andyfrancis’s AchillesBlog

Hey Andy,

Good to know about the pool! I just re-ruptured mine and am trying to figure out how to best keep myself somewhat active. I’d actually never heard of healing long either, but it’s good to be aware of. Thanks for sharing the resources. This page is the best place to find all sorts of stuff!

You are a rock star!! And thanks for the link.

I’m 11 wks and found the pool to be an amazing help. My biggest challenge is my head…I’m over protective of my ankle. Yet I did walk my 1st mile on my 11 week rupture date. That was amazing!!

At 9 weeks, I had been “walking” for only a week. I was on the 4 NWB & 4 CAM walker protocol.

I’ve heard a little about “healing long” but haven’t found much in sites. I’m assuming that’s an overstretch of the tendon. I do toe raises before I walk because my calf/tendon stiffens easily/quickly still. Is that a bad thing?

congrats!!!!!! have you tried to walk without shoes?
Did you start therapy?

It was hard for me, now I have a hard time finding a pair of shoes that doesn’t hurt/irritate my scar which is still sore.

Congrats on losing the boot! Take SMALL steps to start walking more normally. As my PT guy says - it is most important to have good form! When I got out of the boot he said take the smallest step you need so that you can walk with a normal boot. When I started jumping on one foot he said HOLD ONTO THE WALL so that I could do the jump perfectly. As things got stronger I could just put a hand on the wall, then a finger on the wall and I’m still at the finger on the wall point. And walking in the pool is definitely a good thing. I did it too - walked forwards and backwards and sideways.

Good luck on your continued progress!

Congratulations on losing the boot!

I feel the same way at the gym. I stick to a few basic machines and look forward to the day when I can go back to outdoor activities for my exercise (running and tennis for me).

I found pool walking to be very nice - mostly because it was a chance to walk somewhat normally with hardly any discomfort. You spend so much time being uncomfortable during recovery…the chance to feel nice and relaxed, and to walk semi-normally, is as helpful mentally as it is physically. At least, that’s how it went for me. Even now, 24 weeks after surgery, I look forward to going to the pool because I can almost forget that my leg still doesn’t feel right.

Andy:
So what I’m about to write supports 100% what these people found. I am a 53 year old former college athlete. I have lifted, run and continue crossfit workouts mixed with biking and swimming my entire life. I am 6ft 203 lbs with 15% body fat. I provide these stats/intro so any reader can compare their condition and read with cautionary perspective based on my response to a radical functional rehab and weight bearing program I entered after my full rupture of the left leg Achilles (it snap and there was approx a 2-3 cm gap/indent) The swelling and immediate pain and loss of function was frightening in the first hour. I have had injurys prior including a third degree AC joint shoulder blowout with fractured clavicle — pain was nowhere close to this. It snapped as I was stepping off a curb and sounded like a wallop/gunshot. I immediately filled 5 gallon bucket with ice water and froze it and was able to get an appt next am with ortho. He said it’s a total tear. I asked if surgery was better for outcome and he said no better to go with conservative 1st. We was dead on right (for me) they casted it with a 30 deg toe down flexion f

Going well!!

The commitment to FWB has made a great change to everything. I’ve had two physio sessions, another one tomorrow, where I’m getting more and more exercises to do.

I have 7 different exercises to do morning and night, takes about 15 minutes. They are all fairly classical I think….toe raises, pull toes back, minor heel raises although that one is next to impossible at the moment.
The only tip is to only stretch to the point of resistance, which won’t be very far. Beyond that and you risk “healing long” which you will come to read a lot about. To be honest though, you’d have to be pretty dumb to stretch to the point of pain and heal long.

The best news though is I’ve been given the all clear to get on the exercise bike. I had one delivered today, I’ve been on it already for 5 minutes and will do so again shorty. Just 5 minutes at a time on the lowest resistance but at least it’s something.

Once the crutches are gone I barely notice the boot now. OK so it takes me FOREVER to walk anywhere which drives the wife bananas but apart from that life is getting back to normal. Oh, I can’t drive yet, another few weeks f

Hey Andy how is it going?

