Non-surgical repair, 0-3 Weeks, the story so far…….
What a fantastic resource this site has been for me so far, thank you all for presenting a wealth of information.
28th May 8:45pm UK time, I snapped my achilles (full tear) in the same way this guy did http://www.youtube.com/watch?v=p7NiwYqNqlA except I was on a badminton court and the opposite leg….. David Beckham is a very high profile celeb here in the UK so when he did his it was big news….and from the massive media coverage I was already aware of the symptoms. So when the almighty pop hit me (it actually felt like streching the eleastic of a catapult then shooting), I went straight to ground, my foot dropped into equinus naturally and the sports hall personnel quickly got me onto a wheelchair.
Within 40mins my badminton buddies had got me to hospital, within 3hrs I was in a temporary cast foot still in equinus (toes pointing down), within 72 hours I had my first ultrasound and within 7 days I had seen the ankle specialist at the hospital…..at this point the temporary cast became a blue fibre cast, still with toes pointing down….. the height of the injury too close to the calf for surgery and the ultrasound had demonstrated a near perfect healing position of the broken tendon with the foot in equinus (toes pointed down)…. ergo I am following a non surgical approach.
I am now 22 days in since the injury and the ankle pain has completely gone, I keep wanting to move my foot around (I assume this is a good thing) and being housebound during this initial period is starting to take it’s toll on my patience… I find moving around on crutches with only one leg less than easy, but I guess like all of you guys, it’s the fact that you don;t really have the use of your arms because of the crutches that magnifies the frustrations.
Personal hygiene is not a dignified process, no shower (mine is built into a high walled bath and at this stage I am not confident attempting to get in or out of said bath), hanging my head over the kitchen sink to wash my hair - all of this just makes things feel worse than they really are…. I looked into a knee walker or the iwalker but my house is not really big enough to accomodate a trailing leg swinging around.
I am adept at getting downstairs now, safely and speedily but I still go upstairs backwards sat on my backside.
My employers have been very accomodating (considering I only joined them in January this year) and even though I am ’signed off sick’ I am trying to take calls and respond to emails… in fact I found out 2 days after the injury, that one of my customers whom received a mail from me explaining my situation was just coming to week15 of their achilles recovery and directed me here, thanks jimminyc, I think this will certainly help keep me sane… but what were the odds that happening??
With this injury being on my right leg and my car being a manual transmission, I think it will be 12weeks before I can drive again, roll on August 20th surprising how much I miss the freedom of being able to drive anywhere at anytime. My Missus can’t drive and we are living off of internet shopping right now, in fact my better half has been fantastic, working, keeping the house running and tending to my needs…. knowing how grouchy I can be when ‘not well’ she already deserves a medal for the way she handles me and my frustrations… I’d of probably punched me on the nose by now 
I look forward to keeping this blog updated as much as I can, for my own sanity and to share the experiences as the healing continues.
Welcome Andrew. As you already know we are on the same timeline and I too ruptured my AT at ~8:45pm ….but in Cda. I look forward to reading about your journey!!
Thanks Eva10,
It worries me that by the time I get to see my specialist I will of been (non-surgical) in an equinus cast for 5 weeks… already I am 1 week behind….. this is not the specialists fault - but the ultrasound was unable to see me until half way through week4 of my recovery.
By the way, I insisted on only seeing the top ankle specialist, thats a good thing, the bad thing is that he’s only doing ‘outpatient’ appointments on a Tuesday and I suspect I will need an ultrasound before each appointment which can only be on a Monday or a Friday…..interesting that I have to manage my own appointments here at the Alexandra Hospital in Redditch UK.
I’m on the same timeline as you guys, except I have gone the op route. My actual injury was a few days before yours, but my op was 8pm on May 28th, so we began the healing process at the same time.
Unfortunately I don’t have a wife to help (my fiance dumped me a few eeks before the injury), so it’s really taking it’s toll mentally. I’m very depressed, but at least I know why.
