布兰登·库克(Brendan Cook)的阿喀琉斯(Achilles)断裂具有讽刺意味，他现在可以一笑而过。这次受伤没有经历漫长而痛苦的康复过程，也没有完全康复。
In fact, in hindsight Cook was comfortable with what can be a very uncomfortable process thanks to the work ofDr. Andrew Johnson, a podiatrist atSanford Health Detroit Lakeswhose repair of the Achilles in September using an increasingly popular alternative procedure set Cook on his way to a smooth return to full speed.
“跟腱断裂，无论采用何种技术，都需要很长时间才能恢复，”约翰逊说。“但我们和布兰登一起使用的这项技术，由于其强度水平，减少了非负重时间。这本身对病人是非常有益的。”
It was definitely beneficial toCook, a 35-year-old married father of two who played in 136 NCAA Division I hockey games for Bemidji State University and another 639 more professional regular-season games in the United States and Europe prior to retiring in 2017.
Not the ninja he thought he was
He did not completely sever his Achilles playing hockey. That’s where the irony comes in. No, he did it while climbing a wall patterned after the one featured in “American Ninja Warrior,” a television show his children like to watch.
This was one of the promised activities to the Cook children on a family weekend in the Twin Cities. Their scheduled hour at an Eden Prairie training gym affiliated with the popular program was coming to a close. But they all had time for one more trip up the “Warped Wall.”
“I planted hard with my first step with my right foot to drive myself up,” said Cook, who had already made it to the top of the 13-foot wall several times that day. “You could hear it pop. I went down to all fours and there were a few people who were in there whose jaws were on the floor.”
库克的妻子梅丽莎问发生了什么事。布兰登，在他的冰球生涯中忍受了无数次的伤害，但从来没有这一次，不需要猜测答案。他的跟腱断裂了。
“She said ‘Are you sure?’” Brendan said. “I said ‘Yeah, I’m sure.’ My foot was just kind of hanging there. I could put my finger where my Achilles should be and it wasn’t there anymore.”
Speeding up recovery
The injury took place on a Saturday. On Monday morning the Perham, Minn., resident traveled 25 miles to Detroit Lakes to meet with Johnson. The doctor confirmed what both of them already knew. This was a complete tear of the Achilles and would require surgery.
That took place on Wednesday and Cook went home the same day.
“One of the cool things about this procedure is that it used to be that you were laid up for quite a while,” Cook said. “They’d stick you in a cast and you’d be immobile for about two months before you could do anything. The problem there is that your calf atrophies so much that when you do get out of the cast, the recovery takes forever.”
Achilles weekend warriors
Achilles issues are not as common as injuries involving knees and ankles. Incidences are on the rise, though, as “weekend warriors” trend toward bolder physical challenges. Men in their 40s and 50s are the most popular targets.
Ian Lackey is an athletic trainer forSanford Orthopedics & Sports Medicinewho spends most of his time working with the NBA G-League’s Sioux Falls Skyforce. He’s also a former Achilles rupture victim himself.
In his professional opinion, the injury happened to him — he was 22 at the time — because he was out of shape. He has since learned this is a common cause.
“You’re seeing the weekend warriors in their 40s deciding to play more basketball,” Lackey said. “Their tendons are exposed to the jumping and stopping and it can cause an overload of the tendon. I compare it to throwing a baseball all offseason and then when the season opens you try to throw the shot put.”
The Achilles is a tendon, not a muscle, but behaves similarly in some respects. More activity makes it stronger. Less activity makes it thinner and less powerful. Hence, mixing an under-used Achilles with a sudden overload can lead to visits to thepodiatrist.
“It’s a pretty simple injury,” Lackey said. “It’s not like a shoulder or a knee where there are so many different forces. An Achilles has one motion — basically up and down — and you can get a complete range of motion and strength and power back. But it can take a long time.”
Achilles rupture surgery options
There are several ways Achilles ruptures are repaired. Conventionally, when surgery seems the best option, a long vertical incision is made along the lower calf area and the two severed ends of the tendon are sewn together with sutures.
Theprocedure Johnson usedon Cook’s Achilles called for a much smaller incision. Several sutures are applied horizontally through the upper part of the ruptured Achilles and are threaded vertically through the lower portion of the Achilles, then attached to the heel. The sutures are anchored in the back of the heel bone and the severed ends of the rupture are pulled together.
And the result: Cook had a less invasive surgery and was back on his feet in a shorter time.
Stronger, and in less time
“In my opinion it’s a much stronger repair than the traditional way,” said Johnson, who grew up in Detroit Lakes. “And it’s knot-less. There are no exposed knots under the skin. It’s all buried within the tendon. The reason why I really like this technique is that there is minimal surgical exposure or incisions. The strength is either the same or greater than the older methods we’ve utilized for Achilles ruptures.”
It affords patients and doctors more confidence in the strength of the repair. In this case that allowed Cook a shorter wait time to begin working on his range of motion and weight-bearing rehab.
他在床上躺了几天，然后开始骑他的孩子们喜欢的膝滑板车。3周后，他穿上了步行靴，过着相对正常的生活。七周后，他就从靴子里出来了。
“Being able to walk with a heeled shoe short of two months is a pretty big win,” Cook said. “The healing time was as short as it possibly could have been. I was very appreciative and grateful for that.”
Achilles repair close to home
Cook’s athletic background, coupled with his active lifestyle, meant he could take an aggressive approach to rehabbing his Achilles rupture.
“我想尽快回去做我喜欢做的事情——我需要恢复我的理智，”库克说。“我不想只是和家人一起散步，穿着正常的鞋子工作。我仍然认为我是一名运动员，尽管我已经不是一名运动员了。这就是我的看法。”
对库克和该地区的其他人来说，令人鼓舞的是，进行手术和恢复的最佳选择位于他家半小时车程内。
库克说:“除非你是那个需要手术的人，否则你不会考虑这种手术。”“有机会在家附近做手术，得到任何NFL球员都会得到的修复，这是非常宝贵的。当你把它与那种场景相比较时，这是一件很酷的事情。你得到的修复质量和任何职业运动员一样。”
His surgeon agrees with that.
“Population density doesn’t necessarily mean better care,” Johnson said. “I’ve never believed that. I grew up in Detroit Lakes and I was very happy to come back to my hometown to utilize my training. I really think that our ambulatory surgery center and the staff there is phenomenal.”
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Posted InDetroit Lakes,Orthopedics,Rehabilitation & Therapy,Sports Medicine
