Your Achilles Tendon Rupture (ATR) and Recovery
AchillesBlog is a space that has grown over the past few months to bring together people who have injured their Achilles Tendon. You can share your injury and recovery experiences with others who are also recovering from their achilles tendon rupture (ATR).
You’ll also find valuable information about recovering from Achilles Tendon Rupture, and please feel free to contribute to our resource to help others who are on the same path to recovery.
If you think you just ruptured your Achilles tendon, (Please go see a doctor!) and please visit: Just ruptured your Achilles?
If you want to learn more about Achilles tendon rupture, treatment, and recovery, please visit this page:
Achilles Tendon Rupture Rehabilitation Protocols, Recovery Guidelines, Publications, and Studies
If you want to read about other people’s personal experiences with Achilles Tendon Rupture and Recovery, you’ll find blogs by people chronicling their injury and recovery here. If you are starting out on your recovery, then it’ll be very helpful for you to read about other people’s recovery experiences.
My ATR Recovery Chronology is here, and you’ll also see many more on the left sidebar under the title “RECOVERING FROM ATR”. Many of these blogs are on AchillesBlog, and some are blogs from elsewhere that we’ve come across.
If you want to share your Achilles Tendon Rupture story, you can create your own here.
My AchillesBlog is: http://achillesblog.com/dennis
If you want to join in on the conversations of people recovering from ATR, or want to share your story without creating a blog, then you can leave a comment anywhere on the site. It’ll show up on the main page under “Recent Comments”. Feel free to leave a note and say hi. 
If you are looking to buy things that you might need to aid in your recovery (and reviews of some of the products), check out:
Things you might need.
If you have recovered enough to be able to start home exercises and/or physical therapy, this page will be very helpful:
Physical Therapy for Achilles Tendon Rupture Recovery
You’ll also find great information from excerpts from various forum postings on: Posts worth reading
Additionally, you’ll be able to:
- Have your progress displayed (along with everyone else’s) on the site’s NYC marathon course map(Requires only a user registration to add your information)
- keep track of your recovery progress
- Widget: On your personal AchillesBlog, keep track of your recovery process graphically from the date of your surgery on a NYC marathon course map. (personal blog required)
- Widget: Keep track of how many days it has been since your surgery/injury with “Achilles Timeline” (personal blog required)
Widgets require that you have your own personal blog. If you don’t want to blog, then just create a placeholder blog and setup the widgets only. (some people are already doing this)
Dennis
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634 Responses to “Your Achilles Tendon Rupture (ATR) and Recovery”
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Brendan ruptured his achilles on Feb 26th. I think he’s the most recent one of the group.
Here is the link for his blog: Brendan’s blog
He’s contemplating on going back to work after 1 week, which I think is too early.
Hi all..
I had surgery on March 6th after tearing it on the first. Had the surgeon videotape it and will get it on Monday my first post op visit. I have access to alot of medical journals, research, etc so if anyone has any specific questions I can research for you. I am chiropractor, and hope to see patients this Monday after I get my cast on..Should be challenging. Would like to hear about your experiences as far as returning to work.
Thanks
Dr. Ross
Nancy..
sorry to hear that you have joined our club..Need to figure what tissues are causing the burning..
Is it localized or radiating??
What makes it feel better…activity, rest, a position??
Is there any swelling, redness, itching??
Let me know??
ross
thanks for your reply
the burning happens only at one spot
i usually put my hand on it and do a keigel and it seems to help
it does appear to be red when it happens but i’m not sure if it’s me pressing on it that does this…
by the way, i’m in my 8th day after surgery
i sort of going crazy being inactive and so dependent of others!
my first appointment with my surgeon is on th 26th
looking forward to this
do most people get a full on cast on their first visit?
thanks
nancy
Nancy,,
Best to be on the safe side and check with your MD.
As for the cast you will see from surfing this site and doing your research that there is not set protocol. I was in a splint for 4 days then put in a cast. Based on the protocol I will be following the cast is on for 2 weeks and then star rehab.
Do your research, ask questions and you’ll make the right educated decision for yourself.
Good Luck and let me know how it goes.
Doc Ross
Nancy -
I was in a fiberglass cast from just below the knee right after the surgery, for 2 weeks. After that, a checkup and another cast for 2 more weeks. My foot was then put into a walking boot after that.
Hi all, I just found this blog. What a great thing and a great find.
I ruptured on 2/26/08 and had surgery on 3/3/08. I’m out of the splint and into a short cast for 3 weeks. Then on to the boot. I’m glad that a lot of what I have been experiencing (mental and physical) sounds normal. Thanks to everyone who has taken the time to post.
It’s great to know you are not alone, otherwise known as misery loves company!
Jim
Jim, welcome! By the way, how did you find this site? I am always curious about how people arrive here.
Glad that you’ve found this place, and I hope you find the site helpful. Please let us know if you have any questions, and feel free to share your story. thanks!
dennis
when you got your second cast put on, where you able to put any weight on it or did you have to wait until you got your boot?
i can’t wait to walk again…
i’m at the end of week two…time flies when you’re lying on the couch!!
i’m addicted to csi miami
any other good shows out there?
thanks
nanc
nancy,
I was allowed to put 20-30lbs (PWB) right after I got my 3rd cast. (1st cast was in the emergency room, 2nd cast right after surgery, 3rd cast at the 2 week follow-up exam.)
I am looking forward to walking too. I love the old law & order episodes with LENNIE BRISCOE.
hope you are feeling better!
Dennis–I was googling everything Achilles injury, and found your site. Of course I was sitting on the couch with my lap top, foot up. I feel I may be a bit late to start blogging. I’m in a cast now and per MD no limits on weight. Of course I can’t put full weight on my foot. I weigh 235 and can get to about 100 pounds (on a scale) without pain.
Nancy–As for shows to watch, I just finished “The Office” on Netflix instant view. They have the first 3 seasons that you can watch on demand. Nothing like a good laugh.
Uplifting story of the day about young Carsen Main. What a great kid! (denverpost.com). I know there are lots of hoopsters in this group so enjoy (I’ve got skills!)
http://www.denverpost.com/breakingnews/ci_8631581
johnskier - That’s a great story. I hope he gets to score too.
Jim - Hopefully you’ll get to FWB soon. It really makes a big difference.. but I have to be careful to not overdo it, and it’s really easy to forget that I need to take it slow.
Dennis..
Great…long article on everything you need to know..
http://herkules.oulu.fi/isbn9789514284342/isbn9789514284342.pdf
Ankle feeling much better. I think it was just morning stiffness. I did 15 min on the recumbent bike today and it felt great. Did upper body workout too. I figure my only “job” now is to keep fit and keep the blood flowing to speed recovery.
Has anybody tried those cast covers for swimming?
Jim
Jim - Philip is on a vacation, and he bought a waterproof cast cover for swimming. He promised to let us know how well it works. I think he left for vacation yesterday, so we’ll hear from him in a few days probably.
thanks for your tv series advice!
love the office too , 3rd rock, entourage…no new episode though
thanks dennis for the info about the weight bearing
does anyone know when we can start cycling (stationary bike) and swimming?
the only exercise i do is wiggling my toes, hopping around, upper body exercises
week 2 going on week 3 post surgery
i’m worried about packing up the pounds…yickes!
nanc
Hi all just got out of surgery tonight around 6pm…still awake after taking one of my meds (percs). Leg is still numb so the pain has not set in yet. I can’t wait to walk…..
mike
Nancy - during the first 3 weeks I did ride the spin bike with my bad leg on a bar stool and pedaling with my good leg. Not sure I got much of a workout…I wasn’t too motivated to work hard.
Mike - good luck, I’m amazed you’re blogging.
Nancy - Let me preface by saying please consult with your doctor to confirm when he/she believes it is best for you to start biking and swimming. Everyone has a little bit different protocol.
I was able to start riding on my bike trainer at 4 weeks post op (with my injured leg in a cast). I kept it at pretty low resistance and probably half my normal rpm. I was up to about 75% rpm at a moderate resistance while in the boot from 6 weeks to 8 weeks. At about 9 nine weeks I started to ride without the boot, back down to low resistance and rpm. I will also recommend using the heel on your injured foot as you begin to cycle and slowly work up to using the ball of your foot. This will minimize the strain on the tendon.
My doctor also gave me the okay to start pool exercises at week 6. However, I canceled my gym membership awhile back so I haven’t tried any swimming yet.
ok
i guess i’ll wait til i talk to the doc
i’ve been going up and down my stairs on my “derriere” so that’
s a bit of a workout!! gosh..
5 more days until my first post op appointment
how much time off work are you guys planning/planned on taking?
and..when did you guys started driving your car again?
Nancy,
Good luck on the first post op appointment. Goes fast, they look at the incision then cast it up for 2-3 weeks. I was back to work on a part time basis in 5 days. Obviously depends on your job, I was able to have a roll-about in the office and rolled from room to room to take care of patients. It’s very exhausting so if you have an option take 2 weeks off to rest, elevate and heal. I was lucky (f you can call it that) that it was my left leg. Driving caused my foot to swell withing 15 minutes the first week but by the second no swelling.
Hope today is better than yesteday.
Doc Ross
Nancy - I took 2 weeks off of work, 1 week of full rest and then 1 week of working from home (still laying in bed and elevating). I just went back to work for my third week post op, and it was pretty tiring, but it was good for my mind to be out and about. I drove after I got my cast after 2 weeks. I tore my left like Ross though and have an automatic. Hope you have a good weekend!
nancy - I was off about 10 days and worked with wireless from home some during the first 10 days. I think I tried to do too much, however, and caught a nasty cold the week I came back. I also had to ice and elevate my leg at work. You’ll have to judge how you feel and what your work schedule will allow…but I think that if you can stay home two weeks it’s good. Even the third week I was icing and elevating on my desk. After the third week, it pretty much didn’t throb anymore. I was driving within a week…it’s my left foot so that helps. The problem would be if the car breaks down, etc. One time I had to buy gas during a blizzard and I’m crutching around the car, hoping I don’t fall, freezing my tail off. Pretty comical, really. Take care - it gets better.
I’m suffering from “castrophobia” and it has nothing to do with Cuba. This cast gives me the worst trapped claustrophobic feeling. I’m not claustrophobic either, small spaces don’t bother me. I wish I could see what’s going in in there. This is America, I should be able to pay extra to heal faster. Oh well, off to find that Zen book….
Jim
Nancy - I was back to work 5 days after surgery. I mainly have a desk job, especially during the winter, so it wasn’t too difficult going back. I was able to keep my leg elevated on a couple of boxes placed under my desk. For me it was important mentally to get back to some level of normalcy. It was much harder for me to sit around the house. I think you just need to listen to your body and do what feels right to you.
I ruptured my right AT plus I drive a standard transmission, so I was pretty screwed when it came to driving. Fortunately, my partner and my father were able to drive me to and from work. After about 6 weeks I felt tired of being a burden on them so I swapped cars with my father and drove left footed for a couple of weeks until I was out of the boot. Probably not recommended, but I only drove a short distance to and from work.
you guys are such a great help
thanks for all your stories and advice
since i teach grade one, my doctor decided to write me a 6 weeks off note, making sure i did not trip onto anybody’s little feet, toy, chair, etc. and i’m fine with this.
it’s just that you can easily get bored
for driving, i’ve got a standard, and i tore my left AT so, i’ll be patient…like for everything else
i do feel good, just can’t wait to get that first cast off and start physio soon, get moving.
have a good week end
don’t eat too much chocolate tomorrow
nanc
Brendan-
I thought I would get a boot on my first follow up. I get the cast off on 4/8. I think he changed his mind from boot to cast when I said “I can’t wait to go swimming today”. He’s protecting me from myself. My doc said I could weight bear, although I can’t get full weight on my foot yet. I have been doing the recumbent stationary bicycle for 20 min or so, and walking with crutches with as much weight is comfortable. It’s always more sore in the morning, but after the bike I can almost get to FWB with no pain whatsoever. As long as no tension is applied to the Achilles, I don’t see how a little weight bearing should be a problem.
As for how I injured it, I was warming up at a Krav Maga class. We stretched and were running across the mat and changing direction very quickly. Total non-contact injury. At this point my story is the same as everyone else’s, thought someone fell on me, mat slipped, shoe broke, etc. I then vaguely remember my toes almost touching my shin as I went down. Self diagnosed in seconds. I had been hiking for quite a few hours earlier in the day, over mostly very large smooth round rocks, so I had been on my toes for hours piror. I don’t know if this is a contributing factor or not, but seems like it could be. It was my second day back to working out after a nasty bug and 2 weeks off. I’ll save some room for others. Hang in there everyone.
Jim
4 wweks post op but can’t sign up…any help?
T Boor -
Hi, what is the problem that you are having exactly?
Hello from Amelia Island Florida !!
Sorry it took so long to give you all the update on my vacation and the review on the Dry Cast Cover.
First, I don’t know about you all, but I have now gotten ridiculously strong and capable on the crutches. We have been walking around the city, around the hotel, down to the beach with really no problems. It definitely makes me feel much better to be this mobile again.
So for the review of the Dry Cast. First I bought the half leg large version. This was my first mistake. Although, the full leg seemed too long and probably very unattractive, there is no question that it is the better choice. I have been swimming every day and today I went sea kayaking with my son. The cast cover does keep it totally dry but for a few leaks that feel more like sweat or a little moist on the top of my cast. I have realized that this is caused by the fact that with the half leg version there are only a couple inches of rubber seal above the cast. With the full leg version, there would be much more rubber seal to keep the water from seeping in. Truly this minor leaking has not been an issue as I have been wrapping the top of the cast with an ace bandage and it has been absorbing most of the moisture.
So, for the good stuff. The freedom of being able to move around and swim without the crutches has been exceptional and lightened my mood. I would recommend that once you are a couple weeks out of surgery and mobile that you get the Dry Cast and go to the local pool to at least float around for 20 to 30 minutes.
I hope all are healing well. I will check in again soon.
All the best.
PK
brendan I’m more of a wake fan, but they have had a rough year…at least I got to watch every single game this weekend! I’m trying to make a meeting tomorrow, been off the meds since Friday night. I’m guessing that week 2 and 3 is much of the same as week one? Does anyone ever fall asleep and wake up by a muscle twitch…feels like my calf wants to stretch?
mike - I’ve had the twitch the first couple weeks.. it happened a handful of times,but it finally subsided. It used to hurt, but I don’t think it does much damage to the tendon as I think the cast protects your achilles pretty well. I don’t think it’s good for the tendon though.
Philip -
Thanks for that review. I’ll have to put a link to the full leg version of the Dry Cast on the “Things you might need” section.
Glad that you are having a great time out there!
Mike
Yes, I have had the twitches. On night 4 after surgery, I was having a dream that I had to run and jump something. Well, I used my bad leg to push off and woke up bolt upright. That was not a pleasant experience. For the next few nights I was actually a bit anxious to sleep. I have had a few others, but that was the worst. I’m not allowed to have any running, jumping dreams from now on.
mike - i had the same twitches that you and the others talk of…they happened during week 1. To your other question, my week 1 was the roughest, had to keep elevated above the heart to manage…got off pain meds about day 4. Week 2 was a little better, but still laid in bed with elevation and worked on laptop. I’m finishing Week 3, and it was much better than either of the previous 2 weeks. I was back to work, getting stronger on the crutches, not having to elevate as high (still some swelling, but no throbbing).
Wow, every day gets better. I just walked about 50ft without crutches in my cast. I carried my crutches just in case. It’s not so much a walk as a plant, step. But it was a real step, not just a hop. No pain. My doc cleared me to bear as much weight as I wanted while in the cast, as my Achilles is protected from any stumble or accidental weight placed on the ball of my foot. I’m at 21 days post op. I think the occasional weight bearing really helps with the circulation.
Jim
Hi All - today was 4 weeks since post op and I went in for a cast change. My foot is now at 90 degrees and the ortho said every thing looked fine. So, there will be 2 more weeks of casting then I go into a walking boot.
Dennis - the pain and tingling you feel is very normal, it takes time for your nerves in your leg to normalize (I ruptured my other achilles 2 years ago).
herb -
Thanks, it’s good to know that I didn’t damage my tendon somehow. By the way, did you have tendinosis (tenderness, etc..) in your achilles? I am worried about my other tendon as well.
Jim -
Good to hear that you’ve made some progress. Walking gets to be much easier with the boot so hopefully you’ll get into one soon. Looks like you are good great.
Dennis - I have no tendinosis in my legs, however my ortho told me the chances of ruptureing my other tendon was very high if you had previously ruptured your other one (I just think my tendons were very thin to begin with). I don’t know it was smart of me to be on the court again, but hey I played for another 2 years before the other one blew out. I think my case is very rare to have both tendons rupture, so I hope everyone who will eventually be healed, don’t to be discouraged and go out and live life to the fullest.
Hy guys -
Michael here in NY. Had my surgery today. Doc said it went well: 45 minutes, reattached tendon to heel bone using dissolvable anchors. Am in a splint, top and bottom of foot extending to mid lower leg held in place with lots of Ace-like bandages, Doc says it makes it much easier to check the incision.
The sciatic nerve block is still working so, at the moment, my foot is still numb. The anesthesiologist said that it may last as long as 24 hours. I’ m not looking forward to it wearing off. I have the Percocet ready.
Doc and I are now having the
NWB v. WB debate. He wants 4-6 weeks of NWB. I’ve emailed him a bunch of the recent literature about early weight bearing in ATR rehab. He seemed to be underwhelmed pointing out that they were all non-US studies. I pointed out that one was Canadian and that they weren’t really off the reservation. The debate goes on, although since it’s only day one, I have a lot of NWB days ahead under all circumstances. The other issue is how soon may I swim. I am a daily fitness swimmer, and have been for 30 years. When I broke my shoulder blade in a bicycling accident a few years ago I started swimming after a week doing a one-armed crawl, I’m pushing for an immersible fiberglass and Goretex cast as soon as the wound is sufficiently heeled. Doc is worried about kicking while swimming. I have explained that I can swim perfectly well without kicking. I think I’ll bring him around.
If any of you have had experience with swimming as part of your rehab I’d love to hear from you. Also early weightbearing info would
be appreciated. Thanks to all. Michael
Michael -
Glad that your surgery went well, and take good care of yourself for the next two weeks. I had to negotiate a shorter time in a cast with my PA.. so I was able to cut it down by a week. (4 wks instead of 5 wks).
That’s as close as I could get to EWB with my doctor.
I was actually fine being in a cast for 3-4 weeks, since I really didn’t trust tendon’s strength then.
Keep us all posted on your progress, and elevate your leg all the time!
Dennis -
Thanks for the response. My first night was ok, the foot is still a little numb from the nerve block so I was able to sleep with no pain. I bought these big wedge shaped stiff foam pillows at Linen ‘n Things and they are excellent for elevating the entire leg while sleeping. It is a little odd sleeping with leg that raised but it wasn’t that big a problem. I slept better than I thought I would.
My problem will be pushing myself to get back to the office. I’m a trial lawyer (fortunately no trials on the immediate horizon) with lots of clients who need attention. Although there is a lot that I can do from home, there are many things that require being in the office down on Wall Street. My firm will provide a car service for my commute, so that won’t be an issue. I would not want to negotiate either the Metro North railroad or the NYC subways on crutches. Neither is particularly handicapped accessible. As everyone on the blog seems to be saying, I’ll play it by ear. But, that said, I’m not great at sitting around. Tom, going back to work after 5 days, is my current hero.
I’ll keep all informed.
Michael
Michael -
Glad your surgery went well. I had a nerve block too…I actually called at about 26 hours after surgery because I was still numb, and the nurse said that it could last even two days…in hindsight, I wish it had! It was like 15 minutes later, that thing wore off and it is quite a suprise, I would suggest starting on your pain meds ahead of the block wearing off! That pillow sounds pertty good..maybe you could send a link and Dennis can post it on the “things to have” page. I just used regular pillows and had a few nights where I woke up and my leg had fallen off the side of the bed…ouch! As far as the work thing, I’m right there with you…I hate to sit still. I was really anticipating going back after a week as well…but the surgery/pain/healing really sapped the energy out of me…so I was ready mentally, but it’s just more tiring than you think to crutch around during the first few weeks. I spent week 2 at home working on laptop in bed. I think Johnskier also went back fairly early, and with a weakened immune system, caught a nasty cold. Take care and let us know how things are going.
Michael - Good to hear that you’re in good spirits and that you were able to get a good night of sleep. I remember that being tough for me. Not because of any pain, but I think it was just hard to stay comfortable.
It’s a little weird now for me to read when people are going back to work. Unfortunately this blog started up about a month after my rupture, so I didn’t have a lot of good resources. I really didn’t give it much thought when I went back to work. I wasn’t in much pain, had pretty well mastered the crutches by then, and I knew that lying around the house would really affect me mentally. I’m lucky that I work in a small office and during the winter I’m mainly at my desk in front of a computer. And, unfortunately, working from home was not a real good option.
With that being said, I think it is important for everyone to assess themselves on their own. Only you know how you’re feeling. This is a serious injury and you don’t want to push things too hard. It’s good to set some goals, but don’t be afraid to adjust your goals if your body is telling you to slow down.
Great point Tom…it’s always good to continue to mention that everyone heals and deals with this injury different. I think that’s the best piece of advice…listen to your body first…it will give you the signs if you are going to fast/slow with your recovery. Hope everyone is having a good day..and if you’re not…you will tomorrow!
Hi All,
I injured myself last Tuesday, had an MRI today, and surgery is scheduled tomorrow. How much pain for the first few days? Thakfully my ex is letting me stay at her house for a few days post op.
How fast until you can actually get around a bit? My Dr. said I would be walking wiht no cast or boot in three months. Possible?
I have 4% of the tendon still atached, so he said most likely I will have my cast with my two pointed down. He said he would try to avoid, that, but don’t count on it. Any thoughts?
I am a single Dad with three kids and self employed, so this is going to be a tough go.
I go in tomorrow at 2, and operated on at 1:00.
Great blog!
Mike
Hi Mike R -
welcome to our not-so-exclusive club. I had surgery yesterday afternoon. I’m about to take my first pain pill now. I am beginning to feel some slight discomfort and was told to stay ahead of the pain if I can. I had a 97% tear. According to my doc, the surgery was the same as with a complete tear except he didn’t have to locate the loose tendon.
Good luck tomorrow. You’ll get through it as we all will. Not fun but there are lots of things that are worse.
Michael
Hi Mike R - everyone has various degrees of pain when coming out of surgery. However, I would suggest asking for a splint instead of a cast for the first 2 weeks, because your foot will be swelling up in a cast with no breathing room, and it can feel like your foot is ready to explode. I am talking from experience, I ruptured my left leg two years ago and now my right. Having the splint the second time around was so much more tolerable after surgery.
Mike R - Good luck with the surgery. Sorry you had to join the club. My recommendation is to read through all of the blogs on this site to get some expectations of the road ahead. As you’ll see, there are several different treatment and rehab protocols and no consistent level of pain.
Toes pointed down in the first cast or splint seems to be pretty common. This reduces the tension on the tendon. You’ll have to lift your knee a little higher when you crutch around, but it doesn’t take long to adjust.
3 months for walking unaided is very realistic. I started walking without the boot around week 9 and my rehab has probably been a little toward the conservative side.
mike r.
good luck tomorrow
i agree with tom regarding the splint, this is what i have and it is more comfortable to wear as you foot swells, etc.
for myself, i only had to take tylenol 3 for the first week
2nd day, lots of pain, got good painkillers and felt better
after
the side effects of some painkillers is having the runs, which can be very tricky when you’re on crutches…ha,ha
your kids will get used to it all and you’ll see how much they will help out
the two first weeks are the worst…
i’m only on week 3 and feel better…still lots ahead though
nancy
Good luck today Mike.
Has anyone else experienced a somewhat sharp pain down near where the AT meets the heel? I only feel it at certain times when I move around. I am almost 3 weeks post surgery. Thanks.
Drew
Drew -
I had that problem some years back before the ATR. It was diagnosed as bursitis in the heel.
Right now, I have been experiencing minor pains here and there around the incision at varying times. Mostly it happens when I am walking in the boot. I don’t think it’s serious, but I think it’s a good sign telling me that I need to stop and rest..
It’s probably different for your case, and if it is really bothering you, I suggest seeing the doctor.
I think getting up and moving as soon as possible after surgery is very important. I knew this would probably be the biggest challenge for me. Within 2 days I had a spot on the floor where all day I would do push-up, crunches, leg lifts, bicycle in the air while on my back, and any stretch I could think of. I was up to 150 or so push ups a day within a week, and more flexible than before the injury. I think keeping as fit as possible will make recovery that much easier. Not to mention the increased heart rate pushing more blood, oxygen, and tendon building blocks to the injury. I don’t know if there is any scientific evidence of this, but the placebo effect for me is worth every bit!
Jim
hi guys
just came back from the hospital for my first post op appointment
saw my surgeon, checked my tendon and everything seemed to be ok
washed the leg…that felt good
was sent to rehab where they gave me the option to either have a cast or a splint…i did not think twice: a splint
the OT showed me a few stretches to do to work on increasing my ROM, and my quads and all , i was happy with this
my splint puts my foot at a 70 degree angle, which was kind of weird first, to get there
i’ll keep this splint for 3 weeks, use crutches, no WB though
i guess i’m happy overall, i had written down a whole bunch of questions from what i had read on the blog for the last 3 weeks and my surgeon was able to answer them all
the plan is to start physio in 3 to 4 weeks and put me in a boot/aircast in 3 weeks.
i’m happy i bought my laptop in january, i’m sure getting good usage out of it!
nanc
Nancy -
Glad to hear that your post-op exam went smoothly. I am curious what the list of questions you had for the doctor were and what the answers were.
If you post it, I think maybe others going into their first post-op exam will find it useful as well.
Please let me know. thanks!
dennis
my questions were
was my tendon fully tared? yes
it was not a clear tear but more shredded, ugly he said
what was the condition of the tendon now? it felt nicely reattached
when will I start WB? in 3 weeks, also because of the fact that my tendon was shredded
when will physio start? in 3-4 weeks
how often will i need physio? twice a week for basically get a series of exercises/stretches
i asked about ultrasound and he said that “physios do a lot of funny things which we do not really understand” so he did not see the importance of it
what was the difference between a CAM boot and a Aircast?
they were basically the same
when will i get one: in 3 weeks
can i drive my car? yes, if it’s automatic, but be careful getting in or out of it
do i have to elevate my leg? no, it’s healed ok
can i take aspirin(it was discouraged after my sugery): YES
any natural supplements: nothing really has been fully proven to help with the healing process, he recommended having a healthy diet and eat vitamin C< helps with the collagene around the scar
can i take baths? yes sir, no danger for infections
just finished doing my first series of ROM exercises..
it feels good, i’m back in the game!
i think that’s all
hope this helps,
nanc
nancy -
thanks for posting the questions/answers. I am compiling a set of questions, and I’ll post them on the main site after it’s complete.
Hi all,
Well, 5 hours post op, and not feeling all that bad. Trust me, it’s no walk in the park, but not much worse pain than the accident. I am on one Norco, 10/325, and it doesn’t seem to be helping much.
The good news is that my cast is flat footed. I had 20% left. Dr. said more pain now flat footed, but faster rehab.
The only bad news was that they had to open me up almost 10″ , as my tendon was way up in my calf.
It doesn’t seem much worse with foot down or up, but I am definitely elevating.
I have a cast from bottom of knee with all my toes showing. At least I can rub them once in a while!
I am sure pain will be worse tomorrow, but so far, so good.
My ex is taking good care of me. I am glad we stayed friends.
Mike
Mike
Mike -
Glad the surgery went well…I don’t think anyone can claim a 10″ incision! Wow! I think Mitch was leading the pack until today..we’ll have to get a look at that if you can upload a pic after your first post op appt. It sure is good to have support/help around after the surgery, it sounds like you are in good hands. Rest up..the first few weeks are all about letting your body do it’s thing to heal the surgical area.
Putting a face to the name. Here I am goofin’ about at Red Rock Canyon outside of Vegas today (I live a few minutes from here). I’m not far from the car though.
http://farm4.static.flickr.com/3070/2364630139_f7568abd89_o.jpg
Jim
Jim -
Great picture!
Similar to my action shot.
http://achillesblog.com/dennis/2008/02/23/day-16-5-seconds/
I just have to add that none of that weight is going through the tendon, and it is for limited times only. I just want to be able to carry my beer to the couch myself!
Jim - The beer motivation definitely helped me ditch the crutches as soon as I got into the boot. It was extremely satisfying to walk to the kitchen, pop open a cold one, and return to the couch without spilling! Prior to that I would balance the beer bottle between my index and middle fingers while keeping my palm and other fingers on the crutch. It worked, but it wasn’t pretty.
Oh, and nice picture. Looks a lot nicer than the weather I’m dealing with.
MOM”S ROCK!!!
I was laughing so hard my foot nearly exploded. That was great. Your cover is blown Ross!
Jim
PS If I didn’t have help from my wonderful girlfriend I would be lying in a pile of pizza boxes and…well you get the idea.
I hear you Jim. If my wife weren’t here to help me, I’d have starved by now.
Can anyone tell me when the throbbing when the foot isn’t elevated stops? I am 3 weeks post-surgery in the boot with PWB. The throbbing is better than last week but still annoying.
Drew..from the various stories I have heard here..the time varies from person to person. I am 3.5 weeks post op and it’s just been the last few days when it’s been OK to keep it down for extended periods of time. I still like your choice of word, “annoying”, because that is how I would describe mine for the last week…not a painful throb like the first week after surgery…but a kind of numb/tingly feeling that goes away with elevation.
hi guys
for the beer thing..
i wear a kangaroo top(hoody) with a front zipper…stuff your bottle in there, hold your stomach muscles in….there you go!
for the throbbing, same thing as brendan
i’m exactly 3weeks post op
it’s gone better since i’ve got the cast off but still need to elevate now and then, but not has high, just on a pillow
As soon as I can I think it may be Bikram Yoga for me, at least for a while.
Hi all,
Day # 2 after surgery, and a bit more painful than I thought it would be. Yesterday I actually fell down, as my dog tripped me up going to the bathroom. It felt like I ripped out the stitches, or like I had a hot knife stuck in my ankle.
It took 3 hours to get back to only the normal pain. Scared the hell out of me. I thought I would see blood dripping out of my cast.
I am now taking one Norco every four hours, and the pain is much more manageable. I didn’t take anything yesterday until i feel.
Whoever was doing push ups after day 2, well, if I go to war, I want you with me! I don’t know how you could have pulled that off.
Thank God for my ex. She is taking great care of me. She woke me up this morning with French Toast, berries and coffee. I told her with service like this I might never leave. She answered with,”Oh yeah you are!”
Mike R -
That really sucks that you fell. I’ve stumbled a few times when I was on crutches and ended up putting weight on the cast leg.
I’ve been reading a lot about other people’s experiences with Achilles recovery, and everyone’s recovery process has been a little different.
I stayed in bed for 2 weeks with a laptop. In retrospect, I wonder if that was the right thing to do, but I haven’t had too many problems so far, so I guess I shouldn’t linger on it too much.
Glad that you have someone who can take care of you.
Look what my girlfriend made me. I was griping about how my leg always turns to the outside when lying down and elevating. She made this giant pillow that holds my leg from externally rotating. Very cool stuff. Neat desert camo butterfly pattern too.
http://farm3.static.flickr.com/2224/2370430864_4b4d499e68_o.jpg
Thought you might enjoy,
Jim
jim
your girlfriend should take orders…
my boyfriend would never be able to come up with something like this!!
Jim -
You have a fantastic girlfriend! If she wants to make additional ones as a hobby and sell them on AchillesBlog, please let me know.
Dennis-
Thanks, she was flattered by the compliment. Unfortunately, she is very busy right now, I think she made it for her comfort as much as mine (to make me shut up).
I do have a suggestion for the website. I don’t know if it’s possible, but can this “Leave a Reply” box be moved to the top of the page? It’s gettin’ pretty far down there, and I am usually commenting on the last few comments. Just a thought. Otherwise the site is really great.
Thanks,
Jim
Michael-
Just to comment on your shower woes. I think I have developed a really great system. As an ER nurse, bathrooms scare me. I have seen more injured people from the bathroom than any other room in the house (don’t wash dishes either). Combine tile, water, and muscle contractions that can cause people to pass out, with all those hard sharp corners, and you have a recipe for disaster. That being said, I tried to make myself as safe as possible in there. I sit in the tub for showers. I have a water pic shower head and an extension hose so I can lay the whole thing in the bottom of the shower. As for sitting down, I sit in the tub on one of those flat rubber balance balloons, keeps me out off the floor and out of the run off. Also, because of the side I injured and where the faucet on the tub is, it’s right in my back. I got on of those $0.99 rubber balls from Target, slightly bigger than a basket ball, the kind that are always in those big metal cages, and use that as a back rest. It keeps me off of the faucet, and is soft. Next, I put a towel over the cast and set it on the edge of the tub. No worries about getting it wet. This way I can shower while sitting down. If you need extra grip in the bottom of the tub, put a small towel down. When I get out I have a sturdy chair right next to the tub with a towel on it. I can get out, dress on the chair and put on my favorite shoe, and not leave a trail of water. Hope all this makes sense.
Jim
Jim -
Thanks, but I don’t think I can move the comment box, but I’ve added the “reply” button on the comments. It should direct you to the “Leave a Reply” box (on the correct blog). Let me know if this makes using the site easier.
Dennis,
That’s nice. Was that always there and I just didn’t see it?
Jim
Jim -
Thanks for the shower advice. I have a handheld attached to my shower so I’ll give your method a try.
because i seem to be a little worried about my injured foot and plantar fascia, i did a little search and found this site with good tips (maybe you guys had already posted something?)
anyways, it will get better once some of us start moving again
most of the stretches are not applicable for some of us now but good for some of you who are walking
will continue massaging it and icing i guess
if any of you have tried something else that works please let me know
here it is
http://www.aafp.org/afp/20010201/467.html
Nancy -
Thanks for the link. I’ll post it on the site as soon as I can.
I hope your foot gets better soon.
Jim -
Nope, I added it today just for you. Enjoy!
Day 4 and I feel pretty darn good this morning.
Has anyone slept on their side? I have a flat/wedge shaped pillow a friend gave to me to elevate my leg. My butt and back are feeling weird from laying down so much, so I thought I would try the side.
Last night I put the AT(left) leg on the wedge, laying on my right side, sideways, and put two pillows between my two knees. I felt really comfortable when I fell to sleep, and I woke up with the wedge on the floor, still on my side, and no swelling or pain whatsoever.
You think there is any harm doing that?
Hotel Ex is closing today. I am off to my house, and my first attempt at a shower (trust me I NEED it!)
Hope you all have a good Sunday.
Mike
Mike R - sleeping on my side was the only thing that worked for me…I don’t think you are doing any harm, in fact I would argue that getting good quality rest is one of the best things you can do for your AT during the first few weeks post op. For the first week, to get the most elevation, I would sleep on the side of my good leg, put 2 pillows between by legs so that by bad leg was elevated above my heart. I woke up one night with my leg hanging off the side of the bed..and that hurt like heck!
SAME HERE GUYS
i’ts the best way for me to sleep still after 4 weeks
Nanc - I experienced some of the plantar fascia discomfort you referred to while I was in my various casts. I spoke to my surgeon about it at my 4 week post op visit and he recommended pulling my toes up to my shin, as far as I could without feeling any significant pain. I think this helped. My arch felt really tight at week 4, but by the time I was in the boot at week 6 it felt much more relaxed.
Mike R. - I don’t think you’re doing any harm. I agree with Brendan that quality sleep is probably one of the best things for healing. Do what you feel comfortable with during the healing process. We all heal in different ways, so don’t be too concerned if something that is comfortable to you is different from everyone else.
thanks for the advice tomtom
massaging my foot seems to also help
Hi All,
I am a recovering from my second Achilles (bilateral) rupture. I popped the first at 36 playing indoor soccer and the second at 42 playing tennis on hard court. I I want to go back to these games, but I am somewhat apprehensive about the risks. I am ~eight months post-op on my second “event” and am still working to recover the full strength in my calf. Do any of you have any suggestions or metrics for full strength recovery? I have been swimming a bit which is a low stress excercise, but I miss the soccer…….
TZ
tz - sorry to hear that you had another rupture, but glad to know that you’ve mostly recovered from it. By the way, was it on the same leg (re-rupture) or different legs?
I am just starting to walk without the boot, and my plan is to lose 10 lbs and exercise regularly.
I know that it’s not a guarantee, but if I weigh less, then there will be less stress on my tendons.
I also plan to be vigilant about making sure that there is no tenderness in my achilles if I plan to participate in high- impact sports.
If I put in place sound preventive measures, then I believe that it’ll dramatically decrease my chances of ATR.
I believe that you get what you put into it, but there are really no guarantees in life. Do your best and hope for the best.
dennis - I wiped out both left and right Achilles. I do have a neighbor who re-ruptured the same tendon. I gather that is a nasty repair because the surgeon hmust work around the scar tissue fom the first event. Good luck with the ten lbs and the exercise regime
All,
Side sleeping with the leg Achilles leg elevated on some pillows was the only way I could sleep.
I was struck by how much difference In pain I had between the two ruptures. The first (no nerve block) was excruciating and I almost got hooked on the pain meds. I had to flush the remainder down the toilet. The second leg (with a nerve block) did not hurt nearly as much. The second leg also had significantly less atrophy - go figure.
I wish there was some way to partially stimulate the muscle tissues while the tendon is healing and still vulnerable shortly after the operation. Ten years from now they’ll have this figured out……..
Great blog….
TZ
what a treat…
i had a 45 minutes full body massage today…
i fully recommend it
my good leg was absolutely hurting
so were my forearms (because of those *&&%$ crutches)
here is what she recommended to release some of the tension in myr forearms/wrists:
bathe them, alternatively, in hot water(1 min) and ice cold water (10 sec)
i tried it tonight for 5 minutes, it was enough, and my arms felt great
YEA !!! Just back from the doctor 7 weeks post op and the cast is off and the boot is on. My scar looked great but very long as I tore my Achilles very high. The calf muscle is non-existent but I am sure that will come back soon. The doctor did tell me to ditch the crutches as soon as I was comfortable. It took all of one hour before I threw them in the trash - Literally !! I hated those things. It feels very weird to be walking and I am walking with a real limp but I am walking. My doctor has a physical therapy practice in his building so I already went there and am scheduled for my first evaluation tomorrow morning at 9:00am.
I will report on that tomorrow.
So here is something new that my Doc. wants me to do that seems very different from what you all have been doing. He told me that the incident of re-rupture is 19% within the first year. He has prescribed a metal brace to be made for my shoe that will prevent my foot from overextending. This is to be worn once the boot comes off for another 6 months. It is called the Klensak Metal Upright Heel Attached Dorsi Flex Stop Brace.
Seems aggressive. Anybody heard of this. BTW, I am only 39 and in great athletic shape.
PK
To All..
Have not seen any comments or posts about someone getting to the pool for rehab. Interested in getting in and out of the pool as well as using a crutch on the wet deck. So if anyone is doing that can you relay some info,
“One day closer to the end”
Doc,
I have not gotten in the pool yet but I fully intend to as we have a full indoor and outdoor facility at our gym. I did take my kids several times to the pool for their lessons while on crutches. It is very dangerous but dooable if you go slow.