My injury is EXACTLY the same as Beckham’s, playinging football, stepped back with the left foot, and pop. I turned round, but nobody was there.
I’m currently in a boot with my foot at 5 degrees, though it could be anywhere between 5 and 10 as there is leeway.
I’m visiting London Bridge hospital. My next physio is next week, and my next visit to the surgeon is on July 2nd. It will be interesting how we progress, op v non op.
Same injury location as mine - not sure whether that’s good or bad. Non-op too. I’m now at week 16.
As far as I am aware, even many (most?) of the leading orthopaedic centres don’t suggest an ultrasound at each appointment - there are various indications concerning the progress of your recovery. I understand that Redditch has a dedicated ortho centre so you should be in very good hands - may even be more than one ankle specialist. Short of ultrasound equipment though?
As most guys here will agree, the key aspect of your treatment is the rehab protocol which is likely to be most handled by the physios. A boot (hinged if possible) asap, some exercising when you get it, a written plan to follow, and endless patience with your family.
I borrowed a K9 knee scooter - much smaller base, turns in its own length. Andrew Marr mentioned it in a news feature once when he suffered an ATR - you could google for more. I know that ‘my’ K9 will be on eBay soon - I’m holding on to it for a while as I don’t wish to tempt fate.
Good luck from now on.
A week ahead of you and in the UK, Heard mine snap at 7.20 on 20th May.
I have not had any ultrasound but fell lucky seeing an ankle specialist who had just finished big thesis on ATR. Simply did the Thompson test and ran her finger down my achilles and immeadiatley put me in the aircast boot.
I am lucky that my wife can drive but is spending most her time chasing out 4 children about and looking after me. Not sure now who is more stressed her or me. Would be great to hear what your doctors are telling you as apart from keep the boot thats about all the notes I have on what i should or shouldnt be doing. Going up the stairs is now quite normal but coming down always scare the living daylights out of me. I just know the day I go head first down them is on its way.
Try to keep positive is all we can say. Its a long road but will go quicker than you think
Wow - a very similar story indeed! Badminton definitely has a lot to answer for. Having served my 12 weeks of driving I can sympathise. I can tell you that it does get better - I’ve been back behind the wheel for 4 weeks now and the break hasn’t done me too much harm, if anything I’m enjoying driving even more than before. We went down the internet shopping route as well and found that it saved so much money (and time!) we’ve continued with it.
I found two things that heped with the sore hands from the crutches - padded cycling gloves and some handle pads from oarsome potential. The combination of the 2 allowed me to cover a mile on the crutches despite being a similar size and weight to you.
@ Hillsie - I hope you are right and that after this follow-up ultrasound then I perhaps won’t need one again until I am well on the road to reocvery.
You are right in Redditch we do have our own ortho center, it’s just that the scan specialist and ankle specialist I need to see are not at the hospital on the same day….. so once the need for a scan (hopefully last one next week) all should run like clockwork.
Just unfortunate that it’s cost me an extra week in a cast in equinus.
Andrew you are 10 days ahead of me and I would love to keep in touch since you went down the NON surgical route and I unfortunately have just to see how we are both doing at similar levels. Inow live in the USA been here 5 years now but from Bollington, near Macclesfield. All the best on your recovery.
Hi Pauls - I am 59days/8.5wks into recovery, you’ve already commented on my most recent blog entry
The great thing about these blogs is that they are a snapshot of time - so you can compare where people were to where you are at any time… bit like TiVo….it’s helped me through some tough times already
Hi andrew,
I recently also had the honor of rupturing my achilles tendon. This website and everyone’s stories/experiences has been extremely helpful and inspiring. I have decided to pursue recovery through the non surgical method as well. However, one question I have is during the first two weeks of recovery there’s mention of having the foot in plantar flexion. Does that mean to have it in full equinus position (i.e. fully pointed downwards) or just somewhat plantar flexion? Does it matter? I am about a week in, and currently in 20 degree plantar flexion. I’m worried that this is not “plantar flexed” enough, not allowing the tendons to connect and recover.
