alysbach’s AchillesBlog

Poor Norm he is fantastic with his advice. Definately no more surgery been offered for them to remove a tendon from my big toe and use that which would render my big toes useless and no guarentees I would see an improvement no this is me for the rest of my days, limp, unable to stand on tip toes (amazing how this affects you ) cant walk on uneven ground grrrrrr If I could only have ten mins with the dr who didnt diagnose my ruptured tendon

Aly - Just caught this post. Norm is still around but has been restricted to his own page. Bit of a house arrest. You can comment on his page and he will respond. Regarding cramps I know he would say Potassium supplements and I would say Magnesium. Been there before with this issue. Both are good. Magnesium aids the electrical stimuli in the muscles. Having a good salt balance is important for avoiding cramps. I use pink salt only now but I don’t believe it has Mg so I take a supplement when required. Sorry to hear all your troubles are still going on. Are you thinking of surgery to correct the tendon length? Not sure if you would want to go through it all again. Hope all else is well with you.

Hang in there. You’ll get through this.

Patti, there’s a page here — look around the Main Page — with suggestions for things that can help at home, including in the bathroom. A waterproof seat in the shower is one, and I loved having a padded stool — for kneeling — in front of the sink. And another one (or a wheeled chair for sitting, kneeling, and scooting) in the kitchen. Standing on one foot is fun for a few seconds, gets old fast!

Any suggestions on making bathroom Use a little easier

Pity about the shoulder. Good luck and good healing with it!

And I hope you can improve the lives of lots and lots of future ATR patients!

I missed your last post, I sorry you had this experience, but glad that that your doctors finally “listen” and examined the evidence. If you don’t mind me asking, What is your treatment path now (for your leg? Good luck.

I have decided against another op as there are no guarentees that it will improve and the swelling is there to stay, however, after me saying elbow crutches were better than under shoulder ones I am having to have surgery on a tear in a tendon in my shoulder from using elbow crutches (6 months in total) these have caused the damage in my shoulder the pain is unbearable, however there is a six month waiting list for this so I am hoping to get in on a cancellation.

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Thank Heaven for small favors, eh? You haven’t updated us for a long time on how you’re dealing with your deformed leg. Are you contemplating going for another re-op to try to fix it up?

I’m dealing with the exact same issue. A emergency room doctor diagnosed my injury as a severely sprained ankle when in fact it was a rupture of the Achilles’ tendon .I was able to walk on it and even teach classes for 2 months before finally having surgery two weeks ago! Best wishes to you and I hope you have a speedy recovery.

there should be a video of kobe bryant shooting freethrows with his ruptured somewhere

I ran a half marathon with a partial torn one and walked on it for another 5 months.
My Ortho told me had he know I would not have been allowed.

I’ve got nothing but more anecdotes, alysbach, sorry — and one “hearsay” opinion from a fancy sports-medicine surgeon whose name I no long remember!! Not much to take to court, or to a similar tribunal.

FWIW: I walked around (and drove a shift car!) for the 8 days between my ATR #1 and my surgery. Like the others, it wasn’t a pretty walk, but I got around. Most of the time I splayed my toes out to the side, and I CERTAINLY did that when climbing stairs, so I could get my entire injured foot on the step.

The hearsay opinion was from a surgeon at the U. of Toronto Sports Medicine Clinic who referred me to surgery. I’d had an UltraSound exam by then, and after I told him how I was climbing stairs, he told me that if I’d seen him initially, he would have skipped the UltraSound, because he thinks that method of walking up stairs is reliably diagnostic of a complete ATR.

But ALL of this only makes sense after everybody agrees and admits that patients with complete ATRs can WALK!!

Some people say that the first principle of Physics — and maybe even of Science — is “If it exists, it must be possible”. ATR walking clearly exis

I walked on a ruptured ATR for 4 months albeit flat foot and with a horrible limp. (I don’t think it was fully ruptured until month 3, but that’s a whole other story) IT got worse as time went on. I’m sorry to hear of your troubles.

I had issue with my worker’s comp insurance approving the consult with the foot and Ankle specialist for 5 weeks and I finally called and ask them “Are you going to approve me appointment with the specialist, I need an answer so I can decided on whether I need to speak with my attorney about this matter”. They set up the appointment 2 days later and I got my surgery.

Good Luck

Not to outdo Stuart because he is one of my favorite people, but I walked on mine for 2 weeks. It wasn’t a good walk, but I was walking and driving.

The nurse did say at my first visit, well if you did rupture you wouldn’t be able to walk on it, the doctor walked in, and eye balled it.

Good luck!

As Nicky said. I walked into the hospital flat footed. When the ortho nurse called me in first thing she said was Achilles tendon as she watched me walk to the door. I then walked on it for 3 days waiting for surgery. They didn’t even give me crutches.