PK
I’m planning to swim this weekend and test out this fiberglass and Goretex cast. I’ve been contemplating getting in and out of the pool one-footed with the crutches. I’m happy that I have the Strutter crutches because they have a much bigger base than a standard crutch and the base always remains flat on the ground as a result of the hinged spring mechanism. Even with all of that, I plan on having my wife help me in and out of the pool. Luckily, she too is a swimmer. In all events, I’ll report back as to how the swimming goes.
Brendan…
Left foot..
FYI…your gastrocs act as 2nd and 3rd pump besides your heart. In order to circulate the blood up to your torso the gastrocs need to be utilized otherwise the blood pools in the foot, leg and thigh. This stagnation leads to swelling, redness, varicosities and the possiblity of clotting. So wiggle your toes, ask your MD about PWB, FWB or even doing isometric exercises inside the cast/boot.
Doc Ross
small update:
Injury/Surgery Date Summary Table was rewritten.
It’s now actually sorted by surgery date, and it should show your information if you have an Achilles Profile regardless of whether you have a post or not.
I’ve also added “which leg” field. I’ve taken the info from the spreadsheet and what was in the comments and your blogs to fill out most of it. If you want me to add “which leg” info for your profile, either leave a comment or request for an update on the spreadsheet.
You can’t enter the “which leg” info yet from the “Achilles Profile” since I haven’t made changes to it yet.
Dennis,
I am 39 and in tore my right achilles.
So gang. I am still having a real hard time walking in the Aircast boot. It is extremely uncomfortable. Not that I am getting a lot of pain in my leg just that it is really an awkward gate. The only way to swing my right foot forward in the boot is to pigeon my toe out aggressively. It really looks like I am walking like a pirate with a peg leg. Walking this way hurts my knee and back. I am guessing my issue is that I have two wedges and only -12% range of motion, so my ankle just does not bend.
Are you all experiencing this issue?
Thanks.
PK
philip - thanks. As for the boot, how many days has it been? I think if you find a good shoe that has a fairly thick sole, then you won’t have to compensate as much when you walk. (I personally haven’t found one and not planning on buying one anyway since I’ve been walking fine in the boot..)
It took me a week or so, but I’ve adjusted my gait so that my boot leg is always slightly bent. Also I have one of those boots that have rounded sole to make walking easier..
I think others will comment on this, since it’s been a topic of discussion on several occasions. Maybe creating a “How to walk in the Boot” section might be helpful.
Please let me know if anyone wants to give it a shot. I’ll link to your blog from the main page.
Bri - Thanks for sharing your blog. I’ve added your link on my site as well. Cheers to another Minnesotan! Hope you were able to get out yesterday and enjoy the beautiful day. Good weather really helps when trying to stay positive.
Others - I’m sorry I can’t offer up much advice on walking in the boot. I didn’t really experience any troubles with the boot, so I never gave much thought to how I was walking with it. For me, walking in the boot felt almost the same as walking in ski boots - a bit awkward, but easy to make adjustments. My only issues with the boot were that it was larger and heavier than my casts and that my good leg felt more fatigued which I’m sure was a result of the compensation. Perhaps the ease of movement is dependent on the type of boot? Phillip, maybe you could check with your ortho and see if he has a different style of boot you could try.
Hey all,
Just got back from the hospital - I will be in a fibreglass cast for the next 6 weeks (new one every 2 weeks) with NWB.
After that I can put full weight on the foot and begin PT.
Weather is getting nice out and it’s starting to get frustrating!!! lol..
James
Maya…
sounds like we forged from the same mold…good luck with the biking, where are you located??
I am so ready to hop on the bike and get moving..My next apointment is Wednesday and I am hoping that I get the green light on some physical activity.
Doc Ross
James -
Thanks for the update. You can still go outside on crutches. Your upper body will definitely get stronger using crutches. You can try a walker or the iwalkfree as well. Johnskier has used iwalkfree, so you might want to ask him about his experience.
For anyone interested in swimming, see this evenings post on my blog. In a nutshell, it was pretty easy and well worth it - there is a great sense of freedom in the water and only having one good leg is not a problem in the pool.
Dennis…
you may want to add this to the causes of ATR…spoke with a GP and he asked if I was on an Antibiotic..I have done some research and indeed Levaquin contributes to an increased amount of ATRs.
here is some info.
http://www.zimmreed.com/levaquin-tendon-rupture.html
Doc Ross
So for a quick update to my boot walking problems. Yesterday afternoon something happened where I suddenly began walking correctly. I no longer had the pigeoned toed peg leg walk. I have walked a lot today and have tried to evaluate the change. I believe that most of my issues had to do with lack of confidence to “roll over the toe” of the boot. Now that I am walking heel - toe I see what my problem was. It seems intuitive now. This goes to the whole conversation we have had relative to patience with this injury. It is not an every day improvement but improvements by the week.
PK
Here is a look at the calf and incision 5 weeks 2 days post op and 6 weeks post injury. I think I tried to scrub the dead skin off a bit too aggressively, thus the rash.
http://farm3.static.flickr.com/2336/2401132899_61ff6d46f1_o.jpg
I have some serious work to do, but I’ll be taking it slow. Plan to start PT next week. I can’t believe how normal I feel walking in the boot.
Doc Ross - Thanks, since there wasn’t a section on “Causes of ATR”, I’ve added it to: http://achillesblog.com/atr-rehab-protocols/
Jim - aside from your rash
…our ankles look identical. I still can’t believe you are standing there…that’s so neat to see. I have my appt this Friday…I’m supposed to be NWB now, but I have been sort of walking with the crutches, probably 25% on the booted foot…and it feels great.
I had my second post op Dr. visit today. 15 days post op.
They took the staples out, and I am barely swolen at all. No brusing, and the scar looks really healthy.
They recasted me for the thrid time, and I am at a complete full 90 degrees! It feels really tight but I am happy about it. He did the Thompson test, and my foot moved a LOT!
I can PWB up to 20 lbs. on it, which is not bad for two weeks! My cast comes of in two weeks, and into the boot. They fitted me with a cast shoe cover so I can actually stand on it a bit.
I am SHOCKED at how much atrophy there is in the calf! I wil post pictures later today. I am a runner and hiker, and my legs are pretty strong and difined. Not the ATR leg any more!
I wil start ROM and light PT as soon as the cast comes off, so I do feel I am a little ahead of schedule.
He said I was doing really well, but to remember about it being a marathon, not a sprint (like we all hear and say).
He thinks I will be walking in shoes in 6 weeks.
Mike R -
Thanks for the report..I’ve got a pic of my atrophy after 25 days: http://achillesblog.com/brendan/2008/03/28/2nd-post-op-day-25-appointment-questions/ It was a shock to me too how quick it goes, but you figure it’s the most used muscle in the body. You sound like you are on a very similar path to Dennis..looks like a solid protocol. Hope all is well…keep us posted.
Doc Ross-
How do you know if your antibiotics are Levaquin? I too am on antibiotics… Does it say it on the bottle? It’s in the bathroom right now which seems like a long way away but I’ll hobble over and grab it
Here’s another link I found on the topic:
http://www.revolutionhealth.com/articles/health-highlights-jan.-3-2008/hd-611405?ipc=B00520§ion=section_02
Bri,
Levaquin is a brand name for the antibiotic levofloxacin. Levaquin belongs to a group of antibiotics called Fluroquinolones, or Quinolones. They are groped based on their chemical structure and how they stop bacterial growth. If your bottle says levofloxacin, then you have Levaquin. There are other drugs in this group like Cipro, but from what I have read, Levaquin seems to be the biggest culprit in tendon rupture. Rather than drone on…this may help
http://en.wikipedia.org/wiki/Fluoroquinolones
Didn’t mean to steal your thunder Doc, I’m just bored at home.
no problem Jim..
Bored….masters on TV…
Baseball started
Hockey playoffs
Crunch time for NBA..
and you’re reading up on antibiotics….
Doc Ross
Jim - Thanks for that info. Also, if you have a bit more time, can you tell us more about how to negotiate with the health care providers? I’d like to setup a page for those without health insurance on how to lower their medical bills.
I think your knowledge in this area can help a lot of people. If I didn’t have health insurance, (and I almost didn’t), then I would have had to pay 14K.. and that’s more painful than the achilles rupture!
Ross-
That had me laughing. Well, for the same reason an alcoholic avoids the bars, I ditched the TV 3 years ago. I seem to have reached the end of the internet though! I’ve probably given 10x my bodyweight in Levaquin to patients though (sometimes even with steroids, ouch), I wonder how many tendons I’m responsible for. Karma??
Dennis-
Would you like me to email you about the insurance pointers? I’m thinking you must have my mail when I post. I can make a few more comments, but I’m not sure it would be enough to fill a whole section.
jim - thanks. I’ve sent you an email.
Hi all
Just found this site and have been very impressed with the ideas and information gathered. My complete rupture of the right AT occured whilst playing basketball on march 6 and was operated on march 8. I am 38 yo mum with two kids (3 and 1 year old) so not much time to sit on couch and ring the bell. Have been lucky to have good family support but have been FWB since around 4 weeks as it is the only way to get some things done (also no pain). My Doc really didn’t give me that much info regarding my recovery but the protocol has been plaster splint 2 weeks then boot for 6 weeks with crutches as needed. Each week the boot heel is reduced. I am now 5 weeks post op and up to date have been a bit confused about what I should and shouldn’t be doing. Reading your comments has made me feel a lot more confident about my progression and certainly given an insight into the many varied treatments out there. Thanks for the great info posted as I have been very unsure of procedures up to date.
Hi just syumbled across this blog, literally, whilst researching recovery times for ATR. I ruptured my AT at 1835hrs on Wed 20.02.08 whilst playing a game of 5 a side football. Now in week 7/8 of recovery and due back at the hospital for my 3rd and final plaster cast to be fitted and hope to be free from this by 01.05.08.
Can anyone give me any idication to the timescale I might be looking at before i can get cycling again ?
Many thanks from across the pond in Scotland.
Hi Sharon, glad that you’ve found the site useful, and thanks for sharing your ATR story. Looks like you are recovering very well.
I started FWB after 4 weeks (I guess that’s week 5?), and I am now walking in normal shoes. Doctors have varying recovery protocols, and I pretty much adhered to my doctor’s rehab schedule (except when I had my moments of impatience).
If you have any specific questions about our experiences with ATR, please let us know.
JohnK - Welcome. Your cycling question is one you probably want to discuss with your doctor as recovery protocols are all different. But, I can give you an idea from my experience. I am now a little over 13 weeks post op. I was given the okay to start partial weight bearing at week 4. I was anxious to start doing some cardio exercising, so I asked my doctor if it was okay to start riding on my bike trainer. He said that was fine, but just take it slow. I started out at a relatively low resistance and rpm, and gradually increased both. I continue to ride on my bike trainer or a stationary bike a few times a week. I avoid high resistance to minimize forceful movements, but my pedal strokes are back to normal. I haven’t hit the open road yet as I’m still being a little bit cautious, and I’m also waiting for the weather to turn. At this point steeper hills would probably still be tough, but a flat ride is definitely doable.
In my opinion, cycling is a great way to get the blood circulating in the leg again in a pretty controlled manor. A flat ride is manageable early on (3 months), but you may have to wait until you get some strength back in the calf before going on a hilly ride.
Dennis - thanks for the reply and your info has been great.
I guess I have been very lucky in that I have had no pain, even from the injury to the op and afterwards, but this has probably made me feel that I should be doing more. When I asked my Doc, at the 2 week post op stage, about physio and PT he said when I get out of the boot (7 to 8 weeks post op). However,I have been following the Eric Berkson PDF file protocol on goals and activities as I have found this really good. Have you been doing much in the way of exercises whithout the boot? I have been quite active with the boot on - gym, some walking and chasing the kids around. I will tackle swimming in the next week or so. Not so much worried about the swimming itself, more about trying to get changed and showered afterwards. My goal is to be able to walk without boot in 3 weeks as we are going on a family beach holiday (Gold coast as I am from Australia)
sharon - Ever since I was put into a boot, I’ve been doing the home exercises. (although not as regularly as I’d like) http://achillesblog.com/physical-therapy/
The exercises that I have been doing are: #1, #2, #3, #6, #7, #8
Basically the exercises that don’t involve me putting too much strain on my achilles.
But you should always get an “OK” from your doctor before doing them. I asked my doctor about the exercises and he said it was “OK” for me.
At about week 7-8, I started my PT. I should have started at the beginning of week 6, but I couldn’t because some silly paperwork reasons.
When you do start your PT, be sure to not push yourself too hard. Although it’s unlikely, I have heard of people re-rupturing their AT during physical therapy. Brendan has a nice post regarding re-ruptures: http://achillesblog.com/brendan/2008/03/31/discussion-topic-other-atre-rup/
I have to keep reminding myself that it didn’t really hurt too much when I ruptured my AT. That means that it probably won’t hurt too much if I re-rupture. So I can’t use pain as a indication of whether I am getting close to a re-rupture.
Just make sure that you consult your doctor before doing any exercises.
Hi AT Gang.
Just wanted to check in again with the boot experience. Now that I have worked out the kinks on how to properly walk in the boot the freedom has been amazing. This weekend I had was able to do yard work and play baseball with my boys. A real mental boost !!
The good news is that my foot in only a week and half of PT is bending to about -5% which is a +7% improvement in ROM. The PT has been very effective and I have been seeing him 3 times a week and doing the exercised every day.
Another progress report is that I am limping around the house slowly without the boot. I am trying to take it slow but it is hard not to push a little.
Glad to see everyone making such great progress. For anyone new. Read the blog every day it keeps your spirits up on the bad days.
All the best.
PK
Just got back from my third post op appointment (5.5 weeks post op). My doctor said that I can gradually wean myself off of the crutches, which is nice. I am a little hesitant to give them up, though, as I still feel like my bad leg is weak. He had me push against his hand with the ball of my foot and I was surprised at how hard I was able to push. Encouraging. I should start PT next week (they couldn’t take me this week) and I go back to see him in 4 weeks to (hopefully) get rid of the boot. Baby steps!
drew - glad that you are able to get off the crutches soon. It was a major sigh of relief for me when I started walking in the boot without them. I think PT helps a lot, and I wish I had started a bit earlier too. keep us posted.
philiproskin - good to hear that you are progressing nicely. Yes, I loved going from the cast to the boot. My favorite moment was putting the crutches in the garage knowing that I won’t have to use them again. Let us know how your recovery goes, and thanks for your comments.
How do I get my own blog on your site? I am a bit confused on where to start, since I have been contributing already. Will all my old posts be on it?
Just a quick note on the knee walker. You can rent them at any CVS for $80. per month.
Last, how do I post my pictures?
Hi all, Just a question about recovery. The overwhelming feeling I have right now when trying to flex my foot is that I can’t get my calf muscle to “fire”. I don’t know if anyone else has had this sensation. I’m sure this is just part of the process, but it’s just such a weird feeling.
Thanks
Jim
Mike R -
First login if you already have an account, and then
you can go to this URL:
http://achillesblog.com/miker
It should redirect you to the sign-up page.
You can post pictures after you’ve created a blog.
Thanks for letting me know about the CVS and renting knee walkers. That’s a great piece of information. I’ll put that on the main site.
Let us know if you have any problems with the blog signup.
Jim - I think what you’re referring to is probably normal. You’ve likely lost a fair amount of strength in your calf as well as range of motion. I can’t remember if your doctor started you on ROM exercises, but those might help. I think it just takes a bit of time for everything to start functioning normally again. As you start to re-stretch the tendon, you’ll probably notice the calf start to “fire” again.
Jim - Yep, I know that feeling. I tried walking normally by pushing off with my recovering foot, and my foot didn’t respond. It’s getting better though as my calf muscle is getting stronger.
I walked around a few blocks today, and I am getting a little closer to normal walking. My heel is a bit sore though as I think I’ve been walking way too much the past few days. Time to relax and give my heel a break for a couple of days.
Dennis
thanks to you linking my blog to yours i now have quite a few AT (victim) visitors. In AT terms, i am now an ATV (veteran) having ruptured my AT in September 06. While i do few if any specific posts on my AT these days I am happy for people to visit and check out my history and I will answer questions if asked.
my AT has recovered. I dont run by choice although i am sure i could if i wanted to, but i do ride (road bikes) . My calf musculature has still not regained its former beauty but it works ok and it does not pain me.
I wish you and all of your visitors enjoy a similar fate in the longer term.
Be positive , be active - what doesnt “kill you” makes you stronger. Its true - at least for me.
Jeff
Jeff -
Thanks for stopping by. Glad to hear that you’ve recovered fully, and it’s good to have AT veterans around.
I’ve been keeping up with your blog and it’s good to hear that your dad is doing better.
Good luck on your French, and the cheese souffle looks delicious.
Just a few observations about starting to walk in a shoe again. I’m almost at week 7 and am allowed to wear a shoe with heel lifts in the house. I limp quite a bit since my foot doesn’t want to bend much past 90deg. I find if I take very small steps, I can almost get a normal gait. If you are starting to walk without the boot, try very short steps at first. This will allow you to use your foot and calf in a normal motion without undue strain.
Also, since my Dad had hip surgery with a resulting DVT, he swears by these (he uses the next higher compression)
http://www.healthylegs.com/joformenovmi.html
I saw a pair at the local drug store and picked up a set. I have to say they really help with the swelling and just make your leg fell more, normal i guess. I’m not sure the fashion statement I make with one knee high black sock though. I may start something here. I’m in Vegas so it’s shorts weather now.
I know that Orthopedists and Podiatrists both can do this surgery. Is there any other specialty that will do this surgery? The thought occurred to me that maybe this has something to do with the differing recovery protocols. I’m sure each specialty has differing ‘cultures’ on recovery protocols. I was seen by an orthopod and am walking about the house today in a shoe at 6.5 weeks. Seems fairly aggressive to me. Any thoughts?
Jim -
Thanks for the link for the socks. I’ve created the link on the main site: http://achillesblog.com/things-you-might-need/to-help-you-get-around/
Is anyone else at the 8 week mark and still in a hard cast? I will be at 10 weeks, my next Dr visit. Supposedly going into a walking boot at that time. Last visit(week6) they told me wean myself off of crutches, so this past Sunday I just put them down and started walking on my own. Sorta frustrating hearing other recover times–but my Doc is very conservative in protocol..
Brendan-
Did you happen to go to Lees Mcrae College outside of Asheville? Also blog photo tricked you–that photo is from the Rocky Mtns. Some buddies and I go elk hunting out there from time to time. Probably will have to miss the trip this year.
Kevin - nope..went to Warren Wilson..but have driven by Less Mcrae. Should have known the Rockies too…since I live out here in Colorado now!
Found a bright side to this mess–yesterday afternoon I went to my daughter’s coach pitch softball practice at 4:30. If I was healthy that would never happen, would have been at work..haha Is this injury costing anyone else because they are unable to work? Looks like I will be out of the big brown truck for at least 6 months….Kevin
Great website - found it while surfing and looking for those going thru the same thing as me - Just had my first post-op appt eight days-plus and got a good report. Surprised there hasn’t been much pain, but I was scared to death when the cast was taken off. I didn’t want anyone to touch the area and was just waiting for the shooting pain to come, but it never did.
Best wishes everyone !!!!
Tulsa - glad you found the site…there is a wealth of information on various topics for the different stages of your recovery. How did you rupture? How has the first week gone?
hay kev34 / you are 1 day ahead as of injury date .. i have been in the boot since 3/31/08 and started swimming soon as the hard cast came off / it really helps . they let me use the wheelchair getting in and out of the pool .
go for my secound post op next monday . still use cruches as it helps with balance. going into my 3rd week of pt .. i think the swimming works better than pt / but the girls are pretty hot there so i go 3 times a week ..
Brendan -
I injured myself playing basketball. I hadn’t played in two years, but was having the game of my life, hitting all my shots and dishing the ball well. One point to win and was driving to the basket and then it felt like someone kicked me in the back of my leg. Being familiar with the injury, I knew exactly what it was.
The first week was a test of patience. I’ve never felt so helpless and dependant on my family at any time. Week two has been better.
Getting the positive reports and having a support group like this website has been a big boost.
Hang in there, everyone, especially those who are in day one or day two. I never thought I would make it to day 10 post-op, but here I am. I’ts going to be a marathon, not a sprint …
rob h
when you go swimming, do you need to wear a waterproof cast or can you swim without it?
when did you started swimming? week __?
thanks
Rob H–
It will be 10 weeks when I go back to Doc on the 29th of April, I think I go into the boot then…but I have been walking without crutches for eight days now—I use them only when my ankle gets tired..I will be trying the simming pool out as soon as possible.. Kevin
Milestone for myself–I love to turkey hunt, until this morning I hadn’t even gotten to go out and listen for any birds this year..But this morning me and a buddy went out and I was able to harvest a longbeard…It was awesome just being able to get out in the outdoors for awhile….
As we used to say in the Air Force “Suck it up and Press on” we will all get through this eventually….
Dennis..
Found this article. Too late for us but for the future unfortunate this may be of some help..
Interesting reading prior to having surgery
http://www.medicalnewstoday.com/articles/98043.php
Doc Ross
Doc Ross -
Thanks, I’ve created a link in the “Just Ruptured your Achilles?” page.
Hi Doc Ross
(are you really a doctor?) I am eight months into recovery from a complete rupture(due to someone jumping on my leg) and still suffering. Just today being referred back to the specialist…………..is this normal?
Dizzydebs
Yes on the doctor question..
What kind of pain are you having??
This injury takes a full year to fuly recover. You may or may not have pain during this time but the tendon builds up scar tissue over the course of a year.
Hope the specialist visit goes well…let us know
Doc Ross
Just received the video of my surgery..
Too big to post.
interesting to say the least.
Will post a full report after my post op visit on Wednesday..
Hoping to be able to be in 2 shoes…Will be 7 weeks post op.
When did everyone ahead of me (3-6-08 surgery) start wearing two shoes throughout the day??
Doc Ross
Ross - I believe I was back in 2 shoes at week 9, maybe a few days earlier. I probably could have done so at week 8, but was still having to deal with a lot of snow and ice on the sidewalks and didn’t want to take any chances. It sounds like you’re a couple weeks ahead of the schedule I was on, which may help some as you rebuild strength in the leg.
Good luck with the post op visit!
Doc Ross,
Hi. I’m at week 7 post op today (so is Brendan). I was cleared for shoes at week 5.5, but have been wearing the boot when out in public, and shoes in the house with superfeet insoles and about a 1/4 inch heel lift. I’m wearing running shoes with a substantial heel. I still limp a lot, and don’t have much dorsiflexion past 90deg, but that will come. The more I’m in a shoe, the more I hate the boot. The boot used to seem comfortable, but now it really makes my ankle feel stiff. The most frustrating thing is not having full range of motion in dorsiflexion (foot upwards toward the shin). I feel a very tight strap like sensation from my heel to mid calf, almost like the doc put a cable in there. I just want to stretch, but know that could be catastrophic.
Jim….
Thanks for the input..
Did the swelling reduce after you started going into the shoe??
What about irritation of the heel??
Doc Ross
Doc Ross - I was FWB in the aircast at 7 and told to come back at week 9 but the doc was on vacation last week. This is now week 10 and have my appt this week so my guess is I’ll be out of the aircast then. I definitely feel like I’m ready. Others like Jim are on more aggressive schedules it appears. On balance I’m comfortable with the ROM and strength that I have right now and spend a lot of time up and about.
for kev 34 and nancy / nancy i started swimming as soon as the hard cast came off / 7 weeks after surgery / i just take the boot off and use the wheelchair . take it right to the hand rail hop the steps and / then tread water some laps then walk slowly in waist deep area .. kev 34 my turkey permit starts next monday .( michigan ) i can use my quadrunner .. just hope i dont have to chase it .. kev good job on turkey !
Doc Ross,
I have never had much swelling. With the shoe I seem to have a bit more, but that could be because I’m up more with the shoe, and with the boot I have almost no swelling at all. My heel does get irritated easily though. If I am walking on hard surfaces it’s worse. My biggest frustration is the giant rash I got form the cast. It’s much better now, but I can still see it. It’s where ever I had a lot of rubbing with the cast.
For those who ruptured their right AT (or left AT with a stick shift car), how long after surgery did you begin driving again? My wife is understandably getting tired of being my chauffeur. The doctor gave me the ok (I’m almost 7 weeks post op), but I’m not sure how safe I would be on the road.
Drew- I’m still in a hard cast (at week nine today), but I got tired of sitting around so I went for a drive about week 8. I used the cruise control when applicable and I use my left (good foot) for braking…just have to be extra cautious and leave yourself plenty of room to respond to traffic…good luck with it Kevin
Hi guys,
week 9 non surgical recovery update.
Visited the Ortho clinic and had my cast removed and i was examined by the surgeon who advised me that if i had a shoe with me today he would have been happy to let me go home without a cast, but as i didn’t have a shoe i have a cast back on. Next week is a biggie, remove the cast and i am free to start PT.
After last weeks low of not getting full movement, today is a massive high tinged with slight disappointment that i could have been 1 full week ahead in recovery.
Hope everyone is doing well and recovery times are coming all as planned.
Time for me to have a small whisky in celebration, SLAINTHE !
JohnK - Thanks for the update. Hope you enjoyed the whisky! Interesting that the surgeon recasted rather than just putting you in a temporary plaster splint that you could’ve removed when you got home. Oh well, you’ll be out of the last cast before you know it.
Dennis, I sure wish I could edit my comments. I could fix the grammar and spelling errors I make before I’ve had enough coffee or after I had too much beer. That is a very short window of time when I’m at 100%. Off for more coffee.
Tom,
the reason for recast was due to the fact that i never had a shoe with me or i would have been coming home in “two shoes”.
Whisky was great………………homemade Bramble Whisky
JohnK - I realize that they recasted because you didn’t have a shoe. I just found it interesting that there wasn’t a simpler alternative which wouldn’t require another post-op visit. I suppose a plaster splint wouldn’t have worked unless you had your crutches.
Perhaps you’re story is a good one for everyone to remember as they get close to ditching the boot/casts. Bring along a shoe to your post-op visits, just in case!
Congrats to those who are progressing so well (Ross, Johskier) and congrats to Lamar for getting through surgery. Every day will be a little better than the last.
I’m 7 weeks post op today. I started PT this week and had 2 sessions. It felt really good to get the foot moving again and to actually feel my calf muscles working. One interesting note is that the physical therapist had me ride a stationary bike yesterday while in a shoe. I had a hard time fitting my bad foot into my sneaker and definitely couldn’t tie it. She said that this is normal. According to my doctor, I should be back in 2 shoes in 2.5 weeks. Hoepfully I’ll actually be able to fit my bum foot into my shoes!
I’m in Baltimore.
This is off topic, and I am not sur if you heard about teh great white shark attack that happened in Solana Beach, CA (North San Diego County) today. I live in the next town down, Cardiff-By-The-Sea, and just YESTERDAY I sat on my truck tailgate watching my SON surf at the exact spot of the attack for two hours. Very strange stuff.
I have surfed there hundreds of times, and have onl seen dolfins and small leapard sharks.
http://ori.msnbc.msn.com/id/24313314/
Mike
drew
we’re basically at the same point
i also had my 2 PT sessions this week
i can’t believe the difference in my foot!
will be on the bike next week BUT in my aircast
need to wear it for another 5 weeks
do you still use crutches?
at this point, i feel much better walking with them, takes some pressure of my foot
happy recovery
Hey everyone - just found this site and I’m already grateful…i just tore my achilles 100% about 4 hours ago! surgery tmrrw in detroit then flying home to LA…i got lucky and am getting the Detroit Piston’s ortho surgeon, so that makes me feel a little better but I have literally never injured myself seriously or had surgery. so that makes me a bit nervous. alot. My job is one that has me in multiple states per week traveling and tons of air travel (i leave for UK in 12 days)-
so. could u help w/ my questions:
1.)Does anyone know how airplane travel works w/ this injury- w/in 2 weeks of surgery and beyond? is it feasible or stupid?
2.) can i still do my job (traveling for work non stop) and still get my post op visits and physical therapy done?? is it a lot riskier? (assuming i keep weight off of it). stupid?
i snapped my tendon walking back to locker room after a cpl hours of basketball- I’m 28 and in pretty good shape so i’m hoping that helps, but right now i’m unsettled.
oh and #3)- sitting in the ER today- i had my leg stabilized and elevated- then i got a foot cramp- u know the kind everyone gets occasionally- well, i instinctively pulled my toes back to stop the cramp- but that made my tendon go further up my leg and i felt a pain that got me within a milimeter of blacking out- screamed bloody murder in the ER….
HOW DO U HANDLE FOOT CRAMPS???
thanks for any answers-
Rayn
Kristin- You may want to call your doctor about not sleeping. I was on Percocet for the first week and slept like a baby. The not-sleeping for me came later, when I had a pressure sore that was throbbing all night and not responding to the pain meds. I always kept my ipod nearby so at least if I couldn’t sleep I could listen to music. Sleeping with the TV on helps too. I think sleep is really important though, for healing and for state of mind. Good luck!
Ross/Jim/Brendan - How do I know if I have an adhesion? My scar puckers a bit at the top. Is massage OK? I have a friend who tore her Achilles in November and she said her physical therapist said NOT to massage.
Welcome to all the new victims. Don’t worry, it will get better. I am walking around in the boot and it is great.
Jim - Looks like I missed your comment regarding being able to edit your comments. I found a plugin that provides this functionality.
Ok, you should now be able to edit all future comments for 15 minutes. I’ve enabled it for the main site and my personal achilles blog.
If others with blogs want to add this feature on their pages, you can go to: “plugins” tab on your admin console, activate the WP AJAX Edit Comments
As usual, if you can’t get it to work on your own, let me know if you’d like me to activate this feature for you.
Hi all,
I found this website last night, and have enjoyed reading the posts and hearing everyone’s experiences.
I ruptured my achilles 2 weeks ago today playing basketball. I hadn’t played in a number of years, but started back about 2 months ago. My achilles on each ankle had bothered me fot the previous few weeks. Oddly, they felt better the day of the rupture than they had in 2-3 weeks. I had been playing for nearly 2 hours the morning of the rupture. I have a few friends who went through and explained to me the sensation of the injury, so I knew what it was immediately. Very depressing feeling.
I’m now at 1.5 weeks post op in a splint. I’m scheduled to have stiches removed and a hard cast on Monday (I’m anxiously counting the hours!)
I’ve had very little pain, but finding a comfortable position has been difficult. The top of my foot is frequently numb even when elevated, and, though it isn’t as bad as it was immediately following surgery, I still get the rush of blood to my foot when I stand up on crutches.
Any suggestions for comfortable pillow alignment / sleeping positions would be greaty appreciated.
Craig
Craig - I think you’ll sleep better once you get in your hard cast..it’s much lighter than the splint. One thing that helped me was to sleep on my side of the good leg, and put 2-3 pillows between my legs, thus elevating the injured leg. It was more comfortable to sleep…especially for me as I’m not a back sleeper.
I also ruptured playing basketball after a few months of playing…although I had no warning. Good thing is that if we can make it to a year, the repaired achilles should be stronger and we just have to try and avoid tearing the other one!
Glad you found the site…check out everyone’s individual blogs for more stories as well.
Nancy,
I’m able to get around without crutches, but my bad foot (not the tendon, just hte foot) gets a little sore so I usually go back to at least one crutch. I use two crutches when I need to get anywhere quickly or if I’m tired. Good luck with the PT. I know its been great for my foot and I just started too.
Drew
Hi guys,
First sunny day of the year here in Scotland, so as demands the grass has to be cut. I managed both the front and back gardens and also to tidy out the shed and get the garden furniture out without too much difficulty.
Looking forward to Thursday when i become 2 shoed again.
Going now to have a cool beer and a lie down and read my book.
Cheers, John
Alright…a quick lesson learned at 8 weeks here. I’m in the boot..it’s one of the first beautiful spring days here in Colorado. So I spend an hour this afternoon reading the paper outside. I decide to give my leg some time to enjoy the fresh air as well. 30 minutes is all…
At dinner tonight, I think to myself…gosh, my boot is feeling extra swampy tonight. I take the boot off, and notice the ankle and shin are a bit red. Hmm..wonder what that is from? Well some nasty sunburn is what’s it’s from you goof! It’s solarcane for this pasty white leg tonight….ouch! My other leg is fine…so WEAR SUNSCREEN!
Craig-Hey! Looks like you and I are pretty much on the same schedule…I’m 2 weeks post op and get my staples out tomorrow also. Not looking forward to it.
ALL - STAPLE REMOVAL QUESTION - My PA advised in advance that staple removel won’t be fun and that i should take a pain pill prior. Is it “easier” to have them remove the bad ones first, then the easy ones or vice versa? Any help would be appreciated.
Kristin - I’d say go for the bad ones first. Everything is relative in life. So after the bad ones, you’ll be saying.. “Well these others ones aren’t so bad.”
Dennis-Thx for the advice. Yep, I’ll go with bad first then. I’ll let you know how that advice worked out tomorrow!
Kristin,
Please let me know how everything goes tomorrow. I’ve been hoping that the fiberglass cast was lighter and easier to manage than the splint. Judging by Brendan’s response to my initial post, it will be. YEAH!
Bri
My doc told me to massage my scar starting at 3 weeks post op
same with a lot of us here too
so no worries
massage from the heal to the calf
perpendicular around the scar and also
running circles around the scar
good luck
How do i add pictures to my blog ?
johnk -
Looks like you figured out how to add pictures to your blog.
They look great!
You can also resize the images.
From the “Posts” editor, click on the image.
Then you’ll see a little white square on each of the corners of the image.
Just drag one of the corner to make the image smaller/bigger.
You’ll have to drag the corners several times since the edit window is a little small and you can resize only a little at a time.
I hope this helps!
Dennis,
having difficulty resizing these pics, any clues ?
johnk -
did you click on the image first from the post editor?
did you see the little white square on the corners of the image..?
You can just drag the corners towards the center of the image.
You’ll have to repeat it several times since the editor screen is a little small.
Can you tell me exactly what you are having problems with? where are you getting stuck?
I’m glad I finally stumbled onto this site. It’s nice to have some contact with others going through the same process.
I’m 5 weeks post-surgery with a goal of a pain free, comfortable walking, 1st trip to Disney for my 3 year old in December. Not too ambitious, but pretty important for all involved.
-J
Dennis,
there are no white squares in the pictures, might be me though, i will get one of my daughters to help me out later on
Jmon,
I am 5 weeks post op on April 30th. That is also my first PT appt., and I am really looking forward to it.
What day did you have surgery?
My Dr. says three more weeks of the boot, and then lose it and the crutches. We will see, but I am sure tired of these things, although my arms have gotten a lot bigger from using them so much!
Are you FWB? I am partial, but can stand fine without the crutches.
Have you started PT yet?
Mike R
johnk -
Yes, it’s a little hard to find, but once you figure out how to do it, it’s pretty easy.
The tiny white square aren’t IN the pictures.
They are at the corners of the image.
They only appear when you click on the image in the “post editor”.
They are very small.. like white dots. corners of the image.
Dennis,
no joy, when i go to edit there are no images shown, only text
johnk -
Ok, looks like your “visual editor” was turned off in your user settings. Can you try editing that post again?
MikeR
Surgery was March 25th, injury was March 18th. I’m still officially NWB, but I can stand fine without the crutches. No PT yet, just some slight flexing when I’m out of the boot for a while in the evening. Getting antsy though. It feels good enough that I’d like to start doing SOMETHING. My wife tells me our 3 year old is more patient than I am…a little harsh, but she might be right.
Doc told me to come to the 6 week appt next Monday with a shoe…wahooooo! Does anyone go through withdrawal symptoms when they lose the boot? Seems like it may be a little nerve wracking moving around with your ankle unprotected for the first time.
jmon,
I’m almost 8 weeks post op and will (hopefully) be back in two shoes in 1.5 weeks. I am definitely a little nervous about getting out of the boot. The boot has become like a safety net that I am a little wary about giving up. Plus, my bad calf is embarassingly skiny. I guess it has to go at some point though. Otherwise it’ll definitely get to stinky.
Drew
Dennis, I think I have managed it and found an easier way to do it at the same time
Will post a few pictures on Thursday when I get my shoes back.
Drew…
getting closer…congrats..It is definitely awkward at first going to the two shoes…but your body adapts quickly. I wear a brace for some extra support during activity, and get some muscle soreness associated with working out.
Just don’t overdo it.
let us know how you’re doing
Doc Ross
I just wanted to say a BIG Thanks to Bri for helping me with the design of the NYC marathon recovery course map page: http://achillesblog.com/atrpt.php
It looks great, and it’s great to have a real design professional lend a hand.
Please check it out. Thanks Bri!
Hey everyone–
Day 68 post op…Dr visit today, got out of hard cast, finally and into the bledsoe boot(@90 degree fixed)..in this thing for a month with no physical therapy…can swim and try a stationary bike along with flexing my foot while out of the boot..Doc said I could be in the bledsoe for three months(possible) ..
Do you guys think I need to get a second opinion–with this guy being so ultra conservative…I will be at least at 14 weeks and still in the 90 degree fixed boot…Kevin
Kev34,
Congrats on your step forward today.
Personally i think that your doc is being a tad conservative and i certainly would be seeking a 2nd opinion.
All the best !
Kev34..
Further right of Rush Limbaugh conservative. Second opinion warranted in my opinion.
Only problem is that surgeons do not like to second guess a colleague, plus they didn’t do the surgery so their not sure exactly what took place. So finding one that would comment may be hard. Good luck
Doc Ross
Kev34 - I had the same thought as Doc Ross. It may be difficult to find another ortho who would feel comfortable second guessing a colleague. But, it might be worth a try. Also, have you discussed the protocol with your current surgeon? Have you told him that his protocol seems conservative compared to others? Maybe there is a reason he’s taking a more conservative approach with you. Perhaps the severity or location of the rupture has something to do with it.
Doc Ross-
would getting the operative report help anything….probably no use trying a Doc in the same orthopedic clinic,correct??? couldn’t believe how much my calf muscle had shrunk (will try and post pics asap)….also my ankle was so swelled I could barely see one…and the flaky, lizardlike dead skin..good grief…. thanks man Kevin
Bri/Dennis - Great work on the marathon tracker page. It looks great! I think it’s a really good way to keep the pace of recovery in perspective.
Dennis - I had one idea or suggestion for the main page. Is there a way to group the “Recovering from ATR” blogs in the left sidebar of the main page? It seems like we have so many blogs now that it might be overwhelming for new people coming to the site. Can they be arranged by points of recovery, or active vs. inactive, or something like that? Just a thought.
Kev34..
Correct on not staying within the same group…more than likely they will agree with your surgeon. Operative report would be a good start…then you could compare to the ones on this blog and see if there is anything different that would warrant prolonged immobilization. As for the atrophy…about 1% loss per day is average…the longer you’re immoblized the longer to strengthen and fully recover. But statistically in a year we are all about the same no matter what protocol you follow.
