Insanity over!

I am now 22 weeks into my ATR treatment so here goes for my next update.
I have now finished my first round of the Insanity workout programme :-). This has been a real bonus of my ATR injury. If I hadn’t ruptured my achilles then I am pretty sure I would have continued in the same pattern of fitness for the whole of 2013 and hence would not have embarked on the Insanity programme.
So in summary I have been exercising 6 days a week for the last 9 weeks for between 40 - 70 minutes a day. At first I could not do all of the exercises and had to modify them to cater for my ATR. Mid way through I could do all of the exercises and by the end I was able to keep up with the guys on the exercise DVDs.
All the way through the process I kept focusing on the fact that I was not doing it to lose weight or get a 6 pack - just to build up my injured calf and to transition back in to exercise.
In the process I have lost 9lbs and toned my body which is a real plus.
My next step is to go back to my Physio and try to get him to allow me to start jogging again.

Here are some pictures of my calf before and after the workout.

I still have a numb toe which is gradually getting better. I put this down to having my boot on too tightly for the first couple of weeks. My limp is virtually gone unless I am walking barefoot and I am tired.

Someone asked me recently what the positives were as a result of this injury. Here is my reply:
1. I have more empathy for those who are disabled\injured.
2. I have learned to be patient and wait for things to happen.
3. I have been proactive in managing my injury.
4. I have completed a workout and exercise regime that I would have been ‘too busy’ for prior to my injury.
5. I have come to value how much I love running. It is not until you lose the ability to do something that you learn to value it.
6. I have learned so much from the achillesblog community - with special thanks to norm and kellygirl.
7. I have come to appreciate that Norm knows best. I really do think that he deserves some kind of award or special recognition for the help he gives to the forum members on a daily basis.

So my journey continues. I am not even half way through my recovery marathon, so I still have a long way to go before I am fully fit.

Insanity at 16 weeks

I am now 16.5 weeks into my ATR treatment so thought it would be good to give an update.
I felt that my recovery progress had started to slow down by week 13. I had been going to Physio rehab classes once a week but I was just not getting enough exercise on the other days of the week due to work/family life. I really enjoy circuit training but knew that I was not ready for it so I decided to try a different approach. Some colleagues had just started on the Insanity workout programme and were really enjoying it. I thought that this might be a way to keep me focused on my recovery .
I bought It and started on the 17th of August. I am not going to pretend that it is easy and I have had to modify some of the routines (especially at first) on order to protect my achilles. You start off by doing a fit test to give you a benchmark and then do a varied set of workouts each day for 4 weeks ranging from 30 minutes to 60 minute with one rest day a week. Week 5 is a recovery week and then you do another 4 weeks of harder workouts.
I am on week 4 at the moment and feel very good. I can now do all of give exercises in the workouts and feel that my ATR is good as a result.
Only time will tell if this course of action is going to work but at the moment it feels good. I can now do single leg calf raises which I couldn’t pre the workouts. I can also do the exercise routines in a hotel room which since I travel a lot is very useful for me.
Fingers crossed I can keep up with the programme and will not re rupture.
I don’t advise anyone else to try this approach but just wanted to let everyone know that I am still ok and recovering well.

Heel raises gone!

Coming up for 11 weeks now and I am doing well.
Last Saturday my PT looked at my walking and told me that I could dump my the heel raise in my shoe. I was really pleased as I had been told by the doctor at hospital that I would have to use them for 3 months. The PT says he can’t really see any limp when I am walking. Between us I do still need to concentrate to make sure I walk properly. It really is mind over matter for me to walk without a limp.
My PT gave me some new exercises and said I could stop doing my Theraband exercises. He is still managing my expectations by telling me that it will probably be another 3 months before I can jog and 6 months before I return to things like circuits and other high impact sports.
I am ok with this but deep down I would like to get there a little quicker - I can hear Norm saying Incrementally in my head ;-)
At the gym I am now at a point to do a real workout on the cross trainer, bike, rowing machine and all my PT exercises. At the end of a gym workout I am now dripping with sweat which is nice because previously I felt I was just going through the motions and wasn’t really getting much of a workout.
I have been walking our dog for longer and longer and can now easily do a few miles with her over rough terrain.
I sent the picture of me windsurfing in my boot to the Vaco in the UK. They have put it on their website so I am now finally famous after 47 years of obscurity.
In summary I am getting back to being in a good place once again. I wish the same thing to everyone here and to those of you still in your first few weeks - things will get better, you just have to be patient.

