Ok been to see surgeon AGAIN today and AGAIN told him I am unable to stand on tip toes told him this six weeks ago then he said it was different muscle to the tendon, today he tells me it is because I have healed long . he says the only option is another op which would mean taking a tendon from my toe Advice please

5 Responses to “HEALED LONG!!! HELP”

  1. 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 consensus-guidance documents I’ve seen on that topic have been inconclusive, so I’m not convinced. The notion that AT-shortening surgery REQUIRES a tendon graft seems far-fetched, and certainly is based on little or no evidence.

    I think if you used this site’s Search for “shortening” and “surgery” you’d find a number of discussions, including reports from 1 or 2 ATR patients who did go for the surgical shortening.

    In my own case, after two ATRs and one surgical repair, I have a strength deficit on my left side (ATR#2, non-op) that is totally obvious and huge when I do 1-leg heel raises, but totally invisible when I walk, run, cycle, jump, and play competitive volleyball(!), which I do twice a week. No way I’m getting surgery on mine, but that’s only my own personal decision. You’ve got to make yours.

  2. 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!

  3. 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???

  4. 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.

  5. 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.

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