Good Luck
Doc Ross
Tom -
Thanks for the suggestion. That might be a good thing to do actually..
For external blogs, there is really no easy way to group them, as they usually don’t have information tracked on this site.
I can go through each one and categorize them based on their progress, but everyone’s progress is a moving target, and it would be impossible to manage.
I can separate the external/onsite blogs. And then create a widget that lists all blogs on this site sorted by their Achilles profile information (injury date or surgery date).
It’s doable with registered people who have filled out their Achilles Profile. (Users can directly fill out the Achilles Profile only if they have a blog. Otherwise, I have to create them by hand.)
And it would look very much look like: http://achillesblog.com/atrpt.php (with a few fields and
the nyc map left out) I’ll set up something like that when the main site gets redesigned.
The names in the marathon tracker table now link to the blogs if they have one.
Dennis - Sounds good. I didn’t intend to make you do a lot of extra work. I know you’ve sunk a whole lot of time into this site and it really is great. It was just a suggestion if there was an easy way to group the blogs. The links in the marathon tracker seem like a good idea. Thanks again for all your hard work. Oh, and sorry to hear about your car. Good thing that didn’t happen a month ago!
WARNING! Do not mix drinking, crutches, and steep stairs!
Going to my first PT in an hour, and I am really excited. I almost REALLY screwed up last night.
I went with a freind to sushi and had a few large Sapporro’s and a sake. They had an elevator getting me to the second floor when we went.
Unfortunately, the elevator CLOSES at 10:00, and I left around 10:15.
I had not climbed any stairs until last night, and these wre really steep, and I was really buzzed. My first step sent me tipping over, and luckily I used one crutch to push my self backwards, and I fell hard on my butt. It could have been a catastrophe.
I THOUGHT I was really agile on these things, but apparently not!
now, what could be worst
our injury or this one..
have a good day
http://www.youtube.com/watch?v=9ajiXKPOdqo
Tom -
No problem, and thanks for your well thought-out comments and posts.
The car being towed was one of those things that you just have to shake your head and laugh.
Here’s more detail.
I parked on one of the side streets on the upper east side overnight.
The next morning, I walk to the car to find my front license-plate on top of the hood, next to my side mirror.
My guess is that the person in front of me was playing bumper cars getting out of his/her spot, and knocked my license plate off.
The person was conscientious enough to let me not leave behind my license plate, but not conscientious enough to leave his/her insurance/contact info.
But that’s really not that big of a deal..
I was in a rush, and it looked like I would have to replace the plastic mount (broken), so I just drove with the front plate in the trunk to run errands, and eventually to my PT appointment.
This PT office is located in downtown area, the appointment was at 5pm. I found a meter street parking, put quarters in, and ran into the PT office. I come out after PT, and find that the car has been towed. Apparently, I missed the sign that said “No standing from 4pm-7pm”.
I don’t know why they use the word “standing” instead of “parking”.. Cars don’t “stand”, they “park”.
Went to the impound to get the car.
Wait 90 minutes, pay $$ and finally get the car by 8-9pm.
towing fee: $185
parking ticket: $95
ticket for the missing front plate: $65
driving in NYC, priceless.
Coincidentally, I am moving (to just outside of Manhattan) today. A place with a reserved parking.
Looking forward to a few days in Buffalo.. driving up tomorrow after settling into the new place and a meeting in the city. I am not driving in, for the meeting.
nancy -
Ouch! I didn’t need to see that..
A little more warning next time please!
Wow - is this ever a find! I am so glad to have found you all.
I ruptured my achilles tendon playing in a 4.5 USTA tennis league match on Saturday. Surgery is scheduled for tomorrow. I have learned alot, (maybe more than I care to learn?!!) as I read all these entries. But thanks, it helps set expectations, better than my doctors can.
I hope to be back online soon after surgery, but then again…we will see just how soon.
One more question - I will have surgery on May 1 - does anyone think I will be able to comfortably take a trip to Italy at the end of September? The plan is to visit Tuscany (lots of driving), Positano (lots of hills…) and a short visit in Rome.
Sounds overly ambitious, but those of you ahead of me might have some insight.
Tennisjunkie - Welcome and best of luck with the surgery. It sounds like you’ll be around 5 months post-op when you take your trip. I’m only at 4 months, so I’m projecting a bit, but I think you’ll be fine at that point. You may get tired a bit quicker than normal and you may experience some swelling, but otherwise you should be able to enjoy the trip, assuming you’re not planning any sprints around the Vatican. I have a trip planned to Boston in a few weeks, which will probably result in a lot of walking, so I may have some more info to pass along to you at that time.
tennis junkie..
Sorry to hear of your misfortune. By that time frame you should be ok. I am off to hike the Grand Canyon in 2.5 weeks which will put me at 10 weeks post op. Will let you know how that goes.
Good luck with the surgery.
Doc Ross
Tennisjunkie-
I am two days from being 4 weeks post op. I had two trips planned at wk 1 Mexico and Wk 3 family visit to CA. While it wasn’t ideal i enjoyed both and by the way walking a beach on crutches is one heck of work out. I am hoping to go on a golf trip in Northern Michigan Wk 6. Not going to get overly aggressive but its paid for so going in a cart and will play what and If I can.
Point I am making and as you have seen in other responses you should be able to make it. We have to be careful and are limited but I can tell you doing that beats the #$%@ out of staying behind. Good luck.
First day of PT. WOW, am I in PAIN! Worst since day 1 after surgery.
The massage felt SO good at the time, I kept telling her I liked it hard, and she said you won’t say that in two days when you come back!
I refuse to get back on meds, so I am up late working and writing.
My range of motion is 95%. She said she was quite surprised for 5 weeks post op. Rode the stationary bike for 15 minutes, with no boot. THAT is a weird feeling!
I have a few small spots where surgery is not 100% healed. I wonder if that was caused by my three falls?
She gave me 4 exercises, ABC, toe towel scrunch, etc. Quite standard according to everyone here.
I had hoped to do some today, but I think I am going to wait until tomorrow morning.
Overall quite happy, but very sore. It is a big stage, starting PT, and I only see a brighter light at the end of the tunnel.
Mike R
Mike,
Congrats on the start of PT! A major milestone that we are all looking forward to.
How often do you go?
Has anybody (Dennis?) published their PT schedule (sorry if I’ve missed it). I’d be interested to see the different approaches.
Craig
Hey everyone–
Now that I am in the bledsoe boot–and can actually see my calf, foot, etc…I was wondering about all this swelling around my ankle and the majority of my foot.. was that par for the course?? I was in a cast(10 weeks) so I didn’t know if you’ll had the swelling or not. Been putting the ice to it , any more suggestions…..thanks and have a good one..Kevin
Craig,
I go three time a week for four weeks, about an hour per. I am 5 weeks post op.
My Ortho owns the PT office, and it is in his office. I am sure if I need another 2 weeks he will gladly write a scrip!
Did the exercises, and the hardest one is the alphabit.
I am pretty swolen today, but can’t wait for PT on Friday.
Ross, are you walking without crutches 100%?
Kev34 - I wouldn’t be too concerned with the swelling at this point. It seems like some people have experienced less swelling than others, but that is probably because we all heal differently. I’ve read that some amount of swelling can last up to a year. Keep icing and elevating as much as possible. Also, frequent massages of the calf and tendon may help.
Hi guys,
This injury and the internet are wonderful things, came across the following that you might find useful :
http://www.expertvillage.com/video-series/350_therapy-leg-foot-pain.htm
Good luck with this and other PT
Johnk
Great site…
those starting out with PT this site would be a great adjunct for you
Doc Ross
johnk - Great find!
Thanks for sharing that link. I think everyone will find those videos very helpful. I like the video on how to properly self-massage the calf and the achilles.
I’ve included the link in the page: AchillesBlog physical therapy
I’ll continue adding to our resources for everyone’s benefit, so let us know if you find other helpful websites.
Hi all,
It seems to me that the most swelling that I have is late in the day, especially if I’ve been out and about. I’m sure the swelling is primarily due to gravity, but I’m wondering if there is anything that helps counteract the effects of gravity?
Does increasing blood flow to the area of swelling help? I’ve had a cup of coffee for each of the past two days (not a regular drinker, so the caffeine works quickly), and it seems like my swelling has gone down after each time. Is this possible?
Craig
Hey all,
My 6 week post op appointment is Monday afternoon, and I’d appreciate some input on 2 points:
First, a lot of people have posted about self massaging the incision and or achilles. No mention of this from my Doc yet. Should I inquire? Any good resources on benefits so I can educate myself?
Second, during my last appointment (2 weeks post op), the subject of PT came up. My Doc says he’s not a big fan because of re-injuries during PT and he feels lots of walking and stretching are enough for most of his patients. If I’m disciplined about working at this, can I skip formal PT if the Doc suggests it? How much benefit have you all had from the PT sessions?
Thanks in advance for the input.
jmon -
I think it’s worth asking your doctor about self-massaging. I think Ross mentioned something about it and that it helps with adhesion. My PT mentioned that I should massage my scar as well as the general area after a hot bath.
As for the PT, I think it’s been helpful for me. Tom has some good posts and comments regarding the benefits of PT for him. You might want to read about his experiences.
Doc Ross-
I sent off for my medical records, just in case I decide to get a second opinion….they didn’t send the operative report, just the office notes…so I have to make a special request for the report or how should that work…..appreciate your help..Kevin
Kev34
Just ask for it, you may need to sign a release of records form again. Should take 2-3 days after the request.
Doc Ross
I just joined the TWO SHOES club on Friday. I know that it is progress, but sometimes it doesn’t feel like it because I walk so slow. But, it is still exciting. How long does it take to walk normally?
Bri - Congrats to you too for joining the 2 shoes club! As I just mentioned to Jmon, take it slow as you start walking “unbraced” again. Walking slow and keeping a relatively normal gait is more beneficial in recovery than trying to walk as fast as you used to. As far as walking normally, I guess it depends on how you define normal. I still have a slight limp and walk at maybe 3/4 speed (16+ weeks post-op), but I’m pretty comfortable when getting around. 2 months of limping has thrown off my mechanics, so I’m still not walking normal when compared to pre-injury, but I’m far more normal than I was a month ago.
Thanks Tom-
That’s what I’m trying to do, walk as normally as possible even though it is slow! It’s tough, too, because I don’t have the obvious boot telling everyone I have an injury. Oh, to be able to wear flip flops…
Looking back it feels really fast - I had just gotten used to non weight bearing and all of a sudden I was weight bearing in the boot. So don’t get discouraged you NWB folks…
Bri - I know exactly what you mean. The whole world just seems to whip right on by when you don’t have an obvious indicator (crutches, boot, etc.) telling everyone that you’re recovering from a serious injury. Occasionally I will walk faster with a pronounced limp trying to keep up with friends and co-workers. But, then I remind myself that I need to take it slow and I start to fall behind. Pretty soon they realize what’s happening and then slow down for me. It does get frustrating though at times.
Tom/bri,
I can’t even imagine walking with a “normal” gait right now. I don’t have anywhere near enough flexibility to be able to push my knee out over my toes. Right now it’s reach forward with the bad leg, plant, bring the good leg up, plant, and repeat. Still leaning pretty heavy on the crutches too.
Side note: my 3 year old thought I was slow on the crutches. I can’t WAIT to hear what she’s got to say now!
Jmon - It will take some time just getting the range of motion back and re-streatching the tendon. It starts to get easier once everything loosens up a bit. As you get some flexibility back, try to focus on heel to toe movement rather than just pushing off your heel.
Bri..
Good to hear from you. Went to your achilles site and it looks like you’re doing well. Welcome to the 2 shoes club. It takes about a week to really feel comfortable walking, but you’ll get tired by days end. Concentrate on good heel toe gait, some muscles will be sore and achy but a good massage and nights rest will help.
Doc Ross
Bri—Thanks for the encouragement to the NWB newbies. I’m 4 weeks ATR, in a boot doing some PWB. Can’t imagine this summer without sand-court fun, but ALAS! It’s nice to know at least that two regular shoes are in my not-too-distant future. Praying that my doctor tells me that crutch-ditching is on the horizon as well!
6 week post op visit today. It was fairly dissapointing.
Dr. said 4 -6 more weeks in the boot. FWB starting today, but he said “Well. you are basically on your own now”. He said FWB, try to lose the crutches, but stay in the boot for 6 more weeks. He is leaving on vacation for 6 weeks. I have 3 weeks of PT left.
Can someone tell me HOW the hell you are supposed to walk in the boot? One foot is higher than the other, obviously. You cannot flex your foot; what is the trick? Should I use one crutch for a while? It seems so awkward. Any help would be most appreciated.
I want to lose the crutches, but it is a tad scary right now.
Mike R - the transition from crutches to PWB to FWB in the boot is something that I have just gone through. It’s hard to explain, but it just sort of happens, you have to be patient. I transitioned down to one crutch first for a few days, using the crutch on the opposite side. This helped out with my stride. Then it was no crutch for a few hours, and back to a crutch. I think that took about 4-5 days. The worst pain was in my heel, since I had a couple of lifts in the boot. One morning I just woke up and it felt good enough to be on all day without a crutch. Walking in the boot is not glamorous by any means, but you’ll get the hang of it…if you angle your boot out a little it seems to help. I also always have a shoe on my good foot to get me as high as I can. It’s hard to explain, but you’ll get the hang of it, just give it a few weeks to happen.
MIke R- I have been FWB in the boot for just a couple days. Like Brendan said one morning it just felt ok… next thing I knew I made it most of day.
I had an extra lift left over from my boot. If I am doing a lot of walking I put that in a regular shoe or regular boot to try and help me balance out a little. I have appointment tomorrow hoping to lose some of that lift…
Hi All!
Doc Ross, how long were you in the boot? My PT showed me how to walk in the boot with one crutrch, and it is a piece of cake. I just could not figure it out
on my own.
I am walking a bit without it already.
I was really hoping to be in shoes in two more weeks. Since my Ortho is gone for 6 weeks, I guess I will have to gauge that plateu on my own, and with my PT.
Doc, you mentioned that support sock (around $120.) does that help walking without the boot? Or did you just wear it with your boot on?
Mike R
I ruptured my achilles on 4/19/08, had surgery on the 29th and now trying to heal. Was anyone taking an antibiotic shortly before their rupture? I was taking Levaquin and it is linked to tendon ruptures. I spoke with an attorney regarding this and I am waiting to see if I have a suit against the drug company or my physician. Let me know if anyone has experienced the same.
For those that are back in 2 shoes, did you have a hard time fitting into your shoes when you first made the switch? I put a shoe on the foot of the bad leg during PT and I can barely tie it becuase the foot is still swollen. The physical therapist said that this is normal, but I’m getting a little nervous that I won’t be able to wear any of my shoes when (if) the ortho gives me the go ahead to use 2 shoes again on Monday and I don’t think that flip flops will go over too well with clients.
Drew.
Definitely hard to wear shoes the first two weeks. Swelling and the irritation on the scar will limit the type of shoe you wear. Ask for a compression sock, that minimizes the amount of swelling. Any shoe with firm leather has been aggravating. Head to the store and try on several types and I’m sure you’ll find something comfortable.
Doc Ross
Going to the pool tomorrow for the 1st time–anyone have any pointers on what to do in the pool to help the ATR…Just try to “walk around”, swim gentle or what???
Thanks in advance, Kevin
Kev34,
Go in the shallow and walk, flex, and squat. Do the alphabet exercises, try to walk without a limp. go slow and listen to your body. If they have a hot tub use it after. You may notice some swelling later in the day so ice as needed.
Gradually increase to treading water, and then all out swimming..
Good luck and let me know how it goes.
Doc Ross
hi everyone
been reading all your comments very insightful little nervous and hoping mine is not a full blown tear not much pain just at end of day it is a little tender.
i can walk around all day doing pretty much nomal routines i am going to see a new dr. as the one i am seeing #1wanted to knock me out for some ultra sound????talked to several others and wellllll thought that was unheard of,also never suggested any type of exersise nothing!!!just does a xray and says well looks the same ,is it hurting ,and see ya in 4 to 6 weeks.seeee ya!!!obviously i am moving on ,
my friend had same type of problem was not torn but they did numerous excersises and ultra sound wore boot (air cast) 6 weeks and was able to avoid surgery i am so confused and upset so now i through the boot back on just as precaution until i see this other dr. leaving for va-ca on tues just about a week and i am dragging boot with me.
question is it nessary to wear it in the car as we our driving and will stop every 2 to 21/2 hrs to strech but while idle could i loose the boot. ?
any other suggestions or comments would be so appreciated.
dennis and kev hope your doing better each day thanks for response. this is all a little new to me .
well going to try and do some light houswork (with my boot of course) they are a pain i take small breaks and grab the ol ice pack and take a break now and then .
thanks angellady3
I need a little help.
I am 7 weeks post op on Wednesday. Started walking with no crutches in the boot on Friday, and now I am a little concerned.
First, I have a tiny spot on the surgery that is oozing. Dr. said don’t worry, but I am! Second, I have developed a small blood blister higher on the scar. Anything to worry about?
What is the name of the socks from REI? I keep going through old posts and can’t find it.
Walking is SLOW, but I use one crutch if I know I will be out and about for a long time.
Heel to heel. I am trying to listen to my body and not the PT 100%. She also said don’t worry about the oozing.
Mike R
Mike R -
I think you might want to speak to kristinatl. She had similar symptoms as you, I think.
As for the blood blister, I am not sure about that.. maybe someone else will have a better answer?
I hope the wound heals fully, and keep us posted on your progress!
Hi All,
Well, I have been off the net for a few weeks and haven’t checked in for a while. A few road trips to visit family, went to a wedding, and generally not touching the computer (I used it WAY too much when I was laid up). Glad to read everyone is progressing, and sorry to see all the new members, but it gets better.
I’m 10 weeks post op today and went for a 2.6 mile walk today. I am now in 2 normal, brand new, shoes that I have put Superfeet insoles in, and no heel lift. I limp on and off because I don’t have the strength yet to walk normally and roll my weight on the ball of my foot. If I concentrate, my gait is normal, but it takes full attention. I weigh 230 and can put only about 110# on the ball of my foot, injured side. The most difficult thing for me right now is being able to place any weight on the ball of my foot when pointing my toes down, with my knee locked back. My ankle just wants to lock up. It does seem to be getting better though. Heel is a bit mad too because it tends to take all the weight. I find the most uncomfortable things are chores that require standing in one place such as dishes and cooking. I am constantly walking in place to keep things moving. I visited the place where the injury happened and talked with some of the guys who saw it. Kind of nice to get back, if only to visit.
It’s hard to believe I’m 10 weeks post op. At times it didn’t seem like it would ever come, even though I knew it would.
Take care all,
Jim
Jim - good to hear from you…glad your recovery is going well. Although I’m still in a boot, I’ve been cheating a little walking (although I really can’t call it that, more like gimping) around the bedroom in my barefeet. I was on my feet most of the weekend chasing the kids around, mowing, etc…and the heel was totally spent last night. A good night’s sleep and day at the office today and it’s good as new. I’m sure I’m about 4 weeks behind you..but I hope to be able to take a 2.5 mile walk in 4 weeks in my shoes! Good on ya! I’ve yet to visit the scene of the crime…but need to soon, my abs is gettin’ flabby! Cheers!
Brendan, Bare feet is tough. I still find bare feet the most uncomfortable, due to lack of flexibility and strength. I think you will be surprised how good a shoe feels, esp one with a high heel like a running shoe. The fist thing I do in the morning is slip my shoes on so I can get around.
I’m 9.5 weeks post op and saw the doc for the last time (hopefully) yesterday. He gave me to ok to start walking in 2 shoes. It’s amazing how quickly the time goes from surgery to each step of the recovery so to all of you who are in the beginning stages, hang in there because it gets better quickly.
I have found walking in 2 shoes to be tough. I am REALLY slow and my gait is anything but normal. The tendon is also a little sore. Hopefully this is all normal. I hope to start driving again tomorrow, which will make me, and more importantly my wife, very happy.
Drew,
I found it tough walking at first but 2 weeks down the line it is definitely easing off and I started to drive late on on the 1st day i had my cast removed much to the relief of my wife also.
Keep walking and rest when your body tells you to, it is very much a game of slowly slowly from here on in.
Johnk
What are the benefits of using Superfeet insoles? It seems like a lot of people use these when they get back in two shoes. If I buys some, which type/color do you recommend? Thanks!
Drew
Drew,
I got a pair 2 days ago and found the benefit that it relieves the pressure on the heel which reduces the ricks of plantar fascisis(?).
Today is the first I have got home from work and felt fairly comfortable on the sole of my foot.
Drew, I have used Superfeet long before my injury and think they are great. They are not soft, but offer great support and take the shape of your foot after a while. They will feel strange at first. As for color, if you can remove the useless factory insole from your shoe, get the green, if you can’t remove it, get the blue. I have not used the orange, but I did try it at REI, and didn’t like it. Extra padding under the ball of the foot makes it too bulky in my opinion.
Jim
Drew - I got the green ones. If you haven’t worn an insole (which I haven’t)..they take a little getting used to. In my boot, it felt great right away. In my good foot/shoe, it’s a little uncomfortable. The arch support hits farther back than you would think and so it’s a little painful. If you are on your feet all day, you may want to break them in a bit, wear them for 1/2 a day and then take them out…and do that for a week or so. I am just now at a week with them, and both feet feel great! Oh and Superfeet offers a no questions asked return policy..you can try them for up to 60 days and if you are not satisfied just take them back to the store of purchase for full refund. Did I tell you I own 60% of the company? Just kidding!
kev34 your one week ahead of me post op .as for the pool . do some laps and when you rest do heel pumps . i also have a conservative doc . been watching your progress . ps no turkey yet ?
Dennis..
for whatever reason I cannot log on to post on my blog.
Can you check on it ??
Not sure if my login and password is incorrect..Can you email me my login and password??
Thanks in advance
Doc Ross
ross -
I can’t read your password, but I can reset it for you.
I’ve reset it and I’ve emailed the password to you.
Please let me know if you are able to log in.
Hi all,
Kristin, I really feel for you. I am 7 weeks post op, and have a 1/4″ section on my scar that is not healed. I found out yesterday (before my Dr. went to Tuscany for a month) that it was a “stitch spit”.
I guess some stitches are supposed to dissolve, and sometimes they do not; they then try to work their way to the surface. He found the stitch, pulled it out, and said it will heal quickly. No sign of infection.
I will be in a boot four more weeks. My Dr. seemed very aggressive in the beginning, PWB at 3 weeks, etc., and I asked him yesterday why I can’t get in shoes in two weeks. His answer was that most re-ruptures occur in weeks 7 - 12, so he likes a boot on to protect it. I am full weight bearing, walking around fine without crutches.
PT is still only ROM, but I hope to start strength work next week. I ride a bike every day for 25 minutes, and my calf is coming back a little bit.
Mike R
Doc Ross,
Are you using this achilles support now in your shoes?
http://www.activeauthority.com/bauerfeind_achillotrain_ankle_support.aspx
Did you use it in your boot? What do you did you thnk about it?
Have a great trip, and watch out for small holes on the path.
Mike R
Johnk-
still nothing new on my progress-at least not from the doctor..I go back next Tuesday the 20th..but I have gotten more ROM in the foot, swelling has gone down in foot, still swollen around ankle…still pretty tight–seems to be worse if I stetch toes up towards leg..gotta run, daughter has softball game, we are 3-0…look out Kevin
Rob H–
Tried the pool last weekend, not too bad.. going back tomorrow..our season ended on the 11th, I was able to get two longbeards this year, heard birds every morning–but had a river between us…also went to Ohio on a hunt(budddy got 2) and I took my 3 yr old son a couple of times..good luck on recovery and the hunt…Kevin
Doc Ross or Dennis, Does an ankle brace have any correlation to prevent or help prevent an Achilles Rupture? Also I had almost zero swelling after Day 5 Post-Op and I have my second Post-op today with no swelling at all (Day 12) with my 15 staples coming out. Does this mean that my tendon is healing quicker or is this just wishful thinking? Thanks
Hi all,
I went to a party Sat. night, got stranded, and walked 4 miles in my boot without a crutch, quite buzzed!
I am almost 8 weeks post op.
On Sunday I cut the lawn, pulled weeds, and was quite agile.
I swear after those workouts my calf suddenly has gained size; still a bit flabby, but feels much better.
The only problem I have right now is that I pulled a muscle in my AT calf the other day. The AT has no pain, just stiff when I stretch it back towards my leg. The calf pull is quite painful, though. Anyone else have that problem?
4 weeks until shoes!
Mike R
3 weeks since surgery. My foot feels like its got frostbite on the side of it, feels tingy frozen. Entire foot is all fat & numb. No walking going on.
It this normal? What Should I expect?
Monday April 29th, that’s when i had surgery to repair my ruptured achilles tendon.
Greetings from New Zealand
I found this site while looking for AT rehab protocols (8 days 18 hours till I get my cast off) and as some of you will be bored and immobile I thought I would share my little (and long) story. On Friday Jan 4th I was getting the groceries out of the back of a car when a bottle of sparkling wine fell through the bottom of one of those ridiculously thin plastic bags and exploded on the concrete - a shard of glass sliced half way through my right calf muscle severing an artery (always insist your supermarket double bags your wine!!!). I have done enough first aid to prevent myself bleeding to death (pressure and elevation works wonders) and after superb service from St Johns Ambulance and the vascular surgeons at Auckland Hospital I was home and fine - but I couldn’t put any weight on the leg for two weeks and since it is my right leg I couldn’t drive.
Only glitch was the dopey house surgeon of indeterminate nationality in A and E - the notes clearly said arterial bleed but instead of waiting for assistance he decided to unwrap it himself - as he was doing this and chucking the bandages and dressings on the floor I though - where is the replacement dressing - but too late - these was bright red blood arcing through the air. All he had to hand was a plastic incontinence sheet which he handed to my wife and said “apply pressure” - rather than call for help and expose his dopiness he ran off to get replacement dressings which seemed to take forever - meanwhile wife is trying to stanch the flow with an inappropriate tool and the blood is running down my leg and filling my underpants - luckily we met over steaming vats of cow blood so she was able to do this without falling over and scornfully dismissed his offer of gloves. Then he called the vascular surgery registrar.. She would not take anybody else’s word that this was a an arterial bleed - she was not going to waste her skills on ordinary old venous bleed - so she asked him too take it down again - as he started I said “don’t you think you should get some new dressings first” - so he scuttled off with his head down to get some. But apart from that service was great - it’s the nurses that hold the place together.
Anyway after two weeks of NWB I gradually got back into a bit of exercise on my bike and on Feb 26th took off for a 5 day cycle tour in the South Island (surgeon had said this would be fine). First run went great and then as I pushed off on my right toes to throw my leg over my bike there was a “ping” at the back of my calf. “Shit” I said “I’ve ruptured my AT”, however as I could still walk, sort off, all the jocks in the group said no you have pulled a muscle. This was remote country and no doctors were available, but I did speak to a GP on the phone who was of the opinion that a muscle was torn or strained. A chiropractor in the hotel said the same. So using mostly my left leg I completed the rest of the 100 mile trip – it is a disused railway track and pretty flat.
I went and saw my GP when I got back and he diagnosed strained muscle and sent me for some physio. The first thing she did was the Thomson test and said “you’ve ruptured your Achilles mate”. So off for MRI. Seems muscle had return at site of original laceration and gone through the muscle/tendon junction and taken the AT with it in an unusual angled longitudinal tear. So good half of gastro muscle was attached to long floating triangle of AT, while buggered muscle was attached to AT and ankle, but no power.
Had it repaired just over six weeks ago and surgeon said it went well - even managed to sew muscle back together using scar tissue from original laceration. NWB for 4 weeks but now hobbling around on cast. Have had no pain whatsoever - only took pain killers for the first day post op. Hopeful for good recovery in time for Hawaiian holiday at end of July.
Worst bit has been no driving – I had just completed the 7 year restoration of a 1952 MG TD – very frustrating.
As an aside I guess in any other country I could have sued the supermarket for a million or two, but in New Zealand we have the publicly-funded Accident Compensation Corporation which covers all accidents and injury - all my surgery, rehab and even taxis to work is paid for. Downside is you can’t sue anyone – not many US lawyers emigrate to NZ!
So there you go.
Douglas
matts -
Those are some difficult questions!
I don’t plan on wearing any type of braces after I am fully recovered, but instead closely monitor how tender my tendon is, how much I weigh, etc.
Like you, I also didn’t have much swelling.
Douglas -
That’s one heck of a story. I wish you speedy recovery!
Brian -
I can only speak from my personal experience. I experienced similar sensation in my foot when my cast was a bit too tight which resulted in poor circulation in my foot. Speak to your doctor to find out whether it’s because of the cast that’s too tight or something else (like damage to the nerves in your foot).
Keep us posted on what your doctor says!
Matts - IMO there isn’t a brace that could PREVENT a rupture and still allow your normal level of activity. Most ruptures occur when placing a great deal of force on the tendon. I haven’t seen a brace (other than the boot) that would keep you from doing an explosive movement. The best prevention seems to be strengthening and stretching, and even that gives no guarantee. It sounds like you’re healing well. Swelling seems to vary for everyone, though I don’t know that it is an indicator for recovery speed. I think it just depends on the rupture (location, severity, surgical technique, etc.) and on your body’s reaction to injury.
Brian - It sounds like you may have sural nerve damage. You can research the internet for more information, but from what I’ve read, the damage is usually temporary but it can take up to three months to regain the sensation fully. Best to speak with your surgeon about it.
Brendan - Congrats on your progress back to 2 shoes. It sounds like you’re doing great. Keep up the good work.
Thanks Tom and Dennis for your input! I have been asking alot of people about a brace that can prevent an Achilles Tendon tear and they have been saying the same thing as Tom, and that there is no brace that would help after the Boot(or Das Boot), thats what I call it. Only if we could patent a Achilles Tendon Rupture prevention brace, I would quit my day job.
Question for my friends in the two shoes club - what type of shoes are you wearing? I have been wearing running shoes but lately, the back of the shoe has started rubbing against and irritating my scar. I’ve tried other shoes that don’t go as high in the back, but they aren’t supportive enough to walk around all day. Any ideas?
I really don’t want to go out and buy new shoes… sigh…
Bri -
My dress shoes give me the same problem, but it’s not as bad with my sneakers. As a result I just wear my sneakers as much as I can. Have you considered one of those over-sized band-aids with extra cotton balls?
Thanks Dennis, I will give that a try.
Ironically I found that my volleyball shoes don’t go quite as high as my running shoes (I tore my Achilles in those shoes though).
Bri, that raises an interesting question.
Anybody superstitious or apprehensive to wear the shoes that they had the ATR in?
I have a friend who is just over 1 year post ATR who has given me all sorts of advice and direction through his experience. He still has a few types of shoes that give him problems, though it keeps getting better. Just another looooooong part of the healing process.
Hello everyone. I’m now 4 weeks post-op. I just got my 2nd cast today. It’s not quite 90 degrees but around 80. They had my foot at 90 and it was just too uncomfortable. Doc says after 2 weeks in this cast I’ll go to the boot. I assume at that point I will begin rehab. My doc also said that I will not bear any weight on it initially in the boot. He says that I will be out of the boot completely at 10 weeks! Is this normal??? Also, if I’m not bearing any weight initially when will I so that I can be out of it at 10 weeks. I’d appreciate your help. Thanks. And best of healing to everyone.
craig -
YES, I don’t think I’ll be wearing the basketball shoes that I wore when I ruptured mine again. At least not for basketball. When I am 100%, I’ll be buying myself a new pair (diffrent brand too).
Lamar,
Congratulations on your progress. Seems like only yesterday you were considering not going to surgery. You are one month out and well on your way. Glad to hear you are progressing.
Dennis,
I’m not sure I will be able to wear my basketball shoes again, but they were pretty new, as I think I only wore them 5 or 6 times. Hate to toss some new shoes. Maybe I’m just cheap…
Craig
Thanks Jim. You’re completely right, I did have a tough time convincing myself of the surgery. I just hope to continue progressing. How about yourself?
craig -
Well, I won’t be wearing them to bball.. maybe for just working out.
They are Stephan Marbury’s shoes, the “starburry” that cost $15.
I ruptured my AT in my basketball shoes. I’m still not sure if I’ll play again (I wasn’t very good to begin with), so I likely won’t be wearing those shoes again.
Here is a comparison of my legs at 11 weeks 3 days post op. You can see how the scar is stuck at the top. We are working on this in PT trying to unstick it. I still can’t bear full body weight on the ball of my foot on the injured leg. I’m close though. I tried to get as equal angle and lighting as possible.
http://farm3.static.flickr.com/2200/2514968720_bdc0fa057b_o.jpg
Jim
I think that link may have broken. Here is essentially the same picture, color a bit better though.
http://farm4.static.flickr.com/3010/2514132829_799cbfa985_o.jpg
Sorry if this doubles everything.
Jim - I’m jealous…nice legs! The heel and calf look great. I’m sure I’ll be there in a few weeks. I think it’s so neat to see the different protocls manifesting themselves. We’ll all sort of catch up to each other at the 4-6 month period…and in retrospect, an additional 2 weeks in a cast, or 4 weeks in a boot is just a distant memory now. Keep up the good work, and hope that part of your scar gets unstuck…maybe you need to “Cure” it (the band)…with “Doing the Unstuck” A dorky joke to match yours!
Jim - I agree with Brendan, the leg looks great. I’ll swap my good calf for your bad calf any day! Glad to hear you’re healing well.
Jim-Your Bad calf is twice as big as my good one. Being only in Day 16 Post-Op, Week 11 seems along ways off for me. I am in a cast and when I extend my bad leg all the way I can feel my achilles tendon tighten up. No pain, just feels really tight down there. Could it be my scar stretching out? Sorry in advance, I ask alot of novice questions because I am very new with this injury.
Holy &%$#, Jim!
You have the most defined calves I’ve practically ever seen. Awesome. Can’t wait to be able to push up on my toes, too!
Question for all…At what point were you able to stand on the ball of your foot? I’m not there yet, and to me that is my next milestone. For those that can, how far out were you when you were able to rise up on you toes one legged with the injured leg??
Jim - I’m not sure I complete understand the question. Are you saying “stand on the ball of your foot” so there is clearance under your heel? At 19 weeks I’m still not able to do a single legged calf raise with just the injured leg. I’m able to do it in about 3 ft. of water, but not on land. I think it will still be a few more weeks for me. I’m not sure what the norm is for single legged calf raises, but from other blogs I’ve seen, I don’t feel like I’m that far off schedule. You will probably be back to single legged calf raises much quicker because you were weight bearing early on and you have much more strength in your calf to begin with. Hope this helps.
Tom, Thanks for the reply. Yes, my question is basically.
When were you able to stand on the ball of your foot, one legged, heel off the ground with the injured leg?
Hope this helps.
hi guys, im new and i tore up my left achilles may 18 2008. i was playing basketball and went for a power play inside - i felt like someone stepped at the back of my shoe and also felt sharp pain in my ankle going up.
i knew it was not like a sprain - something much more.
i did not goto the ER instead i went straight to a ortho doctor on day 2-3.
he put me in a cast and will go conservative tx but my instinct tells me to get a 2nd opinion - ill be in tampa may 28 for a specialist appt.
My questions :
how long from the date of injury should the doctors do sugery to get the best results? iv e heard 10-14 days when swelling is down ?
also when you had your surgery - what kind of anaesthetics did you get?
Hey, screwdriver. Fellow basketball ATRer here. I did the same as you but my ortho got me into surgery on day 7 because I had limited swelling. I know he usually waits 7-14 days…that being said, I believe it depends on the surgeon.
I had a general anesthesia. I was told it is easier to monitor your breathing since you are face down. Plus, I didn’t want to hear what was going on back there.
Good luck and, as many ATRers here will attest, definitely trust your instincts.
Welcome to the club.
I had my operation 2 weeks from rupture, but my specialist told me that was far too long a wait. I was misdiagnosed initially and didn’t get second opinion until day 12 operation day 14.
I had a spinal anaesthetic which meant although no feeling in legs for some time there were no problems with feeling sick etc.
I was awake for most of the operation but presumably before the nasty bits, they gave me a whiff of something because I must have fallen asleep briefly.
I was told that the spinal injection was far safer than a general. I have had various anaesthetics over the years and would strongly recommend the spinal if you are given the option.
Annie
the mri of my a tendon revealed almost complete tear but when you look at the mri - there are muscle fibers about 1/4 of the tendon still attached - its hard to see the continuity and integrity of the remaining fibers coz the swelling makes the images vague.
im now in a long leg cast and its driving me crazy feeling claustrophobic.when it swells too at night i feel like wanting to go rip it apart.
2nd opinion wont be til may 28 and it is a 2 huyr drive from my home .
IMO the challenge with this condition we are in the the mental anguish . the sudden transition from active to inactive and the depression that sets in.
screwdriver -
Adjusting to the inactivity is difficult, but I hope you can find something that can occupy your time. Understanding that it’s temporary really helps ease your mind.
I spent a lot of time on my computer doing a lot of research on Achilles rupture and reading some books that I had been meaning to read (as well as TV/movies).
I saw an ad for Rossetta stone the other day, and I think starting to learn a new language during my first 4 weeks would have been a good idea.
Hello Dennis,
I just joined the blog today and I am from Dubai city. It is great to see that there are others who share the same experience with you. I reptured my achilles while playing soccer on the 25th of March, 2008. Done the surgery on the 3rd of April, and until this moment, I am still on cast and using 2 crutches. My feet is still pointing little downward…I have had some bad experience with my surgent so I changed to another one although the surgery was perfect and the scare didnt look so bad but the after surgery follow up was awful and he asked me to walk on my feet right after removing the cast which was after one month so i refused because i wasnt able to do it…so I am now with another doctor starting all over. I just want to learn from other members here if its time for me now to start walking or do PT?…in what stage I am? and when will i be able to walk without crutches?
prince -
Glad that you were able to find AchillesBlog.
It’s very interesting to hear that you are from Dubai city. Are you living on one of the palm tree shaped islands? It sounded like an really amazing place to visit from the 60 Minute segment that I watched some months ago.
Glad that your surgery went well, and I hope the second doctor is better. I don’t think there is one correct recovery protocol.
As you can see from everyone’s recovery protocols here, it really varies from doctor to doctor. It’s also what you feel most comfortable with. I started walking FWB with the boot at starting 5th week, but others started much later.. (some earlier..)
You should check out all my past blogs as well as others, you’ll get a lot of information on recovery protocols, weight bearing, boots, crutches, etc..
best of luck and keep us posted on your recovery.
Hi everyone. Happy New Year. I just found this site and sooo wish I had discovered it sooner! I am 9 months post surgery for what started out to be a basic removal of a bone spur and bursa. Expected recovery was 6 weeks or so with some PT. Well…things changed. Despite an MRI presurgical, it turns out thing were a tad more complicated. My ortho ( who is a specialist in feet,ankles and very good) found that I did have a bone spur as expected but …it had punctured my achilles and I had a vertical tear about 2 inches long running up my right leg. I also didn’t have 1 spur..but a whole colony growing around my heel! Needless to say, the overnight stay for the surgery turned into 4 days in the hospital and I’m looking at 18 months to full recovery. The first thing my surgeon told me when I came out of recovery was and asked how thing went: “Well, we found a few surprises! Its as bad as it can get” Good thing I was still half out of it!
