Achilles Tendonitis injury, OCS coming up in FOUR months

[NTXRockr]

Hello All, I've been dealing with an achilles tendon injury that I sustained last July. I've been in a walking boot, rehabbing it physically, or resting in cycles for the entire time, yet I'm still having pain near the attachment point of the tendon and the heel bone. I visited an ortho yesterday, and he says it looks good for recovery but wants me to wear the walking boot for another month, start a twice-daily Aleve regimen and do physical therapy 2-3 times per week for the month, as well as avoid all physical activity using the heel. I asked about cortisone and synvisc shots, but he refuses to do cortisone in the tendon for the risk of ruptures, and won't do synvisc as he says it is meant for knee joint injuries (and now shoulders) but some docs are using it for achilles injuries without proper testing.

If the month off doesn't help, he said some of the other options were platelet-rich plasma (PRP) injections, which he has had good success with in recent patients, or resorting to a full cast for 4-6 weeks to fully immobilize the ankle. Final worst case scenario is surgery, but he says because I'm younger and it's not too severe it looks like that shouldn't be necessary. I've read mixed results about PRP injections, and it's also an elective procedure as insurance companies cannot bill it properly now (thank you Obamacare!) so it may be worth the $300 gamble. As far as the cast, I do not want to go that route as I have a PRT in May as well as another one before my OCS date in July, so that would not leave me any time to rehabilitate physically from the muscular degeneration.


As far as these options, are there any other options I could/should be doing to help me recover quicker??? My only issue is that the pain prevents me from running and exercising, but physically I'm able to do it (hence why I was wanting the cortisone/synvisc).


I believe that I can waiver out of the running portion of the first PRT, but believe I have to at least run the PRT before OCS for them to allow me to go? Another issue is I'm slowly putting on weight due to not being able to workout or run, so I'm over weight standards at the moment and need to workout as soon as possible. Are there any specific workouts I can do for my upper body (or with the boot on) to keep the weight down and stay ready for the push-up and sit-up portions? Weight lifting usually results in a 1-2 pound weight gain the day after, so should I stick to PU/SU and similar calisthenics?

My real worry is that this will negatively affect my OCS class date, as well as potential trouble I'll get in for being overweight. What are the chances that, if I were not 100% recovered by July, they would postpone my OCS date or possibly separate me medically? As far as being overweight in the BDCP, what kind of trouble am I looking at if I do not get it taken care of by May? My OR knows about both issues but simply tells me to take care of it and get it knocked out in time, but I know I'm cutting it close and want to know what could happen if worst comes to worse. I appreciate any help and advice you can offer me, and feel free to email me if you would like to discuss this in more detail than just on the forum.

 

[HH-60H]

What are the chances that....

We can't/don't answer "chances" questions here. That being said, what's the rush? Wouldn't it make more sense to heal properly and go to OCS in the best possible condition? If you push too hard and injure yourself at OCS you run the risk of being NPQ for everything. Or do you have less flexibility with OCS dates because you are BDCP?

 

[NTXRockr]

Of course no one has a crystal ball here...I should have known better than to offer up a question like that LOL.

But truthfully, I was wondering if the Navy would separate me if (God forbid) I was unable to recover in time for my OCS class or soon there after. Being BDCP, will they consider medically separating me? I would love to take my time but unfortunately I have one other issue going against me...I'm 26 as of March 10, so my current OCS commissioning date would tentatively be 08 OCT 2011. That only gives me five months of extra time to commission before I'm 27 in order to keep my pilot slot. So I may be stuck with this current OCS class as any later would risk me missing the age requirement (and I'm unsure whether they can/would issue a waiver for a non-prior, especially right now).

 

[HAL Pilot]

If you are BDCP, you are an active duty Sailor and you need to be talking to your chain of command about this. This is not an option but a legal obligation. Further, they are the ones that will give you the answers.

