ATR’s in UK

Dazf is the maintainer of a wonderful page for people who are recovering from Achilles Tendon Rupture from UK:

“What I would like to do with this page is to hear just from UK patients suffering with a ATR. To find out what sort of help and treatment they are being offered in in the UK by their local NHS board. Also if there are UK patients who are being treated privately as well so we can compare the ways things are done here in the UK.

I would like to take this oppurtuntiy to ask people from the UK drop a reply on here and also tell me about their recovery from a ATR.”

http://achillesblog.com/dazfones/uk-atr/

1,099 Responses to “ATR’s in UK”

  1. Vicky Turner, on October 21st, 2008 at 12:45 pm Said:

    what do you need to know

  2. Hyacinth, on December 3rd, 2008 at 3:17 pm Said:

    I live in London and visited the Crystal Palace Sports Injury clinic, for some physio as my badminton injury had not subsided. To my dismay my physio Kate told me to go to A and E at Kings and get my ankle looked at as I had failed the Thompson test and would need surgery. I am petrified as I work for myself and the idea of having surgery frightens me. I have only visited people in hospital it took me until I was 32 to even give blood and that was frightening.
    Can anyone tell me what the steps are. Do I go into hospital for just an over night stay. Then from reading the blog it seems that I am in a cast for 6 weeks and have to live on the floor! I am sure I am just over reacting! Can anyone just go through the stages.

  3. Richard, on December 3rd, 2008 at 5:37 pm Said:

    Hello Hyacinth,
    First of all bad luck with you injury. Have you actually been told by the hospital that you need surgery? The reason I ask is that there is a non surgical option which you could have. Quite a lot of UK victims have this and it involves a series of hard casts starting with your foot plastered in a’ballet pointe’ position and then gradually moved up every 2 weeks or so unil its at neutral (flat)

    Time wise its similar to the surgical option but has a slightly higher chance of re rupture but less chance of any post op complications.

    Whichever way you and your Dr decide to go there is a period of casting - it goes something like this. If you have surgery then its 2 weeks in a post-op cast/splint. After 2 weeks its stitches out and into a hard cast for 4/5 weeks depending on your Dr. Then its in to a walking boot which you will be able to take off for washing, sleeping and physio. Weight bearing/conditioning carries on until you can operate in 2 shoes and begin to walk again.

    In total its 10/15 weeks(some a bit quicker some slower) before you’re back on your feet. Full recovery is around a year!. That time scale is similar whichever route you choose

    How depressed are you feeling ?- its a bugger it really is. Make sure you spend some time reading this excellent blog it will tell you everything you need to know Read uknodgers account of a non surgical recovery. He’s back on his feet now and functioning again

    Good luck, keep in touch you’ll get loads of support here.
    Richard

  4. Steve, on December 4th, 2008 at 6:36 am Said:

    Hyacinth, I’ve been in a cast for two weeks, if you are reasonbly fit and agile it really isn’t that bad. I live on a three floor house and get around OK. I also go out to friend, pubs, tesco, other shops. Can’t drive though. I ruptured my achilles two weeks ago and am having the non surgery option, this is a fairly common approach in the UK. The risk of the non surgery is that it may not heal and you need surgery at a later date. Best of luck

    Steve

  5. Helen, on December 10th, 2008 at 6:32 am Said:

    I ruptued my left achilles on 13th November playing badminton and heard it pop. Straight to A and E in equinus cast then further assessment and discussion and onto trauma list and finally surgery on 1st december. I am in splint cast now 9d post op and back for suture and wound check at 14d post op.

  6. Peter Fairman, on December 13th, 2008 at 8:02 pm Said:

    Richard,

    I live in Washington DC, originally from UK. ruptured/tore my Achilles during an indoor soccer game. Am interested to hear that non-surgical option is common in UK, here doctors recommend the surgical option. My doctor has recommended this, but, like Hyacinth, I hate the idea of surgery, and the risks of something going wrong grow with age (I am 58)..

    My doctor says a non-surgical operation would consist of a cast covering my whole leg (below the knee only for a surgical operation). You say the cast only covers the foot, which sounds much more bearable. How mobile are you in such a cast? I live alone, and don’t want to have to rely on others. Can you sleep OK and are you able to get to work?

    Look forward to hearing from you,

    Peter

  7. Richard, on December 13th, 2008 at 9:35 pm Said:

    Hello Peter,
    Most of the non-surgicals have a cast which is below the knee. This means you can bend at the knee (obviously) but you are completely non weight bearing and relying on crutches to get about.
    Work is do-able depending on what you do - Crutching around for long periods is quite debilitating and you will need to be able to elevate your foot periodically
    Driving is a no go.
    Sleeping and general personal care becomes a problem solving exercise and after initial frustrations you get into your own routines and its not too bad.

    As I said to Hyacinth (how’s things Hyacinth let me know) have a read of UKnodgers blog. He had a good recovery wtth a conservative approach and is now back on his feet and functioning.

    I’m sure you have realised there are loads of differing protocols for ATR’s the non surgical approach takes no longer than the surgical one but it does seem to be down to the surgeon’s preference

    Keep in touch and please let us know how you are doing, this is a really supportive and useful site which has been a blessing for me during my lengthy recovery

    All the best
    Richard

  8. Richard, on December 13th, 2008 at 9:41 pm Said:

    Peter,
    Hello again, I’ve just re-read your letter and you say you live on your own. You are going to need some help whether you have surgery or not - everyday tasks become very dfficult to manage during the non weight-bearing phase

    Richard

  9. Graham, on December 15th, 2008 at 4:55 pm Said:

    Hi all. I origionally ruptured my right achilles on 3rd august playing football and after 8 weeks post op I was up and walking around unassited. However then in a physio session at the hospital I re ruptured my tendon again on 10th october, just by doing gentle excercise. Obviously as you know the injury is devistating enough the first time. Especially if you lead an active lifestyle as I do. I have major concerns now and wonder if any of you have any input???

    I play drums professionally and the right foot is the primary one I use for bass drum etc. I also liked to keep in shape by playing rugby and football. Its been really hard for me for the last few months as Ive had to miss out on a load of work by not gigging and recording.

    Ive spoke to my doctors and asked for advice but I get the destinct impression they dont fully understand whats involved in my every day job of drumming.

    My question to you guys is does anyone have any experience of re rupture and is it likely I will be able to play drums again properly??? And return to sports????

    Thanks

    Graham

  10. dennis, on December 15th, 2008 at 5:49 pm Said:

    Graham - Sorry to hear that you had a re-rupture. I think this page might help: http://achillesblog.com/re-rupture/

    Also, you can search from the main site, using the google search textbox on the upper right. Type in: rerupture, and you’ll find lots of info.

    I hope this helps, and don’t get discouraged. You’ll get back to doing the things you love in due time. Keep us posted. :)

    Dennis

  11. Richard, on December 15th, 2008 at 6:09 pm Said:

    Graham,
    You blog sends a cold chill down my spine - what where you doing when you re-ruptured and what was the reaction of the Physio afterwards?

    Richard

    ( 8 weeks post op and in Physio !!)

  12. Steve, on December 16th, 2008 at 7:00 am Said:

    Graham, re-rupturing your Achilles must be devastating and I’m really sorry for you, but I’m sure it will recover.

    What I would be interested to know is why re-ruptures happen. Most I’ve read about don’t seem to rupture at the original injury site but above it. Is this because the whole tendon weakens due to inactivity during the recovery period and what happens is not a re-rupture, but a new rupture due to a weak tendon. I’m not a doctor and have no real idea about this but it does seem a real possibility to me. Any thoughts from anyone on this?

  13. Sanfrantourguide, on December 17th, 2008 at 4:20 pm Said:

    I think that it’s one of the most important functions of this site: to remind us all of the danger of re-rupture, how important it is to take it easy, don’t rush healing. So those of us who are so unfortunate to re-rupture can do the rest of us a very, very great service in writing about it, when and where and how it happened the second time, what the doctor said, how the second operation is different (better or worse…) than the first, etc. etc. How physiotherapists can make us go too fast, perhaps??? Or is it something inherently weak in some of us, which caused the first rupture anyway?

    I had a very good surgeon, but I concluded that his main concern was his surgery and that it worked well. If I healed well, walked well, and had no further pain - that did not seem to be in his line of work. A re-rupture probably would be assigned to another surgeon!

    What made me laugh at first when I first came out of the cast and into two shoes: they warned me to be very slow, careful, and flat-footed (no push-off) when walking until Week 10 or 12. If not, and it re-ruptured, THEY would be upset with all the EXTRA WORK!

    I tells ya… people know what it is important to them! To the patient, total healing and no pain and full strength is the goal. So let’s all take it eassssssssy.

    Mary

  14. Graham, on December 21st, 2008 at 2:02 am Said:

    Hi again guys.

    In response to earlier questions from richard. The physios reaction was pretty shocked to say the least. She kinda paniced and took me straight to A&E where the re-rupture was confirmed. The excercise I was doing at the time was walking along the soft balance beam in the hospital gym. I hadnt been up on my toes along the beam yet and it was the first week we had tried it. Unlucky eh. Thats when it happened again.

    The pain was ten times worse this time. It was a very deep burning sensation from the area where it happened. I could still move my ankle a little but the doctor informed me that this was because my calf muscle would be moving it not my tendon.

    The 2nd operation went a lot smoother for me (when I had my first operation I had never been under general anesthetic before. So this time I knew what was coming).

    As far as this recovery is concerned. It appears to be going better than the last time. Im 10 weeks post op now and Ive just started partial weight baring, and im still in the funky moon boot thing. The doctors and physio have taken a much more cautious approach with me this time. Working 2-3 weeks behind the usual scheduele/steps. In my opinion this has really helped this time round. My leg feels real comfortable when im doing my gentle excercises and there doesnt appear to be any swelling in or around the area at all. My physio and consultant are really pleased. There are still concerns of course as its a re-rupture and I still wont be fully weight baring until the end of jan 09 by the looks of it. Im ok with that though. I reckon short term pain, long term gain.

    If any of you have any questions how its getting on or anything else dont hesitate to ask.

    Thanks

    Graham

  15. Sanfrantourguide, on December 22nd, 2008 at 9:01 pm Said:

    Man, sometimes I am glad that they gave me NO therapy! And that I am so reluctant to even try and push it! Perhaps I am deceiving myself, but slow slow slow seems to be the only real way to heal a tendon!

    Mary

  16. Helen, on December 31st, 2008 at 6:46 am Said:

    Am really sorry to hear about you re rupture in October Graham but glad to see that you’re back on the recovery road again. I’m now 4 weeks post op and am in non weight bearing brace with my ankle now moved from full equinus to slight flexion for the next four weeks and then i am assuming i go to neutral after that. Am worried and excited about coming out of my brace and going into shoes- how did you find it? were you still on crutches at that stage. Have also found it very frustrating with regard to differing protocols post op in the same orthopaedic department as the first doctor post op siad 4 weeks equinus, then 2 weeks slight angle with moving my ankle from equinus to new slight angle, then 2 weeks neutral and then last doctor has gone for 4 weeks in each angle- which I suppose makes 12 weeks of slow healing which looking at all the posts doesn’t sound like a bad thing. I work as a vet so my job is quite physical and at 5 foot 2 I tend to have to reach up for things but wil have to do things differently.

  17. Michael, on January 23rd, 2009 at 4:26 pm Said:

    Well I’m on week 5 of the non surgical option, here Australia as in the States the surgical option tend to be more popular but I just don’t like the idea unless it is the last option. Anyway the options are there and surgeons like surgeries, after all that’s their job. So I would like to know the experience of some one who has gone through both alternatives. I have got a partial rupture and due to my impatient I might have to get the surgery after all.
    By the way, I know it sounds lame but I have just found that crutches and wet surfaces don’t go along. AT ALL! So I recommend you to get an extra pair of rubber ends for your crutches, especially if you like to walk every day, as they tend to were-off very quickly and when you least expect it, you are on the floor again and again. I know it is a very frustrating experience, especially for people like me who are very active and like to exercise every day. As someone has already mentioned take it easssssssy and please, walk slooooowly. Believe me you don’t want to feel it again and extend the excruciating recovery.

  18. Sheryl, on February 9th, 2009 at 5:14 am Said:

    Hi, I ruptured my achilles tendon 19th Nov 2008 whilst at an exercise class. Im now coming up to my 12th week non-surgical and am still in the lovely frankenstein boot. my tendon/ankle has been swollen now for the last 2 weeks, which the physio doesnt seem too concerned with. However, i also have a constant deep ache in my tendon which i am taking painkillers for. Has anyone else experienced this, or is it something that I should be worrying about?

  19. Graham, on February 17th, 2009 at 7:46 am Said:

    For sheryl

    I had similar pains when i ruptured mine too I wouldnt worry too much. You didnt have the surgical repair so perhaps its just healing pains. Im 18 weeks post op now after my re rupture in october. My ankle is still swollen and im full weight baring. The doctors dont appear too worried about this. The swelling may never fully go down as teh scar tissue in the area will always probably be there. I still get some aches and pains in my leg now at 18 weeks. I do worry about it a bit but youve just got to take it slow and hope that time will be a good healer.

  20. rudedog, on April 7th, 2009 at 10:24 am Said:

    Hi Everyone,

    I am a 32-year old (reasonably healthy/active) male who ruptured left achilles tendon whilst playing 5-A-side indoor football on 11th March 2009. I had surgery on 13th March 2009. I was initially placed in a plaster-of-paris hard cast (plantar flexion) for two weeks post surgery. Sutures were removed after two weeks and I was placed in a lighter fibre-glass cast (still plantar flexion, although slightly moved towards neutral). I am now nearly 4 weeks post surgery and will have my last cast change this week where I will hopefully be placed in a fibreglass cast (neutral position) for two weeks. In total I will have been in a cast for approximately 6 weeks (NWB) followed by an aircast walking boot. I was wondering if any one on this blog could assist me with the following questions:

    1. Approximately 3 weeks post surgery (i was still in fibreglass cast - plantar flexion) I accidently placed approximately 50% of my body weight on bad leg. I did not experience any pain but felt pins and needles in my foot for a few seconds. I am concerned that I may have caused damage. I was wondering if anyone else in this forum has similar experience/advice?

    2. My orthopod has prescribed a 6 week protocol of NWB casts with the foot slowly adjusted from plantar flexion towards neutral over time. I am due to go into a walking boot after 6 weeks of casting. I was wondering (typically) how long does it take before you can start weight bearing using the walking boot (air cast) after 6 weeks of NWB casting.

    3. I often come across various statistics and scientific articles quoting re-rupture rates (surgical vs non-surgical; open surgery vs percutaneous surgery etc.). I was wondering if anyone has any idea of what time frame post ATR are these re-rupture statics based on. What i’m really trying to get at what point after surgery/treatment can you you truly not worry about re-rupture?

    4. I am left handed and ruptured my right achilles tendon. As mentioned above, I am fairly healthy/active 32 year old male. I am currently NWB on bad leg which implies that I am placing added strain on my good leg whilst using crutches. I was wondering if anyone has any idea about the odds of also rupturing the tendon on the other (good leg) is?

    Any assistance/feeback on the above will be most appreciated.

  21. jgsquash, on April 7th, 2009 at 2:01 pm Said:

    Just “registering” myself as another Brit here!

    Reading the general posts it does appear the UK is a lot more conservative in their approach to recovery than the US and Australasia. I appreciate there is a balance to played here w.r.t to re-rupture and recovery and that there’s no “one size fits all” in terms of rehab.

    Like most I’ve come away from my 2 week post-op appointment really disappointed with the information provided. Thank goodness for the internet and sites like this that share really useful and practical information.
    You can find my limited story at:
    http://achillesblog.com/jgsquash/

  22. SimonD, on April 8th, 2009 at 5:32 am Said:

    Hi

    Sad to say I am now a member of the UK ATR club, following an injury playing football in Glasgow on Sunday 5 April.

    Being treated via non-surgical route, although am a little concerned that this might not be right for me, as a lot of web advice suggests surgery for young and active folks - well I am active if no longer young!

    Anyone consider it worth me trying to get a second opinion? I am a BUPA member through work, but am currently being treated by Glasgow and Clyde NHS.

  23. rudedog, on April 8th, 2009 at 11:06 am Said:

    Hi SimonD,

    I would definitely recommend seeking a second opinion using your BUPA membership. I was in a situation where I ruptured my left achilles tendon playing 5-a-side footie on Weds 11th March 2009. I went to my local NHS A&E where the registrar gave me the options and recommended surgery as I am a young, otherwise healthy, active person. According to the registrar the advantages of surgery are less risk of re-rupture and potential for faster recovery to sport. The disadvantages are: (sural nerve damage, dvt, infection, general surgery comlications). I opted for the surgical option as I wanted to reduce the risk of re-rupture.

    I was initially placed in a hard cast and was told to go home and that they could potentially contact me the next day (36 hours after rupture) to see if they could accomodate me for surgery. Well, I did recieve a phone call from my NHS hospital the next day stating that they could not operate as the surgeons had a full-list for th day. I was a bit annoyed with this response to say the least, but when I mentioned that I had private medical insurance (BUPA) - they were lining up to operate on that day. I guess what i’m saying is that it’s worth using your BUPA to get a second opinion. BUPA will speed things up. However, choice of surgery vs non-surgery really depends on a number of factors and at times the non-surgical option may be better than surgical or vise-versa.

    Anyway. hope you get better soon.

  24. SimonD, on April 9th, 2009 at 3:49 am Said:

    Rudedog
    Thanks for your quick and helpful response. I’ll certainly organise a second opinion.

    Do you know if, assuming the conservative approach heals well with no re-rupture, both treatment routes eventually lead to a tendon that is strong, or will the tendon be stronger following a surgical op?

    Many thanks again

  25. rudedog, on April 9th, 2009 at 6:03 am Said:

    Hi SimonD,

    I have been doing some research on ATRs and in my opinion and according to what I have read from blogs/scientific papers it appears as if the healing of the tendon is good after 12 months regardless of whether you go for the conservative or surgical approach. However, i’m not sure at what time frame after ATR you can be totally safe and not worry about a re-rupture. This is a question that I will raise with my consultant when I next see him in two weeks.

    The other things you need to consider are as follows:

    1. Conservative treatment is more likely to require longer rehab time. You are likely to be in a cast/boot for a longer period of time compared to surgical.

    2. Orthopods generally recommend surgery if you are healthy and would like to return to competitive sport.

    I had surgery two days after ATR. I was initially told that I would be in various casts NWB for a total of 6 weeks post-op. However, today (4 weeks post-op) I had my final cast change where the nurse placed my foot in a near-neutral position. I was also pleasantly surprised when the cast nurse gave me a sandle to place on my cast and she said that I could partial weight bear. In my opinion surgery does tend to slightly reduce time to recover, but it may not be the option for everyone. I think everyone is different and heals at different rates. It’s definitely worth seeking as many opinions as you can before you make a decision.

  26. dancingfeet, on April 9th, 2009 at 10:52 am Said:

    Hi Rudedog,

    It’s so interesting to see what happened with you. I injured my achilles on the 9th and get my surgery done on the 12th in the late evening. I received a split cast for a week , which was so heavy that I couldn’t move nearly at all. After a week they changed it to a light plaster ( I think the usual option) and actually there was no option that after 6 weeks I will get a different cast, like a walking boot. They didn’t mention any phisiotherapy either. To be honest they were giving me just some false informations so far. The only one who was worth to listen was the guy in the plaster room. I have to visit the plaster room in every 3 weeks until I can restore the normal length and tension to the tendon and allow me to do what I could do before the injury. He said that will usually take 12 week in plaster , even so that the doctor who examined me said that after the surgery I might have to stay in plaster just for 4 weeks, if it’s healing all right.
    I’m quite confused, and I really would like to know when I will be able to walk again. With this thing I can’t really resist for much longer, especially because I can’t go to work. So if you have any more information it would be grate to hear them. The plaster guy is also not helping me to pul up my feet, so I have to do it alone, which is….I don’t know I don’t think that this is the right procedure.

  27. cactus, on April 19th, 2009 at 4:26 pm Said:

    Hi all

    I was unfortunate to join the ATR club two weeks ago, I was not offered surgery just put in a cast. I told the doctor i planned to go on holiday in six weeks and they said i would have this cast on for four weeks then i would be given an aircast.

    Can anyone tell me what to expect and will i be able to put any weight on my foot after six weeks, many thanks

  28. andrew5600, on April 19th, 2009 at 4:58 pm Said:

    Hi Cactus, I too suffered ATR two weeks ago while playing basketball. When I was seen by ER doctor, I was asked to go and see an Orthopedic Surgeon the next day. When I did consult the surgeon, he gave me two choices (surgery and conventional) and I chose the latter without further knowledge.

    Cast for 4 weeks then aircast right away? That seems rather short in duration. I am currently wearing Bledsoe Boots and my ortho surgeion told me it would take at least 6 weeks before he makes any adjustments.

    Btw, after 2 weeks, swelling has gone down significantly although on both sides of my foot, there’s extensive bruising. What kind of tests have you gone through and how bad is your rupture?

  29. cactus, on April 19th, 2009 at 5:30 pm Said:

    Hi Andrew thanks for the reply.

    The only test i was given was the so called Thompson test where they squeeze your calf to see if your foot responds and i was told it was a complete rupture.

    I think the Aircast is due to us going on holiday and something to do with the pressure of the plane but that will be six weeks after the rupture so i am hoping i may be able to put some weight on it.

    I honestly cannot believe how common this injury is, i was in a gym class and merely stepped to the side and back then pop. I don’t fancy the thought of surgery but i am worried it may not heal properly without it as i was fairly active and hope to return to that.

  30. andrew5600, on April 19th, 2009 at 5:57 pm Said:

    Ditto…both the ER doctor and the orthopedic surgeon performed Thompson Test on my injured leg and no other test/images were done.

    I too worry about not being able to recover fully prior to my injury as it directly impacts what I do for living. On the other hand, the conventional method seem to work quite effectively as well..It’s just that I am worried about the ‘higher’ re-rupture rate associated to conventional methouid as opposed to the surgery.

    What kind of cast do you have on? Is it like Bledsor Boots I am currently fitted with? Did you doctor ever tell you when you can commence on rehab/physio?

  31. cactus, on April 19th, 2009 at 6:18 pm Said:

    I am in a solid plaster cast from just below my knee with my foot pointed forward to bring the tendon together, no movement of my foot is possible at all.

    I never actually spoke to my doc, i am in the UK and after A&E i had an appointment to see the consultant who as i said done the Thompson test and ran his finger along the tendon looking for the gap and mentioned nothing about physio.

    I too worry about re rupture but i believe it is only slightly better with surgery and i did read that after one year in makes very little difference as the tendon has more or less healed but i cannot confirm if this is correct but you would possibly have a higher chance of re rupture if you tried to hurry things along. I think it is a case of walk before you can run if you pardon the pun and just take things easy and let nature heal itself !

  32. rudedog, on April 20th, 2009 at 3:52 am Said:

    Hi Cactus,

    I ruptured my left AT on 11th March 2009 whilst playing five-a-side footie. I’m from the UK as well and was givin the options of sugery and conventional. The surgeon basically listed the pros and cons of each as follows:

    Surgery pros:
    1. Lower re-rupture rates (1-3% for surgery vs. 5-10% non-surgery).
    2. Surgery is more likely to get you back to competitive sport/physical activity more quickly.
    3. Most orthopods tend to recommend surgery if you are healthy, suitable for sugery and would like to return to competitive sport.
    5. Less time in cast/splint compared to conservative.

    Surgery cons:
    1. Not suited for everyone
    2. Wound infections, DVT, clots, general surgical complications.

    Having said that, I do believe that after 12 months the healing of the tendon should be good regardless of whether you go for surgical vs non-surgical option.

    I decided to go for the surgical option, primarily because of the lower re-rupture rates and that I want to get back to competitive sport. Having said that, my surgeon is fairly conservative and he has placed my foot in a solid cast for a period of 6 weeks NWB (with foot gently moved towards neutral with time). I will be given the boot/air cast 6 weeks post-op where I’m hoping I can PWB.

    Anyway I do hope your recovery goes well.

  33. cactus, on April 20th, 2009 at 4:42 am Said:

    Hi Rudedog,

    Hope everything is going well for your recovery.

    It’s good you were given the option of surgery. When i asked the consultant he said there should be no need as 90% of ATRs heal fine.

    I just fear that the NHS may not want to go down the surgery route as it will cost more but i could be wrong anyway hope things go well for you.

  34. rudedog, on April 20th, 2009 at 5:48 am Said:

    Hi Cactus,

    I do agree with you, there is the worry that at times the NHS may be looking to save money. But I also think a lot depends on the type of orthopaedic surgeon that has treated you and what he/she feels is the best course of treatment. I think you may also find that two different orthopaedic surgeons within the same NHS hospital may have different approaches for ATR treatments. I am fairly suprised that you were not given the surgical option as in most cases they do give you the options of surgery and non-surgery. Having said that, the orthopaedic surgeons are less likely to advice surgery if you are likely to have to complications associated with surgery. Your health status/age are likely to have a significant influence on whether the orthoapedic surgeon recommends surgery or not. For example, if one is heavily diabetic, the surgeon may be cautious in recommending surgery due to wound healing issues.

    Having said this, I do believe that both approaches are succussful in the long-term.

  35. cactus, on April 20th, 2009 at 7:20 am Said:

    I am 38 and in good health but as i said when i asked about surgery the consultant just shrugged it off.

    I have like most people i suspect been doing a lot of “Googling” about ATRs and found many recent reports suggesting the non surgical approach was just as good, if not better so i hope these are correct.

  36. pixie19, on May 10th, 2009 at 4:21 pm Said:

    Hi all

    Sad to say this is my second ATR. Left achilles ruptured when I was playing squash at 17yo and had op to repair it. Now aged 36 and right achilles now done same thing- I’m a teacher and was playing dodgeball with my class. The only up side was that we beat the kids! This experience very different though as this time it seems to be a partial tear so the docs have gone down the non surgical route.

    8 weeks down the recovery route (happened on Friday 13th (!) March 2009) and about to go back tomorrow to see what happens next. Don’t know if reading blogs and all stories online have helped. Very worried about the chances of a re-rupture if I don’t get they don’t get it right and will have to make sure I ask the right questions tomorrow. Wondering if I should have pushed for the op again but hindsight and all that.

    Doesn’t seem to be much about ref. recovery after no-surgery approach so any advice from others who have would be greatly appreciated.

    I have my fingers crossed for positive outcome tomorrow- may even be looking forward to the dreaded boot instead of another cast!

  37. andrew5600, on May 10th, 2009 at 10:40 pm Said:

    Hey Pixie, I too am one of the few who have gone down the non-surgical route. The only difference is that I was fitted with a boot from day 1. Based on my experience, right up until week 3, you do not see nor feel any significant improvement (swelling, limited range of motion and that ‘tendon not connected’ feeling). It was only after 4 weeks, I started to feel that it was connected and although I was not even close to pushing off my foot, I could rotate my angle, wiggle my toes like normal, and put pressure on (no boot) without any pain.

    It’s been just over 5 weeks and I am anxious to get back on my feet and I will do whatever it takes to facilitate a fast and full recovery. I have spend alot of hours researching this forum and the general consensus is that rehab is just as important as the actual operation/non-surgical approach. I believe sooner you start with the program, the sooner you can strengthen your calf muscle and rid all those nasty scar tissues. I have an appointement with the orthopedic surgeon next week and I have a slew of questions for him already!

    Start wiggling your toes to minimize the atrophy and as soon as you get the green light from your doc, start drawing those alphabet letters with your foot whenever you can!

    Hope this helps and keep me posted as well.

    Andrew

  38. Neil71, on May 22nd, 2009 at 8:07 am Said:

    Hi,

    I am a 37 year old, relatively active, man who ruptured my left achilles tendon on February 17th.
    I have been looking at these sights with interest over the past 3 months and thought it was worthwile posting my experiences for other people.

    I had surgery 8 days after the rupture (which happened playing 5 a side football). Fortunately I have health care with my work and was able to go private (after the local NHS hospital told me there were no beds available….although they were very good at A&E).

    My surgeon was fantastic and if anybody who is in a similar situation in the West Midlands, I would definitely recommend him. I was in plaster for 6 weeks post op, where the plaster had to be changed quite often due to a small infection……this went with no real problem (I was back at work, office duties, 2 weeks after my injury had occured).

    6 weeks post op, my plaster came off to be replaced with an air cast boot and physiotherapy. Initially I was PWB with both crutches for 1 more week, followed by PWB with 1 crutch for 1 week and then FWB (still in the boot) for another week. Week 10 post op saw me progress into 2 shoes, where I was able to go on holiday to Ibiza with younger people!!