I went through most of the same things you all did though wish the shorter stories were ones I could claim. But, I am walking, and out of splints, casts, etc. finally. I still wear a brace to support the ankle but I have 2 shoes on!! It is terribly slow. I’m struggling with that now and am very tempted to throw in the towel on the PT which I’ve been doing for 6 months due to severe loss of muscle. I was immobile for a total of 10 months (three pre op and then postop). But, I know it does help and it is getting better. I still have some discomfort walking and especially when I’ve been still for too long and have not moved my foot around at all but it loosens up. I am fortunate though in that I did not have post op infections, and so far, no serious reinjury, just some small setbacks. I stumbled myself through finding cast covers and curtch stories, not driving for 7 weeks and managing a wheel chair for 3 months living alone but…adds to the character, I think?
If anyone has suggestions on getting past this current plateu I’m in I would appreciate it. I’m still struggling with trying to go down stairs and its a main focus of my PT along with strengthening but very frustrating. For those of you already back to full health, congratulations! It is a long road I know and you should be proud of the accomplishment and appreciate it! This is a great website and though I wish I had found it a year ago, its been great to read the comments etc. even now. Thank you. Have a great new year everyone.
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Hi All,
I have just joined the club. I found this web site through google.
I found out that I have a achilles tendon rupture, on Saturday. I was doing a African dance class and I felt as if somone had whacked me across the back of my ankle. When I went to put my foot down it felt as if there was no floor. I was really scared as I have never I a serious injury before.
I’m going to see the specialist this Thursday to find out the extent of the injury. It’s freaking me out that it might take 6 weeks + to heal as my boss isn’t be terribly supportive and is thinking that I’ll be beack to work next week, so it’s adding an extra layer of pressure on a stressful situation.
As far as which route to take, I’ll obviuosly have to wait until I get it properly checked out and see what state I’m in. In honesty I’d rather not go under the knife.
Will keep you posted.
Kind Regards
Julia
Julia: we all hope for the best my advice would be to have a serious conversation with your orho to know all the benefits and risks of conservative vs operative. there is also a TON of golden information on this site. If you dont mind me asking what is it you do for work?
This is a great site.. kind of mental therapy for the ATR!!I tore my Achilles on May 4th. Had surgery on May 7th. Put in the cast on May 11th. It seems that my mind and my body are about 20 yrs apart, As my wife would have put it. I would recommend surgery. I have a lot of buddies that played football most there life and after setting out for about 15 years from any major sports, tried to get back into some sort of activity, tore the Achilles. We all got surgery and they are able to do more with there leg than not. Just my thoughts..I will try and update my story as i go thru the remaining weekswith the cast . then physical therapy.. thanks and good luck to all
Hi all, I ruptured my achilles four years ago on a womens soccer league. I healed well—some infection and a raised wound site—but i am able to exercise as good as new–however, recently, I am experiencing problems with my other ‘healthy’ achilies–i consulted a physical therapist–who told me it is common to rupture your other achilles–even greater than a reinjury of the 1st achilles!!!Has anyone done this—what do you think?
Hey Tennisfanatic, I also had surgery on May 1 and have a trip set for Poland in September. My doc said I should be okay for it if I follow rehab instructions. He said I won’t be fully back to normal till about Nov.1, that’s when I should be able to run and jump and even start to play basketball again if I have the ****s to try it.
Well, I got my cast off and I must say, I’m so excited to take a shower w/ out a bag around my leg and tape around my upper calf… not able to put any pressure on my leg yet, but i’m excited to get thru the cast faze and on to the next step. slowly start stretching the tendon and muscle… July is when I start rehab.. hoping to play golf by august… Any golfers out there that have a story and time line for me??? I miss playing already !!!!
Tell me what I can add to make this website better!
http://www.mahalo.com/achilles-tendon-tear
Everything you’d want to know about Achilles Tendon Rupture. Link, blogs, products, videos, images, news, backtype, twitter question, mahalo questions, video of a typical surgery.
I created this website because I am going through this myself. I appreciate the help with the website because I want to help other prevent it and help myself by learning more about the process
Thanks
Hey everyone, has anyone had a blood clot after surgery and did this hamper the healing time? I was put in a boot 2 weeks after surgery (with no weight bearing for 4 weeks still to come) and a couple of days later (yesterday), i was diagnosed with a large DVT. Has anyone had this problem and can give some info or advice?
SalW - Hope the physio went well and didn’t hurt too much!
In the middle of July and I’m walking like a champ. Well I have a nice hitch in my step, but i’m walking. Swung the golf club last week, wasn’t to bad, no hip rotation, but I was on the golf course 9 weeks after surgery. Started my rehab and must say, don’t pass on it. I used it to help me mentally, as well as physically. hoping to be walking normal by August and about 60% golf swing back too… Hang in there fellow ATR’s… there is light at the end of the tunnel…
Ruptured my achilles training in Muai Thai about 5 years ago, was taken straight to the QMC where it was confirmed that I had sufered a partial rupture.
The consultant that saw me spent most of his time convincing me that I should go for the conventional method rather than surgery (even though I told him I was extremely phyiscally active) went through the casting/boot process and following the final removal of the boot it lasted about 3 weeks before I was back at the QMC with a rerupture.
Had the surgery the second time and was denied any form of physioterapy. The operation seemed to be extremely succesful and I have had no problems since (save it being a little stiff on the odd morning when I wake up). However, I am considering entering the realm of ‘getting fit’ and have spent a few sessions at my local gym.
I have found that, after excercise my tendon does hurt a bit in the morning (after a bit of a rub it’s fine tho).
A few questions Im hoping to be answered are:
1) How strong are repaired tendons in general as have asked numerous people, some say it’s stronger than ever some say it’s crap aftewr its been repaired.
2) Ultimately, I’m wanting to get back into training… circuit training, running, and Muai Thai, do you have any advice on this positive/negative etc. As I am still extremely wary of this tendon, part of me is thinking it’s just paranoia… I just want to know how capable a rebuilt tendon is?
Ta
Marc - I’m not a medical professional, so my thoughts may not be completely accurate, but I thought I’d offer up my opinions to your questions. I hope that’s okay. I have heard/read that the tendon regains most if not all of it’s strength assuming there are no complications. I believe the level of strength is determined by how well the collagen fibers align during the healing process. Initially, type III collagen forms rather chaotically and slowly converts to type I collagen. Type I is stronger and the fibers line up more uniformly. I have a tough time believing the tendon is “crap” after a repair. If that was the case then the re-rupture rate would be much higher than 2-10% and no one would bother with the risks of going through a surgery that wasn’t going to get you somewhat close to normal.
If circuit training, running, and Muai Thai are things in your life that you like to do, then I would strongly encourage you to take them up again. Injury is always a risk, whether it be a re-rupture or a new injury. You just have to make a personal risk assessment on whether the benefits outweigh the risks. Unfortunately, no one else can answer that question for you. Good luck with which ever path you choose.
Thanks for taking your time to respond Tom… you have pretty much summed up what I have been thinking for a while.
I’ll keep a record of my progress back to fitness now, as a guide for others who have been misfurtunate enough to suffer a ruptured achilles.
Marc,
In one study that followed 154 people who had surgical repair for about four years postop, 2% reruptured the same side (all before six months postop), while 6% ruptured the other side. That suggests that after repair, the tendon is stronger than the tendon (albeit likely afflicted with tendinosis) was, especially once the rehab is fully over.
http://www.ncbi.nlm.nih.gov/pubmed/14723785
There is no proven way to work the tendon to prevent rupture, though many things “seem to help,” (the lowest level of medical evidence). One thing that common sense suggests, and is hard to deny, is keeping your weight down.
Many people have returned to their previous activities after this injury.
Good luck!
Mark,
I see you had a re-rupture after conservative treatment. Me, too. Very discouraging. I do not know how studies are done about the success rate of conservative treatment, because the results are very varied. Some say 10 % some say 40% re-rupture. I have a feeling a lot depends on how the tendon was aligned before being put in cast, if it was a complete rupture etc. As here they do not do ultrasounds and MRIs I think they do not really have a clue what is going on. So probably the results are very random.
It seems after the surgery you are feeling well, so after 4 years of no re-rupture I would encourage you to get back to your favourite activities. My surgeon said with successful conservative treatment I get back 75% strength of tendon, with surgery at least 90%.
Good luck!
I would like to do an absolutely un-scientific survey about the success rate of the conservative treatment.
Who had conservative treatment, was it a full rupture, did it re-rupture, if yes when?
I would like to hear from people who did NOT re-rupture after at least 6 months. Though a year is a more sure thing I guess.
Looking forward your replies.
Has anyone heard of a new procedure where the incision on the back of the heel is approx only two to three inches vs six to eight inches long and after 10 days post op they encourage you to start walking on the Achilles, etc., etc.?
I found this info on the below website:
http://www.mdmercy.com/footandankle/conditions/achilles_tendon_probs/acute_achl_tendonrupture.html
Just cutious if anyone else is familiar with the above and has had this type of treatement?
Also, has anyone suffered from “pump bump” on the back of the heel that eventually caused the Achilles to rupture?
Yes Kevin… the new procedure exists, it drastically reduces the rate of infection so the Doc’s tend to reccomend surgery. However, I would still suggest the long scar method would allow the doctors to do a more thorough job, even if the infection risk could end in disaster.
All said… I quite like my scar, gives my leg a bit of distinction
As for everyone who has replied to me, I would like to thank you all for all your supportive words, I am slowly pushing myself back into training but have a long way to go before im doing high round kicks and hitting wil1200lbs of pressure on the ball of my foot (this is how I initially did it… apparrently the tendon can take something in the region of 1000lbs of pressure).
We should have a Achilles Tendon war wound gallery… then we could share pics of how well our docs put us back together.
Finally, my reccomendation to EVERYONE out there who ruptures theirs. Whether you’re active or not, ALWAYS push for the surgical repair. Don’t let the consultants cut money corners with your health.
I hope this is the right place to post this, if not maybe someone can tell me the correct place. Here is my question:
I had Achilles tendon surgery three years ago for a full tear and I still have some minor swelling and yellowish purple discoloration around my ankle. My foot and sometimes my lower leg tingles occasionally and I’ve only recovered about 60% of my calf strength. My insurance only covered four follow-ups with my surgeon and the last one was a year and a half ago. He said everything looked fine and I should expect to deal with this for awhile. I’ve used up all my physical therapy coverage and have continued it at home. Is it normal for me to still have the occasional swelling and constant discoloration? I mean, my left leg in general looks a tad darker in hue than my uninjured right. Any help would be appreciated.
Ruptured my AT 9/30/09 playing basketball, moving backwards in new sneakers, at age 46. I knew I did something bad, but didn’t think it was that bad because the pain so low (I had dislocated my elbow playing basketball 4 years ago and that pain was a 13 on a 0-10 scale). I went to the ER (bad move - 3 hours for nothing), went to OS the next day who said surgery was really the only option. Had surgery on 10/6/09, which went well, but doctor is pretty set on no weight cast for 6 weeks.
I’m a RE appraiser, lots of driving, very busy season, right foot - I feel I’m screwed.
I ruptured my Achilles 5 weeks ago. No surgery. Fiberglass cast now for the past 5 weeks. I’ve been waking up almost same time every night, like clock work, with the worst leg cramps I’ve had in my life - right up my calf. To the point of tears.
Anyone have any suggestions on how to treat that? Any supplements I can take or things I can do to lessen the pain?
Hi Krystine
You poor thing, I have been lucky to avoid cramping so far, but have had lots of twitching and also that horrible restless legs syndrome at night time. But at least they aren’t painful - just annoying!!
The only things I can suggest for cramping is PLENTY of water, and increasing your potassium uptake….lots of organic bananas if you can get them, or a supplement. These are generally an effective means of minimising muscle cramp when combined with stretching the muscle in question….obviously you aren’t able to do that part but the other two things probably still worth a go??
I am going into a fibreglass cast next week, after 2 weeks post op in plaster….you are the first person I have seen mention that you are in one too. What is it like?? Is it lighter, get more airflow etc?? I live in a really hot place and am dreading 6 weeks in that if its anything like the plaster!!!
Good luck hey!!
Krystine- I agree with Ruth that you should make sure that you are well hydrated. My only other suggestion is to see if you can get your doctor to prescribe a muscle relaxant like Soma, Flexeril or Zanaflex. The evening after I ruptured, I got a terrible cramp in my foot - had to stand up to get it to uncramp, which didn’t feel so hot either. Because of that, I got a Rx for Zanaflex, which I took nightly for the first week. I didn’t have any further cramps, although I can’t say it was definitely the med or just my good luck. Hang in there, Ron
I ruptured my achilles on Oct. 20, 2009, 6weeks ago. I had a cast on for 5wks then a put into a boot. On Dec. 3, I have no crutches, YAY!! I feel very free. I am still taking it easy but at least I can get ready for Christmas. I just wish I could wear two shoes for the holidays.
Hi. I’m at day 5 since the injury and am getting the surgery in 2 days. How long till I walk in a shoe again? I’m a teacher and the district won’t let me back till then; their cared about disability pay. I’m new in the district and untenured and scared about potentially losing my job. Being immobile and a non-athletic the next few months is depressing, but my biggest worry now is my job. What’s the general timeline from surgery to boot walking to shoe walking to sport playing?
Also, any advice on a wheelchair? I thought it would be easier and more mobile than crutches.
Lance, from my reading here, it really does vary widely and depends on many many factors. If I had to generalize from my reading, I would say that boot “walking” is a 3-6 weeks thing, and shoes are 4-10 or so. I say 4 because there is at least one person on this blog who was in 2 shoes at 4 weeks…you should read his story.
Lance, The time to 2 shoes is highly variable. I was supposed to be FWB at 4 weeks post-op and 2 shoes as soon thereafter as I could. I ended up having complications and didn’t make it to 2 shoes until nearly 4 months. Also, a lot will depend on your orthopedic surgeon’s approach to recovery. Some are very progressive and some are very regressive(lots of different casts). Ask your surgeon what his/her plan is, knowing that it could change if there are complications like infections.
As far as your work is concerned, I am pretty sure that your employer is required by the Americans with Disabilities act to accommodate your situation and I am also pretty sure they can’t fire you for being on crutches. A lawyer can tell you for sure and I think you should definitely talk with one. You need to understand your rights and if necessary, the school district needs to be reminded of what your rights are.
I would never recommend a wheelchair for this. The muscles in your injured leg will atrophy a lot more than you expect. If you use a wheelchair you will have atrophy in both legs. You need your uninjured leg to be strong when you get to partial and later full weight bearing. Don’t give yourself an additional handicap. I’m 65 and I was on crutches from August 3 until early November. There were times when it was hard but I managed. You can get a “knee scooter” for getting around on one level. You can’t go up or down stairs with it but you also can’t with a wheelchair.
I would have a talk with your HR people and find out what’s what. As others have said, I don’t think they can fire you for this. The federal FMLA provides up to 12 weeks of protection. What do you do there?
Lance is “sport playing” something you need for your job — like, do you teach Phys. Ed.?
The timelines you’ve gotten above are reasonable, but you may also want to check out my first blog and follow the links to the new evidence on a good NON-operative protocol for curing an ATR. I think your NYC doctors may be out of date, and more old-fashioned than the fancy sports med docs I’ve been seeing in Toronto. (Toronto is sometimes called “The Little Apple” ’cause it wishes it was NYC, but I think we’re learning fast on this one!)
Eight years ago when I tore my first AT, I got the surgery because all the evidence showed better results that way than without, especially for us athletes. But that evidence was distorted by the fact that all the non-surgical patients were being immobilized way too long and way too much, with cast after cast. It turns out that it wasn’t the non-surgery that was leading to worse outcomes, it was the long immobilization.
Anyway, see my first blog (find normofthenorth on the home page here and click on it — or just go to http://achillesblog.com/normofthenorth/2010/01/19/second-atr-first-non-surgical-cure/ ) for the whole argument.
You and your surgeon may be all set for surgery, but if it’s no better than the cheaper, easier, less painful, fewer-complications option, I think it’s worth upsetting a few applecarts. . .
Thanks everyone. I had surgery 4 days ago. I got a long incision too. I saw it today - it’s like 10 inches. Doc said the top side of tendon had retracted and was hard to find. Lovely. It went well though. Been resting, recovering at my parent’s with my mom taking great care of me; much better than my wife! But unfortunately I fell two might ago in the bathroom and put lots of weight on my bad foot out of reaction (propping myself up with sing and doorknob and doorknob broke!). Really painful, psychologically too. Doc today said didn’t look re-ruptured but didn’t react as well as he hoped to thompson’s test. But he said it looked ok. It depressed me to think I may have to redo everything. Have you ever heard of that? Fallen? What was the result?
By the way, I’m a classroom teacher, not gym. I could totally go back to work in a few days in a wheelchair or crutches. I feel fine.
Nearly everyone here has fallen at least once. I fell twice and both times put quite a bit of weight on the injured foot. It was fine both times.
Are you going back to work in a few days? When I had my surgery I was told by the surgeon to stay home, in bed as much as possible, for a week. When I did go back I had to make some changes so I could elevate my leg at my desk because my ankle and foot would seriously swell after 2-3 hours of not being elevated. I brought an old pillow to work, put it on my desk and raised my chair as high as possible.
You indicated they might not let you come back until you could walk. Is that still the case?
I hope to go back to work next week. But it’s unresolved yet. My district has this policy about no wheelchair, crutch or boot. My principal is trying to have HR make an exception. I’ve contacted the union. No resolution yet. Thanks a lot, Gerry. Does anyone know if I’m considered disabled temporarily and am covered by the ADA.
Does anyone know how many days post op is good to go back to work? Should leg stay elevated? I was looking at doing it at 11 days post op. Is that too soon?
Lance:
Probably depends on how you’re paid and what you do. I was operated on on a Thursday and went back to work on Monday and was fine. I think I worked half-days for a few days, but it was really no problem. I felt like as soon as the painkillers were unnecessary, there was no reason not to work. I have a desk job and am paid on commission - no work, no pay. That was a big factor.
Lance,
I had surgery August 3 and returned to work August 10. The surgeon said he wanted me essentially flat on my back for a week. But, when you go back is highly variable. I have seen posts here by people who say they can’t go back even several months after surgery. It depends on a lot of things, like what you actually do, can you drive or otherwise get yourself to work, level of pain, etc. A roofer is not going back to work any time soon after surgery. As far as elevating your foot, you will be quite uncomfortable if your foot is not elevated for long periods of time. I took a pillow to work, put it on my desk and raised my chair to maximum height. It isn’t ideal but it works OK.
i ruptured left ATR 1/12/10, surgery 1/21/10, in first cast, get second cast next friday and then a third cast NWB and i dont know what after that. seems exceptionally long. Foot is in downward pointed position, they are going to slowy stretch it to 90 degrees. I havent been back to work yet, I do sales and its alot of drivng and walking and standing. ANyone else have this type of treatment? ANyone else in sales? did you go back to work sooner or later?
Hi Maryjean,
I injured mine on 1/15 and had surgery on 1/20. I’m in the CAMwalker boot at the first week set at 90 degrees and never got the cast. I’m PWB now, but it’s fractional weight. Not sure why you are in several casts. I would challenge that approach. My Dr was a sports ortho and seems to be more aggressive. I’m also in sales, but have been working at home. I’ve had to cancel 5 flights so far, and I can’t drive as I’ve injured my right AT. I’d think you can do a lot from home as far as calling prospects, but you’ll be driving sooner than I!
All the best with the healing process.
Dan
Hi all. Maryjean, I sympathize with you. I’m in a kind of boot that eventually I will walk in. It’s pretty comfortable and if it gets too moist in there I take it off and air it out for a few minutes. I’m 16 days post op now - thank god! I can’t wait to get rid of this boot sometime in March, I guess. It’s starting to stink like I’m homeless though. Does anyone know if you can wash them? The inside seems to be a pullout, but I don’t want to damage it. Only the two splint shafts on the side and the sole bottom are metal - the rest is like thick, soft nylon. My toes are pointed down in it, I think it shows 20 degrees. Anyway, Maryjean, I’m a teacher. I just went back to work yesterday (thanks for the advice Gerry, Tom, Mary, Pete, Mark!) I’m usually on my feet all day. I brought a wheelchair that I rented for a month, am leaving it in my classroom, and also crutching in, out, and around school. It’s hard. My foot feels discomfort from being down, although in general I haven’t had a lot of pain at all these a since the surgery besides the day after. It’s just hard to keep it elevated while teaching. Any advice from anyone on what to expect from having my foot down a lot at this time after surgery, and also from PT, which I start monday? Does it hurt? What will they do? How often must you go? Thanks again, all!
Hello LanceNYC,
My foot didn’t stink at all while in splint or boot and also didn’t get moist at all, I would say it was cold all the time and hairy of course, as I couldn’t wash it at all. Anyway, I went to work 5 days post op (I work in an international transports company so I’m sitting on a chair usually), but I always had my foot elevated. Elevation is pretty important I guess, because that part of the leg isn’t really well blood-circulated and of course, when you are standing it swells a lot and feels uncomfortable. My doc advised elevation at all times. I started PT 2 and a half months after op and I say it hurts. I didn’t feel any pain at all during these months except from same night after op, and now PTs are killing me. Physio must stretch the tendon and work on ROM so he pushes my feet and massage the tendon which is swollen because of the fluids that are been gathered to this area due to the immobility for 2 months. He starts with tens (currents), then ultrasounds (this feels pretty uncomfortable when passing over the incision). I now have 3 days that I started a little strengthen, doing exercises with rubber bands, also at home. I go every day except weekends, 10 days now, I guess I’ll be spending a whole month there, if not more…for me, it’s not only I want just to walk normally, I’d like to get back to basketball, so I’ll do what it takes to get my favourite activity back soon, and more.
Wish you good luck to the rest of your healing procedure and I suggest you keep your foot elevated as much as you can.
Lance- I sprayed my boot with Fabreeze at night and let it air out. It helped a lot. I also vacuumed it out using the nozzle part of the vaccum. (gross, but true!)
norcalsurf70 and LanceNYC
Thanks for the replies. I am finally in a boot now…I did protest.to all those casts.and I need to get back to work. I like the idea of renting a wheelchair but in sales thats kinda weird…anyway i can make phone calls but leaving the face to face a month out. LanceNYC- I had alot of pain letting my foot hang down but now I;m five weeks post op and it doesnt do it that much. If you can keep it at hip level-using a chair helps alot…..Now I’m wondering about PT and when I can start WB…Thanks to all of you I have spent hours reading all of these posts and helpful suggestions! and Knowing there is support!
Does anyone have any advice about dealing with the costs? I talked to the Dr.’s office before surgery and they said insurance covered everything. Then a week or so ago I got a bill from the anesthesiologist for $3,000. I talked to them and they said “We’re separate from you Dr. and we don’t take your insurance. But we submitted anyway and it’s still early.” Of course I was not happy after this as I made sure to talk to the Dr.’s office and had was told there would be no costs. Anyway, so today I received a check from my insurance company for $500 and a statement that said I’m responsible for the rest of the cost for the surgery, which comes to $14,000. The statement said nothing about the anesthesiologist. So worst case scenario I’m looking at $17,000 in payments. That would hurt. My question is, why am I paying hundreds of dollars each month for insurance if this is the “service” they provide for my hard earned payments? Does anyone have any advice on what I can expect or how to handle this? Thank you all. By the way, 1 month post op now and Dr. says in two weeks I should bring my shoe when I visit him because I’m walking out of there! Insurance or not, that’ll be champagne time!
Lance- you must have the crummiest insurance going. Even if you have a high deductible and your hosp, surg, and anes were all out of network, you still shouldn’t be hung w/a 17K tab. If your surgeon’s office told you that insurance covered everything, then you should hold them to that. Another thing is that it is not infrequent for a bill to be sent to you before insurance pays - check your bills and look for the “pay this amount” line/space. Another thing to do is triple check that all parties are submitting claims to the right address - I’ve had problems after a move where bills were submitted to my old insurance. The check you got sounds like what ins cos do for out-of-network bills (prob your anesth). Finally, call all who have sent you bills and see if you can negotiate in-network pricing even if they are out-of-network. Good luck, Ron
Hi Lance,
In Greece soon as you get a job, you get a public insurance. I, however, got myself a private insurance (actually my husband persuated me to do this) and I pay around EUR1,200 per year for this. Soon as I was injured, I called my insurer (a basketball player also) and he suggested a private hospital and a particular ortho surgeon (of course, I checked also with another surgeon, close friend to my parents). Anyway, up to now, all I have paid is EUR130 for the boot (which costed actually EUR530, but I only paid 25% of it). Also, I received EUR850 from my private insurance, as a ’surgical benefit’ - I had a particual term on my contract about it- which helped me paid my PTs so far. When my insurer visited me at home, he said that the whole operation including anesthesiologist and all post-op visits, costed around EUR6,000-EUR7,000 (on an expensive hospital). So, I think USD17,000 is way too much!
I’m at the 5+ week post op mark. Dr says I will walk with two shoes in a week. Any advice? I’ve noticed a lot of progress in the past week. I can put some weight on it and am kind of crutch/walking now. Dr said one crutch is fine now but it’s kinda awkward and on a slant. So happy to be more mobile, but tendon is still very tight. What’s next?
If you’ve been in a cast, toes down, then you’ve got a whole bunch of things to get used to at once:
1- The neutral position (unless you use heel lifts in your shoes for a while, as some folks do).
2- FWB, or WB as tolerated. Many of us find this transition uncomfortable or even painful, often under the heel.
3- Being “free”.
That latter freedom is both a relief and a hazard. At first, you’ll probably be doing a “silly walk”, bad foot forward. (I used a cane for a few days after I stopped using 2 crutches.) Gradually, you’ll be able to step ahead of the bad foot with the good one, first inches then a bunch.
Balance and ankle stability both return gradually over the next few weeks. The strength to “push off” normally at the end of your stride returns eventually. I’m 12 weeks in total, and I’m still just on the verge of that. In my good moments, I seem to be walking perfectly normally, but it may be a wishful hallucination! When I put my bathroom scale a bit behind me and press down with the ball of my “bad” foot, I get to around 120 pounds, so I know I’m close, and SLOWLY getting closer. Doug53 calls this the frustrating plateau.
The other thing to remember is that the move into 2 shoes and FWB may be when you’re most at risk of re-tearing the thing, so be careful!
Lance, I have heard of insurance companies working with the “lead with denial” plan. This plan puts it back on the insured to fight for their coverage in the hopes they will give up and pay. I can’t say if that’s the case with you but for 17k I would certainly become the squeaky wheel…
Greetings…
I have joined your ranks and will soon bear the scars of the orthopedic surgeon.
The day was sunny, the field was lumpy and as I chased the softball…
05/15/10: Snap! Pop! What the…
05/16/10: “Honey, your foot dosen’t look so good…you should see the doctor.”
05/17/10: “Hey Boss, my achilles tendon seems to be injured I need the day off.
05/18/10: “Mr. Walker your achilles tendon appears to be partially or completely torn, I am sending you to the orthopedic surgeon.”
05/18/10: “Mr. Walker your achilles is completely ruptured and I recommend surgery” “I can fit you in Thursday.”
That is my achilles story…oh yes…I don’t recommend paddle boarding with your friends the day after you injure your achilles.
Snappop, if you want to check out the new studies that show that the results of SKIPPING the surgery are statistically on average EXACTLY AS GOOD as the results of surgery — except for the complete elimination of all surgical complications — check out my blog. (Just add “normofthenorth” after the “com/” and scroll down to “A more complete review of the options — surgical vs. non-operative”. Click on it to see all the subsequent posts by many of us.
Even if you do opt for surgery, check out the protocol from the recent studies, because it’s (a) faster and more convenient than what most Docs use and (b) been proven very effective in those studies — especially with very low re-rupture rates, which is usually the main concern that prompts long “conservative” casting, non-weight-bearing, and lack of mobilization and PT.
Howdy there,this is Mariette Crape,just observed your Blog on google and i must say this blog is great.may I share some of the writing found in your weblog to my local buddies?i am not sure and what you think?anyhow,Thanks!
Hunt the seasons. Animals will be in different places at different times of the year. For example spring and summer are good times to find deer in the open while the depths of winter the deer are more likely to be in the bush.
Wow, what a blog! I mean, you just have so much guts to go ahead and tell it like it is.
it happened june 18, 2010- i went to go play volleyball with my cousins-i hadn’t played in years and went straight into the game and just stretched the quads. only 10 minutes into the game i was waiting for a possible set to me when i felt like someone hit me behind my leg with a baseball bat. i went to see the family doctor the following week– i told him i tried the thompson test and that my foot was not responsive-he dismissed it & gave me anti inflamatory/painkiller pills. i was using a cane and limping around at work for 2 weeks. when my back, knees started hurting and i just couldn’t walk normal-my doctor finally sent me to a specialist. july 7th my doctor performed the thompson test and felt the gap in my tendon and confirmed i had ruptured my ac. an mri was scheduled and you can definitely see the the empty white space on the tendon. i had surgery july 15- the pain after surgery was minimal. the doc also used a graft. my livingroom has gotten smaller due to a wheel chair, crutches and walker- i like the walker- i feel more stable but it’s slower(i wish i had a knee walker!). my doctor says i would be non weight bearing for 10-12 weeks! i’m going to watch a’s vs red sox next tuesday- you think it’s too soon- of course i’ll be using their golfcart & wheelchair service.
Sorry you joined the club and even more sorry that your family doctor was a dolt. You should have gone straight to an orthopod or to the ER. 10-12 weeks NWB is way too long. Atrophy has already begun and by 10 weeks your injured leg will look like a toothpick. There is no reason to NWB for that length of time. My surgeon told me there is no basis for being NWB for more than a couple of weeks, nothing is gained and a lot is lost. Go to Normofthenorth’s blog and find his early weight bearing PT protocol and take it to your doctor. Bear in mind that this is your leg, not his/hers, and that you have a right to have a say in the protocol used. Tell him you want to see the hard evidence that prolonged non weight bearing has a benefit. I promise you he/she cannot produce that evidence. I’m shocked that you have a wheelchair, I was on crutches for several months due to complications and I was a month short of 65 when I ruptured mine last year. Good luck with your recovery. Follow the directions on the home page here to set up your own blog. That will make it much easier to keep us all up to date on your progress. It’s very easy for your posts to get buried on this one and uncool to use someone else’s blog to post your updates.
Thanks GerryR! I’m new to blogging and finally emailed Dennis. I’ve spent most of my time on this site since my confirmed atr. My doctor wouldn’t give me a date when i could put weight on my foot- I kept asking when can i wear a boot and start driving?!!!! The doc wrote on my paperwork- 10-12 weeks non weight bearing (i’m thinkin they were cushioning it) i can’t wait to start the blog! Were you the one doing exercises on the wheelchair? Thanks for the advices : )
Athleticsfan, can’t you kneel on the wheelchair and “scoot” around? That protocol of mine — really from a randomized study done recently at U. of Western Ontario — is posted at bit.ly/UWOProtocol . The study that used it is discussed in reference #7 in the Wikipedia article on ATR (spelled out, of course).
Good luck, and good healing!
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I am a 49 year old wife and mom who had ATR surgery April 9th, 2010. This webiste has helped alleviate a lot of my concerns however I am still a little freaked out by the color of my foot and lower leg. Is it normail to have much less circulation at this point? I do keep it elevated the majority of the time…however being a housewife….there are many times that I have to be up and about. Also, is total lack of calf muscle normail? Stitches were removed on 21st Aug and I currently have a boot when mobile. I am also wearing circulation stocking. Thanks for any advise!
Mom, you should start a blog of your own and give us the details. Are you still in an orthotic boot at almost 5 months post-op? That sounds like a LONG time. Or maybe you meant “August “the first time you wrote “April”??
Inflammation and calf-strength deficit are often lingering problems in this rehab, as several of us have documented on our own blogs, including me. I’ll be almost NINE MONTHS in a couple of weeks, and the need (or just “want”?) to elevate is a relatively recent memory, and some calf-strength deficit is still with me.
If your surgery really was less than 3 weeks ago and not 4.5 months ago, then your symptoms sound way more “normal”!
Start a blog, and install the little widget that keeps track of the time and stuff for all of us (4th bullet point way at the top here, and on the main page).
Thank yo very much for this awesome article. I’ve read your articles for a decent time now, and they are always getting better.
Cheers
Looks like I am the latest on this list of Achilles rupturees. Was feeling good getting back into running for three months, then hot yoga for one month, so I decided to test the waters back into basketball. Bad idea at 44. Tore the Achilles the second time I played, on literally the first move of the day. Guy ran off, I pushed off my right leg to chase him, and it felt like a shelve of books collapsed on the back of that leg. Not long after that I vomited a few times either from shock or pain or just the idea that something might be torn. I had left one job two months earlier and starting another with insurance not yet kicked in so I was very nervous. But I realized I had some time to activate my COBRA to pay for a continuation of my previous health insurance. Without that I would have been in trouble. My family doctor confirmed that it was an Achilles tear and now I was the one lying there with the residents looking at my leg saying “Ah, that’s what an Achilles tear looks like.” Nine days after the accident I had the surgery. Eight days after that here I am. By now I am getting sick of the crutches in my armpits all the time. Lot a lot of pain in the leg I mostly don’t take the percocet, the ibuprophin seems to do the trick. They ordered for me that knee-scooter thing but it still had not arrived, I am looking forward to it. I was back at work after four days and everyone has been very helpful. All things are a challenge but they are all possible so I don’t let myself think too far ahead. Face each stairwell as I come to it and it works out. Good luck to you all. Adams
Adams,
Read my blog, I was where you were 12 weeks ago. Same injury, same sport, similar age, similar circumstance. I’m no where near playing basketball again, but I hope my recovery story encourages you to stick with it.
Adams, you should keep your crutches OUT of your armpits! If they hit your armpits when your elbows are straight, the top part is adjusted too long. Adjusting them is usually pretty easy, with a bolt and a wing-nut.
You should have to “grab” the top of the crutch by clamping it between your side and your upper arm. Those things can take the strain (usually). Armpits are pretty sensitive.
It’s your hands, and your straight arms, that should be carrying your weight from one good-leg step to the next.
Many of us ended up with sore hands or scraped wrists, and ended up taping camping-pad foam or foam pipe-insulators around the crutch parts that hurt. Or wearing gloves or some such.
This rehab really rewards creativity — unless you get too creative in finding ways to stress your healing AT, that is!
Hello everybody.. I recently tore my Achilles plain basketball (10/6) and got surgery (10/12). I’ve read a lot about ruptures and hear it happens to people usually 30+. Well I’m 22, so I guess I got lucky eh?
Hey Steven, I must say..this is stunning to me. 22 years old! But in fairness, it actually can happen just about to anyone I think. Its such a crazy sudden move that you could do 100 times over again, but randomly its that one time.
Anyway, the great news is I’m extremely confident that you will heal remarkably well and your only issue is going to be..maintaining strength and conditioning in your legs in the future. My achilles as a basketball and track and field runner was worn already by the time it tore. So the lesson I can pass on to you is definitely if you ever hurt your self, sprain your ankle, feel something achy in either achilles, go the doc and make sure you get an MRI once in a while over the years because if i had known it was so worn and small tears previously..I mean definitely would have done things differently.
But at 22..you are quite lucky and I believe you will be in good hands very soon. In the meantime..gotta be patient and let things run its course. And when you fully recover, promise you..you’ll be back to playing and forgetting it even happened sometimes! But…yea..maybe some excersizes or some gym time for the legs could keep you good to go for next 20 years!!!
I surely wish I had hit the gym little more often, sprained my ankles a little less, and went to the doc when I felt some twinges over the years…We live and we learn i guess so just hope this helps.
hello everyone. I ruptured my left achilles 5 yrs ago at age 29, had surgery 3 weeks later and recovered fully. On 9/24 ruptured my right Achilles and pushed for surgery which was 6 days later. Both injuries playing basketball. Now into my 3rd cast and just counting the days until I can walk again. I’m looking forward again to a full recovery but as with everyone else here, life on crutches is definitely a challenge. I returned to work within a week.
My ortho looked at my chart and said “wow, 2 achilles…you’r unlucky huh!” Was advised though that it was inevitable. I stay in pretty good shape, run, surf, mountain bike and play basketball. I also stretch too so I guess their was nothing else I could do to prevent it?!
Theman, yea, i had my secondary post op meeting with the doctor on monday. I’ll be starting physio in december, walking with out a boot in January, then i’ll be snowboarding in February. Yea, i asked him all of that since thats my MAIN hobby, so im excited
Hello! I ruptured my right achilles 3 1/2 weeks ago, playing volleyball. The following day I was in a plaster cast as I opted to forego surgery. I just returned to my doctor this last week and was already put into an air cast. I was rather surprised, but hopeful that this means I’ll be walking soon. He suggested that I start trying to put weight on it right away, but I am awfully nervous to do so. I have a few questions…
1. Has anyone seen recent research done by the University of Calgary showing that surgery vs. non-surgery routes are identical in recovery? I’ve tried to find the info online but found nothing.
2. I am moving to Honduras (for 6 months) in less than one month. I expect that I can ditch my crutches by then (thoughts??) but also am really unsure of what footwear to take. Before this happened, I had only planned to take flip flops! I expect that I can leave my hikers at home as I don’t imagine I will be doing too much of that. Any suggestions?
Thanks! This is a great site.
Dalene, welcome to a great site — and from a fellow volleyball player who has now “donated” BOTH ATs to volleyball, 8 years apart!
I’ve seen FOUR post-2007 studies, each MORE or LESS showing that surgery vs. non-surgery routes are identical in recovery, though some more than others. They’re listed as end-notes 4-7 in the Wikipedia article on ATR, at bit.ly/Wiki-ATR . There have also been various discussions about their detailed results in different spots on this site, including on two blog pages of my own. (My “thumbnails”: Two of them show just that, while the other two show identical results except for higher re-rupture rates without surgery. All showed much higher complication rates with surgery.)
I’m not familiar with a study from Calgary, but my fave is Canadian, from “Western” (U. of W. Ontario — #7 on Wiki), that was just formally published a month or so ago. It produced excellent (and identical) results in a pretty large group, both with and without surgery, using a pretty aggressive modern protocol.
I successfully followed the protocol that my Doc got from the researchers at UWO (as have several others here), which I’ve posted at bit.ly/UWOProtocol . They used AirCast boots in that study, and started PWB (and exercise and PT) at 2 weeks in, then “FWB as tolerated” starting at 4 weeks in. I had ditched the crutches completely before 5 weeks in. They removed the (2cm) of heel wedges at 6 weeks in. Check it out!
You’ll be close to 8 weeks in when you move to Honduras, and that’s when that protocol says “wean off boot”. I’d wear it on the plane, and DEFINITELY take it to Honduras. You should also do SOMETHING to raise your uninjured foot up so it’s as high off the floor as the one in the AirCast. Methods vary, but get ‘er done, or your body will be out of alignment, unhappy, and at risk of a number of problems.