Would appreciate any feedback or advice.
Thanks!
Ken - It seems you are a bit anxious as you have posted your question in several places. If you are non-op then the angle depends on the gap in your tendon. Generally 20 degrees is more than adequate to allow the tendon to approximate. This should have been checked by your doctor and it really is a question you should be asking there. I do understand your concerns as it matters for a long term good recovery with strength. If your tendon ends do not approximate at this angle then they usually fix you surgically. If you were surgically repaired then there is no issue at all with the angle and some doctors even set tension on the tendon from the start. You will most likely be at this angle for around 3 or 4 weeks which is the time needed for the initial repair with Collagen type III.
Hi Stuart,
Thanks for the feedback. I am actually pursuing recovery through the non surgical route. As you can imagine, it is a little unsettling sitting around and not actively doing anything to heal the tendon, your mind starts to wander… As I am quite active, I am a bit anxious that my healing won’t be perfect/complete.
I did go to my OS, but I did not ask him the specific question on how much plantar flexion is needed for my recovery. I may try to set up an appointment with my OS again to clarify just for the piece of mind.
Once again, thanks for your response. It is somewhat of a relief to hear that 20 degrees is generally adequate to approximate the tendon ends.
Ken - I cannot say the angle is right for you particularly and it is good you are following it up. This should be done of course sooner rather than later as by 3 weeks or even less it would be hard to change without surgical intervention. Richard Wallace in Ireland sets the angle using ultrasound I believe. When the tendon ends are touching you have the angle. It can be measured and then set up correctly for the boot. Some doctors can do it with feel but if I were to do the other AT then it would be non op unless the gap was too big. A phone call to the Doc could suffice but a face to face would be better. Please do not be concerned about the body’s ability to heal itself. Sutures only act as a temporary fixing and it is the collagen that does the real work. Rest and elevate for 3 weeks then you can start work slowly. You have a good boot. After 3 weeks you can take it off and rotate your foot without pressure. I would leave it on until then and not be tempted to take if off even for a shower. If it has to come off before 3 weeks then I would not point your toes up unless you are with your doc and he says so.
Hi Stuart,
I responded a while back, but it said my post was awaiting moderation, thought it would go through by now. Anyways, below was the following msg.
“Thanks for the feedback.
I actually went back and saw my OS today, he mentioned the tendon will recover at “gravitational equinus” meaning the angle at which the ankle points at when it is hanging off the edge of a table is enough (which is about 20 degrees plantar flexion I would say). Although I definitely would prefer how Richard Wallace does it, as it seems more customized.
My OS is also a strong proponent on immediate weight bearing so that the tendon will recover as the way it will be used, instead of recovering through non-use. He was one of the researchers in this study which shows immediate weight bearing as also an effective method of treatment: fai.sagepub.com/content/24/10/775.abstract. So I will begin walking around in my boot. So far, I have been walking around in my boot, and it has been alright–no pain whatsoever.
Once again, thanks for the comforting words. I need to be more confident in the body’s ability to heal itself. The human body is a resilient machine. I’ll let you know how things go in the next few weeks.”
A little update on where I’m at now. You were right in being confident in the body’s ability to heal itself. It’s been three weeks and it seems like the tendon is growing back. When I trace the achilles area, I can feel a tendon getting more and more distinguished. I’ll be checking in with the OS next week at my four week mark. I’ll let you know what he says. Thanks!
Ken - you have worked out how to avoid moderation of posts. Those pesking 3w’s do it. I see no real reason not to trust the way your doctor is treating you and I am sure you will do fine. Look forward to your update. Unfortunately there is not much in the abstracts sometimes. This article has been sited here before as well and it would be good to read the full version. My father did his AT and went non-op. Because of other balance issues he had to weight bear from the start and he got on just fine.