Looks like you guys are really active posting so I wanted to jump in. I ruptured my Achilles and had surgery March 21, 2017, stitches out and walking flat in boot on March 31, 2017. Doc had me walking without a boot on April 28, 2017. 3 more months have passed and progress is still steady.I guess I’m about week 17 or 18 and my life is back to normal. I’m 63 so normal is a lot different for me but I’m cutting firewood, built a deck and doing everything I want without a problem. I can go up and down stairs, even on my toes, but still can’t lift my weight on the toes of that foot. Doesn’t hurt, I just can’t do it. No swelling or pain but my darn heel is still pretty numb, probably from walking on it rather than on my toes.

I’m non surgery route. My protocol was NWB for two weeks then move,move, move! As an avid runner…I have just been so excited to sweat. I’m progressing gradually though…aerobic activity now 30min every other day and no pressure on the aircast.

@ty620.
Hard cast came off at exactly 6 weeks to the day. This rehabilitation specialist came along by pure chance (in conversation with a common acquaintance ). I started rehabilitation with him 3 days later. He was careful initially - it was only deep tissue massages and passive ROM in the beginning.
His massages were magical. The immediate effect was incredible - the effect didn’t last long but each time it reverted to a slightly better condition than before.

I remember after PT session #2 - just 5 days since cast came off - I came home and my wife even made a video of me walking because I practically did not limp.
Next morning of course the tendon was back to its usual self and I would be limping for few more weeks.

@zoomie at what week did you start therapy?
Your progress is very impressive!!!!

I’m at week 6 with boot on. I’m very afraid to put weight on my foot without the boot. I do start therapy the end of my week 7.

@Stuart.
We all should get to the finish line about the same. In 12 month we all will be back to normal activities and difference in strength between 2 legs will be academical.

Regarding the journey to the finish line - I was questioning super conservative protocol in the beginning but looking back at it I can’t say that I am disappointed with the choice of my doctor.

I could walk 2 miles in flip flops by week 8. (2 weeks after taking cast off).
By week 10 my limp was almost not noticeable.
I started jogging at Week 15 on the flat asphalt around my neighborhood. Its been exactly 2 weeks since I’ve started jogging (end of week 16) - the progress has been steady - jogging 3/4 of the mile under 6 minutes. Tomorrow will try to do 1 mile keeping it under 8 minutes.

There is no pain or swelling after jogging. I am usually out of breath or my calf is tired but tendon is holding up (just as it should according to my doc).

I believe the most important aspect of recovery progress is what you do when your cast or boot comes off. And who is helping you with this. I was very fortunate to find a very highly experienced sports i

@sargegirl - Am I right to understand that you are rowing and on a static bike just two seeks post surgery? That’s amazing, I’m very jealous.
I have physio next Wednesday but I’ll be nearly 6 weeks by then, hopefully given the all clear to do the same.

Just to explain for those unsure about ROM. Active ROM is only what you can do with your own muscles. No outside assistance. Initially it will be moving your foot around and I have always told people to write the alphabet with their foot while the leg from ankle up is fully supported. Passive ROM comes later and involves theraband or a therapist manipulating your foot. Walking in shoes will also give the same effect. Everybody has the potential to heal the same but there will be some variance depending on method of treatment. I am not sure what Zoomie’s doctor meant but if it means keeping the foot locked up NWB for longer to gain a stronger repair then studies have shown this is not the case. It is in fact the opposite but it was conventional thinking for a long time. Zoomie is correct about the length of time to fully heal and those following a modern protocol will return to some kind of normal activity a little quicker and those on a more conservative treatment will catch up so after 12 months all are about the same. If you are happy with your treatment then there is no need to worry. Many people will worry about their ROM and I

Thanks for the long post Andy. Confirms everything I’ve been told about early movement. I do my exercises daily and have been so happy to add in cardio now with rowing, biking (both with only one leg strapped in) and pull buoy swimming! Those are all in my protocol after 2weeks. I’ve also found yoga a huge help to keep my ROM going and stretch out some of those compensating aches.