    It is now 12 week post op and the walking on holiday has strengthened my leg immeasurably. I still walk with a limp but am able to drive and virtually lead a normal life. Between week 6 and 10, I had a few sharp pains and burning sensations which frightened me a little, but overall it has gone well.

    I think any advice I would give is take your time and be careful…..it is depressing with no mobility but it WILL get better….good luck.

  39. ian99, on May 25th, 2009 at 6:09 am Said:

    Hi
    Am start of week 8 post op and all seems to be well. Did full ATR on right leg and had the op 8 weeks after a fairly bad ski crash. Delay was due to misdiagnosois in resort (not all french docs know what they are talking about!). Nobody seems to mention problems with size of gap between the ends. mine was 6cms and needed a tendon transfer involving my big toe! I had two weeks in an open cast NWB before moving to a Donjoy boot.and starterd physio straight away. Boot is now infull walking position and FWB without crutches. Next week I lose the boot! caution is still my watchword but everything seems good and there has been no pain since the op. had the op at the London Foot and Ankle Centre and if your insurance runs to it the service and info is very good.

    Patience seems a good approach.

    Ian

  40. Sam, on June 27th, 2009 at 10:29 am Said:

    Hi,
    Originally posted on the “How did it happen?” page but had been told by A&E it was a partial tear - no MRI done.
    (42-year-old fairly active mum, injured in school sports day race.)
    Have now gone to private consultant (husband’s company scheme) at Gatwick Park Hospital and been told it is a full rupture - hurray!
    Awaiting MRI scan early next week to see if surgery possible. Have already discussed pros and cons of surgery vs conservative and being offered the choice myself subject to results of MRI scan and size of gap.
    Glad I took Annie and Cactus’ advice to get a second opinion after reading other posts on this site. Thinking about writing to the NHS A&E department to tell them what they did wrong - did walking on it for two more days cause any further damage?
    Anyway back to elevation & ice packs for the minute.
    Will write further so treatment can be compared - hoping hubbie’s health plan will pay for all privately.
    Sam

  41. cactus, on June 27th, 2009 at 11:09 am Said:

    Hi Sam,

    Sorry to hear your AT is completely ruptured but cannot believe the incompetence of the A&E Doctor.

    You get lots of great info from people on this site who have had an ATR or are going through it, start your own blog and keep us informed.

    All the best for now.

  42. annieh, on June 27th, 2009 at 1:36 pm Said:

    Sam, So sorry to hear your news but glad you went to get second opinion. Like I said I was misdiagnosed by NHS and I went private, I have PPP and so glad I have. I walked for three weeks after rupture so I think a few days should not make too much difference to you.

    I was not given an option my Consultant said operation, no alternative and I had 10 weeks in plaster, using crutches and a borrowed wheelchair meant I could carry on work. You will be amazed how well you will cope and come up with strategies for doing things. I am almost 60 so I think you will manage very well.

    I debated about making a complaint to NHS but that I would just get on with life.

    Good luck
    Annie

  43. Simon Webster, on June 30th, 2009 at 9:21 am Said:

    Hi
    I ruptured my Acillies Tendon just over 10 weeks ago playing Sunday League Football. I limped of the pitch and had a fair idea what had happened, i went home had a shower the pain seemed to be easing. I went to A&E on Wednesday morning after the pain incresed on Tuesday. Initially the doctors decided i was going to have the operation, then they decided i wasnt and was going to be put into a cast.

    I was put into a cast with my foot pointed downwards, none weight bearing. I found things very difficult, getting about was almost impossible,being active boredom soon set in. After 2 weeks my foot was reset, still none weight bearing. After 4 weeks my foot was set at neutral and was allowed to partial weight bear which made life slightly easier, the crutches were a pain but without them i couldnt get about.

    After 6 weeks they removed the cast and the Doctor was pleased with progress. I was put into a removable boot with 2 wedges in, this made for much easier times, it could be removed for showering and i took it off on an evening. After a couple of weeks i removed a wedge and ditched the crutches and was getting around quite well, i even went out for a meal with friends and into town without them.

    At 9 weeks i went to the hospital and saw a consultant who examined my leg. He said it had healed up well and he would discharge me. I asked if i was ok to return to work, he said “yes work, drive yes, dont climb ladders or run on it and you will be fine”

    So Thursday afternoon i took my first unaided steps for 9 weeks. I have a big limp, going upstairs is ok but going down is one step at a time.

    So yesterday (Monday) i went back to work. Im a Plumber, up and down stairs all day, carrying tools, carrying materials quite a physical job! By lunch time my leg was really sore and my workmates were telling me to go home. I got an appointment to see my GP and was given 2 further weeks to rest and build up walking and then some physio.

    So im now able to walk around the house and garden ok, strangely i was able to get about better with the boot on, probably because it gave my leg alot of support . I want to get back to normal, as i said im very active, gardening, DIY, but im not playing football anymore the wife would kill me if i hurt myself again!

  44. sam66, on July 1st, 2009 at 4:08 am Said:

    Having read a far amount of info on this site since my ATR last week, it sounds like you’ve done really well timewise. General opinion, as far as I can see, is don’t rush it and get as much physio as possible when out of casts.

  45. Anne, on July 4th, 2009 at 12:10 pm Said:

    Hi, I’ve partially torn achilles playing badminton, have hobbled around for last 3 weeks, had MRI and now consultant wants to shave heel bone to allow achiiles to run smoothly over it. Does any one have any experiences of this, is it similar process to rupture. i play competative badminton so would like quick recovery!

  46. Smish, on July 4th, 2009 at 4:09 pm Said:

    Anne: I have had both of my heel bones shaved down. I had to have some other procedures as well so I don’t know how much my experience will help you. I have also had a previous full rupture surgery and partial rupture with no surgery. The thing I can tell you is that with all of the trouble I have had with my Achilles tendons I am pain free and my life is getting back to normal. Today I ran around hitting baseballs with an exchange student we have now from Madrid. I had a blast and I didn’t have to hold back much at all. I am guessing you are much younger than me if you are still playing competitive badminton so you should heal up quicker than I did. My most recent surgery was 5 months ago and I am 40. Life is getting sweeter every day!!! If you would have told me a year ago that one year later (after two surgeries) I would be running around a baseball field goofing off with some kids, pain free, I would have told you NOT POSSIBLE.

  47. Anne, on July 4th, 2009 at 5:31 pm Said:

    Hi Smish, thanks for your response. I am older than you so recovery will be longer but cannot imagine not being able to play sport. Any idea of recovery times, consultant was talking about 2 weeks no activity followed by 12 weeks gentle activtiy then can start sport.

  48. Smish, on July 4th, 2009 at 7:50 pm Said:

    Anne: I had a lot of other stuff done including an Achilles lengthening so my recovery was a lot longer than that. I was not cleared to try any kind of a jog until 3 1/2 months post-op and I think that is on the aggressive side from what I have read from others. I have only started to feel comfortable in a jog within the last 2 weeks. My left had not ruptured yet so the recovery was quicker. In fact, my left feels better right now than my right and the right was done July 26, 2008.

  49. Angela, on August 15th, 2009 at 11:26 am Said:

    Hi I fully ruptured my achilles tendon 6 weeks ago playing ball in a friends garden. I am over 40 overweight and not fit. I had not idea what I had done or how long recovery was until I went to hospital and they explained the process, I think I was in shock for about a week. It is my 25th Wedding anniversary on 1st Sept and we were supposed to be in Barbados for it but I cannot go now. I was made redundant at the beginning of the year and had been in a new job on a 9 month contract for only 5 weeks when this happened, I have not been able to go back to work yet. I am going to hospital on Tuesday for my second replaster and really hope I will be able to start putting some weight on as I am struggling to get around on crutches and have to use a wheel chair if I leave the house, which is extremely rare!

    I have had other small complications like putting my shoulder out due to carrying my weight around on crutches.

    This should have been a year of celebration, my son got married, I qualified as an accountant, my 25th anniversary and my other son is 21, however my job is at risk and I have to sell my house if I don’t get back to work in the next week! Which I feel is highly unlikely.

    Recovery has been frustrating especially sitting around all day - any more day time tv and I will scream.

    Any advice on how to get through it, I really want to see some signs of recovery but reading all the blogs just makes me more worried about how the recovery will go, especially as I am not fit to start with. On the other hand reading all the positive comments is encouraging.

  50. annieh, on August 15th, 2009 at 12:09 pm Said:

    Angela,

    You have made the first positive move. Now for the second create a blog and vent all your feelings and frustrations good and bad and you will feel much better because you are telling them to people who know exactly how you feel, you will be surprised at the positive responses and the humour. Don’t worry about age, being overweight or not being fit that is not important really, the important thing is learning to cope and to delegate.

    Your family and work situation must be very distressing for you which won’t help,but I bet you felt better for putting all that down in writing didn’t you!!

    Good luck, get that blog going and vent your feelings..

    Annie

  51. mattachille, on August 15th, 2009 at 2:31 pm Said:

    Angela,

    Your situtation sounds really difficult and it’s obvious from your post that you’re going through a very tough time. I’m in the US on a working visa and in the first few weeks after my injury I had all sorts of fears of losing my job and having to pack up all my posessions and move back to the UK whilst still in recovery.

    For me things have not turned out too bad, but It’s easy to imagine the worst. Hopefully you will get good news at your next doctors visit and be able to regain some mobility.

    I’m sure everyone on this site wishes you well and as Annieh says, keep posting.

    Matt

  52. rainbow395, on August 15th, 2009 at 10:22 pm Said:

    Hi Angela,
    It will get better.
    You have still qualified as an accountant and you have still been married 25 years - both huge achievements that will not go away. Barbados will still be there too.
    Focus on what you can do and this is not forever.
    The job and house situation are biggies but can you work from home or take in lodgers or students temporarily to get you by? - in the scale of things it will not be for that long.
    Set up a blog - keep us posted and vent your frustrations.
    I did mine 6 weeks ago, the day after my husband finished his job, we have 3 quite young children and live very rurally so not being able to drive has been a huge issue. 6 weeks on it has not been as bad as it felt then - the family has coped, maybe we had beans on toast rather a lot for dinner but then the kids love that anyway! Day time TV is mind numbing so I have read more and caught up on things I never had time to do normally - the mending pile has disappeared!
    This site is great. Totally sympathise with your feelings about crutches I couldn’t get used to them at all to start with - I hardly went out anywhere.
    Take care,
    Sharon

  53. Angela, on August 18th, 2009 at 12:07 pm Said:

    Hi Thanks so much for the feedback, it means a lot to have other people who know what this is like to talk to.

    I went to the hospital today and I couldn’t move my foot up enough to have a shoe so they replastered my leg and said I would have to wait another week before going back to work as my ankle was extremely swollen. After explaining about my precarious position at work they decided to take the new plaster off and give me a walking boot. It is huge but at least I can put my leg down for balance, I am really scared to put any weight on it so I limp along with the crutches. It is so much better I have been for a short walk down the road today to see how far I could go, I was really jelly as my other muscles were struggling but it was realy good to get out and not be in a wheel chair!

    I am going into work tomorrow to see how it goes, my consultant said so long as I am not in too much pain and the swelling is not too bad it would be ok so hopefully it will go well.

    Thanks for the support and advice it certainly is hard to keep positive but this site really does help.

  54. dsut4392, on August 19th, 2009 at 12:31 am Said:

    Hi Angela,
    You’ll be surprised by how quickly things improve from here on.
    Now that you are in a boot you will be able to wear a compression stocking. That should make a huge difference to your swelling problems.
    The other thing that I did was put my leg up on the desk on a pillow, but if you don’t have the flexibility even putting it up on a spare desk chair will help.
    You could also work on a laptop and put BOTH feet up on the desk if this is easier for you - just don’t fall off your chair in the process!.
    Finally, take the boot off and wiggle your foot around if you know you won’t be needing to leave your desk for a while. This will help with the swelling, improve blood flow and help get some range of motion back.
    Dylan

  55. bubble, on August 19th, 2009 at 1:41 am Said:

    Thanks so much for this site - I think that it is going to be a great resource for me as I recover from my Achilles tendon rupture.

    I tore my Achilles on July-27 playing soccer and had surgery on July-30. I’m currently in my second cast, the surgeon is still talking about another 2 casts and then the big boot for 2 weeks before I start trying to walk. I’ve given up on the crutches and now wheel around on a knee scooter (I would recommend this as a great alternative to crutches, as long as you don’t need to navigate stairs).

    At this stage I’m planning my comeback 1/2 marathon in early December but I’m yet to speak to a Physical Therapist to see if that is feasible.

    My first thoughts on my injury were that it was just bad luck, but the more I read about it I think there is a lot that I could have done by listening to my body.

    Anyway, thanks again for a great site. I’m sure I will be a frequent visitor over the coming months.

  56. Bigjeff, on August 24th, 2009 at 12:02 pm Said:

    Greetings fellow sufferers.

    I’m two weeks in from my rupture and want to start with a big thank you - I don’t feel quite so lonley now I know you are all out there.

    My story 46 yrs reasonably fit - steps on the football field - takes one pace to the left - bang - drops like he’s been shot.

    I went directly to A/E (I was playing for the Hospital footy team). I got little advice other that whichever route I took surgical or conservative I would be in plaster for months - I took the none surgical route as I now intend to retire from vigerous sports and stick to gentle jogging and hiking.

    A week later at my local frcature clinic I was fitted with an air boot cast - again very little advice - just remove a wedge after three weeks then another after two more weeks then the last two weeks latter - then come back to clinic.

    I got my boot and retuned to clinic to ask was I to keep my weight off the boot or go weight bearing - weight bearing said sister.

    I am doing OK not too much pain and the boot is great but does anyone out there know can I deflate it when I’m sat down - can I take it off for a while if I don’t move.

    The staff were great but I needed an hour to ask all my questions.

    Any help or comments would be welcome.

    Keep up the post’s it has been a great help if a little scarry to read them.

    Cheers

    Bigjeff

  57. leech1050, on August 24th, 2009 at 4:33 pm Said:

    Hi Bigjeff and welcome to the best info site for we ATRers. For your first two weeks, have you been toes down in your cast? and do you know what angle your boot is set at now. I think its normal to start at 30 degrees. I am six weeks and got my first boot today, but then I had the operation, and have fallen behind, read my blog you will see what I mean, big update on the way. I was at the fracture clinic today, and they said they would change the wedge when they thought I was ready. And personal, I would leave the air in till four weeks. But it does tend to revolve around circumstance, ask you consultant. and Good luck.

  58. Bigjeff, on August 25th, 2009 at 5:51 am Said:

    Hi There,

    Thanks for that Leech1050.

    My toes were well and truelly down in my first cast - it was hip to toes and due to my being rather big in the leg weighed a ton.

    I’ll have a read at your blog - but sorry to hear that you had fallen behind.

    The surgeon was not too good at giving any information, I saw him in an outpatient booth and as soon as the surgical option was rejected - I was already eight days post injury and having read that the surgery needs to be performed within five days I was a little trepidatious. Basically he just wanted me out of the clinic and his advice was take out the wedges like I have told you and come back in seven weeks.

    Hence my thirst for knowledge here.

    My logic for the air release was to inprove blood flow to the injury site and hence improve healing - but who knows.

    Just as an aside I have started taking protein drinks too in the hope that it will make sure I have all the nutrients required to repair the damage - anyone else tried or been advised to do so.

    Best of luck with the Boot - I love mine already.

    Cheers

    Bigjeff

  59. Angela, on August 29th, 2009 at 9:40 am Said:

    Thanks Dylon

    The boot is definately better, being able to put my foot down for balance is great. I do take the boot off in the evening and exercise the ankle, the swelling is much better and I can feel it is stronger.

    I am not sure how much weight I can put on it so I still use my crutches to take the weight and just put my foot down for balance. Did you put any weight on yours, I am at 8 weeks now. I am happy with my progress just don’t want to do the wrong thing and put my recovery back. The staff at the hospital are very good but under too much pressure and don’t give much info.

    Cheers
    Angela

  60. leech1050, on August 29th, 2009 at 10:08 am Said:

    Hi Angela
    I am in a boot at seven weeks, I have been told to go FWB as soon as I can. But so far I have only managed 60%. But my balance is much improved also and I am happy with my progress. Did you have the operation? It has been possible for some to go FWB at six weeks. Let your body tell you though, you will know when it feels ok for more weight on that side. I jealous of you, as I still have not taken my boot off, it feels to fragile, but as it is feeling better today, I may give it a go tomorrow. good luck.
    Lee

  61. Angela, on August 30th, 2009 at 8:04 am Said:

    Hi Lee Thanks for the advice, I just read your blog it’s great. Sorry you seem to have had quite a few problems and in a lot of pain but you sound like you are making good progress now.

    I did not have the operation as my consultant said I was not athletic or fit enough. I agreed really I don’t think I would have coped well with a wound as well. I am not in an air boot like yours mine is just a padded black boot with similar bottom to yours and wedges in, I took one of the wedges out on Friday and my leg didn’t suffer too much. My good leg also hurts quite a bit and I also rest when it gets too much and I am paranoid about a re rupture or rupture of the good leg. My consultant referred me to physio to help strengthen my good leg as he was also concerned that it may rupture trying to cope with extra pressure, but the physio could not fit me in for 6 weeks! I have my first appointment with them on 8th Sept so hoping they will help reduce the risks.

    I have been walking today with just one crutch putting more weight on my bad leg, it twinges quite abit but it seems OK.

    Keep blogging
    Angela

  62. dsut4392, on August 30th, 2009 at 11:00 pm Said:

    Hi Angela & Lee,
    We’re all different aren’t we, notwithstanding differences in treatment? I’m a fit active guy, no pain on rupture, had surgery and have had a pretty smooth and pain free recovery, so may not the best benchmark for conservative non-surgical treatment. At my first post-op review at 2 weeks I was told to start PWB, and also told I could sleep without the boot, frightening but a huge relief as well. I was instructed to work up to FWB over the following 2 weeks but was FWB in the boot before 3 weeks, and had the final heel wedges out by 4 weeks post-op. Since just over 6 weeks I have been back in 2 shoes.
    Progress has slowed a little since then due to a skin infection secondary to a stitch abscess, but now I’m on the right antibiotics it seems to be clearing and I’m working on the strength again. Fingers crossed the abscess is gone in the next week or I may need to have it drained, but even so I can’t really complain!

    Physio is not necessarily something you need to see someone for, or reserve special time for. A few years ago I had sprained my ankle and kept rolling over on it months later. A friend gave me a great tip for strengthening he had after breaking his own ankle: every time you’re in the shower, stand on that leg with your knee slightly bent and balance like that for the whole time you wash your hair. Do the same while brushing your teeth, making toast etc. I was a good habit to get in to, and much easier than doing boring exercises thrice daily (and it worked). Could be a good one for you to use on your good leg while you wait for a formal physio appointment, helps with both balance and strength - just be careful to do it where you can easily stabilise yourself with your arms if you start losing your balance.

    Good luck!

  63. sam66, on September 2nd, 2009 at 4:47 am Said:

    In case it’s of use to anyone in the UK:
    I’ve read various other blogs recommending a night-splint to stop the tendon contracting overnight and being painful to stretch in the morning.
    Have just found a site http://www.algeos.com based in Liverpool who seem to offer these spilints for much less than other sites in the UK, ie.£14.95 + VAT instead of £34.95. They also list other possible useful items, eg protection sleeve, cold therapy bootie. Carriage extra.

  64. leech1050, on September 2nd, 2009 at 4:42 pm Said:

    Sam
    Re web page, nice find, they have some very useful kit. I have bookmarked it for future reference. Thanks.
    Lee

  65. sam66, on September 3rd, 2009 at 2:01 pm Said:

    Hi Smoley,

    Was trying to comment on your blog, but it says comments are closed?? Hope you see it here instead.

    Anyway what I wanted to say was that from what I’e read on this site you really should’t be in the boot for 6 months.

    My final cast comes off next Tuesday after 9 weeks and I’ve told to expect to go straight to 2 shoes - we’ll see about that on the day, but if I do need a boot I wouldn’t expect it to be more than a couple of weeks after all that time in the cast. I know I might still need the crutches to start with but there seem to be a lot of stories of people being able to walk, albeit slowly and perhaps with a limp, within a few days of going into 2 shoes. It seems true that to rebuild proper strength and flexibility takes many months, but not using the boot.

    We all know how depressing it can be at times, but there’s hope and a lot of encouraging blogs on this site. Vent your frustration and someone is bound to be there for you.

    Hope all goes well,
    Sam

  66. smoley, on September 4th, 2009 at 5:08 am Said:

    Dear Sam,

    Thanks for your kind words - my first blog response! Yeh, I did get it a bit wrong about the time in the boot. What husband meant was that I might need the boot up to the six month mark from the time of the injury. I misinterpretted him, thought he meant for a further six months after all the cast time so no wonder I was choked! When hubby read my blog and realised I’d misunderstood he put me straight and I felt a lot happier!
    Sounds like you are making great progress and I’m very encouraged by your words. Good luck being back in two shoes. I live in crocs so I’m hoping that will make things easier when my time comes!
    Smoley

  67. annieh, on September 4th, 2009 at 6:32 am Said:

    Morning Smoley,

    Looks like we still blocked from replying on your site. Can you send an email to Dennis to see if he can unblock it for you.

    Anyway, I tried to reply yesterday. Like Sam I wanted to make sure you were not in the boot for 6 months, that would have been horrific.

    Keep blogging and checking blogs the information you will receive will help you greatly, and ask and someone will reply if you have a problem.

    Good luck

    Annie

  68. smoley, on September 4th, 2009 at 7:18 am Said:

    Dear Annie,
    Still feeling my way around the site, can’t see how to unblock comments myself, so will send note to Dennis. Hubby has just taken our dog for her daily run in the woods and fields which was always my favourite bit of the day so feeling bit sorry for self. Does retail therapy have the same effect when done on-line?
    Thanks again for comments re time in magic boot - very relieved when put right about that!
    Am working on list of all the things I can get done over next few weeks (sorting through boxes of photos etc) that would never normally make it to top of priority list. Will hopefully have some work coming in soon which I can do from home and keep sane.
    Smoley

  69. dennis, on September 4th, 2009 at 1:54 pm Said:

    smoley - I am not sure why comments were turned off for this particular post, but I’ve re-enabled it. The default setting is allow comments. let me know if you have any other problems.

  70. smoley, on September 5th, 2009 at 11:03 am Said:

    To Dennis - thanks for unblocking me. Now if you could just pop round and give me a new leg that would be great!
    Smoley

  71. jamie, on September 6th, 2009 at 8:15 am Said:

    Just been told by a fellow victim to check out this site. It really is fantastic, been reading lots of comments and noted all the help and advice. I am not a ‘blogger’ by nature but I will certainly be looking in occasionally over the next few months for help and advice.

    Been staying with Mum and Dad for a month, now it is up to friends to help me out now that I am back in my flat.

    Thanks to the chap who pointed me in this direction, found him by chance when signing up to facebook, something I did to stop the boredom.

  72. feedme, on September 6th, 2009 at 1:52 pm Said:

    Hey jamie..

    You’ll be suprised how much this blog has helped… advice, support and symapthy…

    FM ( luke from facebook)

  73. dennis, on September 6th, 2009 at 8:56 pm Said:

    smoley - I can’t give you a new leg, but I’ve enabled the blog option to “no complications”, “fast and complete healing”, and “good luck all around” for you. Enjoy! :)

  74. smoley, on September 7th, 2009 at 2:58 pm Said:

    Dennis - I have never met you but I already count you among my bestest friends!
    Hugs and kisses!
    Smoley

  75. Steve Scott, on September 14th, 2009 at 9:48 am Said:

    Hey folks!
    Glad to have found this site!

    Have spent the last 10 weeks in plaster (leg freed last wednesday) and managed to get a DVT during my first week (whilst in an A&E full leg temporary plaster when wainting on a a consultant appointment).
    He decided to go for the “natural heal”, so no surgery - just changing the angle of the cast every 3 weeks… oh, and managed to get admitted to MAU for a day due to a “reaction” to the co-dydramol - quickly changed to Trammadol!
    Have my first physio appointment tomorrow - all I was told by my consultant, was to try to begin to place my foot flat on the floor for now - but am managing to wiggle the foot around a bit, despite the heavy swelling.
    Massaging my foot helps too - but am a bit concerned about the pain in my heel which shoots up the sides of my ankles when squeezing the heel from below… anyone else get this? Apart from that, I’m not in any pain - just very stiff and swollen!

    Cheers!

    steve

  76. smoley, on September 14th, 2009 at 10:12 am Said:

    Welcome Steve!
    Good to have you on board! Plenty of people here know more about heel pain and every other sort of symptom/complication/reaction/procedure/remedy than you can shake a stick at. You are in good hands!
    Smoley

  77. 2ndtimer, on September 14th, 2009 at 10:13 am Said:

    You get some funny feelings after 10 weeks in cast when you try to use your foot again.
    Keep wiggling your toes and the stiffness should go away in a few days.
    Ask lots of questions at physio - they are really good at explaining things.
    Good luck!

  78. sam66, on September 14th, 2009 at 10:25 am Said:

    Hi Steve,
    I’ve had those shooting pains in the heel particularly when I try the first few steps with crutches after sitting still for a while. The heel was also the only real area of discomfort when in the cast so think it’s been squished! Obviously there isn’t a lot of fatty tissue around that area to pad it out.
    I find massagins it with some cream to help massage smoothly is good. Ask your physio about it, mine does a fair bit of work on those tight areas.
    Sam

  79. tomtom, on September 14th, 2009 at 10:34 am Said:

    Steve - It sounds like the heel pain you’re experiencing is normal. I believe the nerve endings in your foot start to “go to sleep” while you’re non-weightbearing. The nerve endings get re-stimulated as you start to put pressure back on your heel. It should dissipate in a few days, but as the others said, keep massaging and don’t be afraid to ask your physio about it. Also, keep icing and elevating to manage the swelling. Cheers!

  80. Steve Scott, on September 14th, 2009 at 10:39 am Said:

    Thanks peeps! Glad to know this is “normal” hehe!
    Lots of questions for the physio tomorrow - really need to be able to drive and get out and about after all these weeks of isolation ;o)-)

    steve

  81. graham, on September 23rd, 2009 at 10:37 am Said:

    Just joined this blog site and have started my diary of my rupture at achillesblog.com/graham. I ruptured mine on 16 September in the gym and had surgery 2 days later. Am now sitting on my sofa bored already with a cast for 2 weeks. I then move to ‘beckham’ boot for the next 6-8 weeks.
    Am usually very active so want to start physio soon to get the strength back and reading some online blogs here it is recommended you start quickly but gently. Leaving it too long can cause it to weaken too much. Is this correct?
    Thanks for a fantastic site!
    Graham

  82. Ed Hatton, on September 28th, 2009 at 10:39 am Said:

    My first blog ever! - Hi!!

    I had a complete rupture of my achilles tendon while on holiday in South Africa when I fell off a raised platform. I had surgery in the UK 5 weeks ago and since been fitted with a ‘mobility boot’. I’m told to keep the weight of my foot but so far I have not been given a timescale although I expect it to be for at least another 5 weeks. I think that after reading many blogs there seems to be a wide range of timesacles.

    I’m looking forward to starting physio and recovering my independance again however I have no information to date.

    Its true you cannot walk and hold a cup of coffee at the same time so I put mine in a flask and role it on the carpet!!

  83. smoley, on September 28th, 2009 at 1:02 pm Said:

    Ed - you’re absolutely right about the range of timescales! Next time I see my surgeon I’m going to take him to task about why he’s keeping me in cast for nine weeks with all the inconvenience and muscle wastage etc that entails when many of our comrades state-side seem to be going into the boot very soon after surgery and have a greatly accelerated recovery with apparently few down-sides that I can see from all I’ve read here (overly long sentence - sorry). So well done for being in the boot already. Do you take it off to sleep/bath etc? Where in the UK are you? Keep posting!
    Smoley

  84. Ed Hatton, on September 28th, 2009 at 2:38 pm Said:

    Hi, thanks for the reply,

    The timing was that I had a cast fitted for two weeks following surgery (to repair a 100% ruptured tendon), after which time the boot was fitted with the foot angle set to 45 degrees.

    This remained for another two weeks after which the angle was changed to 30 degrees and I will remain like this for two weeks again. (Well up until Friday)

    On Friday the angle of the foot will be changed to 15 degrees (I can do this myself) and yes this will remain for two weeks again. The setting then changes to 0 degrees for two more weeks after which I expect to start physio. During all this time I cannot weight bear on the foot at all.