 

[feddoc]

If your PRT is in May, not that long from now, I suggest you ask your doc if you are healthy enough to participate..at least in the run/swim. You probably should get a waiver for the run/swim and avoid the risk of goofing up that tendon for the sake of a PRT. I think it is stupid to have you in a boot for another month, plus still doing therapy....then expect you to participate in the PRT. Now is not the time to press on.

I can't speak to the requirement to complete a PRT prior to OCS. At worst, your entry to OCS is delayed. Big deal, happens a lot. BUT, if you decide to do the PRT and screw up your tendon, which is a distinct possibility, then, maybe, your entry to OCS gets delayed to a post surgery>>recovery status. My vote is to get a waiver for the run/swim and focus on rehab of the tendon injury.

And, as HAL said, keep your command informed.

 

[BigIron]

Also, I'm not sure why you are allowing yourself to become overweight. I understand you are limited in your ability to exercise, but you can also control your calorie intake.

 

[NTXRockr]

@Big, I've been on a 1200-1500 calorie diet for quite some time now, and I've done the best I can to maintain my weight but my body likes to lose weight with cardio. To give you all an update, I've since increased my fluid intake to 100+ ounces per day, which has seemed to do the trick. I maintained weight the first week but have shed about 5 pounds the second so that's what I've been needing to do to jolt my body out of the funk it's been in - I just hope it's not too little, too late as I have about 15 pounds to lose and roughly 3 weeks to lose them. My only problem is that as usual, when I do any workouts (weights, no weights, calisthenics, pretty much anything) I tend to gain about 1-2 pounds the next day. I do not know if this is just residual water weight that my muscles hold on to in order to repair themselves, but it takes another day to get back down to the original weight. I've also started a vita-pack multivitamin along with the daily veggies/salad, and am going to start up the whey protein shakes (or is that a bad idea?). It's frustrating, especially trying to lose weight while keeping in shape for the upcoming PRT, but I'm not anywhere near giving up what thousands of people would kill to be given.

@HAL and feddoc. Thank you gentlemen for your responses. I have been keeping my chain of command informed, I email/fax in my bimonthly collegiate contact reports and include any updates as far as medical info or changes in coursework, etc. I had to waiver the run in the fall PRT, and have requested that I waiver the run again for this PRT as well. My OR informed me it shouldn't be a problem, just need the letter from my PCM stating I should not run on it. As far as feedback from the NRD and my OR, they basically tell me to get the weight and the achilles injury in check and be ready to go to OCS on time, so that's what I've been trying to do. I am STILL waiting for Tricare to get a referral for the physical therapy, and had to postpone my first two appointments earlier this week. It looks like I will be doing 3 sessions per week instead of two in order to complete them before May, but that's OK with me as long as it works. So far the boot (along with twice daily Aleve and icing in the evening) seems to have helped some as the pain is slowly dissipating, but it has caused my knee and hamstring to start cramping and feel sore (I assume from the different walk or gait I have with the boot, different muscles working harder than before, etc). I am going to increase my workouts (what I can do while wearing the boot) for the time being and be ready to rock the PU/SU portions of the PRT. I found that the rowing machines are a good body workout that I can do with the boot, but I'm looking for other options to do in addition.

Are there any other tips you can offer me to help my recovery/keep in shape while rehabilitating? Would swimming be a good alternative for cardio (cycling is difficult with the boot on) or would that be too much use of my heel? I greatly appreciate all of your feedback, and will keep you all informed as well as my chain of command. I take my job and duties seriously, and am ready to be healthy again so I can be the best candidate I'm able to be. Thanks again for your advice and insights!

 

[feddoc]

Yea, do some swimming to keep your cardio up. Shouldn't be a problem with your achilles injury recovery.

 

[NTXRockr]

Alright, that sounds good to me. If it starts to feel like it's causing pain I'll stop but I think that's going to help a lot in addition to what I'm doing now. Thanks!