Achilles Tendon Surgery at Duke Leaves Woman Stronger than Before
Foot and ankle orthopaedic surgeon Christopher Murawski, MD, examines Penny Pope's achilles with physical therapist Yana Ginzburg.
Penny Pope, 65, is an exceptionally fit woman, exercising five or six days per week. Following surgery at Duke Health to fix an Achilles tendon that ruptured while walking her dog, she’s back on the bike, the treadmill, and at the gym. “I have been in such amazing hands,” Pope says. “I see why people come from all over to go to Duke.”
A Fateful Step
On October 24, 2024, Pope, of Holly Springs, was walking her golden retriever when she stepped on a loose utility cover. It flipped up “like a see-saw, and I fell in the hole and hit the ground on my face,” said Pope. “When I got up, I knew something was not right on the back of my right calf.”
She and her husband went to the local emergency room, where an X-ray showed no broken bones. Then Pope scheduled a visit to her primary care physician at Duke, who got her an appointment with Duke foot and ankle orthopaedic surgeon Christopher D. Murawski, MD.
Pope connected with Dr. Murawski as soon as they met. “I love him,” she said. “He is warm, honest, and kind, and you can tell he knows his stuff.” Based on Pope's physical exam and an MRI, Dr. Murawski diagnosed her with a ruptured Achilles tendon.
A Decision Made (and Unmade) with Support and Understanding
“I'm a surgeon. I love to operate, but it's our job to help you avoid surgery when we can,” said Dr. Murawski. “I tell every patient that we can treat Achilles tendon ruptures with and without surgery; we talk about the pros and cons of each strategy and make the decision together.”
Dr. Murawski suggested that surgery may be the best option to help Pope recover her athleticism, in part because, he explained, “we know that non-surgical management of Achilles tendon ruptures tends to be most predictable when patients are immobilized promptly,” and Pope was outside of the typical window of time.
Pope was not convinced about surgery. When she heard that it meant she wouldn’t be able to put weight on her foot for the first month, she thought, “I can’t do that,” she said. “And I left! Dr. Murawski was so understanding and so sweet. He just laughed and said ‘You remind me of my mother. She’s the same way.’”
Pope had second thoughts after talking to family and friends. “My husband and I had a follow-up Zoom call with Dr. Murawski, and he was so gracious and wonderful,” she said. “I knew that I needed to have the surgery.” She scheduled the operation for November 21 at Duke Raleigh Hospital, a campus of Duke University Hospital.
The Easy Job
For the surgery, explained Dr. Murawski, “we make a small incision and pass sutures through the Achilles tendon on both sides of the rupture. Then, we tension the repair and tie down the sutures." During surgery, he also used a needle to take bone marrow from Pope’s iliac crest, near the hip. Then he used that to produce a biological concentrate of stem cells and growth factors and injected them at the surgical site. “We know that concentrated bone marrow aspirate can support tendon healing and so Penny and I talked about adding this step because she had pre-existing degenerative changes in her tendon,” Dr. Murawski said. “It’s basically you regenerating you.”
Ginzburg works with Pope on some of her exercises. With physical therapy, Pope has been able to slowly return to running.
Dr. Murawski describes Achilles tendon surgery as “the easy part,” compared with the work Pope needed to do afterward. After surgery she went home with her leg bandaged in a splint for two weeks, and then a leg cast for three weeks kept her immobilized until December 31. On the day of New Year's Eve, she began physical therapy at Duke with Yana I. Ginzburg, DPT, SCS, OCS and Ned Bixby. “Ned is always very encouraging and complimentary, and his positivity helps tremendously” said Pope. “And Yana is the tough one! She gives me challenging exercises, and is strict with form and technique. The two of them keep me balanced, and I am forever grateful for their expertise!”
“We are blessed with a first-class physical therapy team,” confirms Dr. Murawski. “Yana and Ned put her on a great program that was invaluable in her surgical recovery.”
Back at It
“I'm seven months from surgery and thanks to Dr. Murawski, Yana, and Ned, I'm going to be stronger than before,” said Pope. She returned to her stationary bike in January, and in March, to spin classes. She’s also alternating between walking and jogging on the treadmill, and she has added back lower body weights to her strength training regimen. In August Pope will return to her part-time job as an elementary school counselor.
While Pope is thrilled to return to exercise quite literally better than ever, she has mixed feelings about leaving her health care team. “Dr. Murawski is my all-time favorite doctor,” she says. “I’m almost sad that I only have one more appointment with him because I feel like he’s a friend. How great is that?”