You should be able to start walking in soft shoes (maybe Crocs) around then, but maybe only in “safe” places at first. Flip-flops on the beach sound great, but not in the few first weeks out of the boot. (I still have photos of me walking on the beach in a boot with a shopping bag over it to keep the sand out!)
Good luck, good healing, and keep us posted — maybe in a blog of your own, if you have enough time and energy.
Norm - thanks so much for all your info! My doctor has been kind of evasive with some details, and I guess I’m probably not asking enough questions, but this really helps. I tried putting a bit of weight on it last night, it didn’t hurt so much, but the bottom of my foot got all tingly. I hope this is normal and isn’t indicative of some nerve damage or something!
I do have a blog going (see link), it is more of a travel blog as hubby and I have been on the road for over a year, but it does contain me whining about my injury - ha!
My doc said that the U of C study was the latest and greatest, just came out in the last few months. I had two docs look at my ankle, one said surgery, the other said he wouldn’t. I elected not to and so far so good, I am happy with my recovery so far, and I REALLY hope I am walking on the plane to Honduras! And hubby may have to carry me onto the beach then, because be DAMNED if I am not working on my tan as soon as I get there!
Thanks again for the info. Death to volleyball! I sprained my other ankle about 10 years ago when I came down on a ball. I think it is time for me to retire. =)
Norm - one more question, when you said “You should also do SOMETHING to raise your uninjured foot up so it’s as high off the floor as the one in the AirCast. Methods vary, but get ‘er done, or your body will be out of alignment, unhappy, and at risk of a number of problems” Did you mean when I am on the plane, or at all times? This is something that I have not always been doing…
Also, what about exercises I could be doing now? I am just flexing my foot at this point for about 1/2 hour a day, or whenever I feel the incredible urge to get out of my boot (OFTEN!) Is there anything else I could be doing for my calf or thigh to ensure I don’t stumble like a baby deer when I try to walk?
Thanks again, so much. Your website has been a godsend.
hi all! 27yrs from Czech Republic - ruptured my left achilles 4wks ago, playing basketball. same day I had a surgery. in thank to this site - im feeling better when i could read your experiences. im looking forward to jan6/2011 to probably last visit before rehab. thank you again, take care of you all
I’m quite new to wordpress. but what you write in this post is really great and very informative. I think it will help me in the future. Thanks for the great job
I ruptured my Achilles Tendon 5 weeks ago tomorrow. The hospital didn’t explain what was to be expected during the recovery process and decided to put me on the non surgical treatment plan. After doing my own research and talking to a few people, I’ve been told that I might be in a cast for anything up to 10 weeks; following which there is a possibility that an operation may still be needed. I’m quite concerned that they haven’t given me a scan (MRI or ultrasound) but just felt the back of my leg. The leg still swells up and becomes painful unless elevated even after 5 weeks.
Is this normal? Has anyone experienced problems with the non surgical treatment?
Thanks for your help and feedback.
Winters, if you hang around here long enough, you’ll find that some people do experience problems — including re-ruptures — with the non-surgical treatment. And others experience problems — including re-ruptures, and also inflamed or infected and non-healing incisions, & DVT and scar “adhesions” — with the surgical treatment.
Check out some of the new studies (>=2007) comparing the two treatments, using fast rehab protocols. E.g., the newest one is on this site, at achillesblog.com/files/2008/03/jbjsi01401v1.pdf .
They found statistically identical results (strength, ROM, & re-rupture rates) with and without surgery, but different complication rates. But they didn’t keep their patients in casts for anything like 10 weeks! Straight into a boot, exercise and PT and PWB starting at 2 weeks, FWB at 4 weeks (ditch the crutches), and out of the boot at 8 weeks. That fast rehab seems to help the non-ops even more than the post-ops.
Lots of us skipped the surgery, and you can follow our progress on our blogs. Bronny is one of our newest success stories, but there are a lot here.
Opinions differ on the value of the high-tech scans. Many of the best surgeons I saw (and I) think they’re almost always unnecessary and sometimes confusing and misleading. One smart sports-medicine surgeon told me that as soon as somebody describes the way I climbed stairs after my ATR, he diagnoses it as an ATR, end of story. (After briefly trying to climb stairs normally — and having my life flash past my eyes! — I learned that I had to place my WHOLE foot on the step, including the heel. That’s the “diagnostic” response to the combo of ATR and a staircase going up!)
There are some very rare cases (like fractures of the calcaneus) that need different treatment and benefit from MRIs or USs or even X-rays, but they’re so rare I personally think the scans are more to cover some rear ends, than to improve the medicine. As I said, opinions do differ on this.
Swelling often persists for MONTHS, and is painful and restricting/stiffening, too. Elevation is your friend, until your leg tells you that you don’t need it any more.
Hi all,
weeks in my ATR - been blogging about it here if you’re interested.
http://meandmyachilles.wordpress.com/
Just done my first walk in an AirCast Boot - about 20 mins worth. A good day. Hang in there if it’s early days, keep smiling, it will get better.
The best thing is it’s mechanical - and they can fix that.
Take care all.
M
Thanks for making me laugh, your blog really cheered me up. I had an aircast when it was cold, the wind got in through the toe end. I’m still wearing it now its getting warmer. I agree I think its worse in the heat.
Still one of the best days for me was when I finally got the Aircast after not being able to stand up for more than about 5 minutes for nearly 3 months. Fun times….!!
Ta for reading ali39 you gotta laugh about things or you’ll go mad.
I decided to go at this thing in the most positive way I can. odd blip here and there. but I think it helps.
M
Yeah I’m in the middle of sorting out my blog. I’m not wonderfully IT literate and bodged it up initially.
So many things you said really made me laugh. If it was not for the little bit of cycling I CAN do at the moment I would have gone bonkers.
Something really getting to me at the moment, several people eyeing up my moon boot and commenting on how expensive it looks, and asking did I have to pay for it bla bla bla. Really does my head in.
Anybody else had this?
I have to think of a better answer or somebody will get it thrown at them soom….
Ali
Ruptured Achilles on 6/24. Surgery on 6/29, Foot is wrapped in a soft cast with a follow-up post-opt appointment on 7/14
How long are people generally off from work from a post op achilles surgery?
I took a trip to lasvegas last March and this street college kid did the most craziest trick with four cards. I finally found a video of this same illusion. But I ain’t paying 9 dollars to see how it is done. Would somebody please tell me how this trick is performed? Amazing - http://magictricksdirect.com/shin-splint-by-shin-lim-card-magic-trick/
francisbedevil,
I had surgery on a tues night, home by noon on wed, back at work for a few hours on fri afternoon.
I sat around the house on wed and thurs feeling sorry for myself and I was useless trying to help my wife with our young kids. I was in minimal pain so I might as well go to the office and get some work done.
Btw, I work a desk job and only have to crutch a 1/2 block to and from my parkade.
Edmonton
I ruptured my AT Sunday October 2nd, and had surgery Friday October 7th. I’m doing well with the pain level…. Im using vocodin and Norcal but the vicodin seems to work a lot better.
Anyways I was wondering is it ok for me to use Flexiril? I have some from a earlier injury and I don’t want to mess up the healing process of the AT.
Im scared im going to gain weight, Im a high school teacher and coach….. I was pretty active but im worried that with the time off ill gain….
Any suggestions on ways to get cardio? I cant drive (right AT) and will have problem coaching does anyone have any comments on the iwalkfree?
Bigfrank- the best thing I’ve found for Cardio; once your incision heals up, is swimming. Until then, some guys will use a stationary bike - even in a boot - using their heel to drive the pedal so as not to load up the Achilles. I’ve also been Kayaking a lot, but without using my legs, I find it’s hard to really stress my cardio system; I just can’t output the power needed to tax it.
Frank,
Do any and everything you can to stay active and you’ll be fine. I had the same worries, but I was back in the gym after 3 weeks… on my crutches and everything. Just did upper body (of course) machines, etc.
It’s a long haul. I’m at about 14 months and can do everything I used to, albeit not quite as well yet… but still working at it.
Good luck,
Tim
Thanks Ryan and Tim for your response….. I needed it!
Did you guys both go from cast to Boot? My doctor says that ill have this cast on for 6 weeks, and then a boot on for another 6 weeks.
Will i be able to walk pretty normally in the boot? ( Will i still need my crushers?)
I pushed my early schedule hard, harder than most recommend.
Post surgical “cast” to day 5.
Removable splint to day 19. <- no cast
Boot to day 37.
2-shoes starting day 38. (5 and a half weeks)
That’s just what I did; I’m not saying that’s what you should do. So far so good! But, the jury is still out on my approach/recovery (I’m just at 6.5 weeks).
When I started in the boot, (like almost everybody) I was still using the crutches at first (PWB), and did so until day 28. At day 28, I started full weight bearing (no crutches). I started out walking very slow, but was walking/functioning pretty normally within a few days after dropping the crutches.
From time to time, I still use a cane. If nothing else, it seems to help keep shopping carts and other mobile hazards somewhat at bay
So one more thing - it’s probably a topic for my next blog entry - once you get to FWB (walking in the boot), you’re pretty much there in terms of day-to-day functionality. Going to two shoes is a big milestone, but it’s not going to make much of a difference in what you can and can’t do. In fact, the security of the boot, in some ways, allows more.
I am 12 days post surgery and seeming like im feeling better with each day. My doctor asked me to come back 6 days after my surgery where she took of the cast that was on when i woke up from surgery, she removed one stitch from my incision area, and had another cast put back on immediately.
The doctor asked me to come back in 2 more weeks to see if i would be placed in a boot. Im worried because the number don’t seem to add up. When I go back for check up in two weeks and she decides that i can go in a boot, that would mean that i was in a cast for only 4.5 weeks! Isn’t that a bit soon?
I have been driving with my left foot and these crutches are really a pain to get around with…. I would love to get into a boot of some sort but i don’t want to go to fast and end up wost off. Any suggestions?
I have never in my life to for granted just basic walking as much as i do right now!
Check other blogs on the left (click the names). Lots of different ways and 4 weeks to boot is more than ok. I was in boot at 2 weeks and FWB straight away same as a few others. Some have spent 10 even 12 weeks in a cast. What I would ate from what you are saying is that you are with someone who is slightly progressive which is favoured around here as it is considered the best course of action. Good healing!
Say not ate!
Agree with bcurr. 4 weeks to a boot is not out-of-the-norm at all. For instance, if I’m reading it right, this protocol:
http://achillesblog.com/files/2008/03/achilles_tendon_repair_rehab.pdf
has the patient in a boot at 2 weeks.
agree w/all the others. this coming monday i go back for my 2nd post op which is 4 weeks aft. surgery and i believe the plan is for me to get into a “boot or removable cast” (the MDs exact words) though i don’t know what the dif is betw a boot or “removable cast.”
GL w/your recovery.
Wonderful site. Not sure how to start a blog. It takes me to a page full of ads. Ruptured mine on 17th Oct playing flag rugby jumping for a high ball. Complete tear high up. Surgery on Friday 21st Oct. Surgeon has put me in a Vaco Boot straightup. No cast thankfully. He said the casts were old school. No weight bearing for 2 weeks. On blood thinner injections everyday and antibiotics. Quite a lot of pain past surgery for 2 days, lots of high quality pain killer drugs. Pain is fine now. In Australia so summer is kicking in - timing awful, and the boot is hot. Counting down the weeks now until the boot can go. Providing all is good New Years eve I can lose the boot. Oh on the brightside, I am a smoker, and the doctor warned smoking prevents healing so I’ve now quit for 4 days after 17 years and 15-20 cigarettes a day. Good luck to the rest of you.
Hi – really good web site you have made. I enjoyed reading this posting. I did want to issue a remark to tell you that the design of this site is very aesthetically sweet. I used to be a graphic designer, now I am a copy editor.
Awesome Article! Quick read and informative.
YES YES YES! I just went from cast (5 weeks) to a boot! HOOT HOOT! Im not sure what degree my boot is set to but i have two wedges under my heel.
My doctor said to take off boot 3x a day and do range of motion excesses. My doc also said to begin trying to walk with out crutches.
Ryan, in your experience how much should I be walking around with out crutches?
I have to do a lot of my finding of info online….. pretty crazy
Hi BigFrank- great news on the progression to a boot.
I talked about my boot philosophy here:
achilesblog.com/ryanb/2011/09/27/das-boot/
I really didn’t do any “no crutch” walking early- I stayed PWB, with crutch assistance; but did a lot of walking (miles). As I was able to, I gradually worked on getting rid of the wedges, and carrying more weight on my foot.
I took me a little over a week before I could go FWB (in the boot). But once I did, I never looked back. I continued my - relatively - long distance walks, without crutches.
Doh, missed an “L” in the above link (in achilles), and had to strip out the ” h t t p : / / ” to get it past the filters…
I’m a 35 y/o in-shape guy (6′0, 200 lbs) who has played college baseball, and has played flag football & men’s baseball for the last 12 years.
I ruptured my left achilles tendon on Nov. 13 while playing flag football. I play wide receiver and ran a corner route. I ran 10 yards then cut my route off to the sideines, at that point when I made my jab step the back of my ankle felt like it exploded! However, it didn’t hurt, it simply felt like my foot had went to sleep. I knew then and there it wasn’t good and more than likely an achilles injury.
I had an Xray on Nov. 14 (negative, no broken bones), MRI Nov. 15 (revealed a complete tear of achilles), met w/orthopedic surgeon/doctor on Nov. 17, and then had surgery 6 days after injury on Nov. 18.
The first night wasn’t that bad, took the Percocet for pain (but it made me sick, thus I discontinued it). The second day post-surgery was NOT good, painful and sore. Day three post-surgery wasn’t bad, and today is day four and my injured limb does’t hurt.
My doc has set aside a time table that reads like this…
Injury- Nov. 13
Surgery- Nov. 18
NWB- 6 weeks
Boot- 4-6 weeks (but I feel llike March 2 is my target date to start wearing shoes)
Jogging- mid May
Fully recovered- 9-12 months
Does this sound pretty standard to y’all, and is there a particular boot and achilles brace y’all would recommend for me???
Thanks!!!
It sounds a little pedestrian but the end time is realistic. Do a bit of research for yourself but it sounds like your doc is very old school. You can still have a good outcome with the old methods but early weight bearing does aid recovery. I would have thought you could be in 2 shoes much sooner than March and jogging could come sooner than May. You are not clear on when the boot comes. Is that after the 6 weeks of NWB? Anyway, Vacoped or Donjoy boots are good and you need one that can change angles if you get it now but if it is after 6 weeks then a fixed boot may be all you need. Those decisions will be between you and your doctor. Personally I was in a Donjoy at week 1 and PWB in 3 weeks, FWB around the house between 4 and 5 and out of the boot week 7. As I said, do your own homework and don’t just rely on my experience or others. There are links on this site to modern scientific studies. Doctors are not too impressed when you come to them with this so expect resistance if you decide to do that but you can be your own advocate if you understand the information sufficiently and present it intelligently. As I said, your end time frame is reasonable but your quality of life will be better sooner with newer methods.
@Stuart sorry about the time table not being realy clear. Basically from Nov. 18 (day of surgery) to Dec. 30 I’ll be NWB (6 weeks) & in a modified cast (hard splint on shin & top of foot and heavily wrapped around foot, ankle, and calf).
From Dec. 30 until at least Feb. 3 or Feb. 17 I’ll be in a boot (approximately 4 to 6 weeks). My personal goal pre-surgery was to be wearing shoes and walking unassisted was March 2. My doc said more than likely I could ditch the boot mid-Feb.
So about mid-Feb to late-Feb I should be in shoes and walking unassisted. I was hoping to start back jogging by May 1, but was told that might be rushing it. However, I could start biking much sooner (d/k date on that).
Fully recovered by Aug. 13 (9 months post-surgery).
I really like the VACOcast Pro Achilles boot. I also want to invest in an Achilles brace for when I’m wearing shoes and starting back to biking, eliptical, and jogging. I found a brace made by Bauerfeind AchilloTrain Achilles Tendon Support or the Bauerfeind CaligaLoc Stabilizing Ankle Brace
for Achilles rupture.
Also, w/my age of 35 y/o & in good shape, would y’all recommend that I discontinue the play of flag football & softball, or go ahead & play once I’m fully recovered? Hearing y’alls opinions that have already gone through this process makes a world of difference.
Thanks!
Rome - there are many people here who have had a similar time frame but unless there is some significant medical reason that your doctor is aware of then in my lay opinion he is treating you with last century medical techniques. You can still have a good result that way. Some doctors like to protect the tendon for around 12 weeks, when the risk of re-rupture deminishes. My 81 yo father did his recently and was in a boot the entire time, no surgery and went to 2 shoes around the house in 6 weeks. I was average in most of my steps and started jogging around 20 weeks. Locking your foot up for 12 weeks will put you back in that time frame but you can still expect to be almost recovered in 12 months. Do some homework and check out if way I say is right. Search Achilles tendon rupture early weight bearing. No research this century has advocated the way your doctor is treating this and have all pointed to faster and stronger recovery.
@Stuart
the doc did tell me one interesting bit of info after the surgery was complete. he told me and my dad that my achilles was smaller than the average persons. he also stated it was a wonder i hadn’t had this injury long before when i did. go figure! i’ve played sports since i was 5 y/o, and that’s now been 30 years of baseball and football. do you think for this reason alone is whey my timetable is somewhat drawn out?
Thanks!
Rome - I doubt that is the reason. After it is healed it will be much thicker anyway. Read up on how tendons heal (google search). I won’t tell you where to look because you need something to do for now. It takes a while for some doctors to change a method that gives good results and be confident that you should have a good result going down this path. Early motion and weight bearing has shown itself in clinical studies to aid tendon healing and results are excellent. Some doctors don’t like boots early because it gives the patient too much control and more oportunity to do the wrong thing and take it off when they shouldn’t. You will take a little longer to get back to those things you like going this old way but you need to be confident in your doctor and the process. Ask questions and put them to task. Know what you are talking about first. I never advocate doing radical things before you should and would not suggest you throw away your doctor’s opinion in favour of mine. Do your own research. As long as you are happy with the end result then that is all that matters.
Rome- I think Stuart is right. Your doc is treating you with a very slow protocol. I’m not going to call it conservative, because I think it’s more risky: studies have shown that you’re more likely to have a better result with earlier mobilization and weight bearing.
Take a look at some of the info here:
achillesblog.com/atr-rehab-protocols/
The schedule you’ve described would have you coming out of a boot, possibly getting into two shoes at 12 weeks. I’m at 12 weeks right now; I’m not running yet, but I’m doing most everything else.
You want to do everything that gives you the best chance of a good long term result. Though it can be somewhat counter-intuitive, that probably doesn’t mean going as slow as possible now.
@Stuart indeed you are correct, i’m going to have a lot of time on my hands to do some research LOL. I go back next Monday, November 28 for my first post-op appointment. I personally feel the 6 weeks NWB is right on course. Possibly “IF” I’m progressing ahead of schedule, my doc will bump up my time table.
@RyanB I’ll clarify on one statement I made. MY personal goal was to be in 2 shoes by March 2, which is 14 weeks post-op. I said this before I had even went in for my pre-surgery appointment w/my ortho doc. The window to be out of a boot given to me by the PA & doc himself was b/t February 3-17. This time frame would put me at 10 weeks to 12 weeks post-op. Maybe I’ll be on the closer side to February 3.
Did y’all experience muscle spasms or twitches in your leg and toes after your surgery? Mine have been primarily at night when I’m lying in bed. I’ve felt it pull down by the incision, I do hope I’ve not hurt anything. It’s totally an involuntary movement.
Thanks!
I experienced a few twitches/spasms in my calf. They tugged at the Achilles, which could be very painful. I worried about damaging the post surgical healing process. Once I got out of total immobilization, and was moving the ankle joint (@day 5) it got a lot better. Like you, they happened mostly at night. Once I was sleeping free (@day 17) they completely went away.
Thank you so much Ryan! I feel a lot better, and can’t wait till I go for my first appt post-op.
What should I expect from this initial post-op appointment???
Thanks!!!
Rome
Mostly, the doctor will be taking a look at his work. Your post surgical cast/wrap/bandages will come off. They might clean up the wound area a bit. Usually, this is when they take most, or all of the stitches out. They’ll check for any signs of infection. The doctor will probably move the joint around a bit, poke at it, give you a Thompson test, etc.
Then, they’ll set you up for the next few weeks. From the protocol you described, that probably means a plaster or (hopefully) fiberglass cast. They’ll probably set you up with your toes pointed down this time. In a few weeks, they may replace the cast with a new one, with your foot closer to neutral. FWIW, I asked for a hard (but removable) splint, instead of a cast at this point.
You’ll probably see the doctor for 5mins or less. So, before you go, write down a list of all the questions you want to ask.
@RyanB I have all my questions jotted down on my iPhone (NOTES) LOL. I did the same thing on my pre-op visit.
I also found out that I won’t go into a hard cast. I’ll go back into some type of a soft cast/splint.
If you don’t mind me asking about your injury… How, When, Where, What (sport)?
Lastly, are there any Achilles braces that anyone would recommend once I get back to walking, jogging, playing sports?
Thanks for all the replies & feedback… So appreciative of this group!
Rome
Rome- in a nutshell: sprinting uphill,with a weight vest on. I described the circumstances in my initial blog post:
achillesblog.com/ryanb/2011/09/24/hello-world/
@RyanB I just read your blog. I must say your’re QUITE active! I’m sure it’s fun to do a lot of the activities/sports that you do IE. speedskating, skiiing, etc. That’s amazing how your ruptured your achilles. I say that b/c mine was in the second football game of the day for me, and I was at about the 10 yard mark of my route when my left achilles exploded. As yours ruptured well into your lunch time workout at about your 10-15 step into your drill.
However, I did have warning signs…
I had a strained calf about 3-4 weeks before my left ATR. I iced and rested the injury b/t my football games which are played on Sundays. I actually strained my left calf first, then my right calf the following week. My doc said this was the start of all of my problems. But the funny thing about is the calf seemed to have heeled up, then just all of a sudden the achilles ruptured. And in all honesty, the play before I was injured I said to my quarterback, “boy my calf is get’n a little tight.” Maybe I should’ve listened to my body
Do y’all think I can fully recover from my left ATR and come back to play softball and flag football again?
Thank y’all!!!
Rome
Rome- short answer: yes, I think you should be able to come back. Your biggest danger is probably rupturing your other side (I think the studies Norm cites say something like a 300% increase in probability). It’s been discussed here a few times lately- but once you get through the initial healing period (say through the 1st 9 months), it seems to be very unlikely that you’ll re-rupture your injured leg. The difficult challenge will be to rebuild your strength, explosive power, and confidence.
You better be able to do it: you’ve got over 10 years on me. If you can’t do it, then for me- it’s hopeless
Ryan - regarding the stats for doing the other AT. They read as I understand it that if you have done one then you are 200% more likely to do the other than someone in the general population that hasn’t done one. Now if the stats for the general population is 1% ATR (this is a generalisation - I don’t know the real stats but they would be less than that) then I would assume that the chances are not as high as you would assume by the big number but still, as we speak and all day, my other AT has been giving me grief. Having designed lab experiements before I can tell you that you work out how the stats are going to read before you start the experiment so they suit your hypothesis. By this I mean, don’t put too all your faith in the statistical analysis. Use them as a guide.
Rome- I agree with Ryan. You should have a full return and should the other let go then you should be thankful that you only have two and once healed you should be able to what you want without worry. Feel sorry for those who have done both at once.
Folks, it’s not 200% OR 300% of the underlying ATR risk, it’s ~200 TIMES the underlying ATR risk!
Most of Stuart’s point is still valid, though: The underlying ATR risk for the general population is pretty tiny, so even 200x that number is way short of a likelihood or a sure thing.
The scariest story I heard was from a guy (met him in rehab waiting room!) who used to work in a PT clinic that serviced a lot of ATR patients. He told me that when they were through treating an ATR patient who was ready to return to their “high risk” sports, they’d say “OK, good luck, see you soon!” because so many of them came back after doing the other side.
That seems extreme to me (and I DID the other side!) based on the numbers, but the truth is in there somewhere.
I’ll share a decision-making approach that works for me: Instead of focusing on averages or wishes, run through the two BAD outcomes of your two decisions. How bad would you feel (or how badly would you beat yourself up) if you went back to the “scary” sports and you DID tear the other AT, either a year or 2 later or 8-ish years later (my interval). Then do the opposite: What if you gave up those sports, and some genius told you on your deathbed that you wouldn’t have torn the other AT even if you’d returned to them for the rest of your life?
If one of those possibilities would “ruin your life” a lot more than the other, then maybe it’s sensible to avoid it.
Thanks for the clarification Norm. After typing that, I remembered that it might have been an X, not a %. But, what’s a factor of 100 between friends
I take some solace in knowing it will be easy to avoid the (extreme) circumstances leading up to my injury. I’m not convinced I had an underlying weakness- I think I just put a ridiculously high load on my Achilles. A little caution is all it will take to avoid putting a similar load (again) onto the other side. If it goes, it goes: I’ve got no plans to give up any of the sports/activities I participate in.
Breaking my neck gave me a new outlook on things. I could have very easily been paralyzed or have died in that incident. Things can come to sudden and abrupt end at any time; and - knowing so - I try hard to live each day fully. I’ve seen other people react oppositely… retreating into a cautionary shell, looking to avoid risk of a similar injury ever happening again. To each his own.
“The funny thing about regret is,
It’s better to regret something you have done,
Than to regret something you haven’t done.”
- The Butthole Surfers
It has been a while since I read the information so sorry for the error. I usually double check my facts before posting. I have been so busy of late that. Anyway here is the link to the study.
http://www.klokeavskade.no/upload/Publication/%C3%85r%C3%B8en_2004_Scand%20J%20Med%20Sci%20Sports_Contralateral%20tendon%20rupture%20risk%20is%20increased%20in%20individuals%20with%20a%20previous%20Achilles%20tendon%20rupture.pdf
It showed a 6% chance of doing the other. Norm is right though. You have to forget the stats because they don’t always reflect the reality. It comes down to priorities in life and what you want to get out of it. If you live your life worrying about the risks then you would never leave the house.
In some cases, not only do they leave the house, but they build their own house
!
Very funny Ali - As Bcurr has noticed, I now have my own page (xplora). I will be able to post some photos of the house later. A week to go before the big move. House is almost packed.
Hi everyone,
I hope I can get a response. I had surgery to repair my ATR at 10:30 am Thursday, and now it’s 3:30 am Friday and my entire foot is in tremendous pain. It’s in a fiber glass splint, and I’ve got to the point where I can so much move a toe without a burning pain radiating throughout my foot and leg. It wasn’t that bad earlier, but apparently I had a local anesthetic, too, so I guess it wore off. I’m pushing my painkillers to the maximum, but my foot is still killing me…I can’t fall asleep.
Is this normal? How long does it last? Thanks for any help.
Danny
i had surgery last tuesday and the first three days were the worst in terms of pain and discomfort. i actually had a mini panic attack and was tempted to rip the splint off, feeling a little clostrophobic (sp). the best thing to do is to keep it elevated as much as possible to minimize the amount of swelling.
I too had surgery this past Tuesday (Haglund’s combined with an anchilles repair, not a full tear). It is definitely normal. Days 2 and 3 were the worst for me. I maxed out on pain meds and didn’t sleep at all because the pain was too intense. I ended up calling my doctor and he had me unwrap the ace bandages around the splint and pull apart the 2 plaster pieces that cross over the shin a little to loosen the splint up. He said it’s difficult to guess how much the leg will swell after surgery, so a lot of times the splints need adjusting. This helped me tremendously - it relieved a lot of the pressure pain I was experiencing. So maybe try and do that? I will say it does get better. I freaked out last week thinking I was going to be in pain like that for weeks but I can say that I’m now off the pain meds during the day (only taking them at night) and taking motrin as need be during the day. The swelling is still pretty bad but I managed to get ahold of an ice machine that is a cooler filled with ice water and has a hose running from that cooler to a pad that lays behind my knee. It lasts all day and I can turn it off and on to get icing in without having to get up. It has been a lifesaver because I can adjust the temp and ice for longer/more often then I was the first few days…I feel like this has really contributed to my relief in pain because the nights are most painful for me and that’s when I don’t have the machine on. So if you can, maybe look into finding one of these machines. Hang in there though! I’m going to get my cast today and I feel like it’s a huge milestone, haha.
Thank you guys. I added another big pillow to my elevation and it made all the difference in the world. The calf/Achilles area still hurts, obviously, but the overall foot pain has been drastically reduced (as has my anxiety). Thank you for the speedy and detailed responses! This site is a godsend.
Maybe a sunroof and more likely Black, White, Silver, Burgundy or Gray and it must have a Cd Player. =D.
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Great ste foe anyone who is in this club! I am only 11 days after my operation and pretty fed up! Only saving grace is I am going into an air boot next week . Never realised how much effort it takes to do anything but just need to get my head down and recover! Does anyone know how long after the operation it is before you can go swimming ? Would love to have something to look forward too .
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Ray M–my surgeon said I could swim as soon as all the scabbing was gone from my incision…I was in post-op bandaging & casts for 7 weeks after surgery, and about a week after that, all the scabbing had come off and I swam…
For your first swim at least you may want to go with a friend to help with logistics–you will want to be very careful getting in & out of the pool. ATR blog regular RyanB has good advice: have the good leg in the water before you take the boot off, and put the boot on before the good leg is out of the water…
My strategy was to crutch out onto the pool deck with shoe & boot on, my friend carrying my towel. I got down on the pool deck, took shoe/sock & boot off, then went in over the side while my friend moved my ATR gear out of the way. When I got out, she fetched it for me & got me a kickboard to sit on to dry off & boot up again. I was less than graceful rising from the pool deck but managed….I chose to go home in my wet suit & shower and change at home, ‘cos the shower floor looked too slippery & dangerous to me.
It feels absolutely great to be back in the pool again–I hope you can get there soon!
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Hi everyone,
I just turned 69 on 1/23/2012. I ruptured my right Achilles on 11/22/2011, pushing a car. At the VA, they ascertained that I had a partial rupture which at that point didn’t believe I needed surgery. I was immediately put into a splint and placed on crutches until 8 days later, when after seeing Orthopedics, was placed in a boot! I found I could walk in the boot without crutches to my relief. And only took it off while in bed with no problems. Because of the boot, I hardly felt any pain, even when walking with the boot which is quite protective. All was going well, and in late December, Orthopedics Dr. told me my Achilles was healing great and that I might be able to be boot free in another 3 weeks. Then about a week later, as everything seemed to be going great, I somehow injured a tendon or bone bruise (no break) in my ankle in the arch area. Had to wear a surgical compression and take pain killers and ice the ankle-arch! Was sore, even when walking in a boot! With surprisingly no pain nor problem with my Achilles! To walk, I was forced to put most of my weight on the outside of the foot and away from the arch area. Then about two weeks ago, while wearing the boot, I was carrying groceries up some stairs and apparently blew my knee out! I should mention here that I have in the past had to reconstructive Knee surgeries and when last x-rayed 3 years ago, had serious bone disease (osteoarthritis) in the knee and the doctor thought I should have a knee replacement, but my knee wasn’t hurting, so I declined. So it was not surprising that the x-ray they took recently showed the knee much worse. And when I blew the knee out a lot of fluid developed and the knee blew up like a balloon! Now even more problems, as I hadn’t had a physical in a few years, the VA ordered one and they found I had a PE (pulmonary embolism–small blood clot in my lung. So I was placed on warfarin, so with the knee fluid, I had to go to the VA emergency room where the removed about a half pint of fluid/blood! So, back in the crutches I went. bad knee and the soreness still remaining in the ankle, I started Achilles PT. My knee is still a problem, but seems to be improving, my ankle soreness is minimal and I have removed the boot myself and have been walking in crutches with sneaks on, but still putting more weight on the outside of the foot! Forgetting the knee and ankle pain, my Achilles has healed great. Seems to have fully healed in about 8 weeks. I am able to raise my heal standing, onto my toes fairly well. I can walk a little with sneaks on without pain, but can feel the Achilles stretch a bit when walking. Hard to walk normal though especially because of my knee, but getting there. It is January 29, and I will be visiting orthopedics tomorrow and will see what the doctor says about the Achilles, my ankle and my knee! But just to let everyone know, I was told by many people that my recovery would take a long time–maybe 6 months or more and that i would have the boot on for a long time! Seems that that was not true, as my Achilles is doing great after only 2 months. Will let everyone know tomorrow what my prognosis after seeing Orthopedics. Glad I didn’t have to have surgery though! Keep your chin up everyone, because if this 69-year-old fogy can recovery, then you all still have hope! And to be honest, I am a golfer, and was really depressed when this occurred and then hurting my ankle and blowing out my knee didn’t help my emotions! but that didn’t last long, as I am a fighter! lol
Some story, Bob! Were the foot and knee problems both on the same leg as the ATR? Yikes! Glad it all seems to be resolving - 1 old fogey to another!
Norm, saw Orthopedics this past Monday and was told my ankle problem was A medial Tendon tear on the inside of my ankle in the arch area! And yes, all the damage–ankle, Achilles and knee all on right leg! If not for the knee and ankle, I’d actually be walking pretty easily now! The doc said my Achilles healed OK, but I will be needing a lot of PT. Can lift on my toes with both feet at the same time, but can’t lift onto my toes just with my right foot! My knee feels a little better, but still some healing to do! This past Tuesday I find out after some blood tests that I am Type 2 diabetic! Just over the danger line! I weigh about 162 lbs., but plan to lose 10 lbs in the next few months! Am already working out and changing my diet! Losing the 10 lbs should help regarding my knee and foot! Hoping to get into the best shape I have ever been in in recent times by June! These torn Achilles are sure fun! lol
Good luck with all of it, Bob. I think you’re due for some.
[I posted this in the uninsured forum but thought I'd share on this more active page as well]
TO THE UNINSURED…
This post will probably make a lot of fellow rupters feel better, which is my hope. Full rupture Jan 26th, 2012. Even though I’ve never felt that “Bat to the ankle” feeling before, I kind of knew something was serious when I went down in a game of basketball. Just felt wrong and I did the typical “Look around for the person who stepped on my ankle” thing. I tried to walk it off but it felt like I had just put on those hideous Sketchers curved fitness sneakers. No pain really, just weirdly uncomfortable. I had the peg-leg, flat-foot walk.
I was laid off in July of 2011 so I had no insurance. I was freaking. AND, to top it off, my wife and I were moving from Chicago to NJ in 3 days w/ enough stuff to fill a 16′ truck and 2 cats, one of which likes to sh!t in various places. I was in honest shock by what had just happened. I came home and we did the research, leading me to this blog. I was trying to crunch the numbers to see what type of set back this was going to create (financially and mentally.) It was just the worst possible timing for all this. That first night I cried for the first time in years. Like many of you I’m sure, I kept thinking about a life without active sports. A $10K+ bill, confinement for 10 weeks, depending on my wife for all the little things and so on. It was overwhelming.
I’m glad I didn’t head to the ER, which would’ve been costly for nothing more than the slightest peace of mind. I knew what I did. I wasn’t in pain. A therapist would’ve been more effective that first night :).
I had no choice but to put off this injury until we arrived in NJ in 5 days. I helped where I could, but the heavy stuff we moved was left to my good friends. I still hobbled fairly effectively, but no progress in the heel (Which was only wishful thinking.) Pretty much stayed the same until we arrived. I did buy a pair of crutches off Craigslist ($15) and an ankle brace at Walgreens ($32.) Did the trick. But doing this move while being on crutches for the first time in my life (37 years) was a humbling experience.
We arrive in NJ, had help to unload and was now focused on this friggin heel. I decided that heading straight to the Ortho was my best bet as an uninsured citizen. Called around, read reviews and set something up w/ a $250 initial visit doctor in Linden, NJ (Follow up visits are $75.) I was also looking for docs that were known to be conservative in their approach (within reason of course - I still want to do this the proper way.) I was assigned to my man Walter Pedowitz, who has accolades that rival the best. Great guy, and his easy-going personality kept me at ease (I asked what to do if my leg itches, and he said to scratch my nose.) He’s a big proponent of the non-surgical route and said most of his colleagues are doing the same these days. Not much of a difference in the re-rupture rate plus no complications of surgery. That’s good and all, but to be honest, I was only concerned w/ the final tally if you know what I mean. He put me in a hard cast, NWB, crutches etc for 6 weeks. This will be followed by 4 weeks in a walking boot. 10 weeks, which is normal.
OK, so to summarize at this point in this journey::::::
I’M RELIEVED! Yes, 10 weeks is a long recovery time. I will probably never be the same on the court again. I’m already a little set back by the isolation this has created in my life. We are moving into an apt in the Lower East Side Manhattan at the end of Feb. I will still be on crutches and that doesn’t seem practical in a city like NY. Not at all actually. BUT, I may come out of this being better off WITHOUT insurance. If all goes as planned, I may be in for under $600 total (PT not included.)
Cast and Initial Visit: $250
A few follow up visits: $225
Boot: >$100.
Crutches: $15
Shower cap: $12
Sh!t happens, and I just experienced it first hand. It’s been two weeks and I’m trying to feel better about my situation. At least it’s the middle of winter and not summer. Thank the lord it wasn’t my driving foot. It’s all about the positives right? Thanks for letting me share my experience.
To ADD…I saw that Chauncey Billups of the LA Clippers just ended his season w/ the exact same injury we all have/had. I saw the video, did the same thing on the court. Him and I are brothers now :).
bells, interesting on the cast! I was placed in a splint for the first week, and then immediately into a boot which I was able to walk on without crutches! Mine was torn pushing a car the Tuesday before Thanksgiving 2011, and have been out of the boot since the middle of February. Blew my bad knee (same leg) back in the first week in February and was back on crutches for a bit and also strained a medial tendon in my arch area which has caused me the most problems. On and off the crutches because of that! But as for my Achilles, it healed up great, but because of my arch tendon problem am unable to do any heavy PT on the Achilles. Can walk on it without pain, but still can’t lift my self up just on my right toes yet! Just surprised they put you in a cast if you didn’t get it operated on! They claim its best in a boot as that keeps the rest of your muscles and tendons in your leg in much better shape, leading to faster recovery time! I go to the VA Health Center and they are great!
Bell, actually I have been out of the boot since the Middle of January (mistake). I actually was able to drive with my boot on and I drive a stick shift MT. Went to a big parking lot and practiced the touch and it was like a fish taking to the water! (even though it is illegal to drive with a boot on in my state–lol) My doctor told me the heal time would be faster in a boot and at least with me, he was right! Even though I don’t have full flexibility yet, if not for my arch problem, I could actually be walking without a limp or any pain!
Hi everyone,
First off, this site and everyone’s inputs have been a great source of information and very helpful.
I am 23 and I am a full time student and in the military reserves. I ruptured my left achilles tendon last Sunday, 12/Feb/2012, while trying to do as many double unders on the jump rope as I could.
At first I thought I knew I wanted surgery, but when I saw the orthopedic surgeon last Wednesday, he advised me to go the conservative route because he really liked the new studies on Surgical VS Non-surgical. Anyways got strapped in an Aircast boot with heel wedges.
I couldn’t find as much non-surgical experiences with a more aggressive rehabilitation protocol, but if any of you know of some, I would appreciate it if you could send me the link.