    The boot stays on 24/7, it feels like going to bed with shoes on! I do however have the luxury of removing the boot to wash my leg and foot - but thats all. Ha- and how about taking a shower - sat down every time!

    I’m currently off work and board so I’m learning a foreign language now, something I’ve always wanted to do but never had the time.

    Is the timing etc comparable with the general experience?

    Ed (Southampton)

  85. darren, on September 29th, 2009 at 3:41 pm Said:

    Hi All

    Another newbie here and my first blog. I originally ruptured my right achilles tendon on 29 June playing footie. Opted for non surgical treatment and after 9 weeks of different casts I tripped over at home whilst in my air cast and re-ruptured. After talking to the surgeon he recommended that I have surgery this time which I had on 3 September.

    Following the op I had a splint and lots of bandages for 2 weeks until I went for my follow up with the surgeon. At that point he has put me into a cast and I am due to see him later this week. Not sure what to expect next as there seems to be a really wide range of recovery stories.

    Totally fed up after over 13 weeks of crutches, no driving and no independence. Has early physio helped others as I am really worried about the extent of the muscle wastage in my leg?

    Darren

  86. 2ndtimer, on September 29th, 2009 at 10:51 pm Said:

    Hi Darren, sorry to hear another unsuccesful conservative treatment story… I reruptured after 18 weeks. I am just starting to walk in 2 shoes now (31 weeks after the original injury) and yes the atrophy is significant. But my PT keeps telling me I can rebuild the muscles. But I see it will be a long process.
    Keep posting, this site has kept the life in lots of us. Good luck!

  87. 2ndtimer, on September 29th, 2009 at 10:54 pm Said:

    Hi Darren, sorry to hear another unsuccesful conservative treatment story. (see smellygypsy’s recent blog)
    I reruptured after 18 weeks. I am just starting to walk in 2 shoes now (31 weeks after the original injury) and yes the atrophy is significant. But my PT keeps telling me I can rebuild the muscles. But I see it will be a long process.
    Keep posting, this site has kept the life in lots of us. Good luck!

  88. Mustan, on September 30th, 2009 at 1:42 pm Said:

    Hi,

    I ruptured on sunday evening playing football, truely gutted. Consultant recommended non-surgical approach so sat here in a full leg cast for 4 weeks then the beckham boot for approx eight. Looks like a long road ahead…

  89. Jo, on September 30th, 2009 at 6:13 pm Said:

    Hi everyone,

    I ruptured my achilles on 4th August playing five-a-side footie. Hadn’t done any competitive sport since university (I’m 31 now), so think that was part of the problem - didn’t warm up properly either, whoops, what a mistake!

    Am going through the conservative treatment. Had three weeks in full leg cast (!) with my toes in the pointed position, then went to a below knee cast which was change every couple of weeks to bring the foot into the flat position. I’ve just got to this stage and have another two weeks to go before I come out of plaster (so will be ten weeks in total).

    I was given the option of surgery vs conservative treatment but the consultant didn’t really go into the pro’s and con’s. I assumed it was best to avoid surgery but having read all the comments from the US I’m thinking I might have gone for surgery for the speed of recovery and lower re-rupture rate - but who knows!

    One thing I’d like to raise awareness of, without scaring people (because it’s very rare), is the possibility of getting DVTs - with or without surgery.

    I wasn’t warned of the risks associated with having a plaster cast and being immobile and unfortunately I got a DVT which broke off and ended up in my lungs (a Massive Pulmonary Embolism) and I ended up in intensive care and was lucky to survive.

    It probably could have been avoided if I’d been told of the importance of keeping hydrated, and mobile (I’d had a long car journey the day before and hadn’t been told to take breaks every hour or so to keep circulation going etc - like on a long haul flight). Also I was on the contraceptive pill at the time which also increased the risks - maybe too much info?!

    I really don’t want to scare people but wished I’d been told of the risks before hand.

    Anyway, hope that’s been useful - I’ve certainly found this website and all the comments really helpful. Thanks to everyone who has posted!

    Jo

  90. robert, on September 30th, 2009 at 9:19 pm Said:

    Jo,

    I too found that the doctor didn’t go deeply into the merits/demerits of surgery vs. non-surgery. It’s just not ingrained into their mindset. I don’t think your assumption is wrong about surgery. I had surgery but I am finding it may not have been the best route for me. Avoiding surgery at least you don’t have to deal with the incision scar and its complications, and the doctor trimming tendon here and there. The speed of recovery is different for everyone. I have heard that both routes take the same amount of recovery time. So don’t beat yourself up over it.

  91. graham, on October 1st, 2009 at 5:20 am Said:

    Jo, Robert
    I also found my initial orthopaedic doctor in A&E would not give me a recommendation between conservative or surgery. I guess this is related to ‘where there’s blame there’s a claim’ mentality and if the doctor is recommending one over the other and it goes wrong people can sue? Just a theory.
    I initially went for conservative as the A&E doctor told me recovery would be the same. After coming home I searched the net and found this site and some others. Most recommended surgery if you are a sportsman and want to return to a active sports life. The tendon repair is stronger. I don’t know if this is true though.
    In any case I phoned my hospital and changed to surgery. I did not know until after the operation but I had a new key hole technique and the scar is very small, 1-2cm. 12 days post op I have been told to go FWB in a aircast boot! Am a little worried about that but you have to trust your surgeon. Check out some pictures on my blog achillesblog.com/graham
    All the best

  92. darren, on October 1st, 2009 at 3:43 pm Said:

    Just been back today for my second follow up four weeks after surgery. I have been put into an air cast with heel inserts and I have to take one out per week until I go back in four weeks. I have been told I am ok to walk in the boot without crutches but I just feel so nervous about doing this as I am paranoid due to one re-rupture already! Has anyone else found it difficult to try to force yourself to walk again?

  93. graham, on October 2nd, 2009 at 4:36 am Said:

    Darren, yes I did and I was told to FWB after 2 weeks! Very nervous at first but apart from pins and needles all seems OK now in the aircast boot. I am walking around my house with one crutch and then on some steps not using it. All seems OK. If your Doc has OK’d it go for it! All the best.

  94. darren, on October 2nd, 2009 at 3:46 pm Said:

    Hi Graham

    Thanks for your reply. I am gradually getting slightly braver and I will probably try with one crutch over the weekend. I have got a physio appointment next week so I will see what she advises. Has any one had any ultra sound as part of their physio?

    I am going to start back at the gym for upper body and I am just wondering whether gentle cycling will be too much at the moment?

  95. graham, on October 4th, 2009 at 5:32 am Said:

    Darren
    I would ask your physio. Is your physio via the NHS? I am not seeing my surgeon again for another 6 weeks and he didn’t mention any visit to physio’s in the meantime. I am wondering if I should pay and visit a private one.
    I am doing some weights/sit ups/press ups at home but want to try the exercise bike soon - just not sure when!

  96. darren, on October 4th, 2009 at 3:02 pm Said:

    Graham,

    I have got BUPA cover so got my physio through them.
    I have been walking around the house all weekend with no crutches and have got on really well.
    Went to gym this morning to do upper body but did struggle after not going for 6 weeks but will hopefully get back into soon.
    I will let you know how I get on at physio and what sort of treatment or exercises she gives me.

  97. graham, on October 5th, 2009 at 8:12 am Said:

    Hi Darren
    That would be great if you can get some info from the physio.

  98. Stuart, on October 17th, 2009 at 7:18 pm Said:

    Hi,

    I’m 24yr old and keep relatively fit by going to gym and play footy, so to find out i have an achilles total rupture at such a young age has been disheartening and totally knocked me for 6.

    I did it at 5 a side after starting it back up after summer break. Not warmed up or stretched started playing. Within 5 minsi felt the tear and heard the pop!! Went to A&E straight away and they did thomson test, put me in cast and sent me home to come back and see ortho doc next day. He did ultrasound and told me it was a bad total rupture and that they couldn’t opperate as it was too far up towards the calf muscle. So i had to take the non operative proceedure….

    3 weeks in full equince, 3 weeks half position, then 2 weeks normal (foot flat). then onto Physio. Was totally gutted as i was due to go to Tenerife in Oct and would also be off work for 8-10weeks.

    This happened on 8th Sept and i’m due to get cast put in the final possition for 2 weeks. Its been the worste 5 weeks of my short life and i’ve tried to keep positive but its so hard. Everyday things - shower, making meals/cups of tea, shopping and even getting out and about is 10 times the effort than normal. Using crutches is okay getting round house but any further its a pain (blisters). I’ve been a tad low, turned night into day, also by not going to gym and by resting have put on extra weight. Knowing i’m not the only one going through this makes it a bit more bareable, so i’m glad for these pages and other comments.

    In 2 1/2 weeks i’ll be getting cast off for good and i am a bit worried that i’m going to find it hard to put weight (16stone now) onto my leg and start walking.

    Few Questions-
    Is there an aircast that i would be wearing to help after getting final cast off, like i’ve read up the page?
    How long after till i can give crutches up and put pressure on ankle/foot?
    What exercises can i do at gym to start back up my training and to get shape back? bike, x-trainer, obviously not tred-mill.
    I heard it might take upto a year for the achilles to fully heal, and as i’ve not had the surgery and i’m a heavier guy, i’m worried incase it re-ruptures!!!

    I’d appreciate any replies to this or any further info to help.

    Thanks

  99. redman, on October 18th, 2009 at 1:53 am Said:

    Hi there Stuart. Did mine playing footie in london on 16 June (am 32). Had nhs non-operative treatment as diagnosed as a partial tear (don’t be fooled by the name - just a debilitating as a full one!). As a fellow footie sufferer, I thought I’d drop you a line.

    I was given the aircast boot when i came out of the cast after 8 weeks. Not all nhs trusts seem to offer it so check with your consultant. If not, you can buy one for about 100 quid on the net. Even though it aint exactly a fashion statement you’ll feel tons better when you get to that stage, as you can at least do a few things for yourself like carry a cuppa from kitchen to living room! You mentioned that you are at about the 5 week stage - funnily enough so was I when I was at my lowest ebb, and like I say, once you get out of that cast you’ll feel a lot better.

    Now I’ve been out of the boot for about a month, and things are improving but it’s not plain sailing. Be very careful not to overdo things when you start physio (try and get it on the nhs if you can). This could lead to a rerupture, or in my case, tendonitis, which is slowing my rehab down.

    In terms of keeping the weight down, I put on about a stone. It doesnt help that we live virtually next door to a cake shop. That stone has already fallen off just from moving again, even though I’m not doing much of that. So I wouldnt worry too much. The safest exercise for getting rid of weight in the gym would probably be the machine where you cycle peddle using your hands (sorry, not sure what its called), as obviously theres no strain on tendon and its quite intensive. Your physio will guide you though.

    Lastly, just try to hang on in there. It’s a xxxx injury and one I thought I was too young and healthy to do but which got me nonetheless. It came completely out of the blue. And I did 30 mins of stretching before my game! Its as much a mental challenge as a physical one, and just try to take it a day at a time. Good luck mate.

  100. graham, on October 18th, 2009 at 5:14 am Said:

    Hi Stuart

    I was worried about putting on weight as I got to a great ‘fighting’ weight and was ready for my next half marathon. I know its easy to say but try and cut back on what you are eating and eat the right stuff. Plenty of veg and fruit WILL help healing - its what your injury needs. Arnica apparently helps as well.

    I moved into an aircast boot on the NHS 2 weeks after my surgery. As redman says its so much better - I ditched my crutches a day after getting my boot. Initially it was a little weird as you get pins and needles in your foot but thats because it isnt used to carrying weight. I can now walk around fine albeit with a limp in my boot. Still cannot drive though.

    For working out - I concentrated on upper body sessions - arms, back, chest. Get some dumb bells from Argos and do arm lifts etc in your living room. When you move into the boot do some press ups and sit ups to get your heart going as well. It all helps and doesnt impact your bad leg.

    Keep your chin up. Its definatley a mental injury more than physical!

  101. Stuart, on October 18th, 2009 at 6:51 am Said:

    Hi Redman and Graham,
    thanks for your response to message.
    Reading it already makes me feel a whole lot more possitive…

    I’ll definitly be asking for the aircast boot from the NHS when i get out of cast. Seems like its the way to help the recovery.
    I’ve been off work since it happened and am eager to go back, so maybe when i get boot i can get back to light duties with leg raised for periods of time. I work as Loss prevention officer for a high street retailer, so can maybe do cctv (no running after thiefs tho).
    I might try getting to gym to do upper body workout. I remember 1 of instructors was on crutches and did a programme, i’ll get him to do me 1.

    Thanks again for your help guys and good luck with your recovery.

  102. smoley, on October 18th, 2009 at 7:26 am Said:

    Stuart - You will get better soon, don’t get down hearted. I believe it is really important to stay reconnected with the real world. Tap up friends and family to take you places - once you are in your seat at the pub/restaurant/match/gig/cinema (or whatever your cup of tea) then there is no difference between you and anyone else. The rest of you is just fine, it’s only half of one leg that is temporarily a bit duff! People are so pleased you made the extra effort to be with them, it’s really worth it. And you are excused queuing up at the bar when it’s your round! Healing is a very active process so look after yourself in all departments: food/rest/exercise/fun and laughter. And when you do feel fed-up, get on the blog and have a good rant! Good luck,
    Smoley

  103. 2ndtimer, on October 18th, 2009 at 1:07 pm Said:

    Hi Stuart,
    I find recovery with conservative treatment very different from the surgical route. I was interested to hear the explanation why they did not surgery for you. For me it was basically that I was not young (43) and did not do sports.
    So you being so young might be a bonus, you may heal much better than us old folk!
    This injury is very trying indeed, terrible lesson in patience. Unfortunately there is nothing you can do but tell yourself, it will pass. Being housebound when everybody else is too busy out there doing things was depressing me a lot. But once it will be over, and you will be happy to forget about it.

    Keeping the weight down when living on the couch is very hard indeed.
    But you can do upper body exercises with hand weights,
    ab crunches,
    push ups the way us ladies do it: on your knees keeping your ankles lifted off the floor,
    and all sorts of leg lifts: for example while sitting in a chair, hold a small cushion between your knees and squeeze it and lift one leg straighten it, hold it, lower it a little bit, hold, then straighten it again, keep repeating it 5 times, then put your foot down for a rest (the cast gives you an instant extra weight). This works your inner thigh and quads.

    Regarding the boot: if you spend 8 weeks in cast, your foot will be weak but your tendon should heal by then well. So a boot may not be necessary. There are many on these pages, who went without the boot. You maybe happy to transition onto full weight bearing in shoes in a short time. It really varies. I was put in the boot after 7 weeks in cast, and was full weight bearing after 2 days, without crutches. I was comfortable with that, and rather annoyed having to be in the boot for 4 weeks. But you have to be very careful during the first weeks out of cast. So if you have to go back to work, you maybe safer in the boot, and can be out of it at home? Discuss it with your surgeon.

  104. chana7, on October 18th, 2009 at 4:09 pm Said:

    Stuart,

    Have a read of my blog, we seem to be in the exact same postion mate. Im also 24, keep fit (gym & football) and did it playing 5 a side, going down the conservative route… Im 3rd week in my cast….

  105. Jo, on October 19th, 2009 at 4:10 pm Said:

    Hi Stewart,

    I had exactly the same treatment as you. During the last two weeks in the below knee cast (flat foot) I could start putting weight onto the leg and after four or five days I could hobble to the kitchen without my crutches - just on the plaster cast (no boot). After a week or so I could actually hobble quite a long way (very slowly) - about 50 meters or so (no crutches) - wore a big hole in the sock I used to wear over the cast! Not sure if it is recommended to not use the crutches at all (the doc did say I could start putting weight on it) but I got on fine, took it easy and listened to what my body was telling me - it doesn’t seem to have done any harm - in fact I think it put me in a better position once I got out of the cast .

    I’m one week out of the cast now and back into two shoes. It was a bit of a backward step initially getting out of the cast cos I no longer had the support of the cast when putting the weight down - so I need the crutches again. Was sore and stiff and a bit disheartening for the first day or two but once you start the exercises and start loosening up, after a week you start seeing improvement and I feel quite positive again now. Still a way to go but I’m optimistic (first day back to work today and all going well so far). I weigh 12 stone and I’ve been told by the dr to try and only put 3 stone of weight on the leg in the first week out of plaster, 6 stone the second week, nine the third and then my full weight after 4 weeks.

    He did say it’s only a guide and if I feel ok it might be quicker than this, maybe just using one crutch after a couple of weeks if I feel ok. The important thing is to listen to your body, try and be confident but realistic and try not to do too much too soon. But believe me you’ll get there. Have had a few bad days myself where it seems soooo far off but it will get better and it will be a better recovery if you are patient and don’t push too hard. The doc says I should be ok to start running and getting back into sport in six months. I’ll see how I feel in six months but I recon I’ll try and give it a year before I attempt anything competetive - just to be careful. You’ll be fine - sounds like you are much fitter and younger than me! I’m jealous!

    Keep your chin up.

    Jo

  106. Stuart, on October 19th, 2009 at 5:29 pm Said:

    Thanks guys,

    This blog is really good and i already feel alot more settled andfocused to get through this.

    I’m seeing ortho doc on thurs so will have a good chat to him about the next few stages.

    Also my mgr says i could get back to work just part-time if it helps rehab. So will aim to do that at 1st when i’m able to FWB on foot and am 2 shoes.

    Good luck all of you’s with your recovery and i’ll prob be on this every so often till i’m totally recovered.

  107. doc, on October 21st, 2009 at 10:58 am Said:

    Hi guys been reading all your pstings yet no one seems to have suffered a severed achilles tendon….I have did mine in Turkey in august had surgerey on the same day am back in the UK now and have to admit the care inTurkey was far better than that in the UK, at the time of writing am in my 12th week of being in a cast (changed 3 times) which comesoff on 22nd oct and cant wait to get doing physio as I play footie yet as what seems to be a theme the Dr’s really cannot put a time on how long till I play footie…any ideas!!!!

  108. smoley, on October 21st, 2009 at 11:20 am Said:

    Doc - 12 weeks in cast?!! Is that all NWB? If so, you definately deserve some sort of medal. 22 Oct - hey, that’s tommorrow! Good luck!
    How did you manage to sever the tendon? I know someone who walked backwards into a hedge trimmer left under a bush while going for a sneaky pee in the garden at a party (!!) And one of the bloggers here was hit by a luggage trolley at an airport - that’s gonna smart.
    Hope all goes well for you tommorrow.
    Smoley

  109. doc, on October 21st, 2009 at 12:46 pm Said:

    Thanks Smoley and yes all NWB, I did it going trough some large glass doors at the hotel (no wasnt drunk lol), but didnt feel any pain the most pain was the gash on my arm and cant wait till tomorrow and can find out bout my road to recovery hoping to be able to play in a league game on boxing day!!

  110. smoley, on October 21st, 2009 at 1:10 pm Said:

    Doc - nice work my friend. Bet that made a bit of a mess on the carpet. Funny how one pain blocks out another. I once fell skiing and cranked my thumb right back. That hurt like hell, so much so that I didn’t notice that I had hit my head so hard on the tip of my ski in the fall that I had a near perfect imprint of the manufacturers logo embedded in my forehead! Dazed and confused or what!? But I was up to my eyeballs in gluhwein so what did I care! Fortunately, the Austrians have a somewhat liberal attitude to skiing and booze!
    Smoley

  111. Doc, on October 23rd, 2009 at 5:57 am Said:

    Well guys the cast came off yesterday… it looks horrible all that dead skin waited ages in the fracture clinic at City Hospital (formerly Dudley Road) in Birmingham, the consultant I saw was a wast of space initially wanted to treat me for a knee injury lol ayway when the finally sent me to physio suprise suprise it was closed but the team there were excellent gave me some exercises and I went back this morning for some cork and gel insoles can walk a bit put my foot on the floor wth the aid of crutches but at first it feltweird but getting better got another appointment next week..so now starts the long road of physio

  112. 2ndtimer, on October 23rd, 2009 at 11:25 am Said:

    What a relief it must be Doc, after 12 weeks! Time to celebrate.
    It will probably take some time to be able to weightbear, but it will come. Enjoy.

  113. doc, on October 23rd, 2009 at 2:31 pm Said:

    Thanks 2ndtimer….just found a night splnt that stretches he achilles whilst you sleep at algeos.com
    has anyone ever used one of these?

  114. 2ndtimer, on October 23rd, 2009 at 8:09 pm Said:

    I thought you were happy to be out of the cast now you want a night splint? If your doctor did not suggest it, I would not suggest to use it. After 12 weeks you need to keep your ankle mobile. And don’t worry, your tendon will stretch once you put your weight on your foot, nothing works it as well. Just keep moving!

  115. doc, on October 26th, 2009 at 1:11 pm Said:

    Thanks for the advice 2ndtimer!!!

  116. dc, on October 28th, 2009 at 5:36 am Said:

    Hi all had first physio session today fantastic have got rid of one crutch can walk albeit witha limp and still got build ups in my trainers and do stairs no more shuffling about feels good, got another next week then will see about attending gym classes very informative and helpful physio very laid back so here starts the long road to recovery!!!!

  117. Stuart, on November 6th, 2009 at 7:02 am Said:

    Hi, i got my cast off yesterday. Was a relief when it came off and felt good washing it for 1st time in 8weeks.
    its pretty stiff and a tad swollen, doc never gave me much info but does this last long and when should i be able to put weight on the foot. they gave me wedge to put in shoe but the ankle doesn’t feel strong enough to put weight on yet. he never even reffered me to physio, surely i should get physio.
    Also, when can i expect i can start driving my car again?

  118. Jo, on November 6th, 2009 at 9:20 pm Said:

    Hi Stewart,

    You’re over the worst now. I was out of plaster on 13 Oct. The first few days I couldn’t put any weight on it at all - felt very fragile, sore and stiff. But three weeks on, as of yesterday I’ve dumped one of the crutches and have started driving again. Feeling really positive now about the progress being made. Still got a lot to do to get the calf muscle and tendon stretched back to normal but I’m getting there.

    Definitely think you should be refered to physio though - I’ve only been twice in three weeks but they give you the right exercises to do in your own time.

    I’ve found bathing my leg twice a day in warm water (get in the bath is the easiest way) and massaging the ankle and calf has REALLY helped - would definitely recommend that.

    Hope it all goes well

    Jo

  119. Markgraf, on November 7th, 2009 at 8:21 am Said:

    Hi all, well I “have heard the pop” happened Tuesday 27th Nov during a squash game (I’m 47). Was in casualty that night and they diagnosed full rupture and put me in cast. Consultants appointment the next day where the consultant who was brilliant offered me surgery or non invasive. After examining me he recommended surgery and I was booked in the next day (yes this is the NHS). Got bumped off the Thursday list but was in Theatre and done by 7pm Friday night. Out on the Sunday in cast and now and on crutches. Consultants appointment a week on Wednesday so hopefully get the cast off. Keen skier so had to cancel my two ski trips.

  120. smoley, on November 7th, 2009 at 12:03 pm Said:

    Markgraf - Bummer my friend. Glad you got scooped up quickly though. If you’ve done a bit of reading around on this site and elsewhere, you’ll appreciate you are on a long and often steep and rocky path. But hang on in there and you will mend. Sorry you will be missing skiing, but I doubt even the most aggressive recovery programme would get you ready in time. The NHS seem to use a variety of different regimes, depending on the consultant I suppose. The first couple of weeks are definately the hardest. Keep blogging and you will discover a big gang of new friends all in the same boat and with a wealth of knowledge and, more importantly, understanding, to impart.
    Sorry to have to welcome you to the club!
    Smoley

  121. markgraf, on November 8th, 2009 at 3:47 pm Said:

    Thanks Smoley, if I had done a bit of reading on here I would have burned the racquet ;>)
    Insult to injury was picking up my freshly serviced skis today, never mind at least I can sleep with them again. Any skiers on here will appreciate that ,we are a sad bunch lol. In saying that got talking to a young lad that said his went during sprint training at Footie so I guess I 47 I did well to get this far.
    Just crossing my fingers that I get the cast off a week Monday.

  122. Sandie, on November 9th, 2009 at 6:06 am Said:

    Does anyone out there have any info on Haglunds deformity?
    The bone spur growing on my heel pushed out my achilles tendon and I had the op to repair and pin back my achilles and remove the bone spur two weeks today. The surgeon told me that he had to cut through 40% of my tendon to get to the bone spur - which sounded not too good…and then had to insert a titanium pin to pin my achilles in place.
    I am waiting to see the specialist today and see what the next stage will be. At the moment I am NWB in a 45 degree cast with leg elevated for the full 2 weeks and a sexy white stocking on my good leg..
    This site has been an amazing help and encouragement - but I can’t see any posts about the above op - although they are all a tad related.
    I will keep you posted as to progress - the crutches are a pain and my hands have been more painful than the leg! Not much pain in my leg at all - just the occasional sort of sharp short electric shock - like a hot needle.
    Thanks again to all who have really helped me understand the process {:O)

  123. linda lou, on November 9th, 2009 at 11:00 pm Said:

    I had a huge bone spur, at the end of June I found out part of it had broken off, & was “sawing” on my achilles,left foot. It cut my achilles till by the time i had surgery at the end of July only 10% remained attached. I am now 13 weeks post op, they removed the spur and contoured off part of the left side of my heel. My achilles was repaired by sutures,no metal. He made two incisions, one on the left & one on the right side about 4in.ea.and worked behind the flap of skin remaining. I have been doing PT for 3 weeks, and wear an ASO ankle figure 8 wrap brace & compression stocking under it, with tennis shoes, I am starting to walk fairly well. But still have a lot of swelling and sharp pains sometimes. Still stiff but making progress.

  124. sandie, on November 11th, 2009 at 9:41 am Said:

    Thanks Linda Lou
    Now I feel lucky! My specialist has put me in an aircast boot with 2 heel lifters for the next 4 weeks with full weight bearing. My scar doesn’t look too bad about 2.5 inches on the LHS of my heel. And I have got rid of the crutches - yeay!

    I start physio next week and so far am managing to get around albeit a bit shuffly on my own 2 feet - not much pain - just a bit tender around the scar. had a bath for the first time this morning - bliss {:O) Still very stiff and can feel the stretch on my tendon - so not inclined to push too far.

  125. markgraf, on November 16th, 2009 at 1:58 pm Said:

    Just thought I would post an update waited two and a half hours to see the consultant today for my first follow up. Didn’t get to see him but one of his assistants instead. A bit disappointed about the feedback since op (basically none) but that said I have probably learnt more on here. Cast is off and in a pin cast another two weeks NWB. The girl who fitted the cast was very informative and basically it looks like another two weeks in pin cast foot toe down and then it will go to neutral for further two weeks. After that it should be shoes with heel lifts and back driving. Physio tomorrow so hopefully fingers crossed its the long road to recovery. For all, hang on in there!

  126. bosuntom, on November 24th, 2009 at 10:51 am Said:

    any advice on non-surgical route to recovery for ATR?
    I’m hopping about for past 3weeks with no brace/plaster. Is this wise? What might the cosequences be? Cannot afford surgery as my health insurance has expired and local health service is a disgrace. I don’t want to be a cripple all practical advice truly appreciated.

  127. doug53, on November 24th, 2009 at 11:26 am Said:

    Welcome to our group,

    Self treating an ATR is conceivable, with lots of good advice and luck, but the three week delay is of great concern.

    When ATR is treated without surgery, best results happen when the toes are kept pointed down starting within a day or two of the injury, so the tendon ends are kept close together while they heal. If this is not done, the tendon will probably eventually heal, but will likely heal too long. That means when the calf muscle is contracted as far as it will go, the toes are not pointed as much as they should be. This means probably not being able to hold your body’s weight with that calf muscle, a weakness that leaves a limp.

    You may be able to get a “deal” on a surgery. You might want to check with the business offices at any nearby hospitals. Explain your situation,and maybe an affordable solution can be found.

