RUPTURE DAY: Ignorance is bliss… (Jun 8th, 2016)
June 8, 2016 by agnesatr
Wednesday, June 8th, 2015 - it was my last day of blissful ignorance about achilles tendon rupture (ATR)….
MY EMERGENCY ROOM CAST
MY EMERGENCY ROOM CAST - AFTER REMOVAL
I am in the middle of house construction projects and that day I was painting our laundry room. I knew I had to work fast, because I had pickleball meetup in the evening. Not a biggie. I primed and painted the room, including acrobatic acts of doing so behind the water heater and furnace. I cleaned up in time for our pickleball.
It was my second time playing pickleball and my hubby and I just got new paddles, so it was exciting. For those that never heard of pickleball, it is a fast growing sport that is a combination of tennis, badminton and table tennis. It does not require as much running as tennis, but it is still very fast and requires sudden movements and quick changes of direction. So even though I was not running much, there was a lot of pushing off happening, just like in tennis. I never gave it a second thought while playing, however. I have played a lot of tennis and racquetball, so pickleball was no different. That is until I was either receiving a serve, or serving (cannot even remember now) and pushed off my right foot. It was not even anything very quick, or dynamic.
I suddenly heard this loud pop and felt as if someone hit me with a bat on the back of my lower right calf. I collapsed on the court and was in a really bad pain. I was really confused with what happened and was waiting in agony for the pain to stop. The sharp pain stopped a little bit after couple of minutes, but I had this weird numb feeling in my foot that I never felt before. I could not walk as my foot felt like jello. My playing teammates helped me hop off the court and later to the car.
My hubby drove me straight to the emergency room, where the doctor performed Thompson test, which is basically squeezing of the calf muscles and observing if the foot moves. Well, my injured foot was not moving, which I was told, is consistent with achilles tendon rupture. I was referred to orthopedic surgeon and informed that I probably need a surgery. My leg was placed in a half cast (hardened cast in the back of my foot and bandaged to my leg for stability). I was given Hydrocodone pill and prescriptions for crutches and more drugs. I was told to see the surgeon in the next 5-7 days. In the meantime I was ordered to place no weight on the injured foot.
I was in a little bit of a shock, but I hanged on to the word “PROBABLY” in: “you will probably need a surgery” and decided to worry about it when I get to the surgeon. For the moment I just wanted my crutches and bed! We went to 24hr pharmacy and my hubby got my drugs and crutches. While waiting in the car I found out that there is this crutch that looks like a leg and your life would not be so bad with it. That made me more relaxed to see that I am not doomed to be stuck in bed. Yep, that was the first thing that I was worried about after my injury. Being very active, bed rest for few weeks sounded like a death sentence at that moment.
I went to sleep having no idea about what my next year would be like….
Oh jeez…agnes I would like to get a blog on your home projects. This is know u will recover..kidding..remember no weight bearing
The first non weight-bearing (NWB) weeks are definitely the worst of it, especially the first 2 weeks post-surgery while your leg is in a splint. Bathing and getting around are not fun. But try to stay positive, and take it in 2 week increments. Week 6 you should be back on your feet in an Aircast.
I ruptured back on January 28, surgery 2/2. A few things I’ve learned in retrospect:
Move as little as possible the first two weeks while you’re in-splint. High re-rupture risk here.
Crutches are awful but necessary on stairs. Get yourself an iWalk (as you alluded to in your post) or a knee scooter. They make life way easier.
Once you’re in the Aircast, start doing range of motion/movement in bed. Earlier range is better. Earlier use of bands is better (your surgeon will provide you with a set for exercise).
PWB and FWB (being on your feet) will come soon enough. Once you’re there and start actual PT, time flies.
Stay positive. I’m 5 months post-op now, and while I have big deficits compared to my uninjured leg, I have come a long way and am on the path to a full recovery.
It takes focus and determination. You can’t get complacent with PT. If you do everything right, you will be back to normal in a year.
You’re an active individual, so I see no reason you wouldn’t be. I see you ruptured on the 8th, but it’s the 22nd. Did you actually get surgery?
Good luck.
haha - Sukanya - I might actually have time to compile one now.
No wight it is until Dr says otherwise.
mibball - Thank you for all the tips. Taking it 2 weeks at the time definitely sounds good!
I chose non-op treatment. I will post today my decision making week notes. It was a week I do not want to go through again… But, I feel like I did an educated decision.
I did get iwalk2.0 and I surely love it!!!
Looks like your recovery is going well! I hear that the deficit in the injured leg is totally normal for quite some time, but disappears with diligent exercising. Are you still doing physio at 5 months post-op?
I was asked to come in for a 5 month and 6 month check-up to my PT, but followed up with him a few days ago on the phone and said I felt fine and told him how I was progressing. He said skip the 5 month unless I wanted to come in. Last time I went was a couple weeks ago. I will probably go to the 6 month.