Cheers.
I think that’s your cue Norm-
Thanks Ryan, was able to find Norm’s blog.
Also really enjoyed your own blog Ryan and good to see you are back at it.
KM, if you haven’t found the “UWO” study (very likely the same one that impressed your Ortho Surgeon), it’s at achillesblog.com/files/2008/03/jbjsi01401v1.pdf , full text. The link near the bottom should take you to their protocol, but if not, I’ve posted the version the authors faxed to my OS, at bit.ly/UWOProtocol .
Modern, relatively fast rehab protocols seem to produce the best results with or without surgery, but I think they’re especially important for those of us who choose the non-op path. Ironic, but apparently true.
Norm thanks alot for the protocol, I’ve actually been trying to find it for a while. Going to help a lot and will show it to my physio.
The new Zune browser is surprisingly good, but not as good as the iPod’s. It works well, but isn’t as fast as Safari, and has a clunkier interface. If you occasionally plan on using the web browser that’s not an issue, but if you’re planning to browse the web alot from your PMP then the iPod’s larger screen and better browser may be important.
Hi All,
I really need some help\advice.
Fully ruptured my Achilles on 04/03/2012 playing football. i am 28 years old.
Went to A+E on 05/03/2012 and they put on a cast.
Today i had an appointment with the consultant. He told me if i wanted a surgery or let it heal naturally, i asked for his opinion and he said he would recommend natural healing. I asked him i want a boot and do not want a cast. I have been provided with a boot with 4 splints and told to remove one every 2 weeks. got another appointment in six weeks. I have been told not to put any weight on my leg for that six weeks! (tried to ask him for more clarification -but seemed like he was trying to get rid of me)
Having read this blog for the last 10 days, my question is: 7 weeks on NWB is this the correct way to deal with this problem? if not can someone please kindly point me to the correct protocol i should be following so i can go speak to my GP tomorrow. (Based on the UWO study i have decided to take the non-op route)
You help\advice is appreciated and look forward to your replies.
James - if you are going down the non op path and using the UWO protocol then you will be weight bearing well before 7 weeks. My father did his after me and went down the non op path but because of other balance issues from a hip replacement, he was weight bearing the entire time and also was in a boot from the start. You mentioned splints but I assume you mean wedges under your heel. These keep your toe pointed down and pressure off your tendon. With the boot on you should be able to put weight on your leg fairly soon, using your crutches for support. I started weight bearing around the 3 week mark. I also was able to start moving my foot around while it was supported (no weight) about that time. I suggest you read up on how tendons heal. You can’t heal faster than the natural process. The time will vary slightly with every person but you are young and that is in your favour. Xplora is my sight and I have a page for links to further reading that I found helpful. If your doc is not interested then you need to find someone who is. Arm yourself with information but be prepared for resistance.
James - also have a feeling you may be living ‘down under’. My specialist was quite supportive of my ideas but I also had the feeling he was less than interested. He only saw me twice, week 1 and 5. Maybe he was confident I could manage on my own but I was happy not to have to pay the $150 for 5 minutes. I shopped for a physio early as well. The trouble with many physios here is they want a rehab protocol from your doc. While you have plenty of time, make some calls and speak directly to the physio, not the receptionist. If you were playing competitive football then your club should have some medical insurance for you so you will have to check out what is allowed first and what they will pay for.
Thanks for the advice guys - i will make an appointment with my doctor - i am in the UK and doing the treatment through the NHS.
If i do follow the doctors instruction and have no weight bearing for 8 weeks, what are the consequences? is there a more higher chance of a re-rupture?
Thanks alot for your help
sorry i forgot to mention are their any protocol i can print and take along with me to the doctors? thanks
James - on my further reading page you can go to the links on Vacoped rehab protocol and the early weight bearing study. Print them off and take them to the doc. There are other links on the main page for other protocols but this one would work well. They can all be varied according to your own need and progress. You will still heal if you don’t weight bear for 8 weeks. Some here are on on crutches for 12 weeks and do well. Early weight bearing does get you back into a normal life a bit sooner but it will still take a year or more either way to feel good. You could be playing sport as early as 6 months. Read the study and you will see that the outcomes were similar but the quality of life for the EWB group was much better sooner. I would say that I don’t feel passive ROM is good in the first 4 weeks (contrary to the protocol). Active ROM is better. That means you move your foot within its own limitations without any external force such as a theraband. I was also out of the boot around 7 weeks but had wedges in my shoes to take the load off the tendon. This is a dangerous time and you have to be very careful not to trip or mis-step. Look at my milestone page and read other good entries like those from Ryan, Bcurr (Barry). There are more but I have been a bit out of touch for some time. These are just the ones I know personally. The UWO protocol is also worth taking with you. Barry is in the UK (along with many others) and can be of great help with the NHS.
James, I’m a big fan of the UWO protocol, mostly because it’s got one of the biggest and most successful studies behind it, so I view it as a “proven” winner. You can find the pre-publication version at bit.ly/UWOProtocol (in the form the authors faxed it to my Doc), and the published version is linked from the end of the study itself — which is linked from the “studies” page on the Main Page of this site.
Good luck!
Also, my reading of the evidence is that the non-op protocol is a winner, BUT the non-op results with a slow, old-fashioned “conservative” rehab protocol aren’t great. Specifically, all the older studies, using more conservative rehab, showed much higher re-rupture rates than the newer studies (like UWO) that use faster rehab.
None of the studies actually randomized non-op care to faster and slower protocols, so purists would never call it proof, but the pattern is still pretty clear. I wouldn’t stay immobilized and NWB much longer than 2 weeks, and I’d shoot for FWB near 4 weeks, like UWO. If your Doc protests, ask him if his results are as good as UWO’s — or roll up the printout and hit him with it!
Hi guys thanks for your help. I am UK’s NHS is in a big mess! i have just contacted Oped (the people that provide VacoCast boot), i have decided to buy this boot from them for £240 and they will put it on for me and show me how it works.
I feel like im doing my own treatment!! The NHS is a disgrace. Can someone please tell me when i will have to start physiotherapy?
Hello James, I am in the UK also, NHS treatment for this injury is a lottery depending on where you live. I got lucky with my hospital, they have a fast operative and non operative protocol, I have a PDF of it if you would like a copy. Both involve a boot at day 10 (Aircast) and some partial weight bearing at weeks 4 to 6 ‘if able’. Leave a hello on my latest blog and that will give me your mail address, I will send it through. Physio starts week 3 on this one, but all protocols are different and there is no agreed approach it would seem, as I am sure you have realised. Good luck!
James, forgot to mention with regard to the above, PWB is weeks 4 to 6 non op and weeks 2 to 4 with op on my hospital protocol, just to be clear on the comparison. Keep us posted.
Hi Jimmy,
Any chance u can email me a copy to james.saville@live.co.uk
Thanks
Jimminy, the new non-op studies ALL use the same timing for op and non-op (partly because it’s “best practice” and partly to avoid biasing the comparison), and waiting for 4 weeks for PWB is way slower than UWO and maybe all the rest. James, click on (or paste) my bit.ly link above, and you’ll see, and you’ll also see the answer about PT timing — starting at TWO weeks, same as PWB.
UWO has PWB at 2 weeks and FWB “as tolerated” at 4 weeks.
Again, if a Doc or a hospital recommends slower, ask them if their results can match UWO’s! If not, you’ll be getting way higher nuisance and higher risk of a crutch fall, in return for WORSE re-rupture rates — some bargain!
Two years ago I fully ruptured my Achilles tendon. Within 3 days I had surgery to repair and was put in a cast for 8 weeks post-surgery (my leg was in an immobile, hard cast).
After removal of the cast, several of internal stitches that were meant to dissolve, had not, and were visibly poking through my skin. After a few weeks, one of them was naturally discharged and a small, blue, knotted stitch “popped out.” (It literally came out of my skin and I was holding the small stitch in my hand)
One of the stitches was never discharged. It caused discomfort for several more weeks, but I presume that it eventually “dissolved” as it was designed to do.
However, at the site of that stitch, I now have a skin to tendon adhesion. It is sometimes painful and causes my skin to “pucker up” during plantar flexion of the calf muscle system.
I went through post-operative physical therapy, which included techniques to break up adhesions. These included Graston technique, massage, ASTYM, Active Release therapy, and self massage (in addition to general strengthening and flexibility exercises).
The skin to tendon adhesion causes some pain and discomfort and also restricts my range of motion and flexibility. I believe that it is also inhibiting a full recovery of muscle strength in the calf.
My question: What options do I have to break up skin to tendon adhesion in my Achilles? Any non-traditional, unorthodox techniques that have worked for anybody? I would try anything at this point to get back to 100%.
Nick, you’ve given a list of all the techniques I’ve ever heard of, and maybe 1 or 2 more, sorry. But I wouldn’t post your Q on multiple pages here. This page is as good as any, unless you start one of your own. If you haven’t heard much in a week, you could always “bump” it again with a shorter repeat version here. BTW, did you get any release at all from any technique you tried?
It’s maybe conceivable that you have a problem similar to a blogger here named GerryR. It might be worth reading some of his posts. He got 2 or 3 re-ops to clear up a lingering post-op problem caused by dissolving sutures that didn’t. His latest posts are mostly ski videos, after the 4th op finally solved his problem.
Hey guys,
similarly, I have completely ruptured my achilles tendon. This happened about almost 4 weeks ago, and it has been two weeks since I got surgery on it. Unfortunately, I’m only 17, a senior and soon on my way to a University of California. Ruptured my achilles by playing basketball at a local 24 hour fitness gym.
My question is, where do I go on from now? I went to my orthopedic surgeon a week after my surgery and he gave me a removable splint/boot. He said that I should begin trying to stretch it out a bit, but I’m a little hesitant and scared. Is this the correct procedure? I can’t wear the boot yet because my heel is at an angle that is unable to fit properly.
I just wanna know what I should do in my time frame? This sucks because I love to go play basketball and go out. Any information would help!
Cheng-
Go slow my man. I did the same thing playing basketball. does your boot have clocking settings which control the angle of your foot? For me, my foot was pretty much held in a fixed postion approx 15 deg below horizontal for the the first 3-4 weeks. At about 5 weeks I recall, he cranked it to approx 7-1/2 deg below horizontal. at 7 weeks, it was 0 degs and at 9 weeks approx 7 degrees above horizontal. I believe I started putting weight on it (about 50-70 lbs at first) at around 5-6 weeks by stepping on a scale. I could walk without the boot (albeit limping) at around 9 weeks. I’m at 14 weeks now and still have a bit of a limp sometimes. I cannot lift my bodyweight with my injured side yet. You are only 17, so you should recover fully faster than me, but I wouldn’t plan on playing basketball for 5-6 months after your injury. You will need to build up the strength in your leg again, particularly for running and jumping. The last thing you want to do is rupture it again.
Cheng:
This injury has got to be really tough for a 17 year-old. Unfortunately recovery takes time and patience. You will need to talk to your surgeon about exactly what he has in mind for you. You don’t want to go about things too fast or you will be back where you started from. Still, going too slow isn’t good either.
I went the non-surgical route and after 4 weeks in a cast I got my boot and was told to do some ROM exercises. These were mainly gentle plantarflexion and rotating the foot. I was also able to do FWB at week 5 letting me ditch the crutches. I just had my first physical therapy session yesterday at 7 weeks and was told to do dorsiflexion exercises up to the point were I could feel stiffness or discomfort. That said, keep in mind everyone is different. I’m 59 years old and for you things will hopefully go faster. Here is a list of physical therapy protocols which will give you some idea as to what you will be facing:
http://achillesblog.com/rehabilitation/physical-therapy/
Good luck, have patience and keep a positive attitude.
Hey guys sorry for not replying, been so busy catching up with school work.
Smitty,
I do have a boot, but it looks as if there are no angle adjustments available. He inserted a styrofoam kinda sole thing to it, but thats about it. I’m currently about to enter my 3rd week after surgery this Friday. My surgeon recommended me to begin trying to use a towel to start rehabilitation I suppose and that’ll allow me to adjust the angle of my foot to fit the boot. And thats what prompted my question, isn’t it too early for me to try and “bend” my foot? I feel as if it is from reading all these posts and i’m simply afraid to rupture it again. But then again, I want to be able to walk across the stage on my graduation day, May 24th. Ahhh, I’m just very confused on what I should do.
Starshep,
Yes, thank you. I believe I’ll call him tomorrow to reassure he things he told me to do. I’ve just been hesitant because I feel it is too early to do that, but he is a trained profession after all and I’m sure he knows what he’s talking about. Haha. But thank you for the link, I will look into that and begin trying to rehabilitate it.
Cheng:
Looks like you’re about 5 weeks post op. At that time I was doing active range of motion exercise. I could put no more strain on the tendon then my muscles could generate. Using a towel makes me think that you are talking about active assistive range of motion exercises which might enable you to put more strain on the tendon than you should be doing at this time. This is why it is so important to have a physical therapist present to guide you. I hate to say it, but while orthopedic surgeons certainly know about surgery, not all of them are well versed in physical therapy and rehab. And despite what some would like you to believe, they are human and can miss things or even get things wrong.
Also at 5 weeks, I was FWB in the boot. If I were graduating, I could certainly walk across the stage at that point. It might be possible that by May 24th you could be in 2 shoes. Yet don’t get caught up though in dates. The body heels on it’s own schedule.
Starshep:
I’m actually entering my fourth week after surgery this friday, April 27th. I don’t have great insurance, actually I only have medical, so I don’t really have the greatest reliances from medical professions.
Since it’s only my fourth week, do you think I should try using therabands that I have to put some strain on the tendon? But what is “FWB”? Haha.
And I don’t know if I’m going to be in another cast because I have another appointment on May 4th, which would be a total of 5 weeks after the procedure. What do you think he is going to tell me and how i’m moving forward? Am I going to have a boot and start going to physical therapy? Or am i going to be placed in another cast for 4 weeks…?
Cheng:
Whether or not to use the therabands is something you will have to discuss with your doctor. Until the time is right, using them could hurt your recovery. I just started using some elastic band last week (week 8 for me).
FWB= Full Weight Bearing and PWB is Partial Weight Bearing.
Sorry I really can’t give you much insight as to what your doctor will tell you on May 4th. Everybody’s recovery is different. In my case, I was in a boot after 4 weeks in in PT (Physical Therapy) at week 7. The good news is that May 4 is next week so you don’t have long to wait. Hang in there and be patient.
Non-Operative starting week 8 today and have been totally out of boot the past week. During week 6-7…I alternated one day off with one day on. Went on vacation back to the mainland last week, took the boot on the plane with me but ended up not wearing it the entire 6 days I was gone, except for the return trip since I didn’t have room to pack it!!! Still have a significant amount of swelling by the end of the day, but only minimal heel pain at this point. I’ve noticed walking around in running shoes is much more comfortable than barefoot or flip-flops…which takes a bit of getting use too, since I rarely wear shoes around here when off work!!! Still very tight felling with dorsiflexion and some pain on climbing stairs.
I had my 3rd follow-up appointment last Monday before flying out and my Ortho Surgeon was pleased with the progress. He has another patient in early 40’s who insisted on a surgical repair around the same time as my ATR, and said I’m actually a little ahead of him at this point. He seemed to think it was acceptable that I was out of the boot and encouraged me to continue with, ROM, swimming and the water activities I’ve been doing. He feels tendons actually repair a little quicker when stressed/worked. Also didn’t feel there was any need for professional PT or Rehab and gave me clearance to return to work on the 14th. Since I work just 3 day’s a week, I’ve had my schedule set up to work every other day the first few weeks back. Hopefully this will make it a little easier, but I won’t really know for sure until I actually do a couple of 12hr day’s.
freezing body fat procedures frozen…
Hello there! I could have sworn I’ve visited this website - Roundup changing World SMOKINCHOICES (and other musings) before but after browsing through many of the articles I realized it’s new to me. Anyways, I’m definitely happy I found it and I’ll…
Hi all, wish I found this site earlier!!
I just want to ask anybody’s opinion on when to start Physio?
I had a partial rupture on the 9th Feb, was talked out of the surgery which I regret!! Did 8 Weeks in the cast and now walking around in the heel raise. Walking faster each day but still limping. I’ve been told by many people that I should have started physio already if I want to play soccer again before the end of the year. Last saw the specialist on the 1st May and next check up only in Mid-June so wondering if I should start some sort of exercises during that gap??
Cheers
Pree
Pree, your “walking around in the heel raise” means you’re in 2 shoes, but with wedges under your heels? (If not, what?) Most of us have found comforting and apparently helpful, though it’s hard to prove anything. I started PT at 2 weeks post-non-op, though it was mostly very gentle manipulation and the application of a few high-tech gizmos (ultrasound, electro-stim, lazer) that may never have been conclusively proved to help.
At 3+ months, you’re certainly ripe or over-ripe to have PT, or to do exercises. The exercise regime in the “UWO protocol” — at bit.ly/UWOProtocol — could be your guide, except that all the timelines are goofy for you. I’d start near the beginning of the protocol, and do maybe 3 weeks’ worth of exercises every week until you catch up. Don’t just start at 12 weeks, or you’ll very likely hurt yourself.
I’d wait ’til you’ve fully recovered before deciding whether or not you actually regret skipping the surgery. The UWO study — full-text available on this site — showed virtually identical results with and without — admittedly with a much more modern and aggressive protocol than your Doc has had you following.
You might also want to re-read some of the (admittedly rare) horror stories here from people who’ve had problems with infections or surgical wounds that don’t close, or rejected sutures that never dissolved, scar tissue that never freed up, DVT, etc., etc. You’ll never know if you dodged a bullet, but you may have.
There’s a sentence above that should read “Most of us have found PT comforting and apparently helpful. . .” but the “PT” somehow disappeared. ;-(
Hi Pree,
I agree with Norm about starting some physio exercises now.
I also ruptured my achilles playing soccer in late January, and my doc was very slow in getting me started with PT - only 3 weeks ago. However, he did have me doing Theraband dorsi flexion and plantar flexion stretching around 2 months ago - are you doing those yet?
Many of our fellow achilles bloggers, and several studies like the one Norm described above, encourage early weight bearing and associated rehab exercises, so you should definitely try to contact your doctor and ask about starting an exercise program prior to your next visit in June.
Also, on this achillesblog home page there is a link to several really good rehab programs - I definitely used many of those exercises on my own as appropriate for my specific ATR timeframe and progress, to supplement my doctor’s limited stretching regimen. It seems to have speeded up my rehab progress.
Good luck and keep us posted - maybe start your own blog page for updates - mine is Johnsfbay.
John
Hello all fellow AT rupturees,
Here is my story (I live in Finland, so a northern public healthcare experience)
I ruptured the AT in my right leg while doing some cross-fit training doing Box Jumps; As I was landing from my last rep, I heard a loud pop and was sure that someone dropped a dumbell/kettlebell or kicked me in the heel, so precisely what a lot of others have reported. The pain kicked in instantaneously and was about as severe as I’ve ever felt, primarily a huge burning sensation.
Fortunately, a friend of mine (a GP) happened to be in the same gym the same time so I yelped for him to come to assist me. The diagnosis was thus pretty much instantaneous.
I live in Finland, so this experience might be of interest to some of you from a public healthcare point of view, as system we’ve had in place here for a long time.
Anyways, my GP friend assisted me to the local ER where I was taken in with no waiting time and got visited by the orthopedic on duty within about 30 minutes. He carried out the diagnosis (Thomson test), which confirmed my friends initial diagnosis. I was explained the options between the non-invasive repair and the surgical one, but he hinted that the surgery might be a better/faster route for me (male 40 years old, healthy, active mover) .
I was subscribed 6 weeks of sick leave, although I have a desk job and told that I probably can’t / won’t stay away for that long. The sick leave has no effect on my salary / benefits.
I was scheduled for a surgery early thursday morning, which I was somewhat positively surprised that I got such an early repair date (only ~2 days after accident).
Through my contacts in the medical community I also enquired about going into private surgery (I happen also to carry an affordable private insurance which would have covered the costs of surgery), but was told that its the same guys that carry out the operations both in the private and public side. The only benefit might have been fancier hospital facilities and better food.
So I decided to settle with the public one.
I was quite anxious before going in, given that this was my first operation ever. I contemplated also for a while on the anesthesia, i.e. GA or spinal anesthetic, and decided going with the latter due to some horror stories I’ve heard about waking up from GA during operation. Also I wasn’t so keen on feeling nauseous after waking up.
About 1 hr before the operation (@ 10 am) I was given a couple of pills, including a relaxant; Then the surgeon came over (who also happens to be the doctor for the national junior football team) who explained to me the procedure. I was already pretty high at that point already.
At 11 am I was taken into the preparation room where I had the pleasure to talk for a while with an attractive nurse. She then wheeled me into the operating room. I was rolled on the operating table, and put on my side and was told to curl up so that the spinal injection could be administered. Also the nurse gave me another sedative shot which made me feel even more relaxed. I barely felt the spinal anesthetic injection, but immediately my lower body was gone. What a strange feeling!
I was operated while on my stomach, and was sort of passing in and out thanks to the cocktail of sedatives. Suddenly the nurse woke me up and told me that its now done.
I was then wheeled back in to the hospital room with an elevating pillow under the leg. It took several hours for the numbness to go away, and naturally during that period I felt no pain whatsoever.
Even after the anesthetic wore away, the leg really wasn’t that sore at all. That was until another nurse suggested that I get up to go to the toilet (the anesthetic does block your urge to urinate as well!). As soon as I lowered the leg the increased blood pressure really kicked in with the pain (again, a burning sensation). I threw back a couple of Panacods (our equivalent to tylenol 3, i.e. with codeine + paracetamol) which helped a bit.
I was then given some food and basically told that I can go home if I feel like it or stay over. I opted for the former given that I had strong pain killers at home and also a wife to attend to me while I was recovering.
Also - instead of cast I was put in to a “walker” boot, i..e the big black thingy with the velcro straps. This was a very pleasant surprise given that summer is upon us and it allows for me to wash the leg frequently.
The subscription for me is now: wear the boot for 8 weeks: NWB for 2 weeks - after 2 weeks - remove stiches, start gentle bending excercises, followed by PWB for 4 weeks and after 2nd check FWB with the boot.
The entire cost for the operation, boot, crouches, surgery & day in hospital was 95 €, or about 120 USD, which I can get reimbursed from my private insurance. I’ll have to return the crouches and the boot though
Its now 2.5 days from the surgery and I am already off the pills. Even if I do not keep the leg up all the time, it does really not get that sore. Today I also had the first shower and washed the wound. Looked very clean and tidy. Slapped a new wound pad on it and some wrapping.
I remove the boot when not moving so that the leg gets some air.
While this sucks given that the summer vacations etc are approaching, life would have been hell if this had happen in mid-winter, as roads are pretty well iced up over here and the risk of slipping is high.
I can’t drive the car since its the right leg and I have a manual. I’m considering to pursue the wife to finally drive a license
Happy recovery to all you others under recovery,
Arttu
Sorry to hear about the rupture. Your body couldn’t have picked a worse time of year to break down with summer fast approaching.
The first few days are the worst with the blood rushes to leg and getting acclimated to life on crutches. Once you get through the early part things will get a lot easier.
Nothing against crossfit, but there has been a rash of ATR’s lately and they mostly all seem to occur doing box jumps. Box jumps for high reps or time really encourages people to hurry through them and trying to jump down backwards and back up quickly is the perfect storm for an ATR.
Arttu, I had 2 ATRs 8 yrs apart, both at year’s end. If 2001-02 and 2009-10 hadn’t been the two most snow-free Toronto winters on record to date (’til ‘11-12!), I would have been house-bound while on crutches. Summer’s not that bad…
BTW, your protocol sounds close to the very successful UWO study’s, although they move from pwb to fwb (as tolerated) sooner, at 4 weeks. If you check out that study on this site, you’ll see that their clinical results non-op were very nearly identical to their post-op results. Your surgeon’s “hint” may seem quaint in another decade, if ongoing studies continue the recent trend.
BTW my surgery on ATR #1 — including a night in the hospital — cost me only ~$30 more than yours, after paying for crutches and boot. (All else was $0 except the bedside phone!)
normofthenorth,
Ahhah you really picked the right winters to rupture then! Thanks for the UWO reference, and it sounds like this protocol is slightly more conservative. A family friend who is an MD active in the sports injury med community in finland told me that the non-scientific, “suit-of-the-pants” consensus seems to be that op ones have yielded better results. But like you said, data is trickling in and it might be some time before we know “for sure”.
This blog has been a tremendous source of info thanks to you and others!
Tate,
Thanks for your supportive words. Thankfully I have the boot that I can remove and was the leg so that I’m not going to trail a swarm of flies!
In hindsight, while I’ve worked on my technique with box jumps for a long time you’re right that it is a risky one, especially when getting tired. Next order of business (in 6+ months) will be to re-examine my training program to avoid re-rupture! Box jumps wont in in any longer, that’s for sure. I’m also going to advise the PT’s at our local gym who seem to prescribe these quite liberally that they should really be worrying about ATR…
Non-op ATR starting week 11 and all is going well. I’ve been back to work now for nearly 3 weeks, trying to work every other day with my 12hr day - 36/hr week schedule. Since I’m on my feet a majority of the time I’ve found this to be much more tolerable. It’s gone fairly well, although I do have some heel pain, a significant amount of swelling and as the day goes by my gait becomes a little more “gimpy”. Not much pain at this point in the Achilles area, everything in the general region just feel’s very “tight” and worse upon dorsiflexion.
I’m continuing to swim 3 times a week, returned to the gym doing upper body lifting and 30-40 minutes of stationary cycling several times a week which is very boring since I’m a runner. My biggest concern right now is how far go push myself when I feel the pull or stretch in my AT while exercising or stretching…at what point is it therapeutic and when is it too much!!!
My MD did not prescribe any formal PT, other than the WTO protocol. Luckily I have a friend at work who is a Physical Therapist and has shown me several different balance and stretch type exercises which seem to really isolate the Achilles and Calf area. Also when I’m in the pool I continue to work on toe raises. I find this a very beneficial therapy, after swimming for a while everything seem’s to loosen up a little. Back at week 5 or 6 as I started NWB walking without the boot, I would walk back and forth across the pool about chest deep in the water. As things improved I was able to move to a shallower area which required my body to support more of the weight. It’s the same now with the toe-raise exercises, I’m able to gradually move to shallower water and everything is getting a little stronger.
I’m curious at what point other folks have returned to running without fear of a re rupture? The rehab protocol I have is kind of vague after 12 weeks. It just states” Continue to progress ROM,strength, proprioception…Retain strength, power, endurance…Increase dynamic weight-bearing exercise, plyometric training…Sort-specific retaining. I quite certain I’m not anywhere near running at this point, but would like to know when it’s same to attempt it!!!
Hi all,
I posted earlier regarding the injury, and decided its time for a quick report on the recovery; I had a complete tear, and went the operative route.
The healing seems to be going well, had my first check last week (4 wks post-op), and went PWB. Still with crutches, obviously. Funnily enough I can actually “walk” faster than with two good legs, thanks to the longer strides!
The wound healed well with no complications. I’ve been taking showers daily ever since the surgery, washing the leg every 2nd day (can do it since I was put in a “walker” boot with 2 heel raisers).
After the checkup last week I was told to start extensions and uplifts with the foot. There is a definite feel of tension when turning the foot to a right angle, but no pain.
Even not supposed to do so, at home I’ve taken a few steps here and there without crutches, given that the leg feels just fine and taking care not to fall or slip.
I’ll get one wedge off from the boot this week. So far, I’m very satisfied going the op-route.
Arttu
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Hi everyone,
I will be getting our of the Marine Corps in 3 weeks, relocating across the country for a new career, and was planning on taking a vacation with the new bride.
I was playing soccer 2 days ago, heard an audible pop and felt like someone kicked me in the back of the leg. ER doc said it was most likely calf tear, and then today the general practicioner says it is most likely a severe grade 2 achilles tear. From what I have read it sounds like the AT. Can’t really flex muscles and there is no movement during the Thompson test. I can bring foot down and up, but not complete range of motion. A little swelling and I can hobble around without pain or use of L calf.
No immobilization recommended, just RICE.
They won’t be able to get me to a specialist or MRI for three weeks, so I need to make some assumptions now about the relocation/trip. I stay very active, and even if it is just a partial, is surgery the best option for long term strength? I know a lot of this depends on the severity, which I won’t have info on for awhile. Is it really OK to be walking around without the ankle immobilized?
Thanks for any info/help! Would greatly appreciate it!
Matt
Matt;
I don’t know how the military works as far as something like this goes but the Thompson test is a good indicator that you have a full Achilles tendon rupture. Partial ruptures are rare. The longer you wait to get treated, the more difficult your recovery will be and the more likely it will be that you will have a re-rupture. I went nonsurgical and the most recent studies indicate that the results when using modern recovery protocols are just as good for nonsurgical as they are for surgical. Normofthenorth’s blog contains a lot of info on nonsurgical and the modern protocols.
Still 3 weeks is way too long to let this go untreated. Only an orthopedic surgeon can make a decision whether nonsurgical is an option for you. A simple X-ray and consult can determine that. I’m not sure why anyone would choose surgery over nonsurgery but even if you did want surgery and they can’t schedule an operation for you, starting on the nonsurgical route is as simple as having your foot cast in full plantar flexion position for 2 weeks and then half way to flat for another 2 weeks. Most med techs can do that. Hopefully they can at least do that for you. I would not accept just waiting for three weeks.
Hi everyone,
I had my right Achilles tendon surgery on 28 Jun 2012. It was a complete tear and the damage was repaired by LARS tendon graft. I wore the cast for 3 weeks after the surgery. Then I’m wearing the walking boot (non-weight bearing) for another 3 weeks.
Does anyone has experience in the so called “LARS” tendon graft?
Zawminno - you may be the first here to have a LARS. I was told about it by my doc after I had surgery but my he suggested the rehab would have been considerably different to what I had to go through and what you have experienced. His thoughts were that no cast would be required and I would have been full weight bearing from day 1. As it turned out I only had a cast for a week and then a boot for another 6. I was PWB at 3 weeks and FWB by 4 weeks. The doc did say there was an added risk with LARS because of the introduction of an artificial material. It has been used for ACL replacements for some years, mostly with professional athletes because of the faster recovery time but is relatively new for AT’s. I will be interested to follow your progress but it seems as though your timeline is not much different to many others after conventional surgery. The end result is what matters. Hope it is a good one.
I ruptured my Achilles on Friday the 13th (July) doing “mt. Climber lunges” with a trainer. I heard the classic “pop” & thought a weight bar fell on my right heel. In a split second I realized what it was. A trip by ambulance to the ER I was given an X-ray (which knew would show nothing concerning soft tissue). I could walk on my heel and had no pain after initial pop unless I would tweak it. I also still had pretty good range of motion to move it up& down. Dr was surprised that MRI showed full rupture at 8 centimeters. Had surgery on 25th, off pain meds by 29th. Minimal pain, swelling (only when I’m not elevating it) and no bruising that I can see.
Best tips: I got a hospital bed & wheel chair (insurance covered most) waiting for me when I got home from hospital.
Take stool softeners ASAP after surgery, pain meds will constipated you, drink a lot of water (a pin in the neck to go to bathroom all the time) you might need laxatives too. Finally crawled up 15 wood steps for shower-recommend a slide in shower chair with back support.
First dr appt 8/7-anxious to get cast off for a bit (mine is up the back only the wrapped heavily, but still feels like it weighs 20 lbs).
Good luck all
Hi ATR community,
Just ruptured my achillies tendon Aud 04 saw the surgeon yesterday and as I was unsure if I wanted to do the surgery I will see him again Wed…
Seems like the majority of ppl on this site opt for surgery? Just really wondering why when there is so much info on here about non operative treatment?
Obviously I would rather not have to be put under, cut open and deal with the potential risks. …but I also want a good result in the end.
So maybe surgery with a more aggressive rehab like the one posted on here from UWO??
Very nervous and need to make my decision by tomorrow.
Also they put me in an air cast and that thing is really heavy and hurting my foot way more than the plaster cast I had from ER!?! Anyone else find this thing really uncomfortable?
Looking forward to your comments
Indigo-
There is a lot of good evidence supporting the non-operative route. And, as you note, you can avoid all of the potential complications from surgery. Numerous contributors here have had good non-op recoveries.
I went with surgery. If I had it to do all over again - say if I ruptured my other side - I would choose surgery again. There is some risk with surgery, and there is definitely some pain/discomfort. But, it gave me confidence that my tendon was attached and starting to heal- and allowed me to get it mobile and active very early. I don’t think I could have recovered any faster.
Surgery isn’t for everybody. I wouldn’t push anybody in that direction. I think many choose surgery simply because they don’t realize that the non-surgical choice is viable for most of these injuries (to some degree, that was me, the first time around).
It partly comes down to a personal choice- deciding what you’re more comfortable with. The two worst complications you can have are re-ruptures or healing long. The hard evidence isn’t very conclusive- but my gut tells me that surgery might improve the odds of avoiding those somewhat (that’s my layman’s opinion; I’ve got no hard evidence to support it). On the flip side, there are a host of other complications (infection, wound not closing, blood clots, etc.) which you are definitely more at risk for with surgery.
I think you’re on the right track. There IS good solid evidence that modern, faster protocol (like UWO) gives a better (and LESS risky) result. Surgery or not, I would highly recommend that you insist on following one, and avoid the extended immobilization of years gone by.
Good luck!
Indigo
At my UK NHS ortho centre, the rehab protocol is identical for surgical and non-op, and is aggressive/accelerated similar to the UWO protocol but using the Vacoped Achilles boot (weighs about 6 pounds if you want to compare with your Aircast).
I was non-op and able to start weight bearing at 3-4 weeks, losing the crutches almost immediately. I knew that it was healing because it worked - there was continuous improvement. Surgery is best used for complicated cases (and some are very messy) but in my case all it would have given me was a bunch of stitches and the risks that Ryan has described so well. Maybe (just maybe) some sports men and women might benefit, although even hat theory is being challenged.
I’ve had major surgery on my back and it was absolutely the right thing for that condition. Also, I’ve noted that most of the pro-op AT medics are in the US, although that appears to be to be turning towards non-op as they ‘discover’ the benefits experienced by their overseas peers e.g. in the UK.
Choose carefully, and good luck with your recovery!
Indigo,
Ruptured mine 25 weeks ago, went non-op and am very pleased with the results. When my doctor discharged me at 16 weeks he said whether I went surgical or non-op, I would have been at the same point in my recovery either way.
I have never come up with a good reason why in an average case, someone would chose surgery over non surgery. I suppose there is a belief that surgery will yield a more re-rupture resistant fix or a quicker recovery but that does not seem to be the case when using the latest fast recovery protocols like the UWO (see normofthenorth’s blog for more on that). Beyond that, I’m sure a lot of people don’t even realize that non-surgery is an option. My primary care doctor didn’t even know that nor did my physical therapists. Also orthopedic surgeons training and income centers around doing surgery so there might be a bias there.
Thanks for you words of encouragement, I am glad to hear positive results choosing non op.
Will keep you posted….
Great information. All posts have something to learn. Your work is very good and i appreciate you and hopping for some more informative posts.thank you……..
Thanks starshep,
I am at week 5 post ATR but week four in treatment…seems like forever.
I contacted the physio dept @ Fowler Kennedy, they were helpful and suggested working with my therapist here so that the same protocols can be used for my recovery.
Will find out more this Thursday as to what came of that. So far I have been doing my excercises and PWB.
Looking forward to ditching the crutches.
I had surgery June 16th with a complete replacement of my right tendon 6 inches. They took a replacement tendon
from my upper leg and attached it. My old tendon was cut
6 inches off and replaced. I was in a half cast 2 weeks a
whole cast for 2 months and a boot for 6 weeks. On crutch’s for the whole time. After 4 months I got a brace and started walking with docs ok. Now wear the brace for support until next July when I meet him again. I went hiking and fishing with no problem. I also ordered 16 inch boots made by a cobbler very expensive but will allow me to do my hiking and climbing. The doctor said it would take a year for tendon to heal but will be stronger than ever. At first I was thinking it would never end, now it is
almost healed. So hang in their it will get better just follow the doc orders. Don’t take short cuts it will only make things worst.
I have a complete rupture three weeks ago playing tennis and I have a hard cast for two weeks, this wednesday I have my first appointment with the specialist to take it off and I’m very anxious since I choose a non-op treatment.
Some times I have pain on my calf and I wondering if that is normal.
I got a sitter scooter since the crutches make my foot swelling a lot and that is better than a knee scooter I try but was so painful on my leg..
Keep posting after my appointment to see what the doctor said.
My ATR story may be useful to some. I’m 66, retired, don’t drive, have a 40 minute fast walk to the nearest bus, and my preferred mode of transport is a bicycle.
6 months ago I was running for a bus, steep downhill followed by equally steep uphill. Too long a stride going up and I felt an ache in my Achilles. I knew I’d strained the Achilles but not about how long it took to fix. A couple of weeks later, it felt only mildly stiff, I could walk on tiptoe, so ran again for bus, but only on flat. That was stupid! I felt a slight tear then. I was limping around, and could no longer walk on tiptoe. I still rode my bike but walked up hills - stupid! A month later, I was in my yard and slipped on a steep bank. I had to jump for it and landed on my bad leg. That was my big tear. Went to doc - too late. She was obsessed with DVT because my leg was swollen, sent me for ultrasound to look for that, but forgot to tell them to look at Achilles! A month later had scan - no DVT! Leg still swollen, doc remembered not scanned Achilles and sent me for another scan. Achilles almost completely severed at heel bone. Doc wanted to send me to surgeon, but I’d booked a three week holiday in Chile and went on that.
I flew and walked everywhere in walking boots with strong elastic bandage round instep and Achilles - except in bed! I walked only on my heel and middle foot, making uphill a no-no. At the same time I instituted an exercise regime of calf lifts (leg bent and straight) for 10 mins a day. This doesn’t really stress the Achilles, but does improve calf muscle mass and tone. When I got back, I made an appointment with a surgeon, by which time (about 6 weeks after I knew the extent of the injury) the swelling had subsided (it’s only water and healing chemicals), the Achilles had reconnected, but had no real strength, and I could walk normally without limping (only slowly!).
The surgeon said Achilles was fine, but, for another six weeks, the only exercise I could add to walking and calf lifts was swimming - no road cycling. I’m now in the 12th week of 12 for reattaching and building some strength into the Achilles. I can now walk as fast as I could before the injury and without getting tired - suggesting that the Achilles is doing some work. At the end of the week, I can start cycling again, gradually progressing to high gears and riding up hills. This will take another 9 months, by which time the scar tissue should be well on the way out and I will be able to seriously work on increasing strength in the damaged leg.
I was lucky that my Achilles severed at the heel, and that it remained attached on a corner. That enabled me to stick it down with bandage so that it could reattach in roughly the right place. But, even with an almost total rupture, you can still walk and do useful but not damaging exercise. The essential thing is to know the detailed extent of the injury as soon as you can - go to the doc! The other thing I learnt is that tearing an Achilles is very easy once you have an initial strain - it feels a bit like pulling the skin off fish - hard at first but once it starts it goes quickly. So, give those early small tears a couple of months to heal before doing anything involving running, jumping, or cycling.