2 Shoes - At Last!

I moved into 2 shoes last Thursday 18th July :-) This was 9 weeks since my start of treatment and I delayed my appointment by 1 week due to being on holiday.

My appointment with the consultant was a little underwhelming. He asked me how many weeks since the start of my treatment then asked a nurse what  ‘protocol was for 9 weeks’ and announced that I could move into 2 shoes when she told him that that was what happens at 8 weeks. I was given a gel heel raise and told to keep it in my shoe for 3 months. I was also told that I do not need to come back to the hospital. He didn’t even look at my achilles.

I was very pleased to be told to move into 2 shoes but the whole process has made me wonder whether there might be a better treatment path for NHS patients. I work in project and programme management and the first thing that you need to do in any task is to take a baseline of your starting point. Since I was never given a scan when I first ruptured my achilles then I have no way of tracking my progress over time and the quality of my healing process. My achilles feels pretty good and I am pretty confident that with the help of my private Physio I can make a good recovery, but it is a real shame that there seems to be no motivation to identify how bad the initial ATR was and how good the recovery is.

I have enjoyed the feeling of being back in 2 shoes over the weekend and have concentrated on walking as normally as I can. I think I have made good progress but I do have to correct a slight limp when I lose my concentration. The weird thing is that my achilles feels fine. At the moment my limp is being caused more by soreness of the soles of my feet which have become very soft due to being cocooned in a boot\cast for the last 8 weeks.

I am keeping up my exercises and have also started to walk our dog (short distances) in my shoes. As you can see from the photo my calf muscle is pretty wasted so I am trying to build it up again slowly.  I can do some calf raises but my good leg is probably taking a lot of the strain even though my brain thinks I am loading it with half of my weight.

The biggest problem is getting the time to exercise with work commitments. I would love to be able to get back into the pool again as the hydrotherapy sessions that I did when I was on holiday seemed to make a real difference to my recovery. I just have to make do with land based exercises using a theraband during the week

Good luck to all of those still in a cast or boot and thanks for all the advice from the other forum members who are already in 2 shoes and beyond.

Board by the beach

Being stupid in a Vaco

In case anyone else wants to have a play in the water in their Vaco boot. I removed the cloth outer and just used the vacuum insert with some extra foam padding.

Getting ready for the water

8 week update

I should have been in 2 shoes yesterday but I have had to delay my hospital appointment until next week as I am on holiday in Greece with the family this week.
I was partly dreading a week in a beach club full of windsurfers, sailing dinghies and stand up paddleboards. In reality I am really enjoying it!
I went to a physio before leaving for holiday to get a set of exercises and does and don’ts for my holiday. I have had 3 sessions with a Physio on holiday. I am amazed by my progress especially as a result of hydrotherapy in the pool. I have a 30 minute pool routine and a 30 minute routine on dry land.
As a result I have managed to indulge myself by stand up paddle boarding, kayaking, mountain biking through the Greek countryside and windsurfing all with a stripped down version of my vacoped boot.
I have really found the boot to be incredibly versatile and have had no issues with using it in water. I have 2 plastic cast liners so I put one in a proper liner and keep the other to use in the boot when I go into the sea.
I have also been using the standard sole for my water activities and have now dropped the rocker sole completely even when using the boot normally.
I have been walking carefully without boot a few times a day and have managed to do some normal calf raises under the supervision of my physio which I am really pleased about.
I can also walk relatively normally without a limp but have only been doing this once a day in the confines of my hotel room.
The highlight of the holiday has been a 5 mike mountain bike ride on gentle slopes and half an hour of windsurfing. After both activities I felt that I could carry on for hours but I always have a voice nagging in the back of my head saying ‘gradually Andrew - no heroics’.
Looking forward to hopefully dumping my boot next week but for the meantime I am going to enjoy the sun and the water.
Happy healing everybody!

Naked at night!

I went to the Fracture Clinic on Thursday. It was a little surreal as initially the staff told me that I probably didn’t need to be there as normally all they do at a 2 week boot appointment is to remove a wedge. Because I had bucked the system with my own Vacoped then this wasn’t really necessary as I could make the change myself.