I’m sure you just need to check an orthopaedic text book as it is clear cut that you can walk with a rupture. If you go to patient.co.uk (very good web site) and look up symptoms of achilles rupture it says
“A flat-footed type of walk. You can walk and bear weight, but cannot push off the ground properly on the side where the tendon is ruptured.”
Hopefully they will just apologise, good luck

I have been via the complaints that is why I am having a meeting with the head of A and E as they have said the fact I could walk was used to decide that my tendon was NOT ruptured completley even though 9 weeks later I walked in to surgery. I just wandered if there was any research I could download to produce

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You can walk with a complete rupture. You are an example and if you read enough blogs here you will find people who had delayed diagnoses who were walking with a limp.
I think you have other flexor muscles like the big toe one I think that can partially compensate for the loss. A good foot and ankle physiotherapist will give you the details. Your orthopaedic surgeon should know.
Why are you meeting with A and E? You should not be having to prove this? Have you written to the complaints department?

I am one of the people who gained more strength after 21 weeks and although I could do a double calf raise at that point, I found if I transferred all my weight to the ATR leg, then I was unable to hold my bodyweight on it.

Today I can single calf raise on my ATR leg, I have healed long though because try as I might, I can only raise about 3/4 of the way I can on the other leg….point is, it’s not so long to be a concern for anything else.

I agree with Norm because if I had to have another surgery I’d want it ASAP, but also knowing that at 21wks it may be too early to say if where I am today is as good as it gets?

Good luck with your decisions and happy healing.

P.S. I too still can’t go on tip toes on bad leg and have a limp. Thompson test still positive and Matles test positive too.

Hi - saw you at hospital the other day. We share same physio!! I have also been told by same consultant that I have healed long, but I am 19 weeks post partial tear with treatment by cast. Consultant reckons though that my partial tear may have become a full tear. I am presenting with symptoms of a chronic tear. I have recently had an ultrasound scan which showed tendon intact at junction with heel, but further up at the junction of muscle and tendon there is an area 8cm in length which is abnormal. Consultant now wants me to have mri scan which there is 8 week waiting time for. He has told me he wants a second opinion too as he does not know if shortening will be worth it???

I’m a month behind you and can’t stand on tip toes on my ATR leg without assistance. If that is the only reason he thinks you’ve healed long, then I would possibly seek a second opinion 1st before making any decisions concerning a second surgery. I wish you the best and good luck!

He may have been right BOTH times, that you’ve healed long AND that it’s especially your AT’s connection to ONE muscle that’s long. I think my second ATR gave me a normal-length connection to my soleus muscle, but a long connection to my gastroc muscle. (I think some sources call them two different calf muscles, some call them two “heads” of the same muscle.)

This is one of those pure personal decisions, based on your own needs, wants, feelings, values, etc. Depending on how much your “clinical deficit” ruins your life, compared to going through another ATR surgery, with no guarantees of 100% success there either.

A coupla quick responses:
(1) 21 weeks post-op is still early times. Lots of ATR patients — I’d say the vast majority — experience very significant strength improvements after 21 weeks. OTOH, if you’re going to end up going under the knife again, you’d probably like to get it over with. Personal.
(2) Many surgeons and others are convinced that using the big-toe tendon as a graft to the AT makes the repair better — including David Beckham’s surgeon and a few posters/bloggers here. The only scientific studies and

Let you PT massage your scar. It will hurt at first, but, in my opinion, the results at worth it. At 4 weeks post op, my PT gave me a scar massage 3 times a week. It was not enjoyable, I made dramatic hand gestures to highlight my displeasure. After 2 weeks, the pain subsided and my scar has great movement and is nearly healed. In addition, I use Bio-Oil on my scar and do my own massage every night. I am now 7 weeks post op and have been released from the boot and plan to wean myself off of it completely over the next 10 days. Good luck!

My PT recommended Castor Oil wraps which help break up scar tissue. I am taking Serapeptase which is also good for breaking up scar tissue. Good luck in your healing.

Massage could be the solution. But, as norm indicated, it may hurt when being applied. Don’t confuse the massage needed here with the nice relaxing type.

My PT sessions have all started with massage around areas with swelling. Even if doesn’t feel so good at the time it has definitely helped.

Do they let you switch from one physio to another in Wales? You may have a dud. Surgery does some things really well, but it does some things — like getting multiple layers of tissue to grow together instead of sliding over each other — that we wish it wouldn’t. A number of increasingly aggressive (and uncomfortable or even painful) techniques usually administered by a PT are the usual solution to break apart the layers that are supposed to slide over each other (and used to, and still do on your other leg).

I’m not surprised by the ankle swelling in the evening, but also in the morning? Most of us start(ed) the day with the swelling down, after the first few weeks post-whatever. Have you tried elevating your ankle/feet when you sleep? It usually works fine for back-sleepers and some stomach-sleepers. Side-sleepers sometimes Not So Much. A big foam wedge under the mattress could work/help.

I have some hardness around my incision and the hump/swelling on my tendon (at times) and my PT have me doing deep tissue massage on my incision and around the tendon 2-3 times a day with some Coca butter. I think it has helped alot of the last few weeks. Also, since going FWB I’m getting more “toughness” around the surgical site and more swelling. Anyway, I wish you luck and hope it begins to loosen up.

I’ve been having to use RICE (without the compression) 3-5 times a day to keep all the swelling down, but if I do it regularly my foot doesn’t swell near as much. If I don’t do it the swelling becomes very bad by the evening.