Fascinating story, thosthos!! I’m actually shocked that a mostly-torn AT seems to have healed pretty well (and not crazy long) non-op without any immobilization, much less equinus or plantar-flexed immobilization.
You may well be right that minor AT injuries can easily become full ATRs, though that pathway still constitutes a relatively small minority of ATRs, most of which seem to come out of the blue.
Good luck with your continued recovery.
Hi guys,
Just need some advice:
Had my cast taken off today (2 wks post non-op), and knew I was going into a boot. Thinking ahead, I purchased the VACOcast boot, as I heard tons of great reviews.
However, my doc tells me today, that it is not the right boot unless it has the wedges. This seems very contradictory to me, compared to many of the people who post on here. He also tells me, that I’m to be NWB for 6 to 8 weeks. Also seems contradictory. I was expecting to be at least PWB by week 6 (conservative I thought).
I basically had to buy a wedge boot today (as my VACOcast is not here yet). So now I have 2 boots and a doc that seems to stuck in the 90’s??
I’m now considering ditching my wedge boot (once the new one comes) and the doc. Having a second opinion tomorrow.
Have any of you had similar experiences with your doc/PT’s??
Thanks, Ryan
Can anyone please recommend a good/great ice pack that I can wear on my operated foot to reduce swelling on my foot. I do want to purchase a good one that does not make a mess and is easy to use and has good coverage.
Thanks and please Email me at buddelp1@gmail.com.
Thanks for your help Achilles Tendon Injury Blog.
Bud Delp
Hey buddelp1,
Not sure what your budget/medical insurance covers but here’s a few options for icepacks…
Very $$ but I have been drooling over this cryo-cuff set-up (http://www.amazon.com/Aircast-Cryo-Cuff-System-Ankle-Cooler/dp/B000TVNUVQ). My husband had the knee version for his ACL reconstruction and it was a lifesaver!
I also find ziploc bags full of frozen popcorn kernels or a large gel pack gently pressed on and held with a tensor bandage work well and mold around the foot nicely. My physio recommended not using a gel pack directly on the skin b/c it can burn, but in a damp cloth/bag it works much better.
Good luck!
The ice-filled cuffs are great for serious icing. My PT used one on me after the therapeutic ultrasound. What I mostly used at home was single ice cubes. I mostly live upstairs from the fridge, so I put 8-10 cubes jn a bread bag then put it all inside a big wide-mouth thermos jug. The jug and an absorbent chamois/shammy cloth went into my pack and stayed close. When I wanted to ice, I’d pull the bag partway out of the jug, remove a cube, hold it with the cloth, and rub it over the swollen area ’til it was gone. Worked well for me.
BTW, when I mentioned the idea of icing for 5 minutes to my PT, he said “Sure, if you want to chill your SKIN!” He thought 20 minutes was better for chilling deep tissue close to the AT.
I agree with Norm re: 20 min. ice time (5min. useless)… so I’ve found the layer of damp fabric really makes things more comfortable/less burning sensation on the skin.
Hello, My name is Tim.
I ruptured my achilles playing basketball by simply just jumping up for a rebound. I would consider myself as a explosive athlete I played college football at Cal U of PA and now I been in many basketball leagues before i had this injury. The doc said it was a very rare tear/ rupture from what they have normally seen. He said that the tear was really close to my heel and when in surgery he found that the achilles itself had tears in it. So he had to repair that first and then attach the tendon back together. He also said he put in 2 anchors to hold it there in my heel also with sewing it. The question that i have been asking myself is: Since this is rare from other ATR injuries does this mean that my recovery process will be extended?? Why and how so? I also want to get back as soon as possible to activity, i feel poopy about myself being only 8days post op and not being able to do anything. Considering i would be active in many activities at least 5 times a week. I do understand that I have to be very patient as well but i am just wodering if there are any secrets or things that helped others out to speed up their recovery.
As of now i am in a soft half cast and see the doc in a couple days for my first check up. I am wondering what goes on during that and what gets done. I have been elevating and iceing the back of my knee. Taking ibprophen to reduce swelling and aspirin for blood clots. I do have knee scooter and i really suggest that rather than crutches. The scooter is heaven compared to crutches.
ACCIDENT- i was getting out of my friends car and as i was trying to balance myself on one leg i was beginning to fall and quickly with out even thinking caught myself with the bad leg. i didnt feel instant pain but just a very very uncomfortable feeling through my entire leg going up to my calf. It was a sore and a little painful that night but went away the nxt day. Does this mean i am all good? Or might i have done something to myself?
I am new to blogs and everything so if this isnt the correct way, my bad. I am really curious and would love to know more information on my situation
I had Achilles tendon surgery in November 2012. It is now April 2013. I fell and it was torn off the bone. I had the surgery they put two screws in it. I was in a wheel chair for a while, then moved to the walking boot. Well its been 5 months and im able to walk around the house a little without the boot, but my foot is all swollen and i have a bad rash all over the surgery spot and my ankel. I went back to the doctor they wouldnt give me more pain medication and told me they werent sure why i was still in pain and having a swollen and skin reaction, Does ANYONE have any advice??? I need advice…..
Janet, you need a “second opinion” — AKA a different doctor (med. team, clinic, hospital, whatever). We’ve had a few people who’ve had reactions to sutures, or dissolving sutures that didn’t (& some of which eventually bubbled up through the skin!)… GerryR finally got relief from his FOURTH surgery, the last 3 trying to fix the side-effects of his ATR repair. Now he’s too busy skiing and instructing to post much here.
These kinds of problems are rare, which makes it tempting for some “professionals” to just look away. But you don’t have that option.
Whatever’s wrong, you’ve got to find somebody who’s smart enough and interested or professional enough to find out what it is and fix it. I don’t think we can do much more than wish you strength and luck. But we ARE good for that!
Hi All,
I fully ruptured my left Achilles on the 16th of March, 2013 and had surgery on Good Friday. Since then I’ve been in two casts (5 weeks approx) and have two more weeks before going into a boot.
About a week ago, i started a little exercise resume. A bit of abs work, bicep curls (things that in no way effect my legs). the doctor said this was fine and a good idea to keep fit.
Lately I’ve been getting these feelings of warmth in the sole of my feet for no reason at all. There is no pain but it feels like blood rushing to the area. Is anyone familiar with this? Is it normal?
Any advice would be greatly appreciated!
Regards
Lorne
Hi Lorne, I did mine on 16th March too, and have also had occasional warm rushes that then vanish. I’ve also rarely had what feels like a beetle running under my sole. Weird. No idea what any of it is, just the nerves giving mixed messages I suppose.
Thanks for the reply Micah, good to know I’m not alone. I got a bit of pain today for the first time in a couple of weeks in the exact spot where the tear was. Was thinking that maybe I’m resting my leg straight too often, which is causing a pressure on the injury spot as it is pushing down on the cast. I’ve started resting my leg sideways on the outside of my ankle like I did in the first few weeks and will see if the pain goes. You might want to check your cast for a beetle by the way
Just messing, I guess your right re the nerves starting to fire again. How did you do yours? Was it a full rupture? Where about’s is it? Mine is 4cm up from the Calcaneous.
Hi Lorne. Try achillesblog.com/micah1/2013/04/25/shot-in-the-foot/
or achillesblog.com/micah1/ for the full story. I was rather boringly walking up the stairs. My 51yr old tendon must have been like a frayed old skipping rope.
Are you weight bearing in your cast?
Have you got a blog?
yes mine was full at about the same place. Its a bit sore tonight, walked across the road, then from the car to the sportshall and back, pottered about the house, nothing major though. Keep in touch.
Sorry Lorne, I’m incapable of copy and pasting.
http://micah1o1.tumblr.com/ try that.
Hello to the blog,
Full rupture to my Achilles on April 18th. MRI, then surgery on April 27th to allow the swelling to drop for surgery. Doctor was a bit surprised during surgery when he realized the Achilles tore from my calf muscle? Said it was extremely rare and will delay recovery.
Has anyone else had a ATR so high on this blog? (not your typical low rupture)
Hi Hattrick
Sorry to read that you had to endure surgery and its after-effects. Was this your preferred option or were you not given a choice e.g. due to the nature of the injury (unlikely here as modern fast non-op protocols seem to fix most ATRs as well as surgery does)?
My injury was high too although it was the tendon itself that ruptured, leaving an appreciable gap. My consultant suggested that we try non-op first, but bearing in mind that the actual injury occurred 10 days earlier, its position, and the fact that I wanted to be fit again for mountain walking, it might not work well enough. Over 12 months later I have a strong repair that has been well tested and gives me no trouble at all.
In most cases, it is the right rehab that counts for more than a surgical procedure. I’m not going into that again right now (dogs to walk, hills to climb…) but one of the other pro non-op guys like Norm might want to wade in here. Although a few of us have covered this many times before, posts here are overwhelmingly from surgical patients. Possible reasons? Majority of posts are from USA where non-op barely seems to have been heard of; in the first 2-3 weeks a non-op patient has so boringly little to report; more complications after surgery - not surprising, it is an invasive procedure after all.
Happy healing!
hillie,
Thanks for the response. The gap between the Achilles 5 was cm, due to that they highly recommended surgery. They said it could heal by itself as most peoples can, but due to the gap it would take considerable time.
I never really had a chance to speak with the doctor post operation, so I’m just going on what my family said in that it was torn from my calf. I speak with him again on the 7th.
Sent in an email to this site, waiting on a blog approval then will begin writing.. Guess I’ll have some time on my hands for a while.
Tough thing for me is that my job requires physical work. So I won’t even step back into work until I’m able to perform the tasks necessary..
Thanks again!
Hattrick, many surgeons resist repairing high ATRs because they don’t like stitching into muscles, so they recommend non-op.
The only study I’ve ever seen of ATR gap size vs. non-op clinical results (a sub-study using the data from the 2010 UWO Study) showed NO relationship!
And all the modern successful non-op studies (including UWO) used the same fast schedule for everybody, including large gaps. Slow rehab for you post-op may or may not help, but it’s not evidence-based. Good news is that slow rehab isn’t nearly as toxic for post-op as it is for non-op.
Hi All,
I’m currently almost 6 weeks post op and on my second cast which will be removed on Thursday the 16th of May. Thats 7 weeks in plaster in total.
My Dr said I will then go into a shoe with a heal insert.
Is this ok, or should I be going to a moon boot?
I certainly DO NOT want re-rupture and I’m concerned that going from plaster into a shoe is not very supportive and am really worried about it.
If the heel is ok, any idea on where I can source a good half inch heal insert?
My Physio thinks I should have gone out of the cast two weeks earlier and in to a moon boot and thinks my doctor is a bit dated in his approach.
Please help me, as my Dr is an elderly man, very traditional and not willing to discuss things with me, he is very old fashioned. I’m concerned he does not have my best interests at heart .
BTW, my physio is happy to fit me for a moon boot with a heel insert regardless of what my doctor says. Should I go ahead with that and ignore him?
Thanks
Lorne
Hi Lorne,
As a person who did re-rupture, I think going from a cast straight into shoes is very risky. I was even longer in a cast (12 weeks) which on the one hand left more time for healing the tear but weakened all my supporting muscles. So when I re-ruptured it was in a different place because the wound was healed but the rest of the tendon was weak. I wish I had had a moon boot for support.
After the second tear, I was in a moon boot and weaned myself carefully off the boot building back my strength and stability. It took time and I was happy to be in control of my own healing.
So my advice: go for the Moon Boot — it is the best insurance against re-rupture and you will be able to go into more “dangerous” situations with security. You will also “know” when you are ready to walk in 2 shoes securely.
Lorne-
I don’t think it’s so much a question of cast vs. boot; rather - if I understand correctly - you’re being asked to go directly from NWB to two shoes; skipping the PWB and FWB stages. If so, I agree, that’s risky.
If your final cast is a walking cast; one where you can bear weight on it, then it’s functionally very much like a boot, just without some of the convenience (plus you lose the advantage of non-weight bearing mobilization you can do by taking the boot off).
2 shoes at 7 weeks is not that far off the norm, a little faster than average I would guess. Most folks who get to two shoes so early have been doing a lot of weight bearing, some starting as early as week 2.
Ideally, you want to be able to bear weight on your injury, while it has full support and immobilization. Once you are comfortable with that, you can transition to two shoes - bearing weight while the ankle is free to move. I’m a big fan of incrementalism… going from NWB in a cast, directly to two shoes, is anything but incremental.
Hi Lizzie & Ryan,
Thank you so much for replying to my post. You are both life savers as I’ve been suffering with anxiety ever since the Doctors PA told me I was going straight to shoes with a heel lift from an NWB cast.
Ryan, the cast I am in is NOT weight bearing and therefore, your comments support my feelings that it’s a crazy leap to go straight to a shoe. Incremental steps are common sense.
To be honest, I’m still feeling pain in my achilles now after 6 weeks of immobilization, so it’s unlikely it’s strong enough to cope with that extreme transition of going in to a shoe. I’m definitely going to go with the Moon boot and enjoy the peace of mind.
Where are you both in your own recovery? Lizzie, how did you re-rupture? I’m sorry to hear that, you must have been devastated.
Regards, Lorne
Hi Lorne,
Not that you need it but I agree with Lizzie and Ryan, also all the best with recovery
Lorne- I am at 19 months. A long ways out, but I still lurk around here occasionally. I have a pretty extensive blog that documents my recovery, it’s right where you’d expect to find it: achillesblog.com/ryanb
Hi Ryan, Ripraproar and Lizzie,
Good news! My doctor agreed to go with a moon boot for the next stage of the treatment. My physio wants to use a protocol that means i should be out of a boot in about 4 weeks. I got the heel inserts in and am partial weight bearing (PWB) for now with two crutches.
The confusing thing is, that my doctor is telling me to be PWB with the crutches for a few days and then when I feel comfortable, go to one crutch and then to none. The protocol does not give detail on this and my doctor is clueless.
In your experience of treatment, how long would the PWB stage last? How often in the first few days should i be putting weight on the leg and should it be more about stationary weight bearing, than trying to walk/hobble with crutches.
My physio isn’t that great either so I thought I’d find out from some people that have gone through it to see what the recommended course of action would be. They say it’s up to my doctor and my doctor doesn’t give a sh!t. I’d imagine I will probably go with a few days of PWB on crutches, then few days of FWB with crutches, then start removing the wedges gradually. Or should i remove the wedges PWB? God I’m confused. Help!
Thanks, Lorne
I can only speak for myself- my recovery schedule, documented here:
achillesblog.com/ryanb/my-1st-100-days/
PWB was 8 days
FWB was 10 days
That’s faster than most.
You’re asking a question I struggled with, and has been debated here before. Here’s a little chart/graph I created:
achillesblog.com/ryanb/files/2011/12/bootpath.jpg
Do you weight bear first, and then remove wedges and work into shoes (the red path)? Or, do you get your flexibility first, and then add weight bearing (the green path). Most modern protocols prescribe the red path. I did something between the green and blue- I got almost flat in the boot (a very thin 1/2 wedge) while PWB. Then I went FWB, and got fully flat a few days later. I can’t say, in hindsight, if I would have been better on the red path- I wasn’t given a whole lot of direction either, and applied my normal “recovery from an injury” philosophy: range of motion and flexibility first, strength 2nd.
Hi Lorne
Welcome to this blog, are you surgery or non op, I can only be honest with you and give you my experience and tips, many people can articulate better than me and have a knack on researching, so my tips, I’m non op 12 weeks , i would follow Uwo protocol seems to be best researched see normofthenorth blog, he is in my opinion an authority on non op research and soo helpful, seek advice. Fom Ryan, Alton, hillie norm , and many more.
if non op, watch vids on you tube from brady browne , Alton jonttari , lance,
Myself I was in cast 3 days drove and worked from day one, went boot day 3 went fwb , if I did this all over again, I would take Uwo protocol to doc, and follow this, I would not be too timid with pt and listen to my body, I would understand we all heal different , I would and do come on this blog often, sorry if I’ve gone round the houses been out all night ready for my bed, please feel free to ask any questions , take care
RRR
Thankyou once again Ripraproar & Ryan for responding to me when in need.
Ryan, when you mentioned “PWB was 8 days
FWB was 10 days”, for that PWB period, how did you walk?
Did you look like this youtube video attached, or were you much slower and more measured: http://www.youtube.com/watch?v=-qQr6cfIKXw
Did you go slow at first on your first day and then went faster each day? Did you increase gradually the weight bearing a little bit more.
When you started FWB, did you start by just standing on it first?
Sorry for stupid questions.
Regards,
Lorne
PS: I was surgically treated Ripraproar and in cast for 7 weeks.
It was a long time ago… to the best of my recollection:
Starting out, my pace/cadence was not too different from NWB. Instead of touching the ground in 2 places (the two crutch tips), I just touched in 3 (two crutch tips and the bottom of my boot). At first, I was really just tapping the ground, very very little weight. I slowed down a bit, but not a whole lot.
I was doing 2+ mile walks PWB.
Gradually, over those 8 days, I put more and more weight onto the boot, less and less onto my hands. After 8 days, I found that I could stand with my full weight on the boot. And shortly thereafter, I started walking on it (slowly at first).
Thankyou Ryan! That’s all I needed to hear. I feel a lot more comfortable now knowing that I’m doing the right thing. i read your blog by the way, amazing story to see you back to competitive sport so soon. Well done to you. Lorne
Hi Lorne
Your in great hands (feet) following Ryan , keep us all updated on your progress
RRR
Thank you for this blog! Had surgery yesterday after partially tearing my achilles last August due to Haglund’s. The tendon had been acting up for a couple of years.
PT did not work. The surgery was postponed while I finished up college.
The bone was shaved, achilles repaired, and screws inserted. Had trouble sleeping last night with nerve block, (thanks for the suggestion-learned about them on this blog)
an half a pain pill.
I’m a runner hoping to rehabilitate, but hiking and biking would be fine at this point.
Any suggestions would be appreciated!! My boss would like me back at work on Monday (desk job) but I have plenty of sick time.
Thanks again for educating me through the process!
Beth
Hi all,
Just wondering if there is anyone who has had experience with a high tendon rupture?
About 4 weeks ago I had a complete rupture at the junction between the tendon and calf muscles. After some poorly disguised disinterest at the ER, I saw a private surgeon who sent me for an MRI. The MRI showed that there was not sufficient tendon above the tear to do a surgical repair (apparently they cant sew tendon to muscle), so I got stuck with a boot.
Before we got the MRI results, I had said to the doc that regardless of whether I had surgery or not, I wanted to pursue an aggressive rehab - early weight-bearing, etc. After the MRI, it seems that is no longer an option, as the tendon to muscle scarring takes longer to form - I am completely NWB until 6 weeks, and not even allowed to move my foot until 4 weeks.
I’ve seen a physiotherapist for swelling reduction, but that is it.
Has anyone else experienced this? I’m finding it incredibly frustrating and, although I trust my doctor and think he’s a good guy, I would like to know what experiences other people have had - but all the material seems to deal with more traditional mid-tendon ruptures.
On the plus side, I’m almost at 4 weeks now so at least I’ll be able to move my foot in a few days AND I’m picking up my knee scooter tonight, so I’ll be a bit more mobile for the next few weeks! In a lot of ways I think it is lucky that this is an active person’s injury - 6 weeks on crutches could be murder if you didn’t have some basic fitness!
Hope you are all healing well,
Ali
Hi!
It’s great to read about everyone’s ATR recovery stories. I fully ruptured my left achilles playing touch and I knew what had happened as soon as I felt the ‘pop’ as I also done my right achilles 5 years ago playing netball and I was only 25 at the time, so the statistics don’t really work in my favour lol!
The first time I had no idea about ATR and thought I had just rolled my ankle so I just rested it for a few days and was back walking around on it (extremely painfully and only when needed) after that. I also played netball again a few weeks later (only as GS with no running and still very painfully, but wrapped up tightly). I went to the DR’s a few months later (for the first time) as it was still very sore, and just to check up on it and it was then I was told that I had torn my achilles. Scans showed a partial tear and that it had already started to heal itself. So I left it and it took about a year before it was fully healed and I could walk without a limp. It’s now fine and I haven’t had any trouble with it, although I do have a big gap there, and my calf shows the muscle without being tensed, so I’m not sure what happened there?
For my latest ATR injury I went to the hospital straight away and am 2 weeks in a cast, but it’s only a moulded fibreglass half cast covering the back of my calf down to my toes and is then bandaged to keep it in place, which means I can remove it to shower (even though I’m not supposed to!).
But I really wanted to comment here to suggest an awesome product which some of you would love and may not have thought about to use. I’ve seen a few comments about not being able to get around and being sore from using crutches etc. Well my elderly father in law has a mobility walker like this: http://www.austechmedical.com/display-product.php?rid=440
and it is the best thing ever for us who suffer from ATR! I use it like a skateboard and kneel on the chair with my bad leg and use the good leg to push myself around. It also has a shopping bag under the chair which I use to put things into to transport them from one place to the other eg. taking clothes to the laundry. I’ve used it twice at the hospital when going to my appointments and I’ve had so many comments on how great an idea it is lol! They’re not cheap but you can also hire them from the hospital I think.
Anyway, good luck to everyone with your injuries, I hope you heal well and fast
I have a question for boot wearers. Particularly Bledsoe boots.
I am 5 weeks post op and have been FWB for a week with two wedges in my boot (but I guess one stays in??). I just took the last one out and WOW that hurts!
My question is the flappy padding that is stuck to the final wedge no longer fits. Did anyone have to cut it to fit?
The floppy padding that I had been using would have worked too–if you trim an inch or two off the front. It was a sticky mess though and I just used the spare from the bag.
Just either partially or fully ruptured my achilles on Wed, the day before the holiday! Unfortunately I am not able to see the ortho surgeon until Tuesday. In the meantime, I’m in a temporary cast and was given pain meds for comfort. I have been pretty much up and about since the injury. I noticed today that my injured leg is much bigger (swollen) than the other. Im figuring this is due to my being too active. Can I do any more damage than is already done prior to surgery? Can the swelling effect the surgery? This blog has been great with info and questions for the surgeon. Thanks!
Hi Kim, ….. I didn’t get treatment for 2 weeks after my injury. I thought i had a calf injury at first. I had no pain after the day of injury. I continued to be out and about but I didn’t exercise. I started falling due to lack of stability and that pain was horrific. I gave myself the thompson test and failed. I went to the doctor 5 days after that and got treatment.roughly 2 weeks after injury. But I did not have surgery. I went the non op route.
I’ve read some doctors wait for the inflammation to do down before they will do surgery. But I guess it depends on the doctor.
If you are concerned, find a doctor you can see earlier.
Good luck. Happy healing!
Hi Kim, Like a lot of people , I hoped it was a calf muscle- but was pretty sure it wasn’t. The doctor and I went over the MRI the following Thursday and he wished to operate on Friday. That weekend I promised to take my son into Boston for a convention. We would be walking nonstop for two days, 10-12 hours a day in crowds. I was not in as much pain as you are,so I delayed the surgery until the next Wednesday ( Monday was a holiday). My doctor requested I use a low rocker boot when outside my home until the surgery.
That being said, since you maybe have a partial tear, I would be careful until the surgery not to tear it more. Additionally it is preferable to allowing the swelling to go down prior to surgery.
Good luck on doctor’s visit.
Hey everyone,
i had my achilles operated on July 1 and am in the 6th week right now. My doctor said i can change my cast from 30 degrees to 0 at this time but i felt like that was too abrupt to do at once. I’ve changed the angle on my cast to 15 degrees and will drop it to 0 next week but i’m feeling some strain higher up on my calf muscle. Not sure if this is normal or not but just wondering if anyone else experienced this?
My boot had wedges. I removed a 1″ wedge weekly until all three were gone. I’m sure some one else will chime in as well. I didn’t have much tightness except when my foot was first placed in the boot. HTH.
Hi. Does anyone know how I post to my blog? My ATR happened on August 4 and am going into surgery tomorrow August 15. Thanks all!
I can’t figure it out either….after we are able to log in, where do we find the page to start actually typing words on?
I am in of a different dilemma and I hope you guys can give me some pros and cons. I had acute ach. Tendinitis off and on for 3 years. Bouts of swelling and fever around my tendon accompanied by excruciating pain, nerves just screaming and the achilles burning. I’d RICE it till I needed to get going again and then baby it till I could walk right. Over time the tendon deteriorated, and I have multiple micro tears in the length on the tendon. I have been NWB in a boot since 23 May! PT twice a week for the past eight weeks with 6 more weeks scheduled. Yesterday the doc and I talked about having a jacket grafting procedure and the recovery from that OR continuing in the NWB boot for at least another six weeks to 3 months.
I cannot walk with out the boot for more than 25 or 30 steps without residual pain for hours, and walking for more than 10 or 15 min in the boot will also “wake up” the area. I think my biggest fear is going for 6 months NWB, healing and then re-injuring. If you had been given a choice….would you choose surgery, knowing what you know now? Thank you in advance for any input.
Hi, has anyone ruptured both tendons at different times? I did and surgery to repair. three years apart both playing basketball. the second was 9 months ago and I had complications.my body rejected the vicryl sutures and had issues with the wound closing. I’M ok now, I guess. I cant play sports till spring of 2014. im trying to find someone who ruptured both tendons and had surgery to repair. is there anyone out there?
JKZ, I ATRed on both sides 8 yrs apart, and we’ve had a smattering of others who did both sides, ranging from simultaneous (! — maybe only 3 of those in the past ~4 yrs) to ~11 yrs apart. There’s a study on the Studies and Protocols page here — search for “contralateral” — that found that ATR patients have 200 TIMES the normal risk of tearing their other-side AT in the first few years afterwards. Still way far from a sure thing, of course, but way more likely than a first ATR.
I skipped surgery for my second one, as did a few others, but quite a few had both of them repaired surgically. (I was planning to, until my new fancy sports-med OS introduced me to the newest evidence on fast non-op results.) I don’t know which of the “two-timers” is still lurking here, but maybe they’ll speak up.
Of course your problems with stitches and wound could have happened with a first-time ATR, and several people have posted those experiences. Try the in-page search function. One long story is GerryR’s. He had multiple reops to clean out the sutures that caused him long-time problems. His docs mostly denied the possibility, so he was fighting a long uphill battle with most of his support right here. Finally, his FOURTH op solved his problems and he’s been fine since, mostly posting ski videos here.
If I were you, I’d probably look up the stories from those folks, rather than the two-timers…
I ruptured both at same time(bilateral). Besides the NWB for 7 weeks in total, didn’t end up with any issues, my sutures were non dissolve, so they will be in there forever. My incisions are on the inside part of my legs and after 16 months are becoming less and less visible unless you know they are there. I hadn’t played basketball in approx. 10 yrs and ruptured both in second game, first game was a tues night then same week thurs night legs and calves were very tight and ran up/down court a few times and rest is history. I am unsure why some docs cut on the rear part and other on inside part of legs. Kobe was cut on the back I believe, most rear incisions always look so much worst
Lots of rehab, still working out, calves are hard to build muscle
I ruptured mine playing football. Very athletic 29 yrs old. Got surgery 5 days later. I was referred to a surgeon that does this surgery all the time. 7 days after surgery I was off pain meds. I moved my foot inside the soft cast quite a lot after the surgery just until I felt pull and I would stop. When I went to my appointment 10 days later I was able to position my foot almost at 90 degrees to get my hard cast. Nurse said I would be in the hard cast for 4 weeks and then if the dr said it was ok I would go to the boot pwb. Inside my cast I have also moved my foot quite a lot without any pain or swelling whatsoever. Basically I just stretch it a little in all directions. Never to the point to where I feel pain or discomfort. Any opinions? Looking forward to getting the cast off and starting rehab. My personal opinion is that the tendon will heal better when slightly worked instead of sitting stiff. I know that’s one reason why my rom was so good when getting my cast on. I also flew my calf daily. I feel no strain on my tendon at all. Any ideas, opinions, or comments please post I’m willing to listen
I ruptured my AT Nov. 21 and started my non op protocal on Dec. 2nd. I’m 2 day shy of 7 weeks and feeling pretty good. I started full weight bearing at 5 weeks with the Boot. My doc believes in a quick recovery, which I am happy about. After I got the ok to FWB I painted 3 rooms in my house in a week. I did need to takes some breaks due to swelling. I do feel it’s getting stronger everyday though. I’ve been wanting to go to the gym for some cardio. Does anyone know if it’s ok to start riding a stationary bike?
Here’s my link if anyone has questions or an answer to my previuos post. Thanks and Good Luck!!! http://djpain130.wordpress.com/2014/01/20/my-achilles-re…y-non-surgical/
Rudy - Stationary bike should not be a problem at your stage. Start with the heel of your boot on the pedal and slowly move to the toe as tolerated. Start with easier spin and build up. Same goes for when you are out of the boot. BTW your link doesn’t work. You can start a page here easy.
djpain130.wordpress.com/ seems to get to Rudy’s blog.
Rudy, I’d say +1 to xplora. And take a look at bit.ly/UWOProtocol — they ran ~75 non-op ATR patients (and ~75 post-ops) through that fast aggressive protocol and got excellent results. Your “quick’ doctor is still somewhat slower than that study — and a more recent one from Sussex in UK went even faster with great results.
Don’t jump ahead and stay incremental, but I think you’d probably benefit from slowly and gradually sliding ahead toward one of those schedules. Non-op patients especially seem to do best when they go as fast as these aggressive protocols, and have higher rerupture rates when they go much slower.
Hi Rudy
Norm means Exeter and not Sussex tinyurl.com/ops2klk.
At least he was thinking ‘ex’ at the time.
H
Hi, Hillie! NOW do you see why you have to post here every week or so? I can usually remember “Exeter” for a few days. . . Only been to England once, and not sure I got to either Exeter or Sussex — but then memory’s the first thing to go. . .
Thanks for all the feed back! I have checked out the UWO protocal and because of it I have learned alot. I’m going to check out the Exeter protocal.
Rudy
The url that I included above will only take you to the study abstract. For much more information including the rehab protocol check out Suddsy’s achillesblog here at /suddsy, especially the 2 shoes posts. Lots of us posted there for a short while. 10/10.
H
So I have an update on my situation. First I’ll give an overview. ATR dec 15, 2013, Surgery dec 20, 2013, had a splint cast for 10 days after surgery, then went to a hard cast. I was in the hard cast for a little over exactly 3 weeks. I went to the dr. this past tuesday and got my stitches out and a new boot. I am supposed to be PWB until feb 20 when my next appointment is, and i have the theraband exercises for strenghtening.
How it’s going: I’ve only been in the boot for 2 or 3 days. felt great washing my leg! Very surprised how well i can walk. i can actually walk without crutches FWB if i wanted to. No pain walking and no swelling so far. I am doing my theraband exercises a lot and I can tell my foot is getting stronger. I take my boot off at home to rest etc..
Questions: Although I can walk fine and even FWB should I dial back and take it slower? I was told to stop everything if there was any pain at all and to take it slow with the process. I just didn’t know if I should continue walking, or rest although my leg isn’t showing any signs of needing it yet. Any ideas?
To add to my update my boot is also at a normal angle. I don’t have any wedges etc.. I am able to flex my foot back past 90 degees, and flex forward almost as much as my other foot.
3 WEEKS POST-OP WALKING WITHOUT BOOT!
This site was so helpful to me, so I wanted to share my experience.
3 WEEKS POST-OP WALKING WITHOUT BOOT!
I am a 42yr old female and who had a complete rupture to my left Achilles playing volleyball on 13 Dec. This was after I’d done warm up exercises/stretches and finished jogging. I didn’t have immediate pain, just that weird pop, flappy foot feeling, swelling and the gap in the back of my foot. Barely any pain until about 10 minutes later when my calf cramped up. The emergency room sent me home with pain meds, in a splint and crutches, which by the way, are the devil. And instructions to see Ortho the following Monday.
Being active duty military and just plain impatient, I wanted to get back on my feet as soon as possible so I opted for surgery, which I had on 3 Jan. My doc gave me the option of having surgery on Christmas Eve, but who wants to do that?!! I just crutched it and kept my foot elevated to minimize the swelling until surgery. I even managed to maneuver the Vegas strip for New Years Eve with the dreaded crutches.
During surgery I opted for the nerve block to my leg. I BEGGED my doctor not put me in a cast so I got another splint. Woke up with no pain and told the block would wear off in 12-16 hours. This was great because I went home alert, pain free and was able to spend time with my family before the pain kicked in that night. I started taking my pain meds about 7hrs after surgery. The pain didn’t kick in until after I’d gone to sleep. After a while of no relief with just vicodin, I had to double up with Percocet. Now, keep in mind, I have a high tolerance for these pain meds because of a back injury, so I don’t advise approach. This still wasn’t full relief, but improved. By the 3rd day the pain was tolerable so I went to ibuprofen and by the fifth day I was pain free. I still had occasional burning at the incision site when I stood up from the blood rush, but that subsided. Then came the itching! (get some chopsticks)
2 weeks post-op the doc put me in the walking book and authorized weight bearing in the boot, and light/occasional out of boot at home. Ditched the crutches immediately and me being me, I attempted walking without the boot that same day. My foot was tender, but not painful. I now spend more time out of my boot at home than in, which seems to have been beneficial. I already see great improvement in my walking and flexibility. And this is without PT, because my first session was pushed back to 12 Feb. It’s now 3 weeks post-op and I can spend a full day walking around my house, carefully, without my boot. I can even navigate my stairs (14) very slowly and deliberately. This is all with absolutely no pain and very, very little swelling. I do still try to keep my foot elevated when resting and always wear the boot outside. I still limp, the heel of my foot is still a bit tender when walking on bare floors and I have to wear a slipper, my gait is still flat-footed (although I can flex it normal stride when attempted) and I’m too afraid to try a toe raise before my PT appointment.
Of course everyone has to go at their own pace and according to their doctor’s orders, although I did stray from my doc’s orders a bit on the time outside of my boot. My urgency had a lot to do with the fact that I live alone and needed to be able to fend for myself after my daughter returned to college and my mom went back home. But I think it boils down to how you feel and what your body is telling you. Make sure you listen. Happy Recovery!
Impatient - You are kind of walking in that danger zone area. All might go well but the risks are very high. Understanding how tendons heal is very important. At 3 weeks you have some collagen laid down around the injury but it is weak and disorganised, prone to break again if you slip, misstep or fall. There is nothing wrong with early weight bearing but generally it is done while the tendon is protected. There will be no warning signs from your body for a re-rupture. The danger period is up to 12 weeks and slides off from there. I am not suggesting a boot until then as most get into shoes around 6 or 8 weeks. Also from the studies I have read, NSAID (ibuprofen) drugs should be avoided. This injury actually needs an inflammation response to heal. Hope it goes well for you the way you have chosen. I have some info attached to my page if your into reading scientific stuff.
All - In your opinion, when is a “safe” time to start DF stretching? Today is week 9 post-op. ROM is good, weight bearing feels good so I’m chomping at the bit. That DF stretch would just feel so good but not worth a re-rupture! Thanks!
Hey everybody! First I want to say good healing to all….
I ruptured my AT playing basketball and I chose the non operative route. I am 9 1/2 weeks from injury and 8 weeks from the non op protocal. I went to the doctor todayfor my 8 week check up and I walked in in 2 shoes. The doctors were impressed considering I’m still supposed to be in the boot. I’m a little impatient so I’ve been walking around the house since 5 1/2 weeks in gym shoes and sandals. I’ve also researched alot from blogs and you tube video’s. So I was working out my AT quite a bit. I feel because of my impatience, info, healthy diet, and positive thinking the doc released me today and told me to keep doing what I’m doing.
Happy Day!!! Good luck everyone!!!
djpain130.wordpress.com
I ruptured my Achilles Tendon while working out at the gym and was doing a sprinting exercise with resistance, my foot hit a bit of sweat sending my left foot into a loaded doriflexed with a slight medial twist and a loud pop that everyone in the gym just stopped. My first reaction was “Who dropped the weight on my foot” the second reaction was “Oh Sh*t!”
The ortho casted me in a planter flexed position and scheduled surgery 10 days, I took the cast off the night before because I just couldn’t take it anymore.
The morning of surgery the dr came in and said my operation had been bumped due to an emergency and he could reschedule me in two weeks. But because of the time period (24 days) that my Achilles Tendon should already be at least 60-70% healed and he didn’t want to go in there and mess with any of the previous repair.
I had him show me all the data on surgical vs non-surgical and I elected to go with the non-surgical. I’ve would have come out of the cast/boot at the same time, but I wouldn’t have had any of the pain caused by surgery. If I had waited for the surgery it would have restarted the rehab clock 3 weeks later.
So now I’m at 4+ weeks post injury with 3 weeks left in the cast.
Once I’m in the boot - How long do I usually have to use crutches? I have a trip to Europe planned starting 5/29, and I don’t mind being in a boot, but I don’t want to be dealing with crutches.
I’ve read so many different protocols regarding rehab. Has anyone re-ruptured their tendon after non-surgical rehab? And if you did, what do you think led to it?
I enjoy reading all the stories, I don’t feel like a Lone Ranger!!
@mikevball: It doesn’t sound like you had much of a choice but it’s always nice to read about another non-surgical repair. I went almost immediately to FWB in the boot from the cast. The transition was easy. I used the crutches for a couple of days when I went out to the store and such but it was more mental than anything else. I was just nervous. Honestly, once you get locked into that boot securely, it’s very easy to make the transition. You just have to make sure that you are walking normally–pushing your shin against the front of the boot and rocking forward. The other thing if you are going to do a lot of walking is to make sure you have some way of evening up the other leg to prevent any hip issues. There was a Youtuber (Yoda, I think) that re-ruptured after going non-surgical and there was a woman here who re-ruptured as well but I think hers could have been due to getting into the cast later rather than earlier. I can’t find her blog anymore though.
@kellygirl Thanks for the input. I’ll be very happy when I can get a boot this cast is a pain in the butt. Do you know if you can drive a manual transmission with a boot. I have to borrow my wife’s car if I want to go anywhere as mine is a stick shift.
I wouldn’t recommend it personally. Mine was the left foot so I drove no problem. I wouldn’t trust myself accelerating/braking with a boot. It is bulky and wide. I’d switch to the automatic for awhile. Let your wife have all the fun with the stick!
Oops and duh, shows I haven’t driven a stick in ages! It’s your left foot too, correct? Same thing though, I would stick with the automatic.
Mikevball: (1) If you drive a stick-shift “properly”, using your left foot ONLY on the clutch, and your right on gas and brake, I don’t see a problem doing it in a left boot. BUT I’ve heard that some governments and some insurers disagree, so you may want to check first.
(2) The evidence is super clear that non-op treatment can produce reliably wonderful results, but ONLY if a fast modern protocol is followed, and your schedule is much slower than all of them. Before about 2007, non-op care was consistently slow, aka “conservative casting”, and it always had a scary high rerupture rate, often in the 12-25% range. With the new fast protocols — bit.ly/UWOProtocol is the good one I’ve got on a hotkey! — the rerupture rate is in the <3%-5% range. More details in Cecilia’s blog.