I managed to see a doctor and got him to agree to me moving from 15 degrees to 0 degrees. He also agreed to me not wearing the boot at night. I showed him how I could adjust the hinge on the boot so that I could get a range of movement. He initially agreed with me setting a ROM between 0 and 30 degrees but then had second thoughts and said he was worried that I might be tempted to push off my toes when walking. We set the boot at a fixed position of 0 degrees and I he told me to set it between 0 and 10 degrees when I got home adding 5 degrees a week. I found it hard walking with a fixed position at 0 degrees when I left the hospital. It seemed very different from the 15 degree setting that I waked in to the hospital with.

I feel that 5 degrees a week is a little too conservative so I plan to be a bit more aggressive with the ROM setting over the next few weeks. I am just going to have to be careful with my walking style but I am hoping that advice from ryanb and kellygirl on walking technique in a boot will keep me out of trouble.

When I got home I tried out the flat non rocker sole on the boot but I found that I walk better with the rocker sole. I also think that it will be harder for me to walk in the wrong way with the rocker sole.

The first night without the boot on was a bit strange but I am now used to sleeping without the boot. At first you are very cognisant of any movement at night but after a couple of nights it seems to be back to how I slept in my pre ATR days.

I have to have the boot on for another 4 weeks and then I can move back to 2 shoes and start my PT. I personally think that this treatment plan is too conservative and I may well go to a private PT prior to 4 weeks. We also plan to go of dingy sailing holiday in Greece so I have had to put my appointment back to 5 weeks. Hopefully I can get some pictures of me paddle boarding and sailing a dingy in my boot.

In the meantime I plan to continue my normal exercise regime. I went to the gym last week and enjoyed getting on an exercise bike and also a concept 2 rower (my pt originally told me that I could do rowing after I got out of my cast). It is fun to actually feel that I am doing some kind of lower body workout.

Things are progressing slower than I hoped but as the doctor said to me. The Vacoped boot (in his opinion) isn’t going to speed my recovery but should mean that I make a stronger recovery.

Happy healing everyone!

1 week in a boot

I have now been wearing my Vacoped/Vacocast boot for the last 7 days. The first 3 days were not good at all. I started to get very numb toes and ‘pins and needles’ (similar to alton2012’s experiences). It got worse and worse until I read a post from Norm (he should be Sainted!) telling Kellygirl that she may need to pad her boot to make it more comfortable. At the same time I got told by the UK Vacoped office that the vacuum liner for a Vacocast/Ped boot is single use and will break down over time. In the end I padded my boot and ordered a new liner which came the next day. The difference is amazing and the numbness has got much better since.

I strongly urge anyone using a second hand Vacocast to order a new vacuum liner ASAP.

I hired an automatic car and went to see some clients near London for a couple of days. This meant staying in a hotel for a couple of nights with no support network. After the first day on client site I ditched my crutches. I used an ‘even up’ on a pair of trainers and was soon walking comfortably without them. It was a really liberating experience and I took pleasure in simple things like being able to get my colleague a cup of coffee and carry it over to his desk. When I arrived home my 2 boys and my wife were amazed at the transformation. I even managed to play a game of cricket with the kids! It is hard to understand how different your life is when you can stand and walk on your own two feet. I can now have a near to normal life and can’t wait to get back to hospital next week to see how the doctors think I am progressing.

Cast Off!

I feel very happy!

I went to the hospital yesterday with my ebay Vacoped boot! When I asked if I could use my own boot rather than the standard Aircast that they use in The hospital the doctor and staff were more than happy. Some of them had not seen the Vacoped so I showed them how to set it up and helped them put it on. They seemed to love the boot and a couple of them were amazed that I had sourced my own.
The doctor looked at my heel and felt along the Achilles he pushed and prodded but It did not hurt at all. He told me that things were healing very well and told me to set the boot to 15 degrees ( I had pre set it to 30!).
I asked him if I could move to PWB and he said no I could fully weight bear if bearable. He told me that I could take my foot out of the boot when resting but that I have to keep it on at night.
I am still on crutches and I am slowly starting to put more weight on the injured foot as things progress.
The boot is great and I will keep you all posted on my progress going forward.


I have just received my 2nd hand Vacoped boot (bought from Ebay). It is in very good condition and all seems to be in working order.
I have just read the manual and seen a small section that mentions inserting an Achilles pad. I do not have one of these pads so I am wondering if I have purchased the wrong thing. The manual says that the Achilles pad is only needed with the VACOachill in the 30 degree position.

Here is the detail of the model number:
Vaco Model

Are the rest of the forum members using a VACOachill or do you have the same VACOped that I have bought? Any advice would be appreciated.