It’s normal to feel sore after doing too much. Try to do less. If yo feel good after what you did yesterday, try adding 5% or so, but not 50% or you’re at risk. A great guideline for you and your PT is the protocol used in the most successful study published yet — at bit.ly/UWOProtocol . Read it, understand it, ask questions about it, and follow it if you can.

Orthopedic boots are sometimes called “walking boots”, so most patients become FWB and ditch the crutches several weeks before they start coming out of the boot. (In the UWO Protocol, FWB starts at about 4 weeks in, and “wean off boot” starts 4 weeks later, at 8 weeks into treatment.)

I’m not even PWB yet and it is hurting just doing some very light and simple isomeric exercises and active flexing of my ankle during PT and at the house. Also, since I’ve been working out my ankle for the first time in 5 weeks the last few days my swelling has gotten worse, but is easily managed by ice and elevation. I think some pain is normal, as long as it isn’t in your tendon and swelling is to be expected at this point.

Love this post! Thank you for suggesting I read it. And thank you for sharing. So very true sometimes it’s the little things that set me off. Glad to see other people have trip out moments too

You take care, and best of luck for a speedie recovery.

I got them to work by cutting and pasting the link and deleting the “s” before the 1288!

I hope I can Plantar flex like that in couple weeks, once I get to try.

Thanks guys,
today has been a much better day, and the way i am moving around on my boot and crutches shows that maybe i did need the kick up the proverbial to get me going I have physio in the morning and will update with how she feels, (usually not positive) about my progress

I’m sorry you had a day like that. I think we all have a day like that every once in awhile. I’ve been in the situation wear I’m dealing with my NWB status and taking care of 2 eight year olds (1/2 the time). !00% of the time I have to coordinated ride just to get them to (school, scouts, soccer, church, PTA, etc…).

My girlfriend, family, and friends made everything possible. I let myself no (one day at a time). And when it gets to be too much (which it has) I tell myself. Just be patient, I laugh, forget about and do what I can for the day. Usually sleep being a better day. So I hope tomorrow will be that for you. I know it will for me.

I sympathize with you breakdown. I flipper out on my husband about a week ago. We were expecting snow and all my winter stuff is in the cellar. He went down got his winter work pants and left everything else downstairs. I did the whole crying hysterically routine. We yelled back and forth before he took a shower. When he came out he went and got the box downstairs and we apologized. It get very frustrating to not be able to do what you are used to doing. My 3 year old is concerned about the Christmas tree because Daddy can’t put up the tree (fake) only Mommy can. You are not alone and I hope tomorrow will be better.

So sorry. Hope you’re feeling better. I’m only at 8 days but I can easily see a day like this in my future!

Thanks Norm
the pain is from under my heel and after a few false starts i am up and walking in my boot with my crutches
am about to update

alysbach, we’re all assuming that your “huge shooting pain through my heel” is starting from the bottom of your heel. If it’s coming from the BACK of your heel, it’s likely related more to your ATR, and less to your immobilization (and it’s likely more serious, more reason to take it easy soon).

Hi, I had the same thing for the first 2-3 weeks that my cast was off, I think it is just the nerve endings in the bottom of your foot have gone to sleep and when you put a bit of pressure on them they wake up suddenly and it HURTS. I found that in the morning / before getting up / before moving, it would help if I massaged the toe and the heel gently at first then do little pinching movements. It gets the nerves going again. The same principle works if you use hot / cold water on your foot (not too hot though if you are prone to swelling). The Physio advised me to use different materials against my foot - silk, scrubbing stone, cushion etc - sounds a bit kinky but makes a lot of sense as your foot is having to relearn lots of different sensations. You could also try very gently to use a pumice stone; I found I had a lot of dead skin to get rid of in the first few weeks post-cast, don’t use the stone on your scar of course but the heel should be safe. Good luck with it.

Many of us had heel pain when the cast was removed. I didn’t have to wear wedges as I didn’t have a full rupture so I followed Norms advice and got a pair of crocs, I think I was lacking a bit of padding under my foot and it resolved pretty quickly. Plantar fasciitis is a different thing but it can be managed. Many of us on this site have had both (I had PF in one foot and achilles surgery on the other). The 2 felt quite different, I was prepared for the senstiivity post cast thanks to Norm. The PF was always painful when weight was taken off the foot and it was in one specific spot which was on the medial aspect of my heel. Hoping its just a bit of sensitivity post cast. x

I just did it from my page and someone usually gives me an answer here more so than my surgeon will x My pain is just a shooting pain if I put weight on my heel. My physio says it is because my plantar is tight!

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I am also having heel pain @16 weeks post op. How did you create this topic? I hope someone here can help you. =)

Check out achillesblog.com/normofthenorth/2010/04/30/swelling-elevating-is-getting-old/ . After 20 weeks non-op, I’d already spent a great ski week in Whistler, and was bicycling and having fun in lots of ways. But I was still suffering from swelling, esp. at day’s end, if I didn’t take a LOT of time to elevate during the day. Different strokes and folks. . . but lots of us found the swelling lingered way too long.