The most recent and biggest non-op study — from Wallace in Ireland — reported maybe 2.7% rerupture rate among almost 1000 non-op patients. As Wallace says, most surgical studies can’t approach those numbers.
But virtually all of these studies use a boot early, and get to FWB at the 4 week mark, and most start exercise and PT sooner than that. There seems to be a relatively narrow range of “recipes” that works well non-op. There are LOTS of studies that went slower and produced inferior results, and I’ve seen one study that went much faster and also produced inferior results. In both of those outlier directions, surgical patients come out ahead of non-op patients, but in that “sweet spot”, the non-op patients seem to get equivalent results without the pain, scar, time off (desk) work, and surgical complications.
Lots more info on my blog and elsewhere here, or just follow the links in the table on Cecilia’s blog.
I am a serious badminton player, who ruptured in 2013. I am almost fully recovered now and went the non-surgical route. I did have a partial or full re-rupture though, and it was hard to find similar re-rupture cases on here and keep a track of them. Hence, I have created forums for all the various iterations (i.e., surgery, no surgery, surgery twice due to re-rupture, no surgery twice, surgery and then no surgery, no surgery and then surgery etc..) on a forum here:
http://www.achillesbusted.com/forums
I try to come on here (especially the UK section where no surgery is more popular) regularly and at least track the non-surgical stories, but it would be nice if some of you posted on my forums too….especially those who had re-ruptures (i.e., two or more iterations of treatments), and also those who went conservative.
Thanks for this great blog!
No surgery works! I can do one heel raises on my bad foot in the pool….hope to do the same on level ground in another month or two.
And especially thanks to Norm whose posts I often followed….very glad I had no surgery.
Hello all - I feel a little behind the curve since I am actually about 7 months post op - but since I found this site looking around for some answers I figured I would provide my experience and as a question or two at the same time. I fully ruptured my left achilles playing basketball while vacationing in the Philippines with my wife and daughter on 11/16/2013. We were visiting her family and she suggested I play with her brothers and nephews, I was in great shape at the time and hit the gym 3-4 times a week and play hoops often. Unfortunately I was 37, and statistically more prone to that injury playing basketball and as was the case I exploded into a crossover but I was the only one on the ground not the defender…. I was shocked as it felt like nothing I had ever felt before and even looked around asking who hit me? Sufficed to say I got a ride in a trike (small motorcycle with a sidecar) to a “clinic” where they gave me a pin killer shot mainlined into my vein in my fist!!! OUCH!! that hurt more than my leg I think. They took an x-ray and verified there was no break, so I figured I had just severely sprained my ankle. I proceeded to continue our vacation leaving the provincial area where her family was and staying the remainder of our trip (5 days) in Metro Manila. Being a good sport I took my wife and daughter out to the mall. I purchased “a” crutch for my left side thinking I will just hobble around not knowing the extent of the damage I had done. By the time we flew home 5 days later, my leg was not getting any better, but instead of seeing my doctor, I raked leaves, and cleaned my pool since it was fall and leaves had covered our home in California. I went back to work a few days after getting home and all of my coworkers were saying how crazy I was not to go to the doctor, yes my wife did too, but she is always so overprotective. I decided to go see my UC Davis doctor who proceeded to tell me I need surgery immediately, and that I in fact was crazy for not seeing him sooner and remaining somewhat active. I had surgery on 12/05/2013 by an orthopedic surgeon and several weeks later was out of the cast in into a boot. My wife and children were the best support system throughout the healing process, of course I was very stubborn and proud so I tried to be self sufficient more than I should have. My PT went ok - although I dont think I truly gave it my best effort. Now 7 months later I can jog somewhat, and can do most everything I could before, but I am still not hitting the gym. My leg is still tight at the end of the day, so I am wondering if that will go away if I get serious about rehabbing my leg more? Anyone have any suggestions or thoughts? I would love to know when i can actually sprint again, and do more strenuous activity, but maybe I blew the rehab part and need to commit to that more…
Adrianos76, you can’t change the past, but you can change your future. If you’re concerned about your Achilles’ post-op condition, I would suggest going back to a physical therapist and ask for a program specific to your current status. Tell them your concerns and goals and then follow their advice. It’s never too late to work on improving yourself. Good luck! -David
Hello,
I am 48yr old male. I tore my achilles on May31 2014. I was competing in a Master’s track meet. I was long jumping and it snapped on my first step in my approach run. I went directly to the doctor and was told it was a complete rupture. I had surgery 10 days later. I was put in a boot directly after surgery no cast. I was non weight bearing for two weeks. With no pain I decided to dump the crutches the third week. The doctor wanted touch down but no weight bearing for 6 weeks. I have been being careful but decided to be impatient. I am now in my fifth week, been weight bearing in the boot for two weeks now. I also and walking on it without the boot at home and started with some mobility exercises the last week. It seems to be going well. I have little swelling and no real pain since the day after surgery. I was on pain meds for only 24 hrs. I see the doctor today. I am hoping to get one wedge removed from the boot and then go neutral in the boot at weeks 6. I am tasked to remove the boot totally at week 8. I am happy with the progression so far. I started working out again two days after surgery. (upper body only) I started working half days by week 3. I think being in good shape and having excellent balance has helped a lot.
I injured my Achilles in ‘10 playing basketball. I was doing a full sprint and rolled my ankle. It hurt when I first did it and then I kinda limped it off and went home. About 2 hours later the pain woke me up. It was totally unbearable. Every muscle in my body was tense from how much pain I was in and I have a pretty high pain tolerance. They did an x ray to make sure something was broken put me in a splint and gave me crutches. I went to a doctor that was kind of a jerk to be honest. He was pretty arogant, and when you would ask a question he acted like , I’m the doctor who are you. Even said something to that effect to me. Anyways never got an MRI. Was out of work for ~4 weeks. Maybe a little longer. Did physical therapy and went back to work with an ankle brace and a very weak ankle. It was like that for a long time. Its gotten less weak, but within the past few months it hurts a lot. Especially walking up or down stairs or after a lot of walking. And sometimes after sitting or laying down for a while, its so stiff I almost can’t walk on it. Anyone have any ideas?
I am a 41 old active male. I usually run 15-20 miles per week. My Achilles has been sore lately so on Saturday, January 31st, instead of running I decided to play basketball. I was playing defense. I jumped to block a shot and heard a pop. I thought someone had kicked me in the back of my leg with a steel toe boot, so when I turn around to see what jerk would do such a thing…no one was there. I knew something was wrong so I immediately went to urgent care and they confirmed ATR. For the first two days pain fluctuated from 3-7 on pain meds. Surgery was February 3rd feeling no pain 12 hours post op…got the nerve block and taking hydrcodone. I’m in a hard splint and keeping elevated.
1.5 years post rupture, I am going great (non-surgical treatment). However, my healed achilles is very thick and looks odd. I never tried to massage it much, and wonder if I should get a professional to do that and try to reduce the size of the tendon region. Anyone have success in reducing the thickness of the achilles tendon once it was healed? I assume most of the thickness is not the tendon, but rather, old scar tissue that never went away?
31 year old semi-active male who just fully ruptured Achilles two weeks ago. I had surgery last week, which went well as I was told. Today, one week post-op, I went to the doc, who took the cast off, looked at the incision, said I was healing well, and left me without a cast! I have been reading some posts on this blog and didn’t expect that! Doc said that I need to try bending my foot to a 90 degree position before having a boot fitted. Has anyone here else experienced this?? This is very painful and uncomfortable now for me. I still feel like it did after the injury…feels like my foot is dangling. Anyone got any ideas or tips to help the next few days of this recovery prior to boot placement??
miamigolfer - if I read this right you have nothing on your leg to protect the tendon. If that is the case then you are leaving your tendon extremely vulnerable. What would the doctor be thinking. You do not need to be at neutral (90 degrees) before getting a boot. Many are hinged and you can put wedges in them keep the sole flatter but increase the angle. There is also no need to push the repair at this stage if it is hurting. Find another doctor urgently for a second opinion. Above all get some protection on that leg before something dreadful happens. Vaco or Donjoy boots would be fine. Plenty of info here about them.
miamigolfer - Ditto what xplora said. You’re doctor is just plain wrong. Seek another Doctor ASAP.
miamigolfer - Did he send you home with the boot? If yes, go to your local big box pharmacy or medical equipment store and buy like three heel wedges (depending on their thickness). Put those in the boot and start wearing asap. If he didn’t give you a boot the medical equipment store should have a selection of boots to sell you. Then see another doctor when you can get in.
Your incision and achilles need to be immobilized for healing.
Miamigolfer
I never had a cast but was in a splint the first three weeks. Not a good move at all for your Dr. to remove your cast and not replace it with something to immobilize and protect your injury. Also, you do not need to be at 90 degrees in order to go into a boot - that is why they put wedges in the heel. I went into a boot after 3 weeks in a splint and wore wedges with a boot for another 5 weeks. If you are getting around without any kind of protection or immobilization on your injured leg, you are at an increased risk of re-rupture. I would go somewhere else.
As I am at the early stages of sustaining the injury, people’s personal experiences of ATRs have been by far the most useful source of information.
For anyone who is interesting, I am also keeping a blog on my progress and will update it after any significant events/milestones are achieved. Suggestions/comments/tips are most welcome from anyone who is in a similar or more advanced stage of their rehab.
http://www.njachilles.blogspot.co.uk/
As a runner, my goal is to get back into running next year and am in the process of deciding on a suitable local 10km race to aim for in 2016.
I know this is for achilles only, but I can’t find much on the internet about peroneus brevis and I think that all tendons may be similar in recovery? I’m not sure.
I recently had a tendon repair for a longitudinal split tear of my peroneus brevis tendon on June 16th. I am 24 days post-op
For 23 days, I was put in a NWB cast. On July 9th, I got put in the CAM walker boot and for the first 3 days, I PWB with 25% of weight, then the next 3 days I PWB with 50% of my weight. After a week, I am allowed to use all my weight (FWB). In about 2 weeks I start PT.
After a week, is it necessary to still use a walker? I was thinking of leaving those behind or just using a cane after a week. Also, I walked a few steps with my full weight and I did not feel much pain, but I’m just going to listen to my doctor.
On a final note, how do people go down the stairs with a CAM walker if half the stairs doesn’t have a railing? Are the chances of re-rupturing my tendon high? How do I move around in the shower without a boot?
I’m worried. I was told by my orthopedic I’m a good healer (thank God). I was training for a marathon and got injured.
Saab, congrats on your progress. If you’re FWB, you shouldn’t need the walker, but keep it around just in case. I still pull out my crutches from time to time when I’m stiff, mostly when waking up in the mornings.
When I was NWB, I would go up and down stairs on my butt, using my hands and good foot to lower and raise myself. When my 2 year old daughter was around, we’d race down together.
Now that I’m FWB, I go down on my feet. The trick is to keep your booted foot on the lower step. So, step down with your booted foot first, and step up with your good foot. Try to orient yourself so if you slip, you fall down on your butt instead of forward onto your noggin!
As you get more comfortable, you can try going down normally. Achilles injury recoverers need to remember to lift their back heel so as to not stress the Achilles. If the wall is close without the railing is close enough, I keep a hand on the wall for leverage. Hope this helps…
@saab21: Everyone is different. I do not know your injury/surgery and would not speculate on whether it is time to ditch the walker. I am a non-surgical AT rupture case, and just last week made the transition to FWB in the boot. After a couple days of experimentation, I fell confident enough to ditch the crutches completely, but your case need more time.
Regarding the stairs: take it slow, use the railing diligently, and hug the wall as the next best thing for the section that does not have a hand rail. Generally, hurrying equals risk, and you don’t want to accept unnecessary ones. In my limited experience, re-rupture risk seems to be highest from placing too much force on the injured tendon. That could be from over exertion, a stumble, etc.. A slip on the stairs could cause that, but as awkward as that boot is, you could also end up taking a nasty spill if you are not careful. Slow and steady…
On the shower question: I recommend getting a shower chair to avoid undue risk to your injury. We picked a chair up for about $30, and it is had been a huge quality of life boost. I show my own approach to the shower at around the 11:00 mark in this video: https://youtu.be/Bw6wktBPuPQ?t=10m56s
One can do roughly the same sitting in the tub, but it is a bit awkward by comparison.
Best of luck with your recovery!
@ejbvmi @oscillot
Thanks for the advice both of you! Yeah, with the stairs I just learned when going down to put my bad leg first. When going up, I place my good leg first.
I try walking a few steps without any support and I don’t feel much pain but I’m a paranoid person and don’t want to risk anything. I asked my orthopedic about re-rupturing and he said not to think too much about it and that I’m okay.
I’m just glad I can leave the house now, even though I have a boot haha.
ooops! 10 weeks post op. 1st day officially out of the boot. Well the cutest little 1 year old decided to chose that day to walk down the stairs alone. So I jump off the couch to save her. As she face plants on the bottom stop but stops herself, I am recklessly running and leaping and diving. She was fine. I am not. Next day: My foot ballooned up all the way down to my toes. And one quarter sized spot in my incision area swelled up as well, which previously was perfectly flat and healing well. That is really what worries me. I have a little pain yesterday but no real pain today. I am wondering if I would know if I did serious damage, or if this is a normal reaction. My doctor went out of town yesterday….I see my therapist on Monday. waaaa!!!
Lynnie, keep us updated. You did the right thing - remember, this will pass.
Well, I wore the boot all weekend - little pain but I could feel a strain. After speaking with my therapist today who did all sorts of tests and feels and manipulations couldn’t find any issues. The little lump in the incision seemed to have gone…until I crossed my legs and then she found it. So until my doc comes back from vacation I am to continue working it out but not push anything. She thinks I am fine, but found the lump curious. *sigh. If I screwed myself on day one, I will just…I don’t know…but I will be very unhappy.
I apologize ahead of time if I am posting in the wrong spot. I am not sure how to create my own blog yet.
I ruptured my right achilles on May 2nd 2015. I underwent surgery on May 18th. After surgery, I was splinted for 1 week NWB then placed in a boot for 1 week NWB until the stitches were removed. Once the stitches were removed, I was allowed FWB in the boot for 6 weeks. Once I reached the 8 week mark (6 weeks FWB in the boot) I was allowed out of the boot. After being 1 week boot free, I reruptured by missing a step. I had my 2nd surgery on July 22nd and am currently on the 2nd day after surgery. After the first surgery, I had this weird feeling, almost like I knew I would be one of those 4% people that rerupture, and I did. I am 27 years old and do not have diabetes or anything like that. Similar to the first time, I have a weird feeling, this time worried about infection. The doctor expressed his concern about infection or wound complications due to having to go back in and redo the same surgery so recent to the first one. Does anyone have any incite, experience with multiple surgeries or at least words of encouragement to help relieve my stress of worrying about infection. I really have no reason to worry so much about infection since I am taking my antibiotics as well as am a pretty healthy individual. Any help/advice is greatly appreciated. Also, any advice on how to start my own, more in depth blog is also greatly appreciated.
srbecker - keep the wound dry. If the infection controls are in place then you should have no problem but you probably cannot see the wound for a little while. There are a number of people who have been through here in your situation and few had problems with infection. To start your own page go to the home page and on the top left corner you will see ‘Sign up here’ Click on that and follow the prompts. Dennis (the administrator) will send you an email. It seems you were on the right path the first time and your misfortune was not related to your protocol so the temptation will be to baby this recovery. Hope it goes well this time around.
Strange questions :
surgey was on 7/13, first cast off 7/21, and the current cast is due off on 8/11.
Just curious if I am the only paranoid one? By that I mean, sometimes I “think” I feel stuff. I don’t mean pain, or irritation, of anything like that. And am really staying off the foot. I had ONE accident, last about 1/2 second, landed on the ball of my foot.
Just sometimes I’ll feel as if I liquid, or like everything is flopping around inside my leg all loose. These are not 24/7, nor do they come out of the blue. Just sometimes when I’m moving my foot.
For instance right now I can “feel” the inside cloth part of the cast stuck to the TOP/FRONT of my leg, not the back of my leg where the surgery was.
So in my head, the wound opened, bled a lot, and I that feeling I get is from dry blood.
I guess what I’m trying to find out, am I the only one with paranoia?
Believe me, if I felt something non-stop, I would have called the Dr. by now.
My well wishes to anyone going through this. Never had a stitch in my life, and then boom…changed all in a flash.
Sergio
*** Hey Guys! Did my Achilles playing football….
2 weeks post opp. Cast for 1 week, now back in the big black boot !!
Just wanted to know after taking out my first wedge in my boot I still can’t move my ankle 1cm it just shakes.
Is this normal ?? :/
Thanks ***
That sounds normal, kurt555. Your neurons have been hibernating for two weeks and need to restart.
Feels like yesterday even though that was months ago for me. Good luck, my friend.
Kurt555 - best not to try to move your foot just yet. Give it another week for the first lot of collagen to fill the area. Personally I would have left the wedge in as well.
Hi I’ve been reading through all these posts as ruptured my Achilles on 30th sept and had surgery 6th October. I’ve been pretty happy with my recovery so far but my boot comes off next Tuesday and when I take my boot off in the evenings my foot and ankle is still really swollen and my walking is massively restricted with the whole area right up to my calf beneath my knee feeling so so tight. Just wandering if this is normally at the boot removal stage as a little anxious I may not be ready or may have fallen behind in my recovery. Thought I’d see how other people felt coming out of the boot. Many thanks
Hi, had surgery two weeks ago. No pain at all. One slip on crutches. But Doctor checked out was fine. Here’s my problem. After two weeks of no pain I’m starting to get some real aching in the Achilles area (where it was put together). Not the twitches but real aching. Mainly at night. The other night had a wave of pain. Strange like a throb but sharp. Only lasted about one second. Next night same. Haven’t had that but a lot of aching. Is this normal after no pain.
Hi all,
I’m 3 days post-op for an ATR. I’m not sure if I’m posting in the correct place but I’m in so much pain, I don’t care.
An immense pain woke me up just now from sleeping. It felt like someone grabbed my foot and flexed it as far up as they could….hurt like a mofo, far worse then anything I’ve felt since I ruptured my achilles. I’m guessing my leg twitched in the middle of the night? Has anyone had this happen before? How can I prevent it from happening again? Thanks!
Hi, Adrian, and welcome to the club! of course I don’t think any of us wanted to rupture our Achilles or have need of an operation, but … it happened.
I am non-op, and I did wake up with pain and muscle cramps during the first few weeks. I still don’t know how a muscle you are not using can cramp, but they did!
I think I stopped taking pain killers to sleep around the month mark, but would have to check my blog to know. Yet, 2 months into the process I still have a few Acetaminophen with Codeine on my night table “just in case”.
I am not one of the fortunate ones that feel no pain, and I gather you are not either.
I, too, would wake up at 3 and after an hour of frustrating pain, go to the computer to try to distract myself until fatigue called me back to bed.
My suggestion and experience is that planning ahead does help. Find the cycle/pattern of your pain and use pain killers accordingly since they take some time to take effect. Also, find the ones that work best for you. Some pain killers did nothing for me. And, of course, call the doctor if the sharp pain pattern continues… it might mean something important.
Good luck, Adrian! Just read the blogs and be patient with yourself and everyone around you. Hopefully you will be Full Weight Bearing soon and starting Physical Therapy, which will help a whole lot.
Manny
hi folks,
quick question on recovery.
i’m a 28th Jan full rupture, non-op. have had the CAM boot for a week now and life is picking put again as i can do gentle PWB if needed (although i avoid it as much as possible) and it means i have the confidence to move and go places using my crutches without the fear of injury.
of course no-one told me, and the posts here don’t mention, that the CAM boot can get really sweaty and hot. and yeah, as unpleasant as it is, i have had a bit of a smelly foot! (now it is under control as i removed boot, washed, washed boot, and become more aware of how often i need to change socks).
question (after such long winded context, sorry), what in your experiences counts as gentle handling of your affected foot (remember i’m non-op)?
in my case i am happy to put on/off boot to get dressed, wash foot in bucket (shower and bath are still ruled out as i can’t risk re-injury), lie in bed with free foot raised up high and all those little things. of course there will be some handling for putting sock on/off, and flexion of all sorts of muscles/tendons down there to get foot through trousers.
is this too much movement? (remember i never put weight on foot)
thanks for your personal experiences in advance.
ps. my pain is reducing every day, i haven’t had a sleepless night in 3 nights (hope i haven’t jinxed it) and the ‘burning’ sensation that had woken me up were sore spots on my foot (due to moisture and lack of air exposure)
Pozalcer, I’m also non operative, and I had my foot in a cast for two weeks before getting the boot and going Partial Weight Bearing (as much as I could take, which quickly became full weight bearing for short and then longer spurts.
The stinky book and stinky foot issue is real, and that is why many of us have posted that we LOVE TALCUM POWDER. I use a medicated powder on my feet, and it has kept the odor under control, since the sales rep for my boot told me it is not really washable - in spite of the official advertising.
I will wash it later this week, once I’m officially in two shoes, and it won’t matter if some velcros fall off. 
As for taking off the boot, I did not do so since I am overweight and was terrified of injuring myself when waking or even (gasp!) sleep walking (haven’t done it in ages, but I wasn’t going to risk it). I’ve been very conservative, only taking off the boot to shower and for physical therapy until week 8, when I gratefully started sleeping without the boot (the doctor had OKd sleeping without it when I got the boot, but I didn’t dare risk it). Mind you, I fell twice with the crutches, and have had all sorts of weird body aches and pains, but I’m so much better!
Good luck and feel free to ask more questions!
Manny
Manny, thanks again for saving the day, this is why websites like this a life savers!
i have kept the odour under control by using tea tree oil, washing boot with cleaning wipes, washing foot and sock every other day and keeping the boot over radiator for 20 minutes or so twice a day to dry moisture. never thought of talcum powder, will stop at chemist on way home tomorrow.
the more i read the more i learn that the biggest impediment to PWB and FWB is one’s fear of injury. although i’m still taking it easy with PWB i notice i can ‘touch walk’ around kitchen for fetching things or doing dishes, which is amazing!
i haven’t the luxury of a shower or a bath yet, as i can’t manoeuvre into the shower (over a bath) safely without getting the boot wet… and yeah, i agree, it is not washable!
i’m not confident to sleep without the boot yet, but i have spent those moments when i dry the boot with a happy foot in the air and it is blissful!
so far only one fall and luckily had a door entrance to hold onto, as it was with the cast!
thanks again Manny and keep up the great work you are doing, inspirational
suerte
update, got myself some medicated talcum powder and picking it up tomorrow. still don’t understand the difference between regular hypoallergenic baby talcum powder and the medicated kind… but i got the right one!
phoned doctor today to ensure protocol is going according to plan and i have been given a slightly change of plans, rather than 2 wedges off every two weeks i’m to take one off per week… annoying but fair enough, suppose that given all the different protocols and experiences this is gentler on the AT than the full 2 wedges.
so i’ve taken one off and i can feel the AT right now, not painful, not sore, just aware of it, i suppose is the gentle elongation after almost 22 days of being immobile after a full rupture (next wedge of on tuesday, and then one a week till no wedges by the 8th of March). i’m non-op and have decided to go for the aggressive recovery protocol.
have decided to not do any PWB for the rest of the day till the tendon settles, tomorrow i’ll do PWB if needed but will tried to avoid it as much as possible.
thanks everyone for keeping the spirits up!
Great going, pozaicer! I’m glad you are going on an aggressive protocol… I never went down to no wedges in the boot, probably due to my overweight condition… the doctor has me in heels to protect my achilles tendon from stretching too much and leaving me with a limp. I’ll go with that, and besides: I just grew 2″
As for the medicated powder, some have Borax, others have some deodorant… check out the ingredients: they are meant to refresh your foot and keep it dry and odor free.
Good luck!…….. Manny
Hi Posaicer, some people recommend taking the wedge out before going to bed, then your tendon stretches out while you sleep and it’s less tender to walk on the next morning. Definitely rest it from WB if it’s tired, achy or uncomfortable but for non-op remember that WB is important for a good recovery, so if it’s feeling good then don’t be afraid to WB as much as you can (in the boot). Good luck and happy healing.
thanks Manny, i bought a generic medicated TP. it’s got some slight fragrance and deodorant ingredients. so far so good, between that and the tea tree oil it’s all good
(found Borax and the like were four times more expensive!).
Beanie, very kind of you to share with me. i have been aware of my ‘ankle/calf’ since i took the one wedge off. is that normal? no pain, no swelling, nothing uncomfortable, just aware of it (i suppose is the fact that it is gradually being moved by the lack of the wedge). I have indeed done as much as WB (without trying a walking motion) as required, for example moving about kitchen, in public transport for sitting or alighting. will keep the PWB and up it in the next week and will do full WB as of next tuesday onwards.
both, travelling to europe in two weeks time, going to be interesting going through airports with crutches and a CAM boot. quick question, how do you people keep the boot dry if it’s raining? so far i haven’t needed to do so as i’m happy to get it a bit wet and then dry over radiator as soon as i’m at destination, but this won’t be sustainable… my innovative brain thinks that a plastic bag over the air-wrap before assembling the boot will keep the ‘inner’ parts dry and then it’s only the hard cast parts wet… ideas?
thanks in advance
suerte
Pozaicer, I’m glad the talcum powder idea is helping. And I share your high opinion of Beanie and her advice!
As for keeping the boot dry, I actually use a plastic shopping bag over the boot and held with a large rubber band as well as the boot’s top velcro strap, since I didn’t want to get it wet at all (to avoid bad smells). I did this with pouring rain and snow… the bag is slippery, but FWB, I just used my trusty cane. In my case, the boot was almost 2 inches above the ground, so any water that came in had to come in from the top… the plastic bag covered the top, and the bag could rip under the boot with no problem for me.
Finally, about your calf and recovering strength, my doctor said the same you said: that being nonoperative I would not recover full strength… Buena suerte! and just look forward!
Manny
all, i’m still posting here instead of setting up a blog, sorry! maybe i should just do it!
wee update, had a and impromptu physio assessment this evening, wow! i’m over the moon!
i’ve been waiting on this appointment since monday and finally i got a slot for a chat.
PT spent about 30 minutes checking my whole body symmetry and poking and pulling things. unlike the consultants i’ve seen so far, this wasn’t painful as PT understood there are limits and no need to cause pain (something to say about poking doctors who enjoy giving pain!)
PT said that the progress is very positive and that at 24 days it is quite remarkable that i’m moving about without issues and that the tendon is looking better than it should at this stage (as in it is dropping to where it should be rather than being up in the calf area).
As i can’t still bear any weight on the affected foot PT couldn’t check symmetry properly, but educated guess suggests that the ATR was influenced by my shallow foot arches (as this seems to send the impact from sports straight to the tendon rather than spreading it throughout the body).
I was worried about my calf muscle loss, and PT said that what i should really worry about is ‘ass loss’!!! this is due to the use of crutches as the ‘brain-to-as- memory connection’ quickly deteriorates and makes the affected foot side of the gluteus work less and hence drop….
this is the PT advice, i don’t know how much of it is the case, but i did trust the general advice and check-up.
i’ve been sent home with a couple of exercises to strengthen the gluteus, a full core muscle routine (at my request), a ‘green light’ for doing more and more often ROM exercises without weight bearing (as set in http://achillesblog.com/files/2008/03/exercise_at_home.pdf) and within limits, the limit being if you feel discomfort or pain stop; and a big smile.
to date i’ve been PWB but i’ve avoided ‘doing’ the walking motion whilst using crutches. i’ve been strongly encouraged to do the walking motion whilst PWB as fully relying on crutches has negative consequences for the rest of the body (i have a tense lumbar area, tense shoulders, tense calf and tendon on the good leg, etc), as well as suggested to do regular moving about indoors with the boot only (without the crutches) to give the stressed zones a rest.
i go back to the consultant on 8 of March and i can’t weight to be PWB without the boot so i can star the swimming! (i can’t do this yet as there is a large risk of slipping, falling, in the wet area without the boot and i don’t want to get the boot destroyed by getting it wet in the shower/changing rooms).
anyhow, any thoughts/similar experiences welcomed
suerte
Nice Pozaicer, it sounds like you are doing great!
The boot will protect your tendon from too much force and will keep the healing ends close together, so don’t be worried to walk around as much as you can as long as it’s not painful - this will not only give your other body parts a break, it will also help your tendon to heal stronger.
Do you have an EvenUp or have you organised a way to get your good foot to be the same height as the booted foot? If not then I highly recommend getting an EvenUp. You can buy them online for about $30 in most countries. You will save your back and hips and overall alignment if you can keep your legs the same height while you walk around in the boot. It’s also much easier to walk in the boot when both legs are the same height.
All the best Carlos and happy healing!
thanks Beanie. luckily it’s a harsh-ish winter here in Scotland and i can wear my mountain boots without looking more stupid than just with the boot
this has me almost even. i’m not FWB till next tuesday, as per protocol, but my physio suggested that i start PWB with the walking motion to give my body a rest. so indeed, you are the wise one!
i’ll get to EvenUp-like improvements as of the 8th of march once i see the consultant.
my new discovery is that i have flat arches, and not known it after a few decades of having them, and the physio reckons this is what caused the rupture after all these years of ‘abuse’ since i was heavily into basketball, running, squash, rowing, etc….
thanks for the encouragement and you keep to your limits in that mammoth competition you are taking part in!
suerte
thanks Manny, aye, correct, p or c does it fine
you are just about as heavy as i am from what i read elsewhere, i thought i was on the light frame for my height (6 feet)
glad to read another crazy dancer, on standby of course. my thing is salsa and i’ve done a bit of hobbling around but i wouldn’t call that enjoyment! very pleased to hear that once i get to the FWB i’ll be able to make myself even fooler
i’m staying in the boot, quite happily, till the 8th and the consultant appointment, but in the meantime i will enjoy the little things in life
suerte
hi all, an embarrassing self-revelation.
is this what first toe curls look like?
https://www.dropbox.com/sc/s2zq2hef2ft64cl/AABk2y3XTu8cX2jknmtkOdusa
no laughing please!
lol looking good pozaicer. I’m not up to them yet now but when I was doing them pre-op I found it was more rewarding to have my toes of the other foot finish pulling the towel under my heel. Then I could honestly say I reached the end.
hey folks, wee update. i managed to go to europe and back without much trouble. couple of things, it is bloody hard to live on a foreign 4th floor flat without a lift, some countries do not care about people with crutches…, using special assistance at the airport is ace, you quickly underestimate the proportional and positive relationship between physical effort and rest (if you do more of the former you need to do more of the later, i did a lot of walking and little rest, the foot was tender…), it is hard to remember that you cannot buy ‘extra’ stuff as there is no way of carrying it!
my appointment with consultant got moved forward by one week to the 15th of march, so they can asses me with no wedges in the boot. the foot feels much nicer and looking good, the tendon is almost where it should be (non-op, almost week 6). physio starts this wednesday so they can massage out all the crooked health from using the crutches and hopefully next week i can start more complex physio for foot (so far it’s only ROM).
great to see all others’ progress. my towel toe curling is almost perfect
suerte
another update folks, i’ve managed to walk out of the house without the crutches (still in a boot), had to return for them as the pavements over here are too dangerous (mainly risk of a fall or a twisted knee).
it just felt amazing to realise that me and the boot are now one, alas, i come out of the damned thing in two weeks!
suerte
Pozaicer, congratulations on walking out of the house with only the boot… we have a wonderful love/hate relationship with the boot, and with some Physical Therapy you will soon be handling the crazy pavement easily. I still use a cane (properly adjusted for real support) when I know I’m going to walk in an area where I could fall, and did that all the time when I had the boot.
The cane is a lot better than crutches, and if you don’t mind an “ugly” metallic cane, in the US they can be purchased for under 20 dollars.
I am planning to fly in the next few weeks and am actually considering going in my boot… it might be safer and easier for dealing with the airport’s hustle and bustle… but its also more uncomfortable…. We’ll see.
So, now try to get out of the house and practice walking with the boot so you gather strength for going onto 2 shoes. It really helps, even if you do have to learn to walk all over again.
Happy Healing! Suerte, hermano!……… Manny
Manny, muchas gracias por el mensaje pana.
i will consider the cane advice, definitely better than crutches but less ‘visible’. so i have to weight up my options, once i come out of the boot i’ll be most vulnerable in public transport so i may stick to one crutch to ’signal’ to all people i’m not ‘normal’…. sad world…
i would definitely keep the boot for an airport, i had a ‘great’ time jumping queues and being ‘assisted’ by staff through security and priority boarding lanes, definitely worth it
i’m upping my walking game, i now get a tired heel on the boot side (no pain, just full awareness of it and tiredness), most bizarre, and definitely follows the pattern that all of you more seasoned boot ex-wearers mention.
suerte
hi all, just thought that the time was right for sharing my joy and pain with you.
i’m 8 weeks from ATR on tuesday 22 of march, FWB in a boot, will come out of the boot at 10 weeks (as consultant recommended extra recovery, less aggressive protocol).
for my appointment this week i got ready and bought an exercise ball and some resistance bands (around £15 delivered) as these allow you to do more versatile ROM whilst at home. thoroughly recommend the ball, as it allows a lot of ROM exercises without the risk of over using tendon in the wrong way’
anyhow, this is to share a photo of the calves. the state of my injured leg happened within 10 days, tis terrifying to know that use it or loose it seems to hold true for some muscles!
https://www.dropbox.com/sc/2lc3ie2up1s3f7x/AADB_CGgNQWysEdWih5huZIza
suerte
Hi, Pozaicer!
Nice Pics
Nice Bands
Nice Gams ….. LOL
I’m glad all is going well for you!
Manny
gracias Manny, feel free to print the photo of the gams, free of charge
quick post to the fellow ATR people, summer and I are off to the doctors today and we both may come back with no boot! exciting and terrifying stuff at the same time. Summer has been dutiful and stayed put whereas i have been out of the boot at my own orders for short periods of time (about 20 steps at the time, about 3 or 4 times a day) in a safe environment for the last 5 days. I’ve done this to ensure that when the doctor puts me into the shoes i don’t walk like a new born calf.
yesterday i put on my trainers rather than going barefoot for these baby steps and i had a barrage of traumatic memories since i hadn’t realised those were ‘the’ trainers where the ATR happened, i’m actually going to put them to the charity shop and get a new pair (oh my mizuno’s!)
anyhow, will update after the doctor’s!
suerte
bye bye you filthy, yet helpful, animal!
so this morning got to my appointment and the doctor happily announced that the boot was to be a thing of the past.
i asked too many questions, with the exception of the ‘can i drive?’. Doctor said that i can literally resume my life with the proviso that i don’t do any sports, try to run or walk fast; so i’ll assume that i can drive
in a few days or so (as i don’t feel confident enough yet). i was given the option to continue using crutches and to take the boot (as it is going in the bin for health and safety reasons), so i rejected the crutches and kept the boot as a reminder of my dark past.
6.5 hours after the appointment i have walked about 1.5 miles (meetings and getting back from hospital) and i am feeling alive again. there is definitely no power whatsoever in the affected leg, and there is a little limp (but i should expect much on the first few hours of walking i suppose). i have heel lifts for the affected leg, which Dr called ‘a belief that has no scientific evidence, so in the meantime we’ll believe they work and put them on’, and there is no need to even up for me.
Manny, i don’t know if i was brave or stupid, but the Dr said it was fine to walk barefoot at this stage. he basically said that i need to continue till week 12 and then till 12 months and wait to be in the 2.7% or the 97.3% group as there is nothing one can do. i suppose i loathe his wisdom…. i have been referred to PT and in the meantime i will hit the pool this afternoon followed by a sauna, i think that at 9 weeks i deserve it!, followed by the rehab protocols suggested by many around here.
anyhow, to continue with my self-embarrassment to the tribe here are some mementos of the glorious morning
https://www.dropbox.com/sc/t2f5a6r2xn1aiq3/AADW3P_QMjRdZr2B5iWJwcH1a
summer, how did you do?
suerte
3.5 weeks post surgery and I’m still in no weight bearing mode. My knee scooter is an acceptable method of getting around and doesn’t bother me too much, but the agony of not being able to go anywhere by myself is really sinking in. I’m enjoying all the extra time around my family - my wife is a school librarian (thank God for that job right now, otherwise I’d be on my own a lot more) and my daughters are 3 mos and 3 years so I am surrounded by people who love me. It’s still tough sitting in one place a lot of the time though.
I had a splint and “soft cast” the first two weeks but since sutures came out I’ve been in an Aircast boot. It’s not bad, aside from the smell. I am glad to be able to take it off and wash my foot each day, but I keep it on because the stackable wedges are stretching my tendon and I can feel the progress each week. Only a few more weeks to go before I start PT and I love reading about everyone’s experiences with that. I’m going to go to every session and give them everything I’ve got. I want to go back to running again. I want to stay active. This is the least active I’ve been ever! All the best to everyone ahead of and behind me in this process.
Hi guys, this site really helped me go through all the “event” so I will briefly share the highlights which really scared me, and now see them as normal. This might help/calm, some of you guys:
- I ruptured my right tendon while playing football (soccer). I jumped for a header and as I landed i heard a crack, felt a rock hitting my foot and just fell. There was no pain.
- 2 days later I was scheduled for surgery (my decision) and had an external fixator “installed” to avoid the cast/boot ( this went through my heel and lower calf mustle) My doctor is old-school (I live in Romania) and got me into this. Surgery was excellent and there were no complications.
- 5.5 weeks I stayed at home. I used crutches and every 2 days I would have my bandages cleaned (entry points). I would sometimes go out for a beer (I was lucky enough to have a bar near my house). Highlight 1 - During week 1 I woke up to go to the bathroom and before I could reach the lights I stepped on my foot - terrible pain and I was afraid that I had reruptured - nothing had happened. Highlight 2 - I had a very bad rash caused by Iodine (my wife would clean the fixator entry points) which kept me on antibiotics for 2 weeks and really scared me, since the doctor was not sure what it was. In the end, just a rash.
- After the 5 weeks I had a boot for an additional 1.5 weeks. Once I got the fixator off I had expected to be recovered, but I could bearly touch the ground. I 1.5 weeks I could walk without the boot, slowly and with a limp.
- I started recovery after 7.5 weeks from surgery - 3 times a week. Did not progress very well.
- I restarted recovery @ a sport clinic and really imporved in 15 sessions. Massage (very painful) was great.
- I am still not 100% recovered, but can run and do anything. I have problems when I sit/sleep long and suddenty have to start moving.
- I feel that in 1 months (more or less 6 months from event) I will be 95% recovered.
Work on your recovery, do not panic, read, play PS4/Games, be patient and remember to appreciate the people helping you out through these times.
If anybody needs pics or something just let me know!
Have a speedy recovery!
Edi
-
Hey everyone,
I feeling super depressed right now! I’m 30 days into a non-op treatment for a 3cm ATR. I’m still getting no response from the Thompson test and the area where my rupture was still feels soft like jelly. What have other non-op peoples experiences been at this stage. Should I feel some tendon regrowth at this stage? Should I be getting a response from the Thompson test? I’m a wreck about this and can’t freakin sleep. I’m a very active 39yr old male and my livelihood depends on this outcome. Another frustrating issue is I live in the middle of nowhere New Mexico and the next closest doc is 4 hour drive. So the thought of getting it looked at by another doc is not really welcome.
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