    Good luck,

    Doug

  128. Tosh, on February 9th, 2010 at 12:26 pm Said:

    I had a complete rupture at the end of Oct last year. Had an op to sew AT back together and then in cast for exactly 3 months. However, I have now been cast free for a week and a half but everytime I put weight on leg that had rupture my ankle blows up to 3 times the size of the other and my leg swells up nearly as much. ANy suggestions why as my wife is getting worried. Thanks

  129. andymarksonline, on March 18th, 2010 at 10:31 am Said:

    Hi All,

    I ruptured my Achillies 4 weeks ago today playing Badminton at Center Parcs on holiday.
    I didn’t feel much pain just a loud pop and a what felt like a kick in the back of the ankle.
    Anyways, I got rushed to the nearest A&E (Bury st. Edmonds) where they took a look and told me it was completely ruptured (squeeze test). I spoke to the consultant who said there were two options, surgery and conservative. He told me the pros and cons of both options. I decided to go the conservative route as I’m not an athelete and dont like hospitals at the best of times!
    The plastered me up there and then with a ‘back slab’ and my toes pointing downwards and told me to go to my local hospital when I got home from holiday the following week.

    I tried to make an appointment at the local hospital on my return only to be told to go to my GP, which I did then he referred me to the hospital without even looking at me!

    2 weeks after the injury I got an appointment, they took my cast off and sent me for an ultrasound. The doctor said my Achillies was not ruptured completely but still very swollen and he couldn’t tell if it had been ruptured and had healed slightly in ththe 2 weeks or if it was never ruptured at all!

    They put a new cast on and told me to come back in another 2 weeks for another ultrasound which is due next week.

    I’m getting around ok on crutches no major pain just annoyed with the lack of mobility (I’m usually very mobile - hyperactive my wife would say!)

    Waiting for a final diagnosis and whether they are going to need to cut me open or not (hope not!).

    I’ll keep you all posted….

    Andy.

  130. normofthenorth, on March 18th, 2010 at 12:16 pm Said:

    Andy, read about the new scientific info, because it sounds as if your Doctors have NOT! The so-called “conservative” approach, which you’ve been following, produces results that are statistically indistinguishable from typical (good) surgery in every single way but ONE — it eliminates the high risk of infections and incisions that won’t heal and a bunch of other complications!!

    The key to a good outcome is a relatively rapid rehab program, moving NOW into a boot (preferably one with hinges, but definitely a boot) instead of casts, and starting gentle mobilization (all below “neutral” for a while) and partial weight bearing NOW. Waiting around in casts, NWB, makes your life worse AND your expected outcome worse, too!

    See my blog page for summaries and links and a good summary that works well for us non-surgical patients and the post-op ones, too. (The case for moving right along with rehab is just as strong for the post-op patients!)

    Tosh, I hope you found some help! The longer a foot stays NWB (and 2 weeks seems to be plenty, so 3 months sounds actionable!), the harder it usually is to introduce it to WB again. Usually this resolves relatively quickly, though sometimes it develops into heel spurs or other painful complications.

    Good healing, all!

    Norm (in the Commonwealth, though not exactly the UK)

  131. Andrew Pelt, on May 29th, 2010 at 9:41 am Said:

    :) I like your blog. It’s good one.

  132. Burton Haynes, on May 29th, 2010 at 12:42 pm Said:

    wow It’s a great blog. I love it.

  133. Sarah, on July 7th, 2010 at 5:20 pm Said:

    Hi there
    Had a complete rupture nearly 3 weeks ago and just had my cast off today & and aircast boot fitted with3 inserts back on 4th Aug to have boot taken away. I have 3 questions for you experienced people!:
    1) Today the consultant did not even look at my injury or ask any questions. Just looked at dates and instructed the nurse to fit me with a boot. Should he have looked at it/asked me questions?
    2) it is *killing* me today! I was told I could weight bear but it is so sore I cant really so am i doing damage by weight-bearing? Is it too early?
    3) Once I get the boot off - can I drive and will going on a villa-type holiday be ok or will I have loads of physio appointments?

    Oh - and one more!! I have taken the boot off this evening and sat with it up as was so sore. Is this ok as long as I don’t weight-bear or wiggle it?

    Thanks for any help - it all seems so bleak! I have a full time job and 2 kids under the age of 5 and husband is now away for 2 weeks!! Help!!

  134. GerryR, on July 7th, 2010 at 7:33 pm Said:

    Sarah,
    Sorry about your rupture. Please get your own blog so you can a place here to call your own. It also makes it much easier to get answers to your questions, rather than posting the same thing in multiple places hoping someone answers.
    Frankly, I’m shocked that your consultant didn’t even look at the incision, but you do not need to wait for them to ask you how you are doing. You have the right to tell them and to expect answers to your questions.
    The weight bearing at this point should really be partial weight bearing(PWB) and it isn’t too early for that. Keep your injured foot in front of your good one and only put some weight on it. Over time you can increase the amount of weight you put on it. But, if you aren’t putting any weight on it at all you certainly aren’t doing any damage.
    Whether you can drive at 7-8 weeks post-op is really a question for your doctor/consultant. If the foot you injured is your driving foot, that may be too soon, but it really depends on how how your rehab is going at that point.
    Taking the boot off is OK as long as you are just sitting with your foot elevated, not trying to walk without the boot.
    Good luck. Now sign up for your own blog.

  135. normofthenorth, on July 7th, 2010 at 8:27 pm Said:

    Sarah, wiggling your toes should be fine with the boot off (and the leg up), and maybe even gently wiggling your ankle, as long as you stay at or below the “neutral” (90-degree) position. The 145 patients who followed the protocol at bit.ly/UWOProtocol came out quite well, with or without surgery.

    You don’t actually mention if you had a surgical repair or not. Which was it?

    And what was killing you when you tried WB? If it was your AT or calf, then back off quickly and don’t go back there for a while. If it was the bottom of your foot, killing you from the new pressure, then Welcome to the Club! Many of us had that pain when WB for the first time. It does pass eventually (though it can stick around for weeks), and padding (like squishy gel footbeds) definitely helps.

    I started PWB at 2 weeks, and FWB before 5 wks, 2 shoes at 8. But the sole of my recovering foot was unusually tender through all of that and for quite a few weeks on. I’d been in the habit of wearing (cheap Chinese) “massage sandals” with a bunch of hard-rubber knobs to support your sole. NO WAY could I tolerate them after I got out of the boot! Even walking barefoot on a wooden or tiled floor was too much for quite a while, though carpeting was OK. I walked around in soft squishy (cheap Chinese imitation) Crocs around the house — and I’m still using them around the house, 6-7 months later!

    I’m FINALLY at the point where barefoot is no problem, and accidentally stepping on a power cord or something while barefoot is no more of a problem with the recovering foot than with the other one, but it took a long time to get there, and the journey was quite gradual.

  136. Sarah, on July 8th, 2010 at 9:13 am Said:

    Hi there - thanks for both your speedy replies! this is an excellent site for support isnt’ it?

    To answer your questions I did not have surgery (looked long and hard into with lots of professional advice) and so I am in the boot after 3 weeks in a cast.

    The pain was a mixture of calf (tho today that has eased off) and the bottom of my heel which must be, as you say, the result of the fact I have not walked on it for 3 weeks! That still really hurts but it seems like I need to get used to it eh?!

    Will start my own blog as advised!

    Sarah (in England!)

  137. normofthenorth, on July 8th, 2010 at 1:54 pm Said:

    This is one great site, alright, Sarah! But Gerry is right that it works even better after you set up your own blog page.

    Your boot and your walking technique in the boot should both be supporting your stride (when you’re rolling off your boot’s toe) with the upper part of the boot pushing against the front of your shin, so your calf can relax. As you recover, you can push harder and harder with your AT-and-calf (pushing the ball of your foot down against the sole of the boot), but the rigidity of the boot has to make that optional, not necessary.

    A hinged boot gives your foot even more and better options, but it also has to have a “stop” at the neutral position (or even lower-straighter, maybe with heel lifts inside) so your AT-and-calf can have the choice of going along for the ride.

    And make sure you share the UWO study’s protocol with your professionals, because you’re obviously being taken on a much slower and longer ride. That study and that protocol produced excellent results in non-operative patients — see bit.ly/UWOProtocol and bit.ly/achillesstudies for the details that should impress and inform your Doc & PT etc. In this study and 3 similar ones (all done since 2007), the results — including re-rupture rates — were just as good for the non-op patients as the ones who suffered through surgery!

    Earlier, more “conservative” non-op protocols produced a much higher re-rupture rate than surgery, EVEN when the patients were randomly streamed into surgery or not(!), so it’s important to get moving and get weight-bearing and probably to get into PT, too.

    I don’t think I’d “get used to” the pain in the bottom of the foot, or any other pain during this rehab. Abusing the bottom of your heel while it’s screaming might lead to a heal spur (plantar fasciitis), which could hold you back after your AT is healed, so Don’t Go There. Be gradual, and be creative with things like squishy footbeds to make your foot comfy.

    And whenever you build up your boot, try hard to build up your other shoe just as high (NOT easy, I know!), so you can walk straight. You expect to be walking well and fast and long in that boot, and if your hip and knee alignments are all compensating for one “elevator shoe” and one normal shoe, you’re risking messing up your whole body. Me, I slipped a sandal into a velcro “cast shoe” to raise up my “good” foot in the house, and packed multiple footbeds into a low boot (my tallest shoe) for going outside.

    None of these problems, or solutions, will probably excite your Docs, or maybe even your PT, but they’re important in your recovery. Being able to walk comfortably and fast in a boot (without pain!) is one of the major liberation milestones along this journey!

  138. wilsoni007, on July 27th, 2010 at 10:25 am Said:

    Hi All,

    I am into my 7th week in a cast and feeling pretty down. i didn’t have surgery as the consultant explained about the possibility of infection and i work in and out of hospitals every day so didn’t fancy that.
    I am going for my second and hopefully last change of cast next monday. Nobody has even mentioned a boot at all, in fact I wasn’t given much information at all. I drive for a living and my boss keeps asking when I will be able to drive and ultimately come back to work. Can anyone shed some light on this for me please? My biggest fear is re rupture, I really don’t think I could take that at all. I am climbing the walls!!
    Although one good thing is that I have saved so much money by not being able to go anywhere to spend it!!
    I did my leg playing cricket. Would anyone know how long it is before you are able to get back to playing sport? Will I get a boot at my last change of cast???

    Thanks All—John

  139. Ifixteeth, on July 27th, 2010 at 2:52 pm Said:

    I would beg them to put you in a boot but definitely refuse another cast. Check out protocol on this website and go back “armed” with it.

    Good luck!

  140. wilsoni007, on July 29th, 2010 at 5:34 am Said:

    Cheers Ifixteeth.
    I will definitely ask for a boot.
    Does anyone know how long it can take before you are able to drive again from taking off last boot/cast?

    I know everyone is different but a guide would be nice. I drive for a living in sales and i am getting a little pressure from my company as to when I will be back at work?

    Cheers

    John

  141. jski, on July 29th, 2010 at 8:15 am Said:

    Wilson,

    I never stopped driving. I rented an automatic transmission then went back to my own manual trans at 3 weeks post-op with my boot on the clutch. Your situation depends on which leg, what type of equipment, and maybe your doc’s orders. I never asked my doc about driving the manual so he wouldn’t have the chance to say no.

  142. GerryR, on July 29th, 2010 at 8:57 am Said:

    It will also depend on your state laws if you live in the US. In some states it is a violation to drive with a cast/boot/splint on either foot. Mine was on the left and I have an automatic transmission and it is not against the law in Montana. Driving a manual transmission with a boot of any kind is extremely dangerous, IMO.

  143. Smish, on July 29th, 2010 at 9:25 am Said:

    Wilson, A lot of times you will find that is legal to drive with your cast. What is not legal is driving without insurance. The problem lies with your car insurance company and whether or not you are covered if you get into an accident with your cast on. I was lucky, it is legal to drive in my state with a cast and my insurance company still covered me while I was in my casts. Check with both.

  144. jski, on July 29th, 2010 at 10:26 pm Said:

    GerryR,

    I figured someone would bring up your driving topic. This is one of the protocols that’s been guiding my recovery:

    jaxsportsdoc.com/rehab_protocols/Achiles_tendon_repair.pdf

    Cowboys have the answer!

  145. normofthenorth, on July 30th, 2010 at 12:04 am Said:

    Jski, that protocol is pretty close to the one the researchers at UWO used for their study of surgery vs. non — the same one several of us here have been following (without surgery), too. Yours includes a hinged boot, which is one of the “tweaks” I’d add to the UWO protocol (if I grew a third leg!).

  146. duncmck, on August 2nd, 2010 at 3:57 pm Said:

    Hi everyone. I’ve just joined your wonderful club having found the site looking for information on air casts.

    After a complete rupture of my right Achilles at a ceilidh, I am going down the non-operative route after the following comment from my consultant “We normally operate on athletic people but for you sir maybe not!” Anyway, having spoken to a doctor friend who I trust and after reading lots of the postings here it feels like the right route for me.

    Having ruptured my achilles on 24th July, I was fitted into an aircast on 30th July, less than 6 days after the injury. I am being encouraged to start going without crutches and am just about there.

    Is this normal as I haven’t seen any postings for people getting into an air cast so quickly?

    Also, any advice for balancing the other foot as I feel very lopsided at the moment?

  147. normofthenorth, on August 3rd, 2010 at 2:59 pm Said:

    Getting into an AirCast immediately, without surgery, is a fine way to go — though I do prefer hinged boots instead of fixed ones. Several of us here are following the pretty aggressive protocol from a fancy modern study that produced great results with and without surgery, at bit.ly/UWOProtocol .

    OTOH, becoming FWB immediately IS unusual, and may or may not be safe, or a Good Idea. The UWO protocol has 2 weeks NWB (crutches, no weight), then 2 weeks of PWB (crutches, partial weight), and only THEN (at 4 weeks) do you start going without crutches. Going faster than that without surgery is uncharted waters in terms of evidence from careful studies, AFAIK, so you’re part of an experiment.

    It’s not the weight itself that’s risky, I think, but the increased temptation to “fire” your calf muscle as part of your walking, standing, turning, recovering from balance losses, etc., etc. Your torn AT is just starting to work at pulling its ends together and re-gluing them together, and your calf is easily strong enough to tear those ends apart all over again.

    If you have enough “inner calm” to trust the boot even during challenging moments (or enough luck to avoid those moments), then you may turn out fine, even better than the average results in the new studies. OTOH, it seems likely that you’re at higher risk of an early re-rupture than the participants in those studies. Hard to know without evidence, and there isn’t any that I’ve seen.

    For links to the four recent studies that all showed that the non-operative route works just as well as surgery minus the complications and pain, check out refs 4-7 of the Wikipedia article on ATR or bit.ly/achillesstudies. But I think they all started out NWB for something like 2 weeks.

  148. jla2010, on August 3rd, 2010 at 3:20 pm Said:

    I put insoles in my good foot’s shoe but that isn’t quite enough to balance me as much as I’d like. It doesn’t make up for the thickness of the sole of the cam walker. So I took my right shoe (good foot) to a shoe repair shop and he put sole material under my shoe until I felt balanced. After these measurements, the shoe repairman is going to add a 3/4″ sole to the bottom of the shoe to even me out. It should make walking more natural. Keeping my fingers crossed.

  149. duncmck, on August 3rd, 2010 at 3:36 pm Said:

    Thanks Norm and jla.

    You’re scaring me a bit about going FWB. For the first time today I trolled around the office without a crutch. My leg feels pretty OK tonight but maybe I should take it pretty carefully for the next 2 - 3 weeks as you’re right, it would be easy to get complacent and do something stupid. That said, having no crutches feels great - I can’t begin to imagine what it would be like to have to rely on them for months! Anyway, I’ll report on how I get on.

    The shoe repairer option is a great idea that I hadn’t thought of. I’ll be really interested on how it goes - sounds like a winner to me!

    Thanks again

  150. normofthenorth, on August 4th, 2010 at 1:23 am Said:

    Dunc, it goes without saying that you should be mega-careful — give new meaning to “Watch Your Step”!! And it’s also obvious to everybody here that being able to get around without crutches is WAY nicer than having to use crutches. But you’ve also got to make sure your AT heals properly!

    My solution to elevate my “good” foot was primarily to use a thing called a “cast shoe”. It’s kind of a cheap strap-on shoe-sole with nylon and velcro straps that can wrap around a foot, a cast, or a shoe, and are very adjustable. Under $10 at med-supply stores in N.A.. I found a little sandal that was a comfy fit inside one, so the whole thing would slip on and off, and matched the height of my AirCast (and later, my hinged Donjoy MC Walker). That worked perfectly indoors.

    For outdoors, I already had a pair of short slip-on work-boots, like the kind that Merrell sells a lot of. By adding more than one footbed to one of them, I made an outdoor shoe that was almost as high as my boot. Close enough that it didn’t mess up my body, anyway.

  151. normofthenorth, on August 4th, 2010 at 10:41 am Said:

    I just Googled “cast shoe” and clicked on “shopping”. They start at just under $10 including postage online.

  152. Gerryr, on August 4th, 2010 at 11:03 am Said:

    Norm,
    I am really surprised to hear anyone say anything good about those “shoes.” I was given one after my final surgery and maybe wore it for 10 minutes before I took it off and returned it to the doc at my next appointment. The bottom of my cast was definitely not flat so I could not get the thing to stay in place. And since I was partial weight bearing it just made it really hard to get my legs even close to being level.

  153. CKC, on August 5th, 2010 at 4:43 pm Said:

    I tore mine playing street hockey on June 6 and its been almost 8 weeks Post Non Op and fitted with aircast on June 9th. I was on crutches for the first week but then was able to WB with the aircast only . Been doing towel foot lifts and did some exercises in a pool( dont know if i should have done that). Still have the heel lifts;going to see the Doctor next week (10 wks) so hopefully i can get the heel lifts taken out. So hot in the cast; cant wait to get out of them.

  154. 2ndtimer, on August 12th, 2010 at 9:13 am Said:

    He ran around a little and kicked a few balls, and for now that’s enough to keep him happy. David Beckham, who Wednesday made his first appearance at a Los Angeles Galaxy training session since rupturing his left Achilles’ tendon in March (5 months ago!)

    http://sports.espn.go.com/los-angeles/soccer/news/story?id=5456843

  155. Alun, on August 18th, 2010 at 9:56 am Said:

    Hi All

    I have been reading through all the blogs and there is some great advice here. I have an acute rupture and I have been in a cast for 2months now, and they haven’t changed the position since the first time they did the cast. I’m sorry if you think I’m going to ask a stupid question but they will not just take the cast off and leave me with nothing on my ankle, will I go into a ‘moon boot’ or just keep me in a cast.

    Thanks for your time

    Al

  156. duncmck, on September 1st, 2010 at 6:43 am Said:

    Hi. 5 weeks in now so I thought I should post an update. As a reminder, after a full rupture, I went non-op and was put into a walking boot and encouraged to go without crutches within a week. After 4 weeks two of the four heel lifts were removed, and the other two are due to go next week. I will then have the boot for another two weeks followed by a built up shoe for another two. So far so good. I have been encouraged to walk around as much as feels comfortable. For the last week I have been on holiday and found that I can walk reasonably comfortably for about a kilometre as long as the boot is well fitted. If not, I get a bit of bruising on the front of my shin. The only other problem is the smell when the boot comes off - not pretty. Thank God for Fabreze!

    Most importantly though the AT feels as though it is reattached and is not giving any trouble at all.

    So far then the summary is that this treatment is working well.

  157. normofthenorth, on September 1st, 2010 at 3:32 pm Said:

    Alun, you’ll find that ATR rehab protocols — with and without surgery — vary hugely in different places, and with different Docs and “consultants” even in the same place! The lucky patients get a clear protocol at the outset. The very luckiest patients get a good, modern, fast one, that’s been tested and found to produce excellent results! Like bit.ly/UWOProtocol , which produced excellent results with and without surgery.

    If you’ve been casted for 2 months without surgery, you are getting your grandfather’s “conservative casting” protocol. Unfortunately, it produced inferior results, including high re-rupture rates in the 15-25% range. The UWO study (ref #7 in the Wiki article on ATR) had only 3 re-ruptures in 145 ATR patients (half surg, half non-op). Those low but non-zero re-rupture rates are usually explained by “non-compliance”, like people tripping and falling.

    duncmck, you sound like you’re responding well to an aproach quite close to the UWO protocol. By now, you should be able to wear a sock inside your boot (just put it on and take it off CAREFULLY!), which should help the smell. Most boot liners can also be washed out, then wrung out between towels or shammy or microfiber cloths. And some stores and websites sell extra liners to make it easier still.

    Lots of docs use a built-up shoe, with heel lifts, after cast or boot comes off. I went to 2 normal shoes both times (both sides), as did the UWO study. Mostly Crocs this time, because they’re so comfy. I guess the lifts would let you step farther past your healing foot without “frightening” it.

  158. hotels in Ibiza, on October 1st, 2010 at 6:36 pm Said:

    I like this website given and it has given me some sort of commitment to have success for some reason, so keep up the good work.

  159. Jerry Jones, on October 15th, 2010 at 6:22 am Said:

    Hope you don’t find it too commercial to mention that the iWALKFree hands-free crutch mentioned elsewhere on the site is now available in the UK, rather than having to order from Canada or the USA. I have a site at http://www.peglegs.co.uk and have found that most of my customers so far have been ATR patients. I guess it’s because of the product appealing to the kind of active people who often are the ones to rupture their Achilles tendon.

  160. marathonrunner, on October 24th, 2010 at 3:55 pm Said:

    Hi , great that I can post-I would really appreciate some advice-I ruptured my AT on 8 August, given an ultrasound at local hospital (Perth Royal Infirmary ) in Scotland. Ultrasound could only tell that it was over 70% ruptured. No operation was offered, i was simply told that it was going to be put in a plastercast for 8 weeks etc etc

    Plastercast came off at week 9, I had tried a boot at week 4-it was soooo sore (admittedly I had been pegging up and down fields after my horses) hospital put me back into a cast.

    cast off at week 9, told by physio to walk with 2 crutches for support. Now week 11 no hint that I’ll be able to walk-please does anyone have any advice on what i should do. I cant bear much weight on the affected leg and Im feeling pretty bad

    Also feel so very angry that no real discussion given re operation. Now I know the statistics I truly wish I had had the op-I run (or used to) every day, am extremely fit and have four horses to exercise-no riding for at least 3 months Im told

    The physio told me at the hospital that the hospital doesnt operate on cost grounds, basically its a postcode lottery-once I confronted my consultant i was told the tear was high and would hear better without surgery. Ive done a lot of reading and found out this is nonsense. At one point I asked if I would be better off having the surgery now…any advice anyone can offer me would be much appreciated, as Im in a pretty bad place at the moment-yes I do realise its not terminal and it will get better eventually but I just cant believe I am nowhere near walking yet…!

  161. heather, on October 30th, 2010 at 5:40 pm Said:

    Hi,

    Can anybody tell me when the throbbing and blood rushing to your toes stops? I had surgery two weeks ago today and I am in a plaster cast.

    Cheers.

  162. GerryR, on October 30th, 2010 at 6:18 pm Said:

    At two week post-op you should still be elevating and icing at least 12 hours a day, including when you sleep. I don’t recall a lot of throbbing, but I do recall that my foot would swell almost instantly when it was no longer elevated. I did have muscle spasms for about three days after the first and third surgeries that required Valium to control. Have you asked your doctor about the throbbing?

  163. teresa1, on October 31st, 2010 at 9:46 am Said:

    Difficult to apply ice when you’re in a cast!
    The throbbing may be due to swelling of your ankle and/or pooling of blood in your lower leg. The veins that return the blood to your heart don’t have any muscles, and rely on your calf muscles to aid it’s return. Your calf muscle is immobilised in the cast so it can’t do this, that’s why it’s so important to keep your foot up most of the time.
    It does get better- honest!

  164. heather, on October 31st, 2010 at 6:46 pm Said:

    Hi Gerry R and Terrsa1,

    thank you both for the advice. My leg is elevated basically all of the day and night, it only get pointed down to visit the loo, shower get some food and whenever it it pointed down it swells ans throbs. I am seeing my doctor next Tuesday so I will ask him about these issues. I am hopign that he will give me a boot as I hear that this can help with the swelling side of things. Also now my heel and knee are starting to hurt as ny leg has been up in the air as it where for three weeks now, the week before the op and the two after it. So I am not surprised that other things are startign to hurt.

    Terasa 1 you say that it gets better, but when? When did the pooling of the blood, the swellign etc, etc stop for you?

  165. GerryR, on November 1st, 2010 at 12:23 am Said:

    Here’s some trivia, well maybe not, to use to amaze your doctor. The foot acts sort of like a pump. It is below the heart so blood naturally tries to seek the lowest level which is why your foot swells when you’re NWB. Prior to the ATR, every time you take a step the foot “pumps” some of the blood back up your leg so under normal circumstances you can walk around all day and have no problem with swelling. When you cannot bear weight on one foot, it swells because the blood gets trapped in there. This will continue to be a problem until you are back to FWB again and will even give you some problems for a while after that. I elevated my foot at work for quite a long time after I was in two shoes and walking around pretty well.

  166. teresa1, on November 1st, 2010 at 2:56 am Said:

    I found it eased of at about. Two to three weeks. If you’re concerned, ring t he hospital for advice, leave a message with your consultant’s secretary.
    How are you propping your foot up? If you’re using a footstool or similar there is nothing to support your knee and you will be resting the weight of your leg on your heel.
    Sitting on the floor with your bad leg supported by pillows and your back against the chair was comfortable for me as was sitting longways on the sofa.

  167. heather, on November 1st, 2010 at 3:39 am Said:

    Hi Gerry R and Teresa 1,

    Many thanks to you both, once again, great and very usful advice that i will use and follow. Will let you know what the doctor says once i have seen him toimorrow afternoon.

    Thanks agsin !!

  168. heather, on November 2nd, 2010 at 4:53 pm Said:

    Hello,

    As promised a quick update on my doctors appointment today. He is happy and agreed to giving me a nice boot instead of my plaster, I have the Vaco type which mean I can have a nice long bath in the morning, so pleased. Now that I am in the boot and I can put my foot down all the blood rushing has stopped, still some swelling but no where near as bad. I actually feel like I am on the mend now, you guys where right it does start to get better a couple of weeks after the op, 17 days in my case. Great day!!

  169. heather, on November 6th, 2010 at 4:38 pm Said:

    hi,

    I was wondering if anybody else, who plays Rugby, has ruptured their achilles tendon and return to play the game? Would welcome some in sight in to this area, as people are telling me that it would not be a good idea to return to playing Rubgy, not that I plan to this season, but next season sholud be ok ??

    Thanks to all.

  170. GerryR, on November 6th, 2010 at 10:58 pm Said:

    There are many people here who ruptured their Achilles tendon and returned to running marathons. If they can do that there is absolutely no reason why someone can’t return to playing rugby or any other sport. David Beckham ruptured his and is back playing professional soccer. As long as you give your body time to heal and have a good physical therapy protocol there should be nothing preventing you from returning to the game.

  171. normofthenorth, on November 7th, 2010 at 2:49 am Said:

    What Gerry said, Heather! Except that I’m not sure that marathons are actually quite as AT-scary as rugby. But soccer and tennis and squash and badminton and basketball and Ultimate and (American) football and volleyball (my sport) and others certainly are. And almost the only thing that makes people quit those sports post-ATR-recovery (apart from some rare bad-recovery complications) is the fear of “doing” the other AT some time in the future.

    That fear is unfortunately not totally unfounded. :-( . While the absolute risk of tearing the other-side AT seems to be reasonably low — e.g. way lower than a flip-of-the-coin 50% — it’s not vanishingly low. About TWO Hundred times higher than the risk of a random person tearing their first AT, according to a study listed and linked in Dennis’s “studies and protocols” page (which is linked from the main page). I think it has “contralateral” in its title — a fancy word meaning “the other side”.

    Several of us who’ve blogged recently did both ATs, both sides. My second came 8 years after the first; somebody else who’s here now waited 11 years. I think the study followed people for 4, so they didn’t catch them all. (I.e., the total risk is higher than their estimate.)

    I don’t regret a thing, wouldn’t change a thing — partly because I love the activity and the game so much, and partly because my second recovery was hugely quicker and easier and less disruptive than my first (details on my blog). Most people do find the second recovery easier, though many other people choose to play it safe after one, because the thought of another ATR is just too much. Others can steer you to the evidence and the odds, but this is an extreme case of a personal choice we’ve each got to make for ourselves.

  172. heather, on November 7th, 2010 at 4:47 pm Said:

    Hi Gerry and Normofthenorth,

    I apprecaite your advice, word of wisdom if I ever heard them. I am still a long way away from making the descission to return to rugby or not, so for now I will see how my recovery goes, read some more blogs and that your words all into condiseration and go from there.

    thanks again :)

  173. heather, on November 14th, 2010 at 5:37 pm Said:

    Hi everybody,

    Just seeking some more advicem pretty please. I have had my achilles Vacoped boot for about 10 days now and it was set at an angle of 15 degrees. I have changed it this evening to 0 degrees as my foot and ankle will happily go flat. I am now at 4 weeks post op, what does everybody think, is this OKor to soon?