Otherwise, I am all on my own. Had about 6 weeks of official PT, starting out twice a week and tapering off to once a week after 3 weeks if I recall correctly. This was obviously coupled with everything I was doing on my own.
Good luck!
Agnes - please do some reading here about the benefit of early weight bearing for non-op patients. Not sure what you doc has planned for you so hoping you have a good recovery. There have been quite a few pickleball ruptures come through here and when I heard the first one I had to look it up. It must be getting popular.
Wow Agnes.. get well soon. Sounds like Abby is the real hero here.
Good job bro.
mibball - thank you. Good luck for your 6 month check up!
Stuart - I spoke to my doc about it and still trying to figure out how to do it in my boot. Is’s not the one with wedges, but the one that the bottom is in the angle. I am in the process of researching the logistics of it.
And yep, pickleball is growing really fast. It’s a fun game. It was invented in WA state, where we are at, so it is definitely more known here…
Thanks Karan - yep, hubby’s a great help! Could not do it without him!
Hi, I a 40 year old female also ruptured on June 5th 2016 and have bad results with my doc. Kicking me out for not agreeing. I’m in the USA and have terrible insurance. Yours sounds better. Are you doing early weight bearing? Are you doing pt yet. Could I get a timeline for your pt? I’m not sure if I’m supposed to have started or keep it still. Any info would be great. Thanks Lara
Outdoordoll100@gmail.com
Hi Lara, sorry to hear about your rupture and your experience so far. I hope you manage seeing another doctor, so he can lead your recovery! That is the most important as each rupture is different and might require different treatment. Did you have a surgery, or are you going non-op?
I am 3 weeks post rupture (ruptured 3 days after you) and am still NWB with a boot with toes pointing down. I am seeing my doc this week to see what the next steps will be based on my 2 weeks progress. My PT will not start for quite some time still. I am non-op, so I was told the the down pointing angle of the toes is the most important initially. Persons that have surgery start PT a little faster, I think, since their tendon in attached and non-op persons’ tendons need to grow together first.
As far as early weight bearing, I do believe, based on everything I read, it is beneficial to reduce the risk of re-rupture. I will be talking about it to my doctor this week. As I mentioned, I have been NWB for the first 3 weeks from my rupture.
AgnesATR, I did not realize the severity of your injury until I googled on what is achilles tendon. I am glad to see you have found a good doctor with an acceptable treatment plan. I wish you speedy recovery and let me know if there is anything I can help.
Thank you Hu! Yep, I had no idea about the severity of my injury until I googled it as well! haha
Thanks, I’m also non op. I’m gonna follow you and your routine since it was so close to mine. Luckily my insurance changed today and I’m on my way to somebody. Do you know are you supposed to start ROM after 2 weeks? I’m also in a boot with 4 wedges so definitely pointed down. I have been NWB so far.
Thanks for the info
Good luck in your speedy recovery
I wholly agree with Stuart on early weight bearing. I ruptured my right Achilles on 6/1. Decided to go non op and started a mostly UWO protocol on 6/6. I went two weeks non weight bearing, then started partial. As of today 7/3 I am able to fully weight bear, but am still using one crutch about half the time. The boot at 90 degree with wedges makes walking easier. Just use your heal.
opps, I meant heel. Don’t get the toes involved at all.
Oops Lara, did not see your comment here. I started ROM in week 3, after my 2 week apt. I replied to your other comment moment ago.
sloopjohnb - I wonder how are you doing with the walking and healing? I should be going PWB this week. I have been applying pressure on that leg for the last couple of weeks and doing lots of ROM exercises. Curious about your progress!
I’m at six and a half week since injury and week six today of non op treatment. Big day today. I walked without the boot. I am so ready to boot the boot. I’ll be transitioning out of it over the next two weeks. I’ve been working on plantar flexing over the past two weeks, gradually working in some resistance. I haven’t worked the dorsal much past 90 degrees. I’m going to start PT in the next week.
sloopjohnb - I would not be working the dorsi-flexion at all and not sure what the plantar work is you are doing but maybe back off that too for a little longer. There has been a bit of chatter about healing long recently so maybe follow those threads and have a re-think. You are on the early side of an agressive protocol for non-op which is not necessarily bad but it you are certainly pushing the edge. This stage of recovery is very important and will set you up for a good end result. That is what you are trying to achieve so what you perceive to be a gain in the short term could be detrimental to the end result.
sloopjohnb - Glad things are progressing well for you. Your protocol is slightly more aggressive than mine. I am glad it’s working for you and I understand the want to “boot the boot”. I like the sound of that.
I treat the boot though more as a protection for the achilles, so am alright with it and in no rush to get rid of it. I was cleared to remove boot at night next week, but I was told it will not be bad if I keep it on and I will plan on keeping it. I am still terrified of re-rupture reading so many op and non-op ppl having silly accidents and re-rupturing after doing so well.
