know it sucks and it’s okay to be sad, but it’s a good time to focus on other things that makes you happy. If you just started having minor achilles pain, please try doing eccentric heel drops before you do anything else. More info here:

Eccentric Heel Drops & Podcast with Dr. Alfredson (along with other info):

Alfredson Tenon Clinic:

*Minimally invasive surgery for Achilles tendon pathologies:

Lots of love,


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