Happy healing!

Since mine wasn’t ATR but rather surgical cutting of the achilles to remove a bone spur my recovery is a bit different. I totally believe that the sooner you are FWB the less rehab you’ll need due to muscle atrophy. That is my biggest issue now - getting the strength and flexibility back in the calf/achilles. My doc had me doing ROM at 3 weeks which worked great for me. And, up until recently, I was seeing regular improvement in all aspects on a weekly basis. The improvement has slowed down a bit now - but hopefully with a change of running shoes and a slight tweak in my exercise pattern I’ll see more improvement.

Everyone’s case is probably different as well as recovery protocols/results.
Mine was super conservative - 6 weeks complete immobilization in the hard cast with No weight bearing.

Went straight from hard cast into FWB in the shoes and no crutches same day cast came off.

My tendon was so rigid it was stuck in negative 6 degrees of plantar flexion. Every step was a huge amount of pain.

Apparently my doctor made a choice to sacrifice initial ROM for strength of repair. (At least according to him on the choice of protocol). He also told me that walking is the best therapy. And that after a surgery and 6 weeks in the cast unless I fall off the stairs I will not rerupture tendon again.

Recovery is 6-12 month process and 3-4 month down the road initial treatment protocol is not as important as being persistent and keeping an eye on the ball.

Hey Andy this is great news and I totally appreciate your long post!
I have been FWB since week 3 when I got my staples removed and cast off. My surgeon put me in my boot and said FWB and wean myself off the crutches. I ditched my crutches by week 4.

I go see my surgeon again next Monday which is week 7. I will keep you in the loop.

So my scar actually hurts to. I was wondering what should my scar look like at week5. As my surgeon said I can not immerse my foot in water. I am only able to shower which mean I have Terrible dry skin.

Hey Andy was anything said about what type of ROM and massaging the scar?

oh yes good spot, I was typing without reviewing, have changed it to dorsi, thanks

Naturally movement would be AROM but as I said speak it all through with your surgeon and/or physio first.

From the sofa, leg raised.

Andy

Just to clarify, you have indicated up to 30 degree plantar flexion (pulling toes up). Pulling toes up is dorsi flexion. 30 degrees dorsi flexion would be difficult to achieve in a healthy tendon and impossible for a recently ruptured AT. Some people could read this to think they can push the tendon to this level which I feel could be harmful. There is no mention whether the ROM is active or passive and that will have considerable bearing. Passive ROM is dangerous in the early stages. I do agree with other aspects regarding early weight bearing and mobilization within this time frame.

Greetings to you Andy from sunny Southern California,

I appreciate the information you just shared. Thank you for the time and effort you put into researching this stuff.

Today being the start of Week 2 of post-op, I’m going nuts from the inactivity. Needless to say, I’m anxious to get back to normal, but not at the expense of a setback.

I’m willing to share this with my ortho guy next Tuesday to see what he thinks. But I’m up for the challenge.

Thanks again, Andy.

Hey Andy how are you? This is Ty from US (female 40 years old) I had a complete rupture of my right achillies on June 16, 2017 and had surgery June 20. I’m 5 weeks post op I think we are on the same week of recovery??? I noticed we are similar in age and date wow.

So I had staples and cast removed at 3 weeks been in a boot since with 3 wedges. I removed my first wedge 3 days ago so now I’m down to 2 wedges. I’m FWB and don’t use crutches. I use them when I have my boot off. I don’t go back to surgeon for another 3 weeks.

Did you start therapy already? I don’t start therapy until week 8.

Do you put weight on your foot with out the boot on?

Hi Andy,

An update for you on the jogging progress. Since I started jogging on July 19th - this seems like a distant era 11 days later.

My first jog was between 0.1-0.2 miles, favoring my good leg during the jog and tendon getting tight at the end of it. The pace was 10.3 minute mile.

I’ve been jogging every day for the last 11 days. Increasing the pace and distance every 3 days.

Today (11 days after I started) - I ran 3/4 of the mile. Pushing strong with both legs - tendon felt normal (no pain or tightness). Pace was a more healthy 8 minute mile.
I was out of breath at the end of it - but its a general conditioning vs a tendon issue.

