My Achilles Tendon Injury

Hi all, and thank you to everyone who has provided information and support on this site. Below is my Achilles story to date :

The Injury (29/04/2013)

I ruptured my left Achilles tendon on the 29th April 2013 while playing 5-a-side football (soccer) in South Wales. As I went to push off and change direction I felt like someone had kicked me in the back of my left leg. There was another player in my immediate vicinity so I presumed this was the case but when I turned around in agony, clutching at my leg, they were too far away to have been the culprit! Having heard family and friends tales of Achilles ruptures I was fairly convinced straight away that I had done the same.

I experienced searing, intense pain for about 30 seconds as a combination of hobbling and crawling managed to get me off the pitch. Soon after though the agony subsided and I was left with just a numbness throughout my lower leg and foot. In that respect I consider myself fortunate having read numerous accounts on this site detailing intense pain over a much longer period following a rupture.

The Emergency Room (29/04/2013)

I was able to get to my local A & E around an hour after my injury where I was diagnosed using The Thompson’s Test as having a full Achilles Tendon rupture. The Doctor I saw told me I would undergo conservative treatment in a cast for 6-8 weeks with my toes pointing down. I enquired about the possibility of a air cast/boot instead as I have previously suffered with cast claustrophobia but was told this was not an option. I also asked if a scan would be done before casting but was told this was not necessary as would only show what they already knew (i.e./full rupture). My follow up appointment at the fracture clinic was scheduled for around 10 days time.

Follow Up Appointment (08/05/2013)

I was unsure what was going to be done at this appointment as in the emergency room I was told the cast would be on for 6-8 weeks. The Doctor I dealt with was not the same as the one who had diagnosed me the night of my injury and he requested the plaster room staff remove my cast so he could examine the injury himself. He also indicated that an ultrasound scan would be done to reveal the extent of the injury and subsequent healing that had started to take place.

At the time I presumed this would be done the same day while my cast was off however the Doctor only repeated the Thompson’s Test and physically examined my injury. He told me he felt there were still some strands holding the ends of the tendon together and after deciding to proceed with the conservative treatment wished to see me again two weeks later with a view to possibly removing the cast and replacing it with a boot with raised inserts (subject to results of scan I was awaiting).

In the meantime I was told that an appointment would be made ASAP for an ultrasound and I would be contacted within a few days about this.No scans were completed on the day which I found slightly strange but left the appointment with a much more positive outlook than I had arrived in with a view that I may be able to get rid of the dreaded cast in just two weeks time! I was again in a lower leg, below knee cast with my toes pointing down when I left. I was also given Fragmin blood thinning injections to administer myself daily for the full time I was in the hard cast to prevent blood clots forming.

Next hospital visit (15/05/2013)

Over the next week I suffered with the back of my foot rubbing against the lining of the cast. It was very uncomfortable and so I decided to call the hospital who asked me to go down to have the cast checked over by the staff. While there I also enquired the situation with the ultrasound appointment which I was still yet to hear about. The Doctor had recorded I needed a scan but had marked mine as non-urgent which meant it could have been 16-18 weeks! I couldn’t get my head around the timescales given to me and was horrified at the thought of 4-5 months in plaster, waiting for a scan. While at the hospital this was changed to an urgent request which would be completed within the next 2 weeks.

Before taking my cast off the nurses went to check with my consultant that it was ok to remove it. He agreed and phoned the ultrasound department to see if there was any way I could be squeezed in straight away for a scan while my cast was off. Fortunately, they did so I was wheeled off to have the scan done. Having my foot out of plaster was unpleasant but when the scan itself was completed and my foot was manipulated around the pain was excruciating. While doing the scan the Doctor told me I had completely ruptured my achilles and there was no attachment between the two separations.

I was taken back to the fracture clinic where I dealt with another Doctor who I had not yet met. He went through the report from the scan with me and suggested the best way forward was to operate on my tendon. There was still a gap of 1.6cm between the ends of the tendon and I was told that while healing would take place naturally if the ends of the achilles were stitched back together the likelihood of a better recovery would be increased.

Given that a few hours earlier I had only gone to the hospital to have my cast checked over the prospect of staying in overnight to undergo surgery was a bit of a shock to say the least! While it was obviously frustrating that I had spent over 2 weeks in a cast only to start over it could have been further time wasted had I not managed to get my scan done that afternoon.

Operation Day (18/05/2013)

After a couple of delays where I didn’t make the urgent operating lists my surgery was completed on Saturday 18th May. I was slightly anxious as I had never had an operation before, this probably wasn’t helped by the delayed stay in hospital. On the morning of my operation the anaesthetist came to the ward to ask questions regarding any allergies etc and generally to reassure me that there was nothing to worry about. I was taken down to theatre shortly after and put under general anaesthetic for the operation.

I don’t remember much about the coming round in recovery but apparently the surgeon came round to speak to me about what my recovery program would entail. Given no one told me what would happen post op before I had surgery this didn’t seem the best time to be explaining it all to me! Hence I didn’t really find out how the operation had gone or what my position would be over the coming weeks until my follow up appointment a few days later. I left hospital the following day with a back slab cast on and a bag full of tramadol!

Follow up Appointment (22/05/2013)

Before I left hospital doctors suggested a routine follow up appointment for one weeks time but it ended up being only 4 days post op when I re-visited the fracture clinic. The pain was manageable with tramadol and I only took these for around 5 or 6 days post op. Since then i’ve been more or less pain free.

I saw the doctor who told me surgery was necessary previously who explained that was tendon was frayed at the ends when it had been stitched back together and all in all was in quite bad shape. The surgeon wants me in a cast (again toes pointed down) for 6 weeks before then moving onto a protective boot with heel raises. These will week on week be removed to bring my foot into a neutral position. My stitches were checked but not removed as some others on the site have mentioned (presumably dissolvable?). There was no sign of any infection and I was told the wound had healed well so didn’t need to be re-checked again.

As the Doctor was aware of the issues I have had with casts previously I am due to re-visit the clinic four and a half weeks post op (19th June 2013) to evaluate my progress and hopefully I can get out of the cast and into the boot then. Fingers crossed!

I’m still having issues with my toes turning purple quite quickly when I am moving around on my crutches, something I was hoping would have started to subside by now given I am over 3 weeks post op. Because of this it’s been a long 6 weeks of boxsets and daytime TV but at least I can’t slip or do any further damage to myself lying on the sofa with my leg elevated.

While it’s obviously hard to tell in a cast are there ant positive signs of recovery I could be looking out for or any signs of concern to keep an eye out for?¬†When the cast is replaced with a boot what is the usual procedure regarding weight bearing, driving etc once you get to this point?

On the off chance that anyone has managed to read all the way to this point of my first ever blog thank you very much for reading and I wish you all the best in your recovery.

Hang in there and happy healing!