As far as my doc (and what xplora menioned above), healing long was the biggest concern for him, hence the longer time in boot at an angle for me. My foot naturally hangs at over 40 degrees plantar flexion, so he started me at about 35 degrees and slowly moved me up to to 10 degrees now and PWB (at week 5 post rupture). How is your achilles feeling walking without the boot? What was your doc’s opinion on trying to prevent healing long? When you mention resistance - are you using bands in plantar flexion position while doing ROM? Btw, do you have a blog as well somewher?
xplora/AgnesATR, Thanks for the tips and words of caution. The plantar flexing has been about five minutes/three times a day, just pushing the toes down. Just started adding light resistance by using an ace bandage as a resistance band.
Saw Doc yesterday. He feels tendon has healed well and cleared me for PT. He focused more on re-rupture than healing long. I should also note, he had recommended surgery. My first three weeks in the boot were at 30 degrees, then every two weeks decrease by 10 degrees. As of yesterday my boot is at 90 degrees. My walking outside of the boot is more of a shuffle. No tendon pain, but I haven’t tried to stretch it. I’ll wait for PT for that. I do notice the calf muscle getting more use when I’m outside of the boot. I just started sleeping without the boot Sunday night. That was nice.
Thank you for the excellent videos. They are very informative. I am day 2 post op. And broke my wrist at the same time as the ATR. That makes crutches and exercise challenging!
Please keep the updates going they are very inspirational.
I am in South Africa and unfortunately do not have access to most of the equipment that you mention.
Glad you found the vids helpful. And so sorry for both of your injuries at the same time! Hope you will manage using one crutch or cane with the healthy hand. Btw, I just did a quick google search on iWalk in South Africa and this popped up: http://www.orthopro.co.za/iwalk/. You could call them to see if they have some places close to you where you could rent/buy it. Other than that you can improvise with the equipment: make you own showering bag, use patio plastic chair in the shower, or even make Evenup platform. I saw somewhere someone used duck tape to tape some rubber to the sole of their good leg’s shoe to make walking easier. Hey, whatever helps, right?
I hope you are managing as well as you can with one leg and arm! One day at a time!
Hi,
I got my iwalk 2.0 on Friday. It feels great. I am leaving it until day 7 post op as it puts a bit of pressure on the wound.
I also have a smart crutch for the arm with the broken wrist. It puts the weight on the forearm instead of the wrist / hand.
I am now day 6 post op. The leg feels fine with no pain. I started some simple leg and upper body exercises. Starting to feel more “normal”.
Thanks for the support.
hello robertinsouthafrica, i see you’re loving the iwalk, how heavy do you find it? I read some reviews that suggested that the 8 pounds is heavier than it sounds. Can you tell me your thoughts? Thanks
Oh, wonderful Robert. IWalk will be a great help. Smart crutch also is something I hear more and more about. That sounds like a great alternative to crutches. See if your doc clears you for stationary bike in the boot. That is a good way to get your heart rate up when nwb/pwb and get the upper legs without without engaging the injured calf. Glad it’s starting to feel more normal. I remember that feeling very well! Happy continues healing!
Mobile Geoff - I did not find iWalk heavy at all and I am rather small. I found it really easy to maneuver and did almost everything while using it. Stairs are also easy on it. Important thing is to align and adjust it according to iWalk website instructions. You can check out my review of using: https://www.youtube.com/watch?v=LbG9Dqf8bBM
I would definitely recommend it. You have 2 free hands and your life almost back.
Hi Mobile Geoff,
I have only started to use my iwalk 2.0 today. It has massive benefits over crutches. You can carry things. That is a big deal. Walking back to the table with a plate in one hand and a drink in the other is a big step forward. It is a step towards normality.
Check out the video on agnesatr’s blog and also on the iwalk free website. Follow the video’s set up instructions carefully. On day 1 my biggest issue has been steps with no hold rail. Otherwise no issues. If you are physically fit then it should be fine. I take a while to strap it on and off, which is partly due to my left wrist also been in plaster.
Thanks. Robert.
I’m at almost 6 weeks, been using the iwalk 2.0 since the 2nd week. Love it, although I have fallen 3 times.
I’m not as active as some (I’m old) but going to Costco is great, and I can even Swiffer & vac. the house.
I’m also at 6 weeks and the iwalk 2.0 has made it much more bearable. My doc told me two more weeks NWB in a boot. It seemed easier to use the iwalk in my cast but hopefully i’ll get used to it in the boot. I did have to remove the air pump on the front of my boot as the metal fittings caused a lot of shin pain no matter how much i padded it.
vplite and smittyinpa - it’s been couple of weeks since your comments. Hope you guys will be slowly stopping using iWalk 2.0. I know it was a lifesaver for me. I wish more doctors were informing patients about it. Life was just more normal with it! Glad you enjoyed it as well and hope you are progressing well. I need to catch up reading the blogs.