Per doctor’s advice I still run on the flat asphalt in my neighborhood, had not tried hills yet.

Greetings Andy,

I found this site several weeks ago, right when I blew out my left achilles tendon. I knew exactly what happened. The experiences everyone has shared has been extremely helpful and encouraging.

Andy, noticed you injured yourself a day after I had my incident (6/16/17). However, you had your surgery on the 29th. Twelve days later. It took me nearly six weeks to finally have surgery (7/24/17).

Since you’re the closest to me on this recovery timeline, I’ve thought it a good idea to kind of shadow you somewhat. Knowing full well each of us heal at a different rate and may require different therapy, it may help me have a general idea of what to look forward to.

Keep up the good work. And maintain that positive outlook.

Way to go! Keep at it! Definitely keeping things elevated as much as possible for the first 2-3 weeks is key. My doc had me do it for 3 weeks.

Congrats on taking some one crutch steps! And moving into the accelerated protocol. From what I’ve read, that seems to be the way to go. I bet it won’t be long until only having one free hand is not enough and you move to crutch free walking! Keep up the great work!

Hi Andy. Yes!! First step is so exciting!!! Congratulations on your progress!

Today I did only 0.1 miles as the tendon started to tighten up. Doctor told me not to push it if feels uncomfortable. Hoping it will be better tomorrow.

@andy - mine was surgery.

Well It was a very slow jog at the pace of 10.3 minute mile.

Doc told me I could try if it feels comfortable to do 0.2 miles for a week then try 0.4 for 2 weeks.

I felt pumped up and nervous at the same time at the end of the run I wanted to go longer as ankle was holding up , luckily I held my horses.

Only 15 weeks and you are jogging? Wow…..amazing! I bet you were nervous.

Were you surgery or conservative care?

I’d like to think I could jog a mile by Christmas (that will be week 25)

Andy

I am so pumped up! Today is exactly 15 weeks since my ATR and I went for my first jog outside this morning total of the whooping 0.2 miles.
Could not have imagined just 4 month back that running 0.2 miles will be so much anticipation and excitement.

Ankle didn’t hurt during run and still feels normal. I keep feeling it out every so often holding my breath that it does not swell or start hurting.

Andy I think your mega goal of jogging by Christmas is very doable. Only question - how far will you be able to jog.

You are about 3 weeks ahead of me…only I’m the non-surgery route. I look forward to reading your posts so I know what is to come in my journey for this active girl across the pond in Canada!

Good luck! Sounds like you have a good mindset for the recovery. For what it’s worth, everything got a lot better for me after the first 4-5 weeks. It’s tough being immobile early on.

Keep us updated!

Those all seem very doable. I’m hoping to play in a soccer tournament in September - we’ll see I suspect it won’t be the achilles that keeps me out - but my fitness level! I won’t play with my team if I’m not an asset.

Thanks for the support! I have 3 “Mega Goals” as I call them.

1. Play golf on my 40th (November)…..I reckon that’s an easy one to achieve.
2. Go for a run on Christmas Day.
3. Run a half marathon exactly a year post surgery, June 29th 2018.

Maybe I’m aiming high, time will tell.

A

Good luck Andy! I found sleeping to be incredibly difficult! Was so glad when I got the OK to not wear the night boot. You’re doing the right thing in following the docs orders and elevating. I got the OK at 3 weeks to do very simple ROM (forward backward and side to side) and that was it. But I was NWB for 6 full weeks due to my surgery. And yes the calf atrophies very fast (use it or lose it has a new meaning to me now!) and takes a long time to get back. I’m at 5 months now and am still working on it. Still don’t have the flexibility and strength of my good foot. And now the progress isn’t seen weekly either so I have to work harder to motivate myself - LOL! You go from daily progress to weekly progress to ??? Although I did move from jogging .25 mile to jogging .5 mile and will try for .75 mile in a couple of days. So I guess that is also progress - but I HATE jogging! Keep being patient!