    Heather

  174. heather, on December 6th, 2010 at 11:09 am Said:

    Norm of the north,

    I hope that you see this post as I have no other way of getting hold of you:)

    You mention the UWO protocol in another post to a blogger, do you have a link to it, as I would love to see it.

    Thanks

    Heather

  175. normofthenorth, on December 6th, 2010 at 12:35 pm Said:

    Heather, if you ever have a question like that again, the “Search AchillesBlog” form on the upper right should be able to find most things for you instantly.

    The UWO Protocol should show up at bit.ly/UWOProtocol , and the study (abstract) that used it should be at bit.ly/UWOStudyPub . Let me know if that doesn’t work.

  176. heather, on December 6th, 2010 at 3:33 pm Said:

    Thanks for the advice and for the link :)

  177. business mobile phone plan comparison, on February 25th, 2011 at 8:01 am Said:

    What else could you say? Not everybody has the exact same thoughts but it’s good to see a diverse range of ways of thinking about things, to put it crudely. Makes you settle back and wonder about your personal habits and preconceived ideas at times.

  178. rainmaker, on March 17th, 2011 at 1:07 pm Said:

    Hope everyone is continuing along the road to recovery!

    I have been treated by the NHS so far (I actually have private cover but NHS were so rapid I did not get a chance to use it so far!)

    I completely ruptured my AT on the 28th of Feb and had the operation the next day. I was given the choice of whether to go surgery or conservative.

    I went back today and had a fibreglass cast fitted rather than a plaster cast. I am due to go back in a week and a half to decide whether I want a boot (surgeons preference) or to keep in cast (nurses preference). I do not know what to do…

    If anyone could help on my questions below I’d really appreciate it.

    1. The recovery time for boot or plaster seems similar - what is the difference?

    2. The nurse told me that she would go for a cast as there was less chance of a re-rupture especially through falling - is this true? This is important to me as I have a 2yr old and have already fallen over his toys once!!!

    3. Does an extra week or so in a cast makes re-rupture less likely? I am not going back to footy so I just need to be mobile for work and need to drive - I cannot risk or afford a re-rupture and I want to take the safest option not necessarily the quickest - which is which is very confusing!

    4. Boot or cast???

    Thanks all

  179. janet, on March 17th, 2011 at 1:17 pm Said:

    Hi Rainmaker

    I was in a fiberglass cast for 3 weeks…originally the doctor said 5 wks but at 3 figured I’d be much happier in a boot and I was. The nice thing about the boot is it can be removed for showers or baths.

    I think the majority here would absolutely say go for the boot. I have fallen with both and managed not to rerupture anything. It is my opinion having done both that they both offer quite a bit of protection as far as that goes.

    I’m a bit ahead of you in the whole process. On friday, if all goes well I will be out of my boot and back in shoes. Total time for cast and boot was 7 wks although quite a few members of the club that nobody wants to be in moved along a lot quicker than I did.

    Definitely boot…..will be interested to see what you decide

    Happy Healing

  180. click to view, on March 18th, 2011 at 11:58 pm Said:

    RIP Jet Harris. Thus we mark the passage of time as we grow older, by the passing of our youthful icons.

  181. rainmaker, on March 22nd, 2011 at 7:27 pm Said:

    Thanks Janet - still trying to decide…

  182. rainmaker, on March 24th, 2011 at 11:32 am Said:

    OK I have decided to go for the boot.

    I remembered that I had a friend who works in medical sales in Orthopedics… So he asked around all the top consultants and the general concensus was to go for the boot. The main question that they asked was related to my trustworthiness. Could I be trusted to do what I was told and wear the boot when I was supposed to.

    They see no difference in re-rupture rates for teh boot especially when you have had surgery.

  183. cheap art print, on April 15th, 2011 at 9:33 pm Said:

    I’m beginning to feel concern for Prince William. He’s seen the system of Royalty destroy his mother and now I suspect the same thing’s happening with his bride to be Kate, whose legs are visibly getting far, far too thin. Really, in this day and age, isn’t it time we did away with this nonsense? It doesn’t benefit us and it seems given the pressures involved it no longer benefits the Royals themselves either.

  184. Mark73, on April 17th, 2011 at 9:09 am Said:

    Husband has possible reptured his achilles, in a point down cast for 2 weeks and then the consultant has left him with NOTHING on his foot, just to not bear weight on it! I’ve told him to keep manually poining down until he gets the scan to cofirm the rupture. NHS is not being helpful.

  185. jimthejoiner, on April 19th, 2011 at 1:43 pm Said:

    hi everyone.
    i have recently gone through an op to lengthen my achilles by about 3inch and also had steindler release during same procedure.
    i had the op on the 10th of march, everything went well in the theatre but several hours later (in middle of the night) hospital staff had to cut the plaster cast to reduce pressure caused by swelling.
    plaster cast was reinforced with fibreglass the following morning then i was given my crutches and sent home.
    i have honestly felt no pain in my foot what has taken me by suprise, i am very pleased with my progress.
    i am now into my 2nd cast which was fitted on the 4th of april and i was walking without my crutches within 4days.
    i was initially told that this cast would be on for 6weeks but when Dr saw how wounds had healed at change over of casts and removal of stitches he informed me that i would only need it for 4weeks which now matches up with the hospital date i have recieved through the post only the other day.
    i believe i am getting a “beckham boot” to wear for a few weeks whilst gettin PT.

    I am interested to hear from anyone who is at the same stage as myself to see how their progress is in comparison to my own and also to hear accounts of other folks experiences during PT.
    Many thanks, i hope everyone is recovering as well as i feel i am

  186. normofthenorth, on April 19th, 2011 at 2:13 pm Said:

    Mark73, that treatment doesn’t sound helpful, I agree. Compare that “treatment protocol” with several that have produced excellent results in large studies, including bit.ly/UWOProtocol . (The fulltext of that 2010 study is now posted on this site.)

    Even relatively aggressive modern protocols like that one generally immobilize the ankle joint “point down” for a month or more (that one for 6 weeks). The immobilization might be less important with totally successful NWB, but most of us lost our balance or tripped or slipped at least once during our “crutch days”, and doing that without a boot or cast is much scarier than with (which is scary enough)!

    If you can arrange to switch Docs or get a second opinion or buy an orthotic boot (and some heel wedges), I’d do it. If there’s doubt about whether the AT is torn or not, I think it’s only prudent to treat it as an ATR while the doubt is being resolved.

  187. normofthenorth, on April 19th, 2011 at 2:18 pm Said:

    jimthejoiner, was your tendon reattached with a graft to span the 3″ gap, or was it just left to heal naturally? Has your ankle been kept near the neutral position (90 degrees)? How did you develop one too-short AT? (And how about starting a blog to give us all your story?!?)

    I’m assuming that your “walking without my crutches within 4 days” means 4 days after you got the 2nd cast, ~4 weeks post-op, and not 4 days post-op. Yes?

    3″ sounds like a huge gap, but the only small study I’ve seen indicates that non-op “cure” works equally well with all size gaps, so that shouldn’t be a problem.

    Good luck, and keep us posted!

  188. jimthejoiner, on April 19th, 2011 at 4:02 pm Said:

    hi norm,
    i have had an issue with my arms and legs since early teenage years (i am 30 this year) and i was always told that i had a growth spurt which ment tho bones grew but muscles didnt (i cannot fully straighten my arms at elbows and wrists). my heel on one foot was roughly 3inch off the ground and the calf muscle on other leg is rather tight too but not to the same extent.
    i am gettin married this october so went to my GP last May and got reffered to orthopedics again (several times since school age) and i demanded something be done so i could walk down the aisle with normal gait.
    the surgeon took one look at me and asked if i could have genetic testing as he believed i have a very rare form of muscular dystrophy and that he was interested to find out more and see whether he could do anything with my leg to assist my walking.
    finally got taken into theatre (almost a year later) and had the Z-cut procedure to the achilles where they basically cut and splice (to lengthen) the tendon.
    has the steindler release on side of my foot to alter position of the sole as there was excessive arching.
    yes sorry to mislead in last post, i was walkin within 4days of getting 2nd cast fitted,very happy with how everything feels so looking forward to taking next step and getting boot on so that i can get to physio and then back to work.
    any idea of how long it generally takes from starting physio to gettin back to work?
    many thanks for any help, and yes i am lookin into starting a blog to keep folk in same situation as me updated. i am new to this so do not know exactly what i am ment to do.
    jim

  189. jimthejoiner, on April 19th, 2011 at 4:05 pm Said:

    my ankle has been set just beyond 90degree to allow for settlement of the tendon when healing so that it does not pull back towards the way it was pre op

  190. jimthejoiner, on April 20th, 2011 at 4:40 am Said:

    Blog created

  191. normofthenorth, on April 20th, 2011 at 4:53 pm Said:

    Thanks for the clarifications, Jim.

    “Getting back to work” timing depends a lot on what “work” is. I mostly sit at a computer, and I didn’t miss a day this time. (Last time, with surgery, I missed most of a week, time off for moaning in bed.) If you’re a pro athlete, that would be VERY different! Some people can work in a boot and elevate their leg a lot, others not so much.

  192. jimthejoiner, on April 20th, 2011 at 6:29 pm Said:

    thanks norm
    i have got to drive to my work and the issue is that its my right foot which has been operated on so i am sure you can guess my next question
    roughly what stage do i have to be at before i am allowed to drive,have read many different accounts of time scales online but you seem to be very well informed so that’s why i asking your opinion

  193. normofthenorth, on April 20th, 2011 at 7:41 pm Said:

    (I think you’re asking EVERYBODY’s opinion, Jim, but that’s how good forums are SUPPOSED to work! ;-) )
    Driving post-ATR is one of the more divisive issues around here, and for good reason. In addition to the obvious “moral” considerations, there may also be legal ones, like whether it’s legal, whether your insurer will cover you in case Something Bad happens, etc. When I tore my first AT, the right one, I drove pre-op in shoes, making sure my heel was on the brake pedal. Post-op, after I was FWB in a FG cast, I may have started driving again, and also in the hinged boot I eventually got into. Switching to 2 shoes makes it easier to fit onto the pedals, but raises the spectre of rerupturing during a failed emergency stop, unless you put your heel on the pedal.
    Are your passengers and “neighbors” at greater risk because you’re driving post-ATR? You betcha! Is it a bloody nuisance not to be able to drive yourself around when you’re used to that? You betcha!

  194. ceperky, on April 20th, 2011 at 10:09 pm Said:

    Honestly, I have been driving with my left foot (since my ATR right leg) before surgery and after. I have come accustom to it and now it comes natural. I had a couple people ride with me, and they didn’t notice the difference. I looked it up online, and it doesn’t seem to be illegal. I just cross my leg over the injured one.

    At first I was very careful because I would hit the break or gas to hard. I tried driving with my injured leg, but I didn’t have enough strength to hit the break pedal in my BMW.

    You can also buy a left footed pedal. They probably sell them online. You know…the kind they use for driver’s ed.

    I do not drive long distances because it is not a comfortable position.

    I am 3 weeks out from surgery, and I am hoping for a boot in about a 1 1/2 week!

    Connie

  195. jimthejoiner, on April 21st, 2011 at 3:47 am Said:

    many thanks for your help and info Norm and Connie,this site is amazing.
    I have recieved more info on this site than i have from my Doctors at present (mostly due to the fact that they dont know what has caused my condition.
    I guess i will just have to hold on and see how i fee once cast is removed and boot fitted before i decide when i will be in a safe condition to drive.
    I cannot see much on this site about anyone else who has had their achilles lengthened as most have just ruptured theirs but I am trying to work along the same lines in terms of recovery.
    I am confident using my left foot for braking whilst driving my car as i do alot of track racing in car so this technique does not bother me and in Scotland i dont believe its illegal.
    Thanks again for EVERYONES help,much appreciated.

  196. normofthenorth, on April 21st, 2011 at 4:20 pm Said:

    I’ve heard that driving in a cast or an orthotic boot is illegal in some jurisdictions. Searching this site should turn up several past discussions.

  197. normofthenorth, on April 22nd, 2011 at 1:04 pm Said:

    (Why am I almost always the last poster just before this site becomes unavailable for hours or days or weeks? Is it something I said? ;-) )

  198. Tom Perry, on May 1st, 2011 at 4:02 pm Said:

    I ruptured my right Achilles tendon four weeks ago now. I went for the non surgical option and was put in an aircast boot the day after with 5 heel wedges. and told that I should start limited weight bearing as soon as I can and build it up.

    I am now finding it easier to move around and have my next hospital appointment in two weeks time and am just hoping that it is healing ok.

  199. Tosh, on May 1st, 2011 at 5:07 pm Said:

    Ruptured my tendon 10 weeks ago, left leg. Went for the non operative option and with the brace was able to walk and function as normal but very very slowly.
    Started to drive 2 weeks ago after the brace came off and have to say NHS 2 weekly sessions have been invaluable.

  200. normofthenorth, on May 2nd, 2011 at 3:06 am Said:

    Tom, do you know how thick those heel wedges are? My fave protocol — at bit.ly/UWOProtocol — uses 2cm of wedges for 6 weeks. Others use a bit more, or measure in degrees (which would only be identical for one size foot). Many protocols withdraw wedges/plantarflexion in steps, while the UWO protocol did it all at once (though I amended it by spreading it out over a few days because it felt too abrupt to my ankle).

    That study — fulltext linked here, in the ATR Rehab Protocols, Publications, Studies page — produced excellent results both with and without surgery, so it should be a model, I think. Like Tom, it used the AirCast Boot (the company co-sponsored the study), another convenient conjunction. . . It also gets its patients off crutches (FWB) and out of the boot more quickly than many hospitals do, maybe especially in the UK.

  201. Tom Perry, on May 2nd, 2011 at 3:14 am Said:

    Hi Norm, they are 1cm wedges then after 6 weeks I should remove one each week up until 10 weeks where hopefully I will be out of the boot.

  202. liverpoollass, on May 2nd, 2011 at 2:27 pm Said:

    I to went non op and have been really happy with the treatment I received from the NHS and the recovery I’ve had. Hope yours goes equally well. Don’t worry about whether its healed or not because it will. It amazes me how truley brilliant the body is. Just make sure you don’t try to ‘run before you can walk’ as the saying goes.

  203. normofthenorth, on May 2nd, 2011 at 3:04 pm Said:

    5cm of heel wedges sounds like a tonne, Tom. I’ve seen one cadaver study that concluded that the ends of the tendon are adjacent (”approximated”) at about 20 degrees PF, and I’m guessing you’ve got a lot more. Another popular approach is to immobilize the ankle in “gravity equinus”, which is the angle the ankle takes when your foot is just hanging, e.g. if you’re sitting on the end of a high bed/becnh/gurney. . .

    I don’t know if there’s much risk of having the torn ends overlap with excessive PlantarFlexion, but if it’s possible it sounds undesirable. I also don’t think I’ve seen a study with better non-op results than the UWO study, which used a modest 2cm. . .

  204. Tom Perry, on May 2nd, 2011 at 3:31 pm Said:

    I’ve just checked details of the wedges and it looks like it will be 34 degrees as the wedges can be found here.

    http://www.aircast.com/index.asp/fuseaction/products.detail/cat/2/id/105

    After 6 weeks it will reduce by 6 degrees each week that should stretch it out without doing it too quickly. I have my 6 week check up 2 weeks tomorrow so will see the progress.

    It looks like you have done a lot of thorough research Norm it is very informative thanks.

  205. normofthenorth, on May 4th, 2011 at 2:30 am Said:

    Those wedges are fancier than the ones I got, which were simple symmetrical wedges.

    Good Luck and Good Healing!

  206. markblack, on May 25th, 2011 at 12:04 pm Said:

    Hello,

    33 year old who didn’t warm up enough and tore his Achilles where the muscle and tendon join playing basketball.

    I didn’t have surgery, I didn’t want to, but I would of if the doc had told me to, because of where I tore it I don’t think it was the best option.

    I’m 6 weeks in and so far so good. Just out of the cast and into an Air Cast Boot with 4cm heel raise had my first trip to the physio yesterday so started my exercise routine yesterday (5 times a day) Foot is starting to get moving again.

    I’ve blogged all the way through and tried to note anything useful that I learned, and be honest.

    http://meandmyachilles.wordpress.com/

    It’s a long slog, but I do feel like there is light at the end of the tunnel.

    More physio next week along with getting the heel raises down to 2cm.

    All on the NHS, The Royal Free in Hampstead who I have to say could not of done more for me.

    If you’ve just done it and your reading this, don’t get down it’s a cliche but staying positive has been the best thing for me.

    Good luck and look after yourself all.

    Mark
    http://meandmyachilles.wordpress.com/

  207. normofthenorth, on May 26th, 2011 at 11:27 pm Said:

    Mark, your “33 year old who didn’t warm up enough and tore his Achilles” may have a smidge of statistical validity to it, but there are a huge percentage of us here who warmed up thoroughly and/or played several competitive games first, before tearing our ATRs. That’s also what happened to me TWICE, on both sides (8 yrs apart).

    So stop blaming the victim already! ;-)

  208. mark black, on May 28th, 2011 at 10:32 am Said:

    hi normofthenorth

    I know it could of happend even if I’d been better prepared!

    But I should of warmed up better, you live and learn don’t you.

    Hope all’s good with you. Did it get ‘easier’ the second time? (bad choice of words I know)

    M

  209. normofthenorth, on May 28th, 2011 at 2:10 pm Said:

    My second one was much easier. Partly because I knew what to expect, but mostly because I skipped the surgery (and the days of moaning, pain-killers, pain, huge swelling, incision, staple removal, scar and scar-irritation) and also followed a much faster protocol than my first-time “ultra-conservative” OS would permit.

    OTOH, I was essentially at 100% at ~10 months post (op) the first time, and I think I’m plateaued closer to 85-90% this time (at a year and a half). I did have a heart valve replaced on Dec. 1, which hugely interrupted my ATR return to normal(!), but still. . .

    Gadzillions of words and details and links to studies, etc., on my blog.

  210. mark black, on June 3rd, 2011 at 10:46 am Said:

    hi normofthenorth

    Sorry to hear about your heart problems, never rains but it pours I guess. I’ve had a good look at your blog, some interesting stuff on there.

    good luck with the rest of the healing.

  211. Tom Perry, on June 9th, 2011 at 3:38 pm Said:

    I am now walking about without the aircast boot after 9/12 weeks of conservative treatment and it feels really comfortable.

    Next step is to see when I can drive again. When have others started driving

  212. chuckp17, on June 9th, 2011 at 4:55 pm Said:

    Tom: I was driving about 5 days after surgery, but it really depends on the type of car you have. I have an automatic transmission, Honda Ridgeline, so it is very easy to move your right leg over to the passenger side and drive with your left foot. I have become very adept at this very fast. I drove about 750 miles last weekend in the mountains. If you need to use your injured leg to drive, maybe try it around your local neighborhood first and see how it feels. Good luck!

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  214. alison, on June 26th, 2011 at 10:40 am Said:

    I hope this will help somebody. The only place I could find when I wanted to hire a knee scooter/knee caddy in the U.K. was from wheelchairs-r-us, web site http://www.wheelchairs-r-us.co.uk.
    It is a Birmingham based company, the equipment got to me really quickly and I was able to assemble it myself (sitting on my backside). I loved being able to carry stuff around on the front of the scooter. It got me over the worst in between crawling around on all fours. Happily I am a bit more mobile now and back to a more ‘normal’ gait.

  215. crutchman, on July 6th, 2011 at 2:04 pm Said:

    I ruptured my Achilles tendon in London UK and you can read about my experience here. http://www.achillesblog.com/crutchman/ If you have any question don’t hesitate to ask.

  216. ryanoseris, on July 18th, 2011 at 7:40 am Said:

    hi all, particular normofthenorth if you can get this
    I had an ATR 5 weeks ago after a fall up the garden steps (totally sober i might add)
    off to A+E where a cast was fitted in the ballerino position for what was to be 4 weeks , however due to a suspension of the fracture clinic at my local NHS hosp had to wait until 5 weeks (due off this week )
    I have read lots of blogs and searched for info , all of which is great and found loads of tips for recovery
    However my situation is this 0 as well as the ATR i also have something called Hoglands Nodes (also known as heel spurs) these in effect mean the achilles tendon has further to travel
    Try as i may i cannot get a straight answer from all involved whether this will have an effect recovery or increase the risk the risk of re rupture
    Any one got same or similar or any info??

  217. Katherine Gruening, on August 17th, 2011 at 3:55 pm Said:

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  218. petec, on September 12th, 2011 at 3:33 pm Said:

    I did my ATR in turkey where they operated about 3 hours of my entering the hospital. I then went to a&e at the QE hospital birmingham on my arrival home. they booked me in to trauma clinic the next day (saturday) where they changed my dressing and booked me in for a scan on the monday for suspected DVT (due to my recent flight home) which was all clear. due to the removal of my partial cast for the scan i was given a temporary cast until the next day when i was due back to trauma clinic for the removal of stitches. i was then given a fibreglass cast and told to return in 3 weeks (tomorrow) it was when leaving the hospital in a wheelchair i saw a young soldier with one arm missing and both feet missing from about half way down his shins, wheeling himself outside for some fresh air. it was then i vowed not to complain about my ’slight’ injury and just get on with the healing process.

  219. Stuart, on September 12th, 2011 at 4:10 pm Said:

    Peter - What a difference perspective makes. I am with you on this. The reality is often difficult to see until you have such a confronting image.

  220. ali, on September 12th, 2011 at 5:22 pm Said:

    Too right Peterc. When I got back from hospital I read a book ‘Of life and Limb’ by Jamie Andrews, who lost both feet and hands to frostbite. I eventually got in touch and I’ve asked him to come to speak at my mountaineering club. He is so positive, his attitude helped me see things differently (now he is back to doing the activities he loved before). I haven’t found this easy at all but, there is an end in sight somewhere.

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  223. Naomi, on September 25th, 2011 at 12:58 pm Said:

    I ruptured my Achilles completely on tues, have to wait til this tues to see the specialist and still don’t know if they will do surgery. I do have the option to go private thankfully but need some advice. i am 33, used to be active and want to be again, have a young daughter and drive a bit for work. So annoyed :-(

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  225. Stuart, on September 26th, 2011 at 3:08 pm Said:

    Naomi - I am sorry not one here got back to you but I do hope you are sticking around. It may well be too late to answer any questions but there is enough information within the site to at least have an idea when you see the doctor. I am not in the UK but there are plenty here that have gone NHS and done well. There are also some that have been less than happy. You are fortunate to be able to go private. At least then you would have the choice of doctor. It is not necessary for you to have surgery but if you go the non surgical route then you should do some research about more modern protocols. Normofthenorth is the best here for that. Because you have a young daughter you will need to be mobile as soon as possible so you should try to get into a walking boot. You may be in a plaster for a couple of weeks but there is a period of no weight bearing so the boot could come after that. It is going to be a long road to recovery but having a doctor and physio with modern thinking should get your life to bearable in 3 months. As a guide (not to be taken literal) you could be full weight bearing in a boot (no crutches) in a month, wearing 2 shoes in 2 months and walking reasonably well in 3 months. That is to say if all goes well and there are no other factors. Normal will take much longer. I hope you have someone around to help you. It is very hard to do the initial few weeks/month on your own. I hope it goes well for you.

  226. nome007, on September 27th, 2011 at 2:33 pm Said:

    Hi, I am in a walking boot :-)feel more mobile now. Doc things it’s not a full tear as he traced it with his hands. I can start bearing weight when I want and have been cautious but doing well so far. Back in 2 weeks to monitor there healing and if not healing, I will then have the op. I am lucky to have my other half and family to help but hard when you are very independent lol Thanks x

  227. Andyccf, on October 22nd, 2011 at 10:06 am Said:

    Hi Everyone Thanks all for putting your experiences here - it makes me realise that I’m not the only one!
    My rupture was 17 Oct and it took me a full 12 hours to accept that it was more than a little strain.
    Anyway I am now day 4 of the 1st cast and starting to realise that I will be spending most of my time on the floor at home.

  228. feedthegoat, on October 30th, 2011 at 4:48 pm Said:

    hi all

    Ruptured my achilles on sunday last week (23rd) playing 5-a-side football in north london. Complete shock to me - have run 3 marathons in the last 4 years and played football for 20 years so no idea why now.

    Was seen privately on Monday (BUPA) and had surgery on Wednesday. From what I have read on this site my experience so far all seems pretty typical.

    Biggest pain is keeping the leg up all the time. Anyone reading this - I’d love to know your opinion on the “above the heart” thing. My surgeon didn’t seem too bothered by this - he just said “up”.

    Good luck to everyone.

  229. bcurr, on October 30th, 2011 at 5:53 pm Said:

    Google for edema (the swelling of feet) and every site will come back with raising the foot above the heart as the main thing to do as its the fastest way of decreasing swelling. Keeping your foot up but below the heart I think just stops the swelling happening so fast. Anyone who has done it though will count keeping the foot up high as one of the best recovery things to do in the first few weeks.

  230. lainey, on November 1st, 2011 at 5:02 pm Said:

    feedthegoat, I had surgery 6 weeks ago and have just come out of the cast. A nurse told me that as long as you keep your leg higher than your hip its ok, and that seemed to work well for me - as soon as I felt any swelling I did that and it went away again. Its also to do with preventing DVT, as by raising your leg you allow the blood to flow back down your leg.
    Hope that helps!

  231. Kay, on November 5th, 2011 at 5:02 pm Said:

    Hi. I am clearly one of the lucky ones… not a rupture but achilles tendinopathy - tears in my tendon that have meant walking with a limp for the past 14 months. - Sometimes with only low level pain but sometimes a real, painful hobble that means i can’t even give the dog a 10minute walk. I have gone down the private route with 2 procedures involving saline stripping to try to remove the vascularisation (not successful) and then 4 days ago PRP (Platelet-Rich-Plasma) to help kick start the healing process. Just wondered whether anyone else has experienced PRP and what dos and don’ts you could share re the rehab process. Many thanks

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  233. Heather, on November 21st, 2011 at 10:52 am Said:

    4 weeks ago I had my achilles tendon peeled off at the OS Calcis, fragments and bone spurs removed and then reattached to the periosteum with vicryl sutures. Has anybody else out there had this operation? Any idea how long ther recovery period is the stages involved?

    I appreciate all and any help that you can give.

    Thanks!!

  234. nome007, on November 22nd, 2011 at 3:16 pm Said:

    9 weeks since rupturing my Achilles and I am now in 2 shoes starting the long road of physio. I had conservative treatment and my range difference is 17cm from my god leg range which is a lot but apparently good as it means it’s healing well. Consultant is Mr Kurdy. can’t drive for another 4 weeks though :-(

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  236. Tamterelle, on December 17th, 2011 at 7:16 am Said:

    Hello there everyone …. I ruptured my Achilles tendon a week ago today and am in a pot … I am doing everything they told me to do … No weight bearing and elivate it high and to rest … My biggest problem is that it feels very crampy now and again (mostly when on crutches) and it spasms quite a lot … I think it’s just it repairing but has anyone else had this ???

  237. Mike R, on January 4th, 2012 at 11:49 am Said:

    Hi Tamterelle. I did mine a week ago (Dec 27th) and have been plastered and then replastered. Just found this site and I’ll set up a new blog. As for cramps try 1/2 a teaspoon of salt in a pint and a half of water. Drink regularly. I added lime juice cordial to taste. I suffer from cramps normally but with a cast ? Aiee ! to date not so bad but standing is a nightmare.

    Mike R

  238. Tamterelle, on January 4th, 2012 at 12:48 pm Said:

    Hi Mike R … I was back at the hospital on the 30th December 2011 for what I thought was a change of pot. However the consultant said he wanted to leave it for another two weeks so as not to mess about with it. He advised me to take an aspirin a day which I have been doing. My next appointment is on the 13th jan 2012 in which the realignment of the foot will be done. I think I am doing ok and after the first week have not had that crampy feeling nor no pain … I asked the doctor if that was normal and he said it was a good sign. I am hoping and praying that the tendon will take the stretching and not snap again as I have read this is a possibility … The only problem I really have is boredom and virtually no exercise… I do keep exercising the leg and wiggling those toes though… I hope you have a good recovery and keep me posted … Live hearing how others are doing as I felt until I saw this site like I was the only one x

  239. monkeytrousers, on January 29th, 2012 at 9:26 pm Said:

    Hello all,
    I am 33 and ruptured my achillies on 22 December while running for a train. I jumped down a steep kerb (approx 1 foot) and felt something snap. At the time I was more interested in saving my iPhone which I threw across the pavement. I managed to get on the train at which point the pain started. I could put weight on my right leg, but it was extremely painful and my slow limping walk made me a fire hazard. I was picked up at the train station and went home (thinking I twisted my ankle). The following morning I woke up in pain and told my wife I need to go to A&E. My inlaws were going to take me due to child care issues, but being stubborn I said I could drive myself. So got to A&E and hobbled in (not sure how I got there seeing as it was my right foot, although I did use the handbrake to assist in stopping once). The doctor advised that I had fully ruptured my achillies and I was to expect a lengthy recovery. They sent me for an X-ray, as a back up but confirmed the diagnosis. Due to the Christmas period clinic hours were not available for 5 days so they put my foot in the equinous position and placed me in a half cast to the knee ( cast at back and across toes with thick bandages at the front). I visited the clinic on the 28th and the doctor advised I had 2 options surgery or cast method, after probing by myself he said he would recommend the cast method due to new research. Although had I chosen the operation he would have done it that same afternoon (without me having to call on my private medical insurance) He also signed me off work for an initial 8 weeks. I then went to be fitted with a new cast for 4 weeks, again in the equinous position.

    During those 4 weeks, my ankle felt sore with the main being similar to a sprain. I also had sharp shooting pain across my calf and was terrified of getting cramp. I got purchased a waterproof cast cover and perfected the art of showering like a flamingo would. My hands would ache in the mornings and evenings from using the crutches and I did find it frustrating not being able to do anything for myself. To top it all, we had booked a short break at centerparcs on the 2nd January and I could not do anything except ride the mobility scooter I hired (and have a beer or 2). I have 3 children aged 5 and under and I have struggled not being able to interact with them in the way I normally would. The whole situation is putting a large strain on my wife (who is officially the new wonder woman with what she has had to do by herself.

    I went back to the clinic on the 25th, January to have my cast removed. The consultant, felt along my tendon and could feel no gap so advised I will now be moving to an airboot, and I should try walking as soon as I feel confident. He suggested 3 or 4 wedges, fixed for 2weeks and then to remove 1 a week, he will then see me again in 4 weeks. I was told not to take the boot off except to remove wedges, he also reminded me not to expect any sporting activities in my life for 6 months. The boot I have been given is an Aircast FP and he left me with the nurse. We tried an initial 3 wedges but the pain was too much when trying to plant my heel the boot. I am sure a lot of it was psychological but I did not want to feel any more pain which incidentally was worse then the initial rupture. We went upto 4 wedges and I managed to secure the boot. The pain and discomfort of the boot now prevented me from walking on my crutches and we used a wheelchair to get me to the car. Looking back it was the pain of adjusting my ankle from equinous to approx 20degrees and a real fear of knocking it alongside the extra weight of the boot. I managed to hop from the car to the sofa and undertook a regular course of paracetamol and ibuprofen for the next 2 days (which if you know me and my aversion to painkillers, demonstrates how painful it was). The 1st real positive was being able to put my foot on the ground to help with balance when doing simple tasks like brushing teeth. The 27th Jan was when I first attempted weight bearing and by the end of the day could walk 5 meters without crutches. My wife’s reaction was similar to watching a toddler taking their first steps.

    My new boot is too big for the waterproof covering i bought, so i now have to lower myself into a bath backwords and carefully shower using a mixer tap whilst keeping my leg elevated. My biggest concern is that my boot is not very comfortable, the first night was horrific in trying to get comfortable. I have had regular burning sensations on my feet and toes, with a shooting pain in my calf. Loosening the velcro fastening helps but it does not alway prevent it. The sole/heel of my foot is also very sore, and I am developing a small blister at the front of the ankle where my foot meets my shin from the boot rubbing (the padding from the front plast cover takes some adjusting to prevent this). In addition to this I have suffered with chronic back ache in recent years which got worse late last year and now Is causing me as much pain as my achillies injury, which is not good. I had been attending a physio before Christmas which I have had to delay until I am back on 2 feet unaided.

    When loosening my straps on the 27th I found that a strange odour was emanating from the boot (after closer inspection I can only describe it as a new biological weapon targeting the nose) my foot did not smell after removing the plaster but seems to in the boot. I have therefore gone against doctors orders and gently removed my boot for 2 minutes, bathed my foot in detol and warm water and changed the tubigrip sock that I wear under my boot. I was very careful and gentle, and plan on doing this every 2/3 days. The amount of skin that starting peeling from my foot was not pleasant, but the feeling of warm water on my foot was appreciated. There is obvious muscle wasteage in my calf. My other concern is not having any trousers/jeans that I can get on without removing the boot so I am in shorts, just as the meteorologists are forecasting a cold snap heading our way over the next 2 weeks.

    Today is the 29th and I can walk around the house without crutches, although I do tire easily. I can now fetch my own drinks (only half filled to prevent spilling though) and can do more to help with the kids, only taking occasional paracetamol too.

    I am working from home again starting tomorrow (did so in the week leading to the cast removal) but only a few hours in the morning and afternoon. My employers are very happy with this as I am still officially signed off for 4 weeks, but I am extremely bored with daytime tv and want to be kept upto date.

    So all in all progressing well with a couple of really painful days, many bearably painful days, lots of frustration, plenty of boredom and the inconvenience of having limited mobility over the Christmas holidays.

    My final comment is about being sick of hearing “that’s worse then a break” when you tell people what you have done. DO THEY NOT THINK I KNOW THAT grrrrrrr.

  240. David Schofield, on February 3rd, 2012 at 3:13 pm Said:

    Monkeytrousers. Just read your story and wondered how you are progressing. I ruptured my achilles nearly two years ago whilst skiing. It was a difficult journey, with very similar experiences to yourself. Im 40, and opted for the cast method to recovery. If its of any help to you, the tendon healed very well and now feels as strong as ever. Im now looking forward to returning to the Alps in four weeks time. Make sure you do plenty of physio when you are advised. Best of luck, I know exactly what frustrations you have. Keep up the humour.

  241. shellshocked1977, on February 16th, 2012 at 5:25 pm Said:

    Hey folks, thought Id add to the long list of UK ATR sufferers and throw in my tales of woe with a frank recommendation for the Vacoped Achilles boot.

    I suffered a full ATR whilst playing tennis on 11th January. It was to be the start of my new fitness regime in prep for a dream holiday to Oz in March. Needless to say both the tennis and the fully paid trip to Oz have gone out the window!

    I changed direction quickly on the court and pop the tendon went. Ive never suffered any injury like it but knew immediately what had happened. Within 10 mins of the ATR I was in my local A+E in Bromley. Unfortunately I had a further 3.5 hrs wait before I saw a trainee doctor. She had a look and diagnosed it as a partial rupture, said there was little that could be done and I should go home and rest it. Fortunately for me her diagnosis had to get checked by her mentor who ultra sounded my ankle and confirmed a full ATR. I had a visit to the cast room, left leg (toes to below knee) place in a front slab cast. I was given Ibuprofen and co - codamol and given an appointment for 8 days time at the fracture clinic. That when I became an Internet doctor! For the next 8 days I researched every aspect of the injury, specifically looking at the pros and cons of surgery Vs conservative. I was a bit confused but was weighted towards surgery.

    The big day -
    The consultant immediately said that he has been treating full ATRs conservatively since the 1990’s and uses a special boot rather than casting.. A trip to the casting room and I was fitted out with a rather S+M looking fracture boot. The boot was a Otto Bock Malleo Immobil Airwalker High (try saying that after a few drinks). The boot was fitted with wedges at 30 degrees and had a pump to pump up airbags around my ankle. I was given an appointment for another 2 weeks time and told to elevate the leg with no bearing of weight. At first the boot was comfy and a nice relief to be able to keep my foot clean by removing the boot and washing it. However the boot was clunky and the straps created pressure points.

    The Vacoped -

    I did a bit of research and there was a lot of talk about a boot call the Vacoped with supposedly 25% quicker healing time through its use. I had already bought an £85 pair of ‘Smart crutches’ (worth every penny) to assist me so I thought Id give the Vacoped a go. The price from the Uk supplier was a bit steep at £240 inc vat so I thought Id give ebay a go. To my astonishment I ended up buying one for £40 (one careful owner, 4 weeks use). The Vacoped had eased the pain of having this injury. After showing it to the consultant on my next appointment he was sold. Its just so much more comfortable and versatile than the one they issued me with. Much more hygienic too as it comes with interchangeable terry towelling liners and you can take the sole off in bed at night. This not only lightens the boot but stops you taking any debris into the bed.

    On this visit ( 3 weeks post rupture) the consultant said that the tendon was reconnecting nicely and to drop the angle of my foot to 20 degrees with a view to being 50% weight bearing by the end of the next 2 weeks. The adjustments on the Vacoped are a doddle. You use a plastic key to adjust the angle at the back of the ankle.

    Where Im at today -

    I had my 3rd appointment today (5 weeks post rupture) the tendon is healing nicely and the consultant says I can drop the angle down to 10 degrees this week and then when Im comfortable 0 degrees (natural right angle) the following week. Better still I am now fully weight bearing. Once at 0 degrees I can take the boot of in bed at night. My next appointment is in 3 weeks with a view to starting physio in the next few weeks also.

    So there you go. I was truly apprehensive about going conservative (no political pun intended) but Im kind of glad I did. I never though Id be full weight bearing 5 weeks after the rupture and on track to a speedy recovery. I can honestly say that the Vacoped has been a blessing, along with the Smart crutches. If you can, its worth investing a little in you own recovery. The NHS stuff just isnt up to scratch but at least they were open about that. Ill look forward to giving you the next update in 3 weeks time!!!

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  243. james2001, on March 14th, 2012 at 2:54 pm Said:

    Hi All,

    I really need some help\advice.

    Fully ruptured my Achilles on 04/03/2012 playing football. i am 28 years old.

    Went to A+E on 05/03/2012 and they put on a cast.

    Today i had an appointment with the consultant. He told me if i wanted a surgery or let it heal naturally, i asked for his opinion and he said he would recommend natural healing. I asked him i want a boot and do not want a cast. I have been provided with a boot with 4 splints and told to remove one every 2 weeks. got another appointment in six weeks. I have been told not to put any weight on my leg for that six weeks! (tried to ask him for more clarification -but seemed like he was trying to get rid of me)

    Having read this blog for the last 10 days, my question is: 7 weeks on NWB is this the correct way to deal with this problem? if not can someone please kindly point me to the correct protocol i should be following so i can go speak to my GP tomorrow. (Based on the UWO study i have decided to take the non-op route)

    You help\advice is appreciated and look forward to your replies.

  244. netballer21, on March 15th, 2012 at 10:32 pm Said:

    Hi there, I’m Lauren

    female, 21, and I ruptured my achilles 2 weeks ago playing netball.

    I am being treated at Walsgrave Hospital in Warwickshire, UK and am receiving non-operative treatment.

    I’d love to exchange emails with someone at around the same recovery rate and age as me, to discuss how its going.

    Thanks so much

    Lauren

  245. Louise22, on March 16th, 2012 at 6:50 pm Said:

    Hi James I was advised 6 weeks NWB to let tendon rejoin then 4 weeks FWB in boot with removable wedges then progress to 2 shoes I am week 7 FWB in boot lots of movement in ankle feel not bad hope that helps, louise

  246. Tamterelle, on March 18th, 2012 at 4:53 pm Said:

    Hello there everyone … Sorry have not been on in a while but I have been a busy bee since getting out of cast and living life to the full. It is 14 weeks yesterday that I fully ruptured my Achilles tendon and 14 weeks tomorrow that my first proper cast was put on …. All in all I was in a cast for 9 weeks but the last week of that I did walk on it. However the first week out of cast felt like I had taken a major step back and was very upsetting for me. I think I thought I as soon as the cast came off I would be better. How wrong was I, being in the cast was the easy bit. Phisio started on the day my cast came off and i have had 3 sessions since. The first week out of cast for me was the hardest as I now had a sense of freedom but the stiffness in the tendon and ankle was unbearable. Phisio has helped and anyone starting it, listen to what they tell you and do what they say. It is very hard at first but with the exercises it does loosen up i promise. My problem now is a constant pain in the inner of my righ heel 1 inch up. They are not sure what it is but they seem to think it because they set my foot wrong in the cast. Also please take things carefully because my consultant told me even though I am quite far on re rupture is still a possibility. I am now walking but still with a limp, however every now and again my right leg feels completely normal without an ounce of tightness but most of the time there is some degree of it present. For the past few days I have done very little phisio work as we have taken a massive tree down in our garden and I have been project manager, but have been on it a lot. I can tell with how it feels that phisio has not been done and being on it a lot with virtually no rest it is very tired. I am straight back on that phisio tomorrow and I know after two days it will feel great again. Hope your all well big hugs x

  247. Catherine Bartlett, on March 19th, 2012 at 7:09 pm Said:

    To my fellow netballer21, Lauren
    I ruptured my Achilles playing netball over a week ago, I’m 32 and love sport esp netball, just gutted. I opted for surgery, don’t have a lot of pain, some aches here and there getting cabin fever already and feeling mostly like a lot of people don’t understand how serious it is, would be great to share experiences. My follow up appointment can’t come soon enough!
    Take care
    Catherine

  248. Nigel, on March 29th, 2012 at 3:50 pm Said:

    I ruptured my AT last friday and have been in a cast since whilst waiting for the consultant to approve surgery. I have just found out today that if I was younger (48yr old) they would have performed surgey but due to my age they would prefer the non surgical procedure. I am well p***** off how do they now how active I am and what my job involves. I have tried to explain this to them but they do not want to listen, WHAT DO I PAY NATIONAL INSURANCE FOR.
    6 WEEKS BEFORE I GO BACK OFR A FOLLOW UP APPOINTMENT WHAT A GLORIOUS NATIONAL HEALTH SERVICE WE HAVE.
    I will keep you all informed on my recovery progression, chin up or is that leg up and rest

  249. HarleyLady, on March 29th, 2012 at 5:05 pm Said:

    Cant believe they denied you surgery. I am 52 and have had mine fixed in Nov and retore in Feb and had surgery again. SO far my insurance has been pretty good. Whats this world coming to? Socialized medicine? You are definitely NOT too old. Go to a different Orthopedic Dr. Keep us posted.

  250. DylanUK, on March 30th, 2012 at 10:39 am Said:

    Hi everyone, been reading this site for weeks and thought I’d add my progress on treatment through the Manchester NHS (who have been very good) so far. I’m 37, very active and fully ruptured my left Achilles on 23rd Jan playing badminton. I’m currently at week 9 since rupture.

    Week 1-2
    After a quick and very obvious diagnosis I was put in a plaster cast in A&E for 1 day only and given an appointment the following day for the fracture clinic. The consultant did a Thompson test and felt my Achilles and put his finger in the gap! He told me about both options for recovery but said he treats all these injuries the non-op route with very good results. I had no option for surgery but wasn’t that concerned as didn’t really know about either method. I was put in walking boot on day 2 with 5 x 1cm heel raises. No weight to be put on for 2 weeks.

    Week 2-4
    Follow up appointment at clinic. Consultant felt tendon and said to continue with this treatment. He took out a lift (now down to 4cm) and said to put full weight on the boot as soon as possible and wean off crutches. Started to come off pain killers, went to FWB after a few days, ditched the crutches a few days after that.

    Week 4 – 6
    Follow up appointment at clinic. Consultant said he could no longer feel a gap and was reasonably happy. Took another lift out (now down to 3cm) and told me to come back in 4 weeks, but take another lift out myself at week 6. Also arranged for physio to start at week 6.

    Week 6 – 8
    Took out a lift myself, down to 2cm. Started physio at hospital to do basic ROM exercises. At week 7 I was given more exercises which involved pressing against my foot and pushing against a towel.

    Week 8 – 10
    Where I am now. Had my 8 week appointment with the consultant who felt all along my leg and tendon, he said it has re-joined the best that can be expected and to now take the lead from the physio, which will continue to week 12. He made another final appointment for week 16 where he said he expected me to walk into his office normally! I am now walking bare feet around the house (very small steps) and doing small calf stretches. I will wear the boot outside though for the next 4 weeks. My ankle swells and calf goes very tight but ice on the ankle and heat on the muscle helps.

    I have a lot more detail than this if anyone has any questions but things are progressing well. Hope it is for others too! It is amazing how much the treatment on the NHS varies, looks like I have been lucky with mine.

    Whilst I’m on – special thanks to Normofthenorth – you put my mind at ease about the non-op route in the early stages! So far so good.

  251. DJ, on April 2nd, 2012 at 7:26 am Said:

    So you went non op and ditched the crutches at week 4?
    I want off these damn crutches ASAP!
    Buy I have the don joy which is angled down now so walking without crutches won’t be an option until I get the boot to neutral which is in 4 more weeks.

  252. DylanUK, on April 2nd, 2012 at 10:35 am Said:

    Hi DJ - Yes, the consultant was keen for me to put weight on the boot and start walking without the crutches as soon as possible. He’s also a big non-op fan. My boot was the standard NHS one, which does not look anywhere near as good as the Don Joy ones and my foot was angled down too, as I still had 4cm of heel lifts, but I could still put my full weight on it at week 3. I just wore a walking boot on the other foot to get my legs as level as possible. The Don Joy boots look like they are made in the same style - maybe you should ask about putting weight on it sooner than 4 more weeks?

  253. normofthenorth, on April 2nd, 2012 at 4:06 pm Said:

    DJ, as Dylan suggests, there’s NO relationship between getting your ankle at 90 degrees (”neutral”), and WB or walking. MANY of us got to FWB and walking — and walking fast, too — while our ankles were still angled down. It’s not hard. It does mean that you have to work a bit harder to get your two legs balanced in height — e.g., to find a high boot and add some footbeds to it for your other foot, or get a thick-soled “cast shoe” and stick a slipper or sandal into it, or even take an old shoe to a shoemaker for customization. (The Vaco people and others sell “elevator shoes” designed to balance the height of an orthotic “walking boot”.)
    The method isn’t important, but it IS important that you get balanced before you start walking with your hips imbalanced. Early WB is helpful to your AT, but messing up your whole body’s alignment in the process is a Bad Thing.

  254. dj, on April 2nd, 2012 at 7:58 pm Said:

    thanks for the replies.
    I am lost here though. there is NO way to walk in my DJ mc walker boot right now with it down at 22.5 degrees. in order for me to walk my foot would have to be 2 ft ahead of me for the bottom of the boot to be level with the ground. I am not sure if this makes sense or not. the Vaco boot is flat on the bottom BUT the foot is angled down inside it on top of heel raises. so you could stand down on it. Am i lost here???? haha
    maybe i need to attach a pic to describe this! haha
    i can stand in the DJ boot but the boot foot is 2ft ahead of the right (good) leg because of the angle. not to mention that i had ACL and meniscus surgery on my good leg 8 months ago and now that is sore and bothering me from having all the weight on it.

  255. dj, on April 2nd, 2012 at 8:10 pm Said:

    thanks for the reply!
    I would try to walk or do more but the BOOT is angled down NOT just the foot.. its the foot AND the boot.
    if the boot was flat to the ground with the foot angled down inside it i would be a lot happier!

  256. plummy, on April 5th, 2012 at 1:08 pm Said:

    So much negative stuff about the NHS. I don’t work for it in any way, but happy to say that I am pleased so far. ‘Conservative’ treatment began with 2 weeks NWB in fibreglass cast, then into a VacoPed boot at 30 degrees PF, and able to weight bear as comfortable. After week 4, boot at 15 degrees and able to remove for bed - nervous at first, but what a relief. Do more exercises. Walking mostly with no crutches. From week 0, I had the use of a K9 walker (not NHS) which was useful as it helped to take the strain off my good leg. Still handy to have around as a mobile leg-rest. May appear on eBay one day! Working at home right now although need to be careful as with foot down, ankle and leg soon swell up. Because ATR doesn’t get the coverage of bone fractures, people assume ATR not so serious and that you will soon be mended, and even able to sit at a desk all day - not so if you are after a quality repair.

  257. Louise22, on April 5th, 2012 at 5:11 pm Said:

    Hi Nigel I am 49 and did full ATR 10 weeks ago non surgery —cast 6 weeks boot with wedges for 3 now walking ( all be it with slight limp ) in 2 shoes . I met a girl in physio last night full ATR 9 th Jan ie 2 weeks before me. She hadsurgery still in boot so don’t worry surgery isn’t always answer , good attitude and physio encouraging movement and weight bearing has been right approach for me . 10 weeks sounds like life time but has flown in keep positive

  258. Louise22, on April 7th, 2012 at 11:49 am Said:

    Ps went shopping today ,walked around for hours no problems drove my car manual!!!!!!!!! Don’t think you would really notice limp 10 weeks 4 days after full ATR conservative treatment feel almost like my old self only probs still is coming downstairs and walking barefoot

  259. DJ, on April 7th, 2012 at 3:16 pm Said:

    When did you lose the boot and start walking?
    When were you walking without crutches? And what kind of shoes are you walking in now?

  260. Louise22, on April 8th, 2012 at 2:18 pm Said:

    Hi DJ, I started walking in boot without crutches on second day of boot ie week 6 , I am walking in normal boots with inch heel and trainers with one heel grip inside I find high heels quite easy but that’s not stretching tendon obviously. Can’t do downstairs and bare feets quite difficult without limping. There is no difference between plaster cast and boot with wedges, as wedges are removed you will have to drop heel height of other footI started in a 3 inch heel wedge but as I dropped wedges I had to wear a flat heel on other foot

  261. Louise22, on April 8th, 2012 at 3:14 pm Said:

    Dylan we seem to be same stage I did full left ATR on 24thJan! One day after you my consultant said ditch boot on week 10 best physio is walking which I am doing with 1small heel wedge in left shoe good luck

  262. DylanUK, on April 9th, 2012 at 2:33 pm Said:

    Hi Louise

    Yes we’re a day apart! Looks like we followed slightly different protocols but are at the same point. It’s 11 weeks today since I did it. I can walk around the house slowly but with a limp and the tendon feels pretty tight but loosens with stretches. I’m doing the strengthening exercises for my calf but the progress seems a bit slow, I’m at physio on Friday so will know more then! I’ve started driving too, like you it’s my left AT so only the clutch to worry about! I’ve ditched the boot now but being really careful out. Like you though I have to go down stairs one at a time, but can walk up them ok. Hopefully things will just progress at a steady rate now - for us both!

  263. Louise22, on April 9th, 2012 at 2:39 pm Said:

    Hi Dylan I have physio on Wednesday , we can compare excercises!!!

  264. Louise22, on April 12th, 2012 at 4:20 am Said:

    Physio last night 11 weeks ATR ———– OMG I thought 2 shoes ,driving etc was stretching tendon,it wasn’t! Started on treadmill at very slow walk, this encourages walking without limp agony lasted about 2 mins . Then onto bike and calf stretch OMG followed by soleus stretch didn’t think I was going to be able to drive home Woke up this morning tendon aching had to take ibrobrufen is this normal?

  265. Alison, on April 12th, 2012 at 7:01 am Said:

    It appears that there are a lot of differing experiences on here, both in treatment and options of treatment.
    I ruptured my achiles tendon dancing on the 23rd of March.
    I was put in a temporary plaster to keep the foot immobilised until I could have surgery (unlike a previous blogger age didn’t prevent the option, I’m 53)
    I had percutaneous surgery to repair the tendon on the 27th of March and was put straight into another plaster cast which was on until today (12th of April)
    I am now in a walking boot and have been told I can fully weight bear, presumably as soon as I can bear the pain, which is at the moment considerable.
    I have four wedges in the boot at the moment with instructions to remove two in twoo weeks and then another two in four weeks.
    The boot should be removed at six weeks and then who knows?
    My consultant tells me I’m part of a trial he’s conducting with regard to percutaneous surgery and weight bearing at two weeks post op and that this treatment should give me a quicker healing time and less chance of re-rupture.
    Indeed it does seem to be more the norm in Canada and America according to the blogs I’ve read but maybe comparatively new here in the UK.
    Unfortunately I have to keep the boot on at all times, it’s rather heavy and will make the sheets dirty, and showering is going to be just as difficult with this as it was with the plaster!
    I hope the pain recedes enough to do as my consultant says and actually bear weight and then I can let everyone know the outcome!
    If anyone else has gone this route I’d love to hear from them.

  266. Brian Hamman, on April 12th, 2012 at 3:24 pm Said:

    Wow, I am jealous Allison! I had my surgery on the 28th of March (1 day after you) and doc says that I will be in a cast at least another 3 weeks before going to the boot. I will certainly tell him about your story when I get my cast changed next Tuesday morning. Anyway, I absolutely wish you the very best of luck in your recovery and please keep us posted!
    Thanks,
    Brian

    P.S.: I wodner if your doctor will let you take off the boot, at least for showers, a little earlier than 6 weeks post-op?

  267. Paul, on April 12th, 2012 at 6:17 pm Said:

    Hi Allison

    I ruptured my achiles tendon 26th of March(during football), and had percutaneous surgery 29th of March. Was put in a cast for 2 weeks, and had the cast removed today(12th of April).
    The physio got me fitted into a walking boot,and I can fully weight bear from today.
    I was told that I can take off the walking boot for showers. Also told to keep the boot on in bed,but only for a couple of days.
    Had a walk(well kind of a”walk”) in the city with crutches and no pain at all. Limping around at home without cruches.
    Been told that i will wear the boot for 6 weeks,next appointment with the physio in 2 weeks.

    Interesting reading other experience with ATR.
    (Should mention that I live in Norway)

  268. normofthenorth, on April 13th, 2012 at 1:04 am Said:

    Last numbers I saw, percutaneous ATR surgery had a pretty small market share (<~15%) in the US, and maybe even less here in Canada (where I’ve not hears of one yet). And the results were no better than normal “open” surgery and often worse. Maybe it’s making a comeback in Europe & UK?

    The only recent trend I’ve noticed here in Canada is more Docs and hospitals recommending non-op with fast (booted) rehab, following the successful Canadian “UWO” study, pub. 2010.

  269. Alison, on April 13th, 2012 at 7:34 am Said:

    Hi Brian,
    I presume you’re in the UK? It does seem to be more normal here to be in a cast for longer periods of time.
    I’m pleased to say the pain is considerably less today and I have been walking though not without pain.
    I won’t see my doctor again until the boot comes off in 6 weeks, maybe I’ll chance taking it off for showers in a few days, it is difficult hanging one leg over the side of a bath!! :-)

  270. Alison, on April 13th, 2012 at 7:39 am Said:

    Hi Paul,
    You seem to be receiving the same treatment as myself.
    I’m amazed (and jealous) that you can get around without crutches and with no pain!!
    Since you are allowed to take the boot off for showers and even to bed, I might try at least taking it off for showers myself.

  271. DylanUK, on April 13th, 2012 at 8:17 am Said:

    Hi Louise

    Had physio today. I’ve been stretching my calf for the last week and started back at the gym where I did 20mins on the bike and 10mins slow walking on the treadmill before my tendon ached too much. I’ve been given more strengthening exercises, the main one being to raise my heel whilst standing at a table, using my arms to take most of the weight initially. (This is really difficult!) My tendon is tight mostly in the morning and aches a lot, so does my heel and I’ve still got fluid around the injury site which is sore too - but nothing unbearable, I think it’s just part and parcel of the recovery process! My leg isn’t strong enough to ‘push off’ so I’ve got a limp too. I’m going to work on this a lot over the next 2 weeks but try not to do too much. Will keep you posted on the progress. I’ll be at week 12 on Monday.

  272. Louise22, on April 13th, 2012 at 4:24 pm Said:

    Hi Dylan,we seem to be following same exercise pattern except you are doing a lot better Perhaps down to age and you seemed to be a lot more active prior to injury. I can’t manage heel lift at all yet! Like you I will persevere and try to accept that this injury takes time , although I am the impatient patient. Good luck

  273. Alison, on April 14th, 2012 at 5:24 am Said:

    I am now on day two of (sort) of full weight bearing, the boot I have on my left leg has a huge base and I am finding it very hard to actually walk because of the difference in height between my left leg and my right, what’s the answer? Has anyone got one?

  274. Paul, on April 14th, 2012 at 7:47 am Said:

    Hi Alison

    I’m using a Nike Air on my right foot….works fine for me(day 2 of full weight bearing)

  275. Alison, on April 14th, 2012 at 9:16 am Said:

    Hi Paul,
    Are you walking with your ATR leg bent? I’m wearing a sketchers shape up trainer which has quite a deep sole but isn’t near enough to balance out the boot.
    It makes my ‘good’ leg ache trying to compensate.
    Though reading some of the posts on here I consider myself lucky to be in a position to walk, wonky or not!

  276. Paul, on April 14th, 2012 at 9:29 am Said:

    Hi Alison,
    My ATR leg isn’t bent…..I’m walking as normal as you can do with this type of boot. No problem walking around at home without the cruthes….use crutches outdoor.
    A massive progress since Thursday…..some stiffness but no pain at all.

  277. Alison, on April 14th, 2012 at 10:10 am Said:

    Hi Paul,
    Your boot must be quite different from mine, I have a 5 inch sole on this thing.
    Still, like you I have had a dramatic improvement since thursday so I’m really pleased.

  278. Paul, on April 14th, 2012 at 10:25 am Said:

    Hi Alison,
    If interested this is the boot ; http://djoglobal.com/products/procare/maxtrax-rom-walker

  279. plummy, on April 14th, 2012 at 11:56 am Said:

    Hi Alison

    The uneven walking can put a lot of strain on your good leg, so it would be good to add a little height. I found the Oped Evenup at http://www.vacocast.com/storage/pdfs/VACOcast_accessories.pdf. UK office should be receiving soon - you could try them on 01380 722177.

    I am about to have my boot adjusted to neutral (ROM 30-0) and begin progressively more intensive exercise with theraband, etc. I have had boot for almost 4 weeks and have the thinner sole fitted (started with very deep Achilles sole).
    Good luck with rest of your recovery!

  280. Alison, on April 14th, 2012 at 12:48 pm Said:

    Hi Plummy,

    I don’t suppose one of my stilletos will do? :-)

  281. plummy, on April 14th, 2012 at 1:44 pm Said:

    Hi Alison

    I don’t know how safe that would be but could be a good look! How high?

  282. starshep, on April 14th, 2012 at 1:58 pm Said:

    Allison:
    Stilettos might be a bit unstable but you have the right idea. Getting the other foot up to as close to the same level as the booted foot as you can helps a great deal. I stuffed 2 pairs of gym socks into the heal of my shoe and it works pretty well.

  283. Alison, on April 15th, 2012 at 5:20 am Said:

    Thank you for all the replies, I wouldn’t really have tried stilletos. Though Plummy I do have some lovely ones!
    I have found a wedge sandal that works reasonably at home, I don’t think I’d try wearing it out though.
    I will try Starshep’s idea with packing out a trainer for outdoors.
    It’s interesting that at the hospital they told me that a normal trainer would be fine, obviously they’ve never actually tried walking in one of these b****y boots!

  284. Louise22, on April 15th, 2012 at 4:30 pm Said:

    Hi Alison I wore a high heeled wedge boot which was the perfect height, the wedge gave me support and was much safer than a stiletto . I also felt a little bit more like me having a nice trendy boot on !!

  285. Dom Longman, on April 16th, 2012 at 4:46 am Said:

    Tore my achilles (full tear about 2 inches above heel and a partial rupture lower down) playing 5 a side on March 15th.
    Tbh it didnt hurt too much after the inital Pop, so thought I just sprained it. A and E the next day was good, then NHS consultants just wanted to cast me. Luckily I have private through work, who following an ultrasound described it as a right mess and so had surgery 2 weeks after the incident. Very glad I have as at 38 and still hope I have a few marathons left in me. Glad to hear some tales of recovery on this site.
    2 weeks after the op, just been recast to put more tension on to the tendon, so hopefully in another 3 weeks will be cast or put in a boot, as this hopping around and one legged showers is driving me nuts!. Trying to avoid the self pity of not being able to run/cycle etc by realising, although lengthy, this is ‘hopefully’ a temporary thing.

  286. Alison, on April 16th, 2012 at 8:13 am Said:

    Hi Louise,

    I can certainly identify with feeling a bit like yourself again!
    I found a reasonable height wedge boot that I can wear, so it’s not too bad now.

  287. Adam, on April 16th, 2012 at 9:08 am Said:

    Hi all

    Ruptured my achilles on Sunday 8th April, had a scan on Thursday 12th and operation on Friday 13th (I’m not superstitious!). I’m 26, did it playing football in my left leg pushing off. Played football 2-3 times a week most weeks, and do a couple of spin classes per week, but I wouldn’t say I’m outstandingly fit.

    I’ve started a blog discussing my experiences with the NHS and the treatment I’m getting here, feel free to read if you think it will help - I’m doing it to keep myself sane.

    http://adamsachilles.wordpress.com/

    I’m currently in a plaster cast and will be for 6 weeks, followed by 6 weeks in a plastic boot at different angles. Then there will be a good few months of physio

  288. plummy, on April 19th, 2012 at 7:55 am Said:

    Hi, Nigel, still there?

    I’ve just re-read your entry above and was sorry to read about your apparently potentially lengthy recovery protocol. I appreciate that every case is different - certainly most medics too.

    If you feel like it, why don’t you update your entry and tell others how you are doing now?

  289. Deb, on April 29th, 2012 at 2:29 pm Said:

    Hi All,

    Ruptured AT on 3rd of March Dancing of all things !, was put into a cast the next day and then sent to the fracture clinic the next day.

    Consultant decided to put me into a non weight bearing cast of 4 weeks and then to go back have angle of foot moved and re-plastered and told to return 2 weeks later to have foot moved and re-plastered again all non weight bearing them hopefully go back after 2 weeks and be put into a boot.

    Went back after 6 weeks to find I was seeing a locum consultant with a rather different view, he’s put me in plaster for another 3 weeks and then he wants me in a shoe with a 1 inch heel.

    My cast is now weight bearing but foot is not back in neutral, as the lady who plastered me said she wouldn’t put it straight back to neutral straight from the position I was in as I would be in agony she pushed it back as far as was bearable and the re-plastered and put on a flat walking boot with pads in the heal, been in plaster 7 weeks now and am walking on my crutches and have been hobbling round without them.

    Not to sure about going straight into shoes though as soon as the cast is of, cause each time the cast is changed there is just no strength there.

    Anyway I have probably sent you all to sleep by now but any comments would be welcome

  290. Plummy, on May 7th, 2012 at 12:14 pm Said:

    Hi Deb

    How are you now?

    I guess that every injury is different, and surgeons have their preferred treatment regimes. I ruptured my AT a few days before you and began with foot cast at 30 degrees for 2 weeks, followed by Vacopedboot at 30 and weight bearing for 2 weeks. Angle and free movement adjusted every 2 week s to the point now where I can, with care, begin to stretch the tendon a little and move foot up past flat. Very little pain until recently when I have possibly been too mobile. Due to try shoes in house in a few days time. Fingers crossed!

    After reading blogs, etc over past 8 weeks or more, I have noticed that total recovery period varies little. Importantly, it is early mobility that seems to be improved with newer protocols, though not without some aches and pains as exercise and movement increases. Back to hospital next week for review of progress, probably followed by plenty of physiotherapy.

    I hope that this helps in some way, but don’t forget, treatments vary, as do the injuries themselves. Also, hospital budgets vary too. I hope that you are not too uncomfortable - how are you getting about?

    Please keep updating.

    Bye

  291. Deb, on May 7th, 2012 at 5:35 pm Said:

    Hi Plummy,

    Due back to hospital tomorrow (8th May), hoping cast will be removed but unsure what will happen after that, either straight into a shoe as per the locum or if it’s the normal consultant maybe into a boot !

    I have to be honest I hate the crutches although have been using them a bit and then mostly limping around without them so that I have hands free to carry things. Have to have a sit down after I’ve been on my feet for a while as my heel starts to burn although I think this is possibly to the cast rubbing, also I find it puts quite a bit of pressure onto my other foot trying to spread the weight.

    I have a feeling I’ve had it quite easy up until now because the pain has been bearable, although I am dubious about trying to walk with the cast or a boot.

    Thanks so much for replying you do feel a little lost and reading all the blogs help, everything varies so much.

    Good luck with trying the shoes !

    Will post about what they do tomorrow

    Bye for now

  292. Deb, on May 8th, 2012 at 10:06 am Said:

    Well here’s my update, went back today had cast off, have been put straight into a shoe with some very roughly cut heel pads told to remove one every couple of weeks.

    Have an appointment to go back in 6 weeks but if it feels ok just cancel the appointment !

    No Pshyio offered and was told I don’t need to use my crutches just walk !

    Not to happy but will try it have no choice.

  293. Plummy, on May 8th, 2012 at 11:17 am Said:

    Hi Deb

    Wow, what can I say? At least you are into shoes now. Were you given any guidance about type of shoe, and what you should and should not do? Any exercises to carefully stretch calf? See a physio today at all?

    As I said before - different regimes, and difficult for us to know which is the best. Budgets too…

    Dare I ask which hospital?

    Good luck, take care. Keep updating. My update next week.

    I don’t think we can direct mail like on Twitter.

    Bye

  294. Alison, on May 9th, 2012 at 8:55 am Said:

    Hi Deb,

    I also ruptured my tendon dancing! Perhaps the twist is too ambitious at my age!
    I really think after reading the posts here that I’ve been incredibly lucky in my treatment.
    I ruptured on the 23rd of March some time after you, had surgery within a few days and was plastered for 2 weeks, after which I was put in a boot (fully weight bearing) with height wedges being removed every two weeks.
    The last of which come out tonight. Then in two weeks I see the doctor again to have to boot removed.
    At which point I should receive physio (hopefully) and be back in shoes.
    Your experience sounds dreadful!

  295. Deb, on May 9th, 2012 at 2:32 pm Said:

    Hi Plummy and Alison,

    I am under Kidderminster General Hospital in Worcestershire !

    The consultant said he wanted me in 1″ heeled shoes, I tend not to wear heels but not completely flat either just graduated, try finding 1″ heeled shoes when you want some ! So took my graduated shoes with me in the hope that it wouldn’t be the same consultant, not to be, as I said they put me into my shoes with a wad of felt cut outs.

    My shoe was so low at the back because of the cut outs that I have put them into my trainers which come higher up at the back and stay on better.

    I have to say my tendon feels very stiff but it’s my heel that is agony at the moment.

    Didn’t see a Pshyio at all Alison just told by the guy that does the plastering
    to gently work my foot to stretch the tendon.

    I am walking a little unaided in my trainers but not for long because of the pain in my heel.

    I shall wait for your updates and let you know how it’s going, take care both x

    I have

  296. Alison, on May 10th, 2012 at 4:19 am Said:

    Hi Deb,

    Ironically I’m under ‘Queens’ in Romford one of the worst performing hospitals in the country! But as I said I’ve been lucky.
    I took the last 2 wedges out of the boot last night and though like you my heel is sore (no idea why) but because I’ve been fully weight bearing for 4 weeks already I have no problem walking.
    I do think the problem with finding a shoe for the other foot to match the height of the boot or in your case wedges in your shoe is a pain, I’ve had to find 3 different ones.
    And I hate sleeping in this thing, but it must have been worse in a cast for all that time.

  297. Plummy, on May 10th, 2012 at 5:28 am Said:

    Hi Deb

    I’ve been fortunate in being looked after by Royal Devon & Exeter’s fracture clinic. Exeter has one of the best orthopaedic centres in Europe and I have a lot of confidence in the people there.

    From today I can try shoes on both feet but indoors only, and with silicon inserts in the heels. I put one of these under my ‘good’ foot a couple of weeks when the heel on that side became sore. Worked well. My Vacoped boot doesn’t have wedges as it adjusts the angle from the back. It has been very comfortable but I’m glad not to have had to wear it in bed after its first 2 weeks (after week 4 of rehab).

    Review at hospital next week and discuss physiotherapy plan.

    Deb, could you discuss further with your GP? You have concerns and GP might also be able to make a referral to a physiotherapist.

    Take care, you too Alison.

  298. Deb, on May 10th, 2012 at 11:15 am Said:

    Hi Alison and Plummy,

    It’s strange Alison I can put up with the stiffness in the tendon it’s my heel that really hurts, it’s funny you should say the same, I don’t know why either.

    I have ordered some memory foam heel wedges even if I only put one in my other shoes to try and get some sort of level it may help.

    I may make an appointment to see my doctor if the pain in my heel continues although not sure he will be able to do anything.

    I can walk in trainers unaided with a limp but do have to rest it on and off purely because of the pain in the heel.

    Take things steady you two it feels really strange being in shoes at first

    Take care both, keep updating

  299. Plummy, on May 11th, 2012 at 7:17 am Said:

    Hi Deb, Alison

    I tried both shoes yesterday evening indoors for a while. Felt a little weird, lighter and less supportive I guess. So far today it has been the boot because I have been outside and we are all slopes and steps.

    I was wondering if trying ankle supports similar to those worn by tennis players might help at this time, to give more support during early shoes-only days.

    Any thoughts?

    Apart from all that, the main issue for me is the soreness in the calf of the weaker leg. I’ll ask about this (and the support too if I remember) during my next check up.

    I mentioned before about trying a heel pad/wedge under my good, but sore, heel. Maybe coincidence, I can’t be sure, but the heel pain soon went away.

    Have a good weekend both of you, weather looking good.

  300. Deb, on May 12th, 2012 at 3:37 am Said:

    Hi Plummy, Alison,

    It does feel strange in shoes doesn’t it !, I am quite confident indoors although it’s quite painful because of my heel !

    Have to say went out for the first time last night it was my daughters birthday so we took her for a meal and boy it’s different walking in the house to walking outside, uneven pavements, kerbs and people, hubby dropped me quite close to front of restaurant because there are a lot of steps down from the car park which I would not have managed, but still felt very vulnerable.

    Maybe my own insecurities !!, but you are so aware of what your foot is doing.

    Make the most of feeling safe and comfy in those boots girls !!

    Have a fab weekend and no running :)

  301. Deb, on May 13th, 2012 at 6:12 pm Said:

    Hi anyone,

    Has anyone experienced pain in there heel after cast or boot removal ?

    Have been out of cast for 6 days now and into shoes, rat about 6″ inches up on left leg, although I can walk a little with tightness in the tendon, it’s my heel that is causing me a considerable amount of pain

    Has anyone else had this ?, getting a little desperate now, any thoughts or comments would be appreciated

    Thanks
    Deb

  302. Alison, on May 14th, 2012 at 11:40 am Said:

    Hi Deb,
    I work with a man who was the physiotherapist for the England tennis team and he dealt with a lot of this type of injury, he explained that the tendon is attached fan shaped to the heel bone and that the pain is likely to be the calf muscle stretching the tendon away from the heel.
    My pain simply stopped today, it had been constant since my ankle was put at 90 degrees and now it appears to have vanished!
    You may have to put up with it for a while but hopefully yours will go away soon too.
    I am amazed at the differing treatments in this country, and dismayed by the lack of information we all get!
    Keep well.

  303. Deb, on May 15th, 2012 at 12:17 am Said:

    Hi Alison,

    That would make a lot of sense, pain is worse when I’m on my feet, so thank you for that.

    Hope your getting on ok keep me posted

    Deb

  304. Deb, on May 21st, 2012 at 5:16 pm Said:

    Hi everyone,

    Still in a lot of pain with my heel !!!!, driving me totally mad, don’t know if I should go to my GP or if I’m being a big poof, been two weeks since cast removal, and another 4 weeks until I can go back to consultant.

    Offered no pshyio so no one to ask if this is normal.

    Any suggestions would be really welcome.

    Deb

  305. hillie, on May 22nd, 2012 at 6:42 am Said:

    Hi Deb

    Hi Deb

    Looking back at your earlier entries in this column reminded me of your situation. Of course you should see your GP, and even ask for a referral to another hospital if necessary to see a different consultant. Also, some ‘cottage’ hospitals provide good physio facilities if you have a referral from a GP or consultant. So, a visit to your GP I think - why not take a friend in with you?

    Don’t forget, good as this blog page is, we all need sound, professional advice too.

    Good luck

  306. Deb, on May 22nd, 2012 at 2:12 pm Said:

    Hi Hillie,

    Thanks for replying, feel very frustrated at moment hence the moaning.

    I think I will keep going until the end of this week and then if no better make an appointment to see my GP,

    Just don’t think I can stand the pain from my heel for weeks on end, I generally have a very high pain threshold but this is something else.

    Thanks for taking the time to reply

  307. hillie, on May 23rd, 2012 at 5:50 am Said:

    Deb, come on, you need to talk to a professional, this has gone on long enough! Leaving it until the end of the week will mean an appointment in about a week’s time I guess. Can you wait yet another week?

  308. Alison, on May 23rd, 2012 at 8:06 am Said:

    Hi Deb,

    I agree with Hillie, don’t leave it.
    I had my boot removed yesterday and all the pain I had in my heel has gone.
    Weird being in shoes again and very scary!

  309. hillie, on May 23rd, 2012 at 10:18 am Said:

    Sorry Deb, you’re outvoted! All meant in the nicest way of course. I was so impatient when my heels hurt that I called the physio direct.

    Alison, you’re right about the shoes, what a great feeling. Apart from that, I’m having a problem with quite bad swelling around the ankle and foot. Resolved well with ice pack and elevation but limiting my choice of shoe even more than I expected. Looks like I’ll be wearing hiking shoes with my suit next week.

    Probably spending too long at my desk and not keeping leg raised enough. Seeing physio on Friday so will talk about it then.

  310. Deb, on May 23rd, 2012 at 5:18 pm Said:

    Hi Hillie and Alison,

    Ok ok I will make an appointment tomorrow to see my GP !

    Hillie my foot and ankle swell too, daft tip someone told me was to wet flannels wring them out not to tightly then pop them in a bag in the freezer they come out a little stiff but give them a couple of mins, then wrap it around ankle and foot. Have to say I find it better than an ice pack because it moulds to foot and ankle.

    Will let you know how I get on take it easy in those shoes you two !

    Take care both

  311. Alison, on May 24th, 2012 at 8:18 am Said:

    Hi both,

    I guess the swelling is pretty universal then! It gets worse as the day goes by.
    I’m so looking forward to swimming tomorrow, it’s the only exercise my doctor will allow at the minute!
    take care.

  312. hillie, on May 26th, 2012 at 5:39 am Said:

    Hi Deb and Alison

    So the appointment is now made, Deb? Great, improvement on the way I’m sure.

    I love the tip about the wet flannels - I’ll be trying that today. Swelling is my main problem right now. Hardly any of my shoes fit!

    At 12 and a bit weeks, wearing both shoes, and now able to drive, I feel liberated, but vulnerable too, knowing (and frequently being reminded) that I do not want a re-rupture. I saw my new, clock-watching NHS physio this week and was given a new set of exercises to try, plus emphasis on swimming, walking (on the flat), cycling (static bike).

    Have a great weekend.

  313. Sheena, on May 27th, 2012 at 1:20 pm Said:

    Not sure how to do this but need to ask an urgent question as ruptured my tendon last Thursday, went straight to A and E and they cast it in ballerina. Going to fracture clinic Tuesday. Have read all weekend and this is the best blog.
    If my hospital doesn’t go down the fast boot rehab as done by normofthenorth can I insist? It is NHS in Berkshire. Seems like the UK is more drawn to non surgical approach. Can anyone help me with my decision. Also, I’m worried if it needs surgery that it will have been left for a week when most people have surgery within two days if that’s the road they go down.
    Many thanks.

  314. hillie, on May 27th, 2012 at 2:16 pm Said:

    Hi Sheena, sorry to hear about your injury.

    I’m 12 weeks on from my ATR and had the same concerns about surgery v boot. I’m pleased that I had read up on the subject extensively in the early days, although much of the content was from the US - nothing wrong there of course, but the bias seems to be heavily towards operative treatment.

    I also read the current research by Rebecca Kearney at Warwick Uni, discussed the options with my GP and my consultant, and was happy to take the accelerated (some say “aggressive”) non-op route.

    I was fortunate enough to get one of the best boots on the market (after 2 weeks in the lightweight cast) and was weight-bearing with the boot from Day 1 (foot down at 30 degrees, then adjusted fortnightly, finishing at Range of Movement, ROM, of -30 + 15). Out of boot 2+ weeks ago, now in shoes and driving. Carefully mowed some lawn today. Seeing physio and exercising more than for some time. Downside has been the swelling in foot and calf as I did more - however, a short rest, leg up, (keep an ice pack handy) and all is pretty much ok. It is still going to be a long job and i recognise that I need to be especially careful now with no protective boot, and getting back into a normal life.

    Remember, everyone is different. Different rupture (mine was high into calf), different physical and personal situation, different experience and scope of the hospital team (oh, and different postcode too of course!).

    Good luck Sheena, here’s to a good recovery.

  315. beralic, on May 27th, 2012 at 2:17 pm Said:

    Hi there Sheena,

    Sorry to hear your joining our club or ATR recoverers. I was also treated on the NHS (Edinburgh), non-op. There normal course is to put you through a set of casts, but as I flying just over 2 weeks after injury they gave me a boot without much in the way of questions asked (flying with a cast is problematic) so if they do resist, my suggestion would be a little white lie that you have to fly soon and that a boot would be advantageous because of that! make sure you discuss it on Tuesday not a later visit though cause for me anyway 2 weeks was as fast as they could get me into the boot as its not something stocked in the hospital and has to be ordered…

    Would not worry about non-surgical, as long as you don’t go on a very slow rehab protocol (NHS protocols tend not to be the fastest but not that slow either, and you can always shave a few days off each time they ask you to make an appointment for a couple of weeks!) Many people on here (myself included) have had great results without surgury, I’m back cycling/rock climbing and all other sports bar squash at ~6 months which I’m quite happy with :)

  316. starshep, on May 27th, 2012 at 3:34 pm Said:

    Sheena,
    I don’t know how the doctors are in the UK with patients telling them what they want, but my experience here in the US is that the more informed a patient is, the more inclined doctors are to seriously listen to what the patient wishes. Get a print out of the UWO study and bring it with you. Be familiar with with its results and ready to make your point. Yet there are some conditions where non-surgical is not an option.

    I’m about at 14 weeks since my ATR, went non-surgical and couldn’t be happier with my recovery.

  317. normofthenorth, on May 28th, 2012 at 1:05 am Said:

    The UWO study is at achillesblog.com/files/2008/03/jbjsi01401v1.pdf . There’s a link near the bottom to the protocol they used, and I posted the copy the authors sent to my OS a year or so earlier, at bit.ly/UWOProtocol .

  318. sheena, on May 28th, 2012 at 5:21 am Said:

    Hi all,
    firstly, can I say thank you for your responses, I can’t describe how much happier it has made me feel not to be alone. I will listen very carefully to my doc when I see him tomorrow but my gut screams none surgical the whole way unless they insist on surgery. I get the feeling that the NHS lean towards non op anyway. Maybe to keep down costs or maybe because it is the best way. I have been “unlucky” with surgery in the past having had to have the same op re done 3 times so I am wary of the knife. Starshep, I have print out on my desk, thanks. Normofthenorth,thanks for the link but found you on day two….many thanks! Beralic, thanks for the flying tip! Hillie thanks for the Rebecca Kearney tip I will read right now.
    I have two young kids and I’m an old but very active mum so it’s very frustrating and feel sorry for hubby who is in shock!
    I’ll keep all posted so I might be able to help others in the this club!
    So glad I found this blog!

  319. sheena, on May 28th, 2012 at 5:32 am Said:

    Starshep, I know you’re not a doc but you say there are some instances when non op isn’t an option. What are those instances? Can you point me int he right direction as to what they may be please then I can read more.
    As I say, I know you can’t give me medical advice.
    Many thanks.

  320. eastcoastrunner, on May 28th, 2012 at 10:12 am Said:

    Sheena– my case is one that required surgery. I was not able to go the non-surgical route. BUT, mine isn’t a rupture. I had severe tendinosis. My AT tendon kept making small tears that healed and tore over and over again, causing themiddle of the tendon to calcify and huge chunks of boney growth form over the insertion point (very similar to Haglunds) The calcified part of the tendon began to tear vertically into the “healthy” part of the tendon. I required surgery to clean out the calcification, tie the healthy sides of the tendon back together, remove all the chunks of boney growth from and around the insertion, then screw my “new” tendon back into my “new” calcaneal bone. This doesn’t sound like your case, but it is one example of not being able to go non-surgical. Good luck to you!!

  321. Alison, on May 28th, 2012 at 10:24 am Said:

    Hi Sheena,

    I had percutaneous surgery (story posted on the 12th April on here) and I have nothing but praise for my treatment, walking full weight bearing at two weeks post op in a boot.
    Now just under nine weeks and in shoes.
    Still a long way to go and wating for physio, but pleased with my progress so far.

  322. sheena, on May 28th, 2012 at 4:19 pm Said:

    Hi again guys and thanks so much for your help. I actually paid to see someone today as I was pretty concerned. His first route is non surgical if he can but he said once he ultra sounded then he would know if he needed to operate….I won’t be able to pay for that one! He scanned it and it was 1.5cm apart but there was a small bleed there which may hinder the reattachment. He has put me back into a cast with my toes pointing as far down as they could possibly go as this was the only way the two ends would meet and he’s asked me to slightly weight bear after 24 hours. thing is, my cast has a heel so high I will need a Christian Laboutin on the other side! I guess I’ll work something out. So, if he says surgery after two weeks then so be it. All you guys have made me feel better because all of your outcomes are positive. thanks again. I did forget to ask him why he chose cast over boot. I will ask in two weeks.

  323. starshep, on May 28th, 2012 at 6:44 pm Said:

    Sheena:

    Sounds like you are making some progress. One case where surgery is required is if there are bone fragments from a tear near the heel. I think Norm mentioned this in an earlier post. There may be other factors that I am not aware of too.

  324. sheena, on May 29th, 2012 at 8:27 am Said:

    Hi all,
    quick question. I’m in new cast and PWB should I have the leg elevated when I’m immobile? Did tendon last Thursday night so 4 days in. Foot fully pointed down.

  325. beralic, on May 29th, 2012 at 9:26 am Said:

    Hi Sheena, yes generally it is best to keep the leg elevated as much as possible, helps stop swelling etc. if its not causing you much bother (pain etc or you are not getting any swelling then maybe not too critical for you, but I found it helped quite a bit, the higher you can raise it the better (level with ot just above your heat is recommended)

    Hope things are feeling ok!

  326. sheena, on May 29th, 2012 at 3:04 pm Said:

    Hi Berlic,
    thanks for the tip. Did anyone’s pain get worse at night? I was fine yesterday after new cast was fitted but had the worst night I have had since the injury. Took twice as many pain killers as I should and it didn’t touch it. As soon as I got up and moved around it was fine.Been fine all day but getting sore again now.

  327. normofthenorth, on May 29th, 2012 at 3:07 pm Said:

    As beralic said elevation’s all about controlling swelling, which is important. Experience with swellin — how much and how long — varies hugely.

    Some pros think that a larger gap (or even a complete ATR vs partial) indicates surgery, but that’s not consistent with the evidence, IMO. MOre discussion of that evidence elsewhere, incl on my blog pages.

  328. Sheena, on May 30th, 2012 at 4:10 am Said:

    Hi Norm,
    my foot is pain free when I have it on the ground. Ballerina position but PWB from day one in a cast. When I elevate it I start to get bad bad pain in my shin area. Not a friction pain but terrible pain, achilng and stabbing in waves. Very bad in bed. Any thoughts? He is ultra sounding in two weeks to see if it is knitting together. It was indeed a full rupture.
    She.

  329. kimjax, on May 30th, 2012 at 7:19 am Said:

    Sheena- my pain starts around evening and is worse at night. Even at almost 4 weeks postop, I get discomfort in the evenings/night. I think it’s from swelling at the end of the day, and icing and elevation help a lot. I keep a small cooler with two cold packs by the bed at night, and needed them every night till recently.

    I’m the opposite of you as far as elevation. That brings me instant relief from the pain of blood pooling when my leg is hanging down. Pressure on the bottom of my foot helps with this - but was only allowed to start PWB this week - resting on the floor only.

  330. sheena, on May 30th, 2012 at 11:24 am Said:

    Hi Kimjax
    thanks,saw the doc again as was so bad. He has said it’s due to the fact that I managed to point my toes so far down when they set the cast (this was good as it meant the tendon ends met fairly well) I will get aching and pain in the over stretched shin area. I guess it’s like a ballerina staying “en pointe” for two weeks. They said they could take the cast of and change the angle but I said I would put up with the pain if it means there is more chance of the tendons meeting. So here goes painful nights. I’d like to try to avoid the surgery but if it doesn’t knit then I’ll get it done in two weeks.

  331. starshep, on May 30th, 2012 at 5:19 pm Said:

    Sheena,
    Is there some reason your doctor thinks that the tendon might not knit? From what I understand, it is very rare that it doesn’t even for non-ops.

  332. sheena, on May 31st, 2012 at 5:09 am Said:

    Hi Starshep,
    I think he was being a little non commital but he was concerned that even being set in full plantar flexion the ends of the ruptured tendon were only just touching. My guess is that if the tendon ends don’t meet when in plantar flexion they can’t heal as there is nothing for them to heal to? When having the ultra sound and they pushed the foot into full plantar flexion then the tendon ends met so I’m really hoping that it will start to heal. I think he didn’t want to rule anything out to be honest as he knew my hopes were non op. I think he was basically saying, “this should work but if it doesn’t I will operate”. Which I guess is him preparing me for surgery but hopefully i won’t need it.

  333. starshep, on May 31st, 2012 at 5:49 pm Said:

    Sheena,
    I’m not sure if the ends need to touch initially for mending to take place although it is probably the preferred case. I believe I heard somewhere that the scar tissue does fill in the gap even if the ends aren’t touching.

  334. David, on June 1st, 2012 at 8:35 am Said:

    Sheena,
    The nurse I saw today said that the achilles will ignore other tissue and only bind with itself. (unlike nerves which will try to join onto anything - hence the tingle.)
    So if your ends are touching you may be lucky.

    BTW
    I am 2 weeks post-op. I was in a cast and now am in a boot.

  335. sheena, on June 1st, 2012 at 1:42 pm Said:

    Hi David,
    I think you’re right, the ends have to touch, that’s the impression I got when they did the ultra sound. I have follow up on the 11th so hopefully will know then. How have you been after the op David and what sort of boot did they give you? Did your surgeon explain why he casts for two weeks and then goes into a boot. I didn’t ask my guy when he introduces a boot but I’ll ask when I go back in ten days. I get a lot of pain at night from the front of my leg due to toes being pointed down. How soon after your injury were you operated on?

  336. David, on June 2nd, 2012 at 6:01 am Said:

    Hi Sheena,

    I have a Air Walker boot http://tinyurl.com/cmzesd3

    They told me that a cast was needed to immobilise the foot so the tendon can start to heal, I thought I would be in another cast at a different angle every 2 weeks but the thinking is now to get you going as soon as possible.
    The nurse told me that some surgeons get you in a boot straight away!
    I get pain under my foot when I put too much pressure on it but I think that is due to a tight tendon and will get better.

    This is the funny bit….I snapped my tendon on Saturday, thought someone had kicked in in the calf. Went to my doctor Monday and he thought I had pulled a muscle. (so did I to be fair) Carried on driving, working, shopping etc with a bit of a limp. 10 days later I phoned for a follow up at the doctors because I felt there was no improvement, saw the doctor Monday at 9am. He sent me to A&E and they took about 30 seconds to do the thompson test (which he never did!) and diagnosed a snapped tendon. Had a scan and the operation was needed. They were a bit amazed that I had been carrying on pretty much as normal for 2 weeks. I was in and out - operated on on Wednesday.
    The cast period was fine but frustrating as I couldn’t do much so I feel better now I can get my foot down. Borrowing a motobility scooter for getting around!
    I Should have been seen 14 days later but the hospital forgot about me so it was 17 days.
    Back in 6 weeks but I’m not sure if I have to adjust the boot in the mean time so I’ll ring on wednesday to check.
    One thing, the boot has given me back ache because I am walking on the tilt.

  337. hillie, on June 2nd, 2012 at 7:15 am Said:

    Hi David

    I’m following my hospital’s ‘accelerated’ protocol, used for surgical cases and non-operated. I wore the cast for the first 2 weeks, then into a VacoPed boot which was adjusted every 2 weeks until I went back to 2 shoes 4 weeks ago at week 9. This has mostly worked well for me, giving me weight bearing mobility since end of week 2, and the ability to start light exercising at the same time.

    I do have a bit of an issue over past few days with increased swelling in ankle and foot, and spoke to physio. Apparently I’m probably doing too much of some exercises so we’ve tweaked my routine a little. Everybody’s different…

    Good luck with your recovery.

  338. sheena, on June 2nd, 2012 at 8:40 am Said:

    David,
    how on earth did you get around for two weeks like that ? when I did mine I tried to put weight on it and I felt as though the floor was sinking away from me, as though I had put it in very runny but deep mud and I couldn’t weight bear on it at all. You must be very brave!
    I’m guessing because you walked around on it for two weeks without the ends being pushed together you had to have surgery? Hope your hospital doesn’t forget you again. Have you driven with your boot on? Does anyone know the rules about driving or do you think it’s down to individual insurers? I’m guessing so.

  339. hillie, on June 2nd, 2012 at 11:18 am Said:

    Hi Sheena

    If it is a left ATR, and you drive an automatic, and depending on the boot size and the space around it, etc., then that might be judged as ok I guess. However, my hospital gives out a written protocol clearly stating that you can drive a couple of days after going back into shoes, and able to do an emergency stop. So, if I’d had an accident with the boot on, and anyone checked my physical status, I wouldn’t have had a leg to stand on…

  340. David, on June 2nd, 2012 at 11:25 am Said:

    Hi Hillie,
    When you say weight bearing after 2 weeks was that 2 weeks from boot or 2 weeks from op? 4 weeks in total.

    Sheena.

    My right foot is booted so no driving until I get more.mobility and can take the boot off for driving.
    Not brave, bloody minded is what my.wife says!

  341. sheena, on June 2nd, 2012 at 12:31 pm Said:

    Ha ha! Having done it and know what it feels like nerves of bloody steel more like. The thought of walking on my foot that night made me feel like throwing up. Really, I went white and had to sit down. I wasn’t crying I was laughing as it was only the second time I had played badminton. Had I known how long the rehab was I would have been laughing on the other side of my face!

    Thanks Hillie….it’s my right foot and don’t have an auto so would be tricky as it’s the right foot anyway….Can’t bear the thought of the summer hols with a 7 and 5 year old not being able to drive them anywhere..Happy days!

  342. hillie, on June 2nd, 2012 at 12:56 pm Said:

    David

    I didn’t have the operation - being treated under the non-op accelerated (some say ‘aggressive’) protocol which enables early mobility. Weight bearing began 2 weeks after treatment started i.e. immediately I moved from cast to boot.

    Currently in 2 shoes with silicon heel pads, and driving ok. I’m now at week 13.

    Mostly ok now, some swelling but icing and elevating from late afternoon as necessary.

    I hope that this helps.

  343. hillie, on June 2nd, 2012 at 1:12 pm Said:

    Sheena,

    Remembering how detached and painful the injury felt when rupture happened, I was apprehensive when it came to weight bearing after 2 weeks. I needn’t have worried as the boot gave me lots of security and protection. If anything, the problem was with the ‘good’ leg (my left) because it felt so strained due to height difference - choose your shoe carefully or get hold of Vaco’s add-on for your shoe to make height of both feet similar. The more level you can get your hips, the better.

  344. sheena, on June 2nd, 2012 at 1:18 pm Said:

    David,
    btw, I was put in a cast and told to PWB immediately.

  345. starshep, on June 2nd, 2012 at 2:31 pm Said:

    Sheena,

    My doctor said it was up to me as far as when to drive goes but said I should wait until I was in 2 shoes. At 7 weeks after my ATR I started physical therapy and was given a Thera-Band to work my calf muscle. I immediately thought, “gas pedal.” At week 10 I started on 2 shoes with crutches. At week 12, I was on 2 shoes without crutches, but only cleared to walk indoors. At that point I figured that if I could change out of my boot once I got to my car and could work the brake pedal with my left (uninjured) foot, I’d be okay. I gave it a try, it worked out fine and I’ve been driving ever since.

  346. sheena, on June 2nd, 2012 at 3:38 pm Said:

    Thanks starshep…I have a stick shift and did my right foot so may be a while…..sounds like it’s going really well for you.
    How scared are any of you guys of re repture…makes me shiver to think I’ll ever even run again at this stage?

  347. sheena, on June 2nd, 2012 at 3:44 pm Said:

    Hillie,
    for two days I wore a high heeled boot on my left foot but got sick of it and now I have this two inch heel on my cast and am very out of kilter but managing fine actually but not sure what it’s doing to my hips? Do you use a vacoped boot? If so which model? The Vaco’s add ons, can they go into any shoe?
    I see the surgeon on the 11th as he wasn’t 100% whether my rupture would meet and heal, hope it does. If you have a vacoped was that NHS or are you private? I did read way back that someone bought theirs on ebay, was that you Hillie? Maybe not think it may have been someone else?

  348. sheena, on June 2nd, 2012 at 3:49 pm Said:

    Hillie,
    just re read, you’re in Vacoped, was that NHS?

  349. hillie, on June 2nd, 2012 at 4:33 pm Said:

    Hi Sheena

    Yes, I’ve been using the VacoPed, although I’m now in shoes (keeping the boot handy though for a while). Oped now has a UK office which I called a couple of times e.g. about the lift up accessory - should fit most shoes). You can get to them through http://www.oped-uk.co.uk/ and 01380 722177.

    I wasn’t the one who bought my boot through eBay although I did see that too - mine was supplied by my NHS Foundation Trust hospital and is the same as supplied to many sportsmen, etc. Adjusts easily for angle and I found it comfortable. Expensive I think but less so than regular recasts and less hassle.

  350. sheena, on June 2nd, 2012 at 4:34 pm Said:

    Hillie,
    thanks for your quick response. will be on it ASAP!

  351. hillie, on June 2nd, 2012 at 4:43 pm Said:

    Sheena

    If you any problem seeing the accessories on the web page, check out http://www.vacocast.com/storage/pdfs/VACOcast_accessories.pdf

  352. sheena, on June 2nd, 2012 at 5:01 pm Said:

    Thanks Hillie!

  353. starshep, on June 2nd, 2012 at 6:11 pm Said:

    Sheena,

    Hell yes, the thought of re-rupture is scary. You just got to trust in your therapist, do what they tell you to at the pace they tell you to go, concentrate on what you are doing and not think too much about the bad consequences.

    Beyond that, find joy in the small victories. Don’t worry about running or dancing yet. Look forward to partial weight bearing, then full weight bearing for now. The rest will come in time.

  354. David, on June 4th, 2012 at 4:48 pm Said:

    You are all talking about therapists and physio, my orthopeadic nurse said. “no physio, once you’re at 90 degrees and full weight that’s about it.!”
    Better get on with it I s’pose :(
    Day 3 and I can get about 60% weight down on a single step but not standing still. Is that about right?

  355. sheena, on June 5th, 2012 at 8:44 am Said:

    David,
    can I tell you a little story if I may. without sounding rude, get your self some physio advice ASAP.
    About 3 years ago I had really bad tennis elbow, really bad. A four year old and a one year old and hubby out of the house 12 hours a day. Was pretty painful.
    We (at that time) were fortunate enough to have private health. Off I trotted to the surgeon that my GP reccommended. He was very good. He injected steroids into my elbow along with a pain killer and did some weird manipulation which hurt like hell saying the ligament ( I believe it’s a ligament that causes the problem, can’t quite remember now) would re grow in a better place. He had snapped it off! This is a procedure he does all the time and is done under local. Seemed to work and I recovered, no physio. Then it came back, so I went back and he did the same thing all over again but said if this doesn’t work we will need to do surgery….I said OK.
    It didn’t work. It hurt like hell for weeks. I couldn’t lift it, move it, nothing.
    I happened to be having loads of dental work done at the same time. Cost a fortune. Wish I’d looked after my teeth better! My dentist asked me what was wrong as I was wearing a bandage and a brace etc. I told him and I told him that the surgery option was next.
    He said “don’t go under the knife unless it is the very last resort”. My dentist does mxao facial surgery so he is sort of a surgeon I guess?
    He then told me that he was a marathon runner and that he had had really bad problems with an injury to his foot. I cannot remember what the injury was. He was told unless he had surgery he would never run long distances again.
    He decided to go down the physio route first. Educated himself then found the right person. Not cheap probably 50 quid a pop. Hard work but he totally healed it himself with the PT and is back running marathons.
    After this conversation I came home and had a chat with my hubbie. We actually bought a home PT course from a physio that specialises in tennis elbow. £25 quid and we downloaded a book and video and I started doing the excercises at home every day as the video and book told me to. At first I was very rigid but as my elbow got better I slacked off. All in all I gave that physio about 80% effort and totally cured my tennis elbow myself. It tweaks a bit now and then but that’s because I’m lazy and never do the excercises any more.
    I’m not advocating for one minute that people don’t listen to their surgeons and not have surgery.That’s about listening and choosing the best thing for you but what I am saying is this. If you don’t do physio on that foot it won’t be the same. I’m sure if you ask the NHS you’ll get it. I bet David Beckham had the best physios in the world on his foot. I know he’s an athlete but so what.
    My sis shatttered her ankle 3 years ago falling off her horse. Great surgeon put her back together on the NHS but she was offered little or next to no rehab. She was slow on doing her research and only after starting to educate herself about rehab paid for a physio who had worked with athletes. My sister has said that without her physio she would never have the strength or range of movement she now has.
    Even if physio isn’t for you David make sure you get some advice and I would go back to the NHS and ask if neccessary. If you can pay then do that as it will be quicker.
    What are everyone elses thoughts on this?
    I’m only 12 days in and may need surgery yet if my tendon hasn’t started to reattach when I go back next Monday but I would be looking for physio either way once I am ready. Thoughts?

  356. sheena, on June 5th, 2012 at 9:01 am Said:

    David I’m sure you’ve seen this but if you haven’t have a look.

    http://achillesblog.com/ericbabula/

    He gives a great blog about his PT.

  357. David, on June 5th, 2012 at 9:38 am Said:

    Hi Sheena,

    I was more than a bit surprised when she said no physio, reading your post and speaking to friends and family has made me think that I do need physio. I’m going to get to the doctor who thought I had a pulled muscle to perscribe me some, he owes me a favour!
    I’ve never had an injury like this, a couple of sprained ankles is all I’ve had. I think I’ve only had 3 days sick in the last 15 years so this is all new to me.
    I appreciate your advise and your tone has “convinced” me! :)
    Not a teacher are you?!

  358. sheena, on June 5th, 2012 at 11:20 am Said:

    Ha ha…no I’m not but I do have two kids that I boss around constantly. Poor them. I think I’m just appalled at what a lottery health care/advice can be. This is the first “real” sporting injury I have had after years of snow boarding so it’s a shocker to me too. I have had a bad back for years but maintain that with osteopath. I can’t imagine ever getting back on a board again at the moment just for fear of being “out” again like this when you’ve got kids and family miles away.
    Re your doctor, he more than owes you one!
    My little girl was misdiagnosed with swine flu two years ago and given anti virals when they were doling them out over the phone….she ended up in Great Ormand street for emergency chest surgery as it was pneumonia she had so should have been given anti biotics instead. Her lung collapsed. I don’t really trust diagnoses any more and I know the internet can be bad but if it wasn’t for this blog and others like it I would have learned much less as the doctors and nurses just simply don’t have the time or resources they need for things like this. The NHS is great and thank goodness for us all that it’s there but I think we have to be a bit more pushy sometimes even if we fear becoming unpopular with the nurses etc. It’s your ankle and you want it to be back to normal as much as possible. Hope you get your PT. Maybe have a little look round the net too just to get an idea before you go to doc?

  359. hillie, on June 5th, 2012 at 12:40 pm Said:

    Hi David

    It looks like Sheena has convinced you to take a step in the right direction, but, for what it’s worth, some additional input because I hate to see apparent poor treatment and a lack of information about what to expect, do, etc. “90 degrees, full weight, that’s it” - I don’t think so!

    You DON’T want the injury to just heal. It will do that. In a fashion.

    You DO want a high quality repair. You need to develop strength, flexibility, reliability, and confidence in your movement. You need all of this at the right time.

    There’s been some good stuff in these blog posts. I’d read them again if you haven’t already, recent months anyway, then go get that further, deserved, advice (and listen to it). You could ask for a rehab schedule - what to expect when, PT basics, boot adjustment angles, etc. Get it in writing - I know that I wouldn’t have remembered everything.

    Easy peasy? No. Just persistence and seeking the best. Why not?

  360. starshep, on June 5th, 2012 at 12:52 pm Said:

    David:
    Based on my experience, I’d say in most cases physical therapy is even more important than what a doctor does. My doctor did a Thompson test to confirm it was an ATR, an X-ray to confirm there were no bone fragments that broke off, put me in 2 casts, then a boot and wrote up some very basic orders for physical therapy.

    Even if you have surgery, unless you have some unusual circumstances, it doesn’t seem all that complicated for the average orthopedic surgeon.

    By contrast, I have had 14, 1 hour sessions with my therapist and do 3 sets of exercises at home per day along with it.

    If you want more insight, my blog goes into detail ofnmy 14 physical therapy sessions.

  361. David, on June 5th, 2012 at 1:18 pm Said:

    Thank you all for your input, it has made me really determined to get the most out of this.
    I’ll make a few calls tomorrow and get things moving.
    It is MY tendon and they better fix me right!!

    A few more questions if I may.
    When should I start physio? I am 2 weeks from operation, 3 days out of the cast in an airboot.

    How much weight should I put on the bad foot? (Don’t want to overdo it)

    I get a pain underneath my foot at times, in the ball of the foot area and then back from there,is this normal?
    (I have had this for about 3 years, I thought I had a collapsed arch and wore insoles to help but I think it was the start of my achilles giving way)

    Thanks again for your input, I better get some reading done. Starshep, your PT blog is very helpful, I need all of that!

  362. hillie, on June 5th, 2012 at 1:42 pm Said:

    David

    After my 2 weeks in a cast, I was able to start pushing against a Theraband with the ball of my foot, 3 sets a day. More exercise built up after that at fairly quick rate. I’m not going into detail because this will be established between you and your physio. Will vary for many reasons.

  363. hillie, on June 5th, 2012 at 1:55 pm Said:

    David

    Sorry about that, went too soon, finger trouble!

    At end of 2nd week, when I started exercising, I began weight bearing and weaning off the crutches “as comfortable” but easy to judge in practice.

    Concerning your foot trouble - I had similar trouble about 4 years ago, and over (?) pronation and a surgeon I knew suggested a visit to a local specialist sports clinic, which custom made an orthotic for both feet. What a difference, walked so much better, not cheap but invaluable. Then, 6-8 months ago, started wearing some shoes which the inserts didn’t fit so well. By March I had ruptured my Achilles Tendon! Coincidence or bound to happen?

  364. David, on June 5th, 2012 at 3:02 pm Said:

    Hillie,

    You are right not to give me too many details, I WILL do the wrong thing if given a choice. (Bull in a china shop says my wife)
    I definately need an exercise routine so will get on to the Doc asap.
    Sounds like you and I have had the same thing, I changed from support insoles as I sprained the other ankle hill walking in France (should never have had one in the left shoe) to comfort insoles and 9 months later….ping!
    Heel lifts for the left foot should be arriving any day now so that might help push me along and save my hip!

  365. sheena, on June 5th, 2012 at 3:14 pm Said:

    Hi David,
    so glad everyone has helped. I’ll be back on here after the 11th when I get my verdict asking all for advice.

    Can I ask a question to all reading this please?

    How many of you ATR sufferers in the UK got their Vaco boot on the NHS?

  366. hillie, on June 5th, 2012 at 3:48 pm Said:

    Sheena

    Just to confirm, my VacoPed boot was supplied by my NHS hospital. If you need numbers or where sold,or tech data, you could ask Oped in Devizes. I found some of their (?) YouTube video’s online too.

    I understand that mine goes back to fracture clinic for refurb when I have finished with it.

  367. David, on June 5th, 2012 at 4:20 pm Said:

    I have an NHS supplied chaneco boot.

  368. sheena, on June 5th, 2012 at 5:14 pm Said:

    Thanks guys.
    Hillie, I looked at the links you sent to me thanks. It will be interesting to see what’s on offer before I ask them.

  369. David, on June 6th, 2012 at 8:22 am Said:

    OK, I just got off the phone with the surgeon’s secretary and have been told that I must keep the 3 wedges in for 6 weeks and then into shoes with wedges.
    I thought that I would be lowering every 2 weeks but I guess not.
    I should get a call from the GP tomorrow regarding physio.

  370. hillie, on June 6th, 2012 at 10:43 am Said:

    Hi David

    A good physio could make all the difference, and provide guidance re the technical issues, like boot adjustment (or not). It seems that with some you meet with them and exercise frequently, while with others they decide on an exercise programme, which you agree to follow at home, then you see them again a few weeks later. Mine is the latter - I don’t mind but I have to keep reminding myself to do it…

  371. tom-p, on June 6th, 2012 at 2:59 pm Said:

    Its good to hear that you are all making a good recovery, i’ve just come back on for a read as ruptured my achilles in April 2011 and had conservative treatment in an aircast boot.

    From what I now know you will make a full recovery as soon as I could I started cycling to try and build some muscle back in the calf and from initially struggling to do about 6 miles 12 months after the initialy injury I now cycle between 150-200 miles per week and I would never know there was an issue.

    One word of advice though is get a good physio and dont rely on NHS pyhsio as it will make a massive difference

  372. sheena, on June 7th, 2012 at 7:59 am Said:

    can I ask you a question please? I have been in plaster since 24th in full equinis position.I was ultra sounded and said to go back in two weeks to see if healing. I’d like to go non op. The doc told me to do some excercises and to PWB from day one. this morning I was doing some leg lifts back wards and my calf went into a cramp in the same position your leg would be if you were NWB. I immdiately stopped and tried to relax and put my hand into my cast to stretch out the muscle. I was and am really concerned that the cramp could have pulled the tendon up into the calf. My calf muscle ached for a while and for the first time but only for a very short while the injury area tweaked a bit. Has anyone got any thoughts on this? I’m now worried that when I go back for ultra sound on Monday I won’t have healed at all or maybe re tracted up and have to have surgery. That will be after spending 18 days in a cast.The injury site had a very slite dull ache which it didn’t have before. Should I call consultant. It is tweaking now where it hasn’t before at all?

  373. David, on June 7th, 2012 at 11:48 am Said:

    Hi Sheena,

    The only words of comfort I can give is that if you are in a cast that should stop a rupture. If you cannot move your foot you should not be able to pull on the tendon (?) It could just be a cramp and we all know how bad they can hurt.
    I stumbled in the first week after op and went full weight on my foot, hurt like hell but all seemed ok because my foot didn’t (couldn’t) pull on the calf muscle.
    Hope this is of some reassurance

  374. ryanb, on June 7th, 2012 at 12:36 pm Said:

    David/Sheena,
    Not trying to make you worry, but I wanted to caution everybody about being overly confident in a cast (or boot). It is definitely possible to injure your Achilles while immobilized.

    Your Achilles is like a rope. Motion doesn’t stress it: force does. You can load/stress it without moving it. If you wanted to break a rope, you’d might tie one end to something solid, and then really yank on it. The Achilles anchor to the heel (which is locked down in a fixed cast/boot) is that “something solid”. Your calf muscle provides the yank.

    The cast/boot is intended to hold things still, to give the tissues time to mend without disturbance. It WILL keep you from stressing the tendon by over-stretching it against a relaxed (but tight) calf muscle. But people have re-ruptured in a cast or boot.

    It’s been a topic of debate here before- but in some situations (such as with a calf cramp), I believe there are cases when you might be safer out of the cast. If I’m going to yank on that rope, I’d rather the other end be free to move (can’t break the rope that way). So, for instance, I slept with my foot free as soon as I could.

    Just be careful… that’s all I’m sayin’ :-)

  375. normofthenorth, on June 7th, 2012 at 2:04 pm Said:

    I chimed in on my page, where Sheena posted the same Q. (BAD Sheena!)

    I largely agree with Ryan (again! :-) ).

  376. sheena, on June 7th, 2012 at 2:50 pm Said:

    Hi,
    firstly apologies for repeating the post. My husband has just told me that is not to be done and explained why. Really sorry. Never blogged before. I will go back and read the rules. I wasn’t sure who would see it if I posted on the UK page only so apologies for that.
    Ryan, Norm,
    thanks. I am worried as my injury area did hurt after for a while. I think it has pulled on the tendon but don’t know how much until I go back Monday.

  377. David, on June 7th, 2012 at 6:25 pm Said:

    Sheena,
    I really hope that a cramp is not going to bust your achilles. Norm and Ryan have made good.points that I never thought of. Can you feel the tiptoe reflex? I couldnt at all when snapped but now can. DO NOT push it but if the reflex is there it might be ok. My brain sent the signal but the foot did nothing.
    Fingers crossed for you.

  378. sheena, on June 8th, 2012 at 7:31 am Said:

    Hi David,
    what’s the tip toe reflex. If I wiggles my toes too much my heel aches?

  379. David, on June 8th, 2012 at 8:29 am Said:

    HI Sheena,

    When I was 2 weeks with a snapped tendon, I would try going on tiptoe but nothing worked. When I stumbled last week I tried going through the motions of tiptoeing even though I was in plaster and I could feel the pull in my calf which reassured me.
    How is it today?

  380. sheena, on June 8th, 2012 at 9:07 am Said:

    Hi David,
    set up my own blog today http://achillesblog.com/sheena/
    Have you got your own?

    Today the back of my calf still has that dull ache but I don’t know if I feel I can dare go onto tip toe. Spoke to the Consultant’s secretary and it is a wait until Monday job. who knows. I’ll be gutted if I need the op as it will feel like I have wasted two and a half weeks maybe three by the time they do it.

  381. David, on June 8th, 2012 at 9:36 am Said:

    Hi Sheena,

    Please don’t try standing on tip toe! I meant can you feel the muscles moving as if you were trying to tip toe when sitting down.
    I guess it’s going to be a long weekend.
    I can imagine how you are feeling, it must be almost like having a re-rupture.
    I really am keeping my fingers crossed for you.

  382. sheena, on June 8th, 2012 at 9:53 am Said:

    Thanks David,
    can’t really tell to be honest with you. It will be a long weekend. Normofthenorth said he can’t reacall a rerupture on this site due to carmp.
    Thing is I won’t really know I guess as it may not have healed well anyway hence me going back for the 2nd ultra sound.
    This injury is a time game it seems.

  383. DavidR, on June 8th, 2012 at 10:19 am Said:

    Hello all,

    I’m new here so here’s a quick run down. Got dumped and thrown out by the woman I was going to marry and ended up having to move back with the parents at almost 32. So a few weeks later I decided to get back to sports to make myself feel better after all that had gone on. Did a few 5-10k runs, always stretch, and they went quite well. Then work asked me to play 5 a side, we were late to the pitch so didn’t warm up. Then late in the game BANG, everyone heard it, I know nothing about the body but I knew immediately what it was, and A&E confirmed it that night (May 22nd) and gave me a follow up appointment over a week later. Full rupture of the left achilles.

    I started to get impatient and as I have some level of private cover through work went to a hospital on May 28th at which point I was advised to have surgery that day, I agreed it would be a good idea. I’m in a cast and have a follow up appointment on June 12th. I have taken some heavy falls on the parents stairs so I’m unsure how things will look when the surgeon assesses me.

    The physical aspect is hard to take, especially on a long road to recovery and especially being male (I haven’t had any support from friends or seen anyone since the day it happned, guys really are rubbish, it’s very lonely, especially as only a few weeks ago I was living with the ex). But I was not prepared for the mental strain of the lonliness and it has plunged me into a deep depression in which I have totally lost the plot and done some very hurtful things to my family. I have even admitted I have issues and need to see a head doctor. Who would have thought that a ruptured achilles could have such a devastating effect. My family are loving but once I’m better who knows whether they will still want to know me, fingers crossed.

    It has all been incredibly hard, and the length of recovery is getting to me, so I hope for the best going forwards. Work have been fantastic, so I’m lucky I will have a job to go back to and rebuild my life and I know it’s all part of what we all go through. But let me tell you this, I will never forget that day and the knock on effect it has had. Roll on recovery and a new happier life with smiles and lots of walking!

    Good luck everyone and I will be checking in to see how you are all doing.

  384. sheena, on June 8th, 2012 at 10:46 am Said:

    DavidR,
    you sound pretty crappy. I’d be behaving badly too if I didn’t have two kids under 7 around to try to set some sort of example to. My hubby bears the brunt of my moods at the moment. Have you thought of setting up your own blog? It helps to vent. I set up mine today. It’s easy. Email Dennis from the home page and then away you go. I have been non op and in plaster for 15 days but may need surgery next week and go back to square one. If not we could compare our recovery?
    Your family will still love you. You’ve had two bad hits in a short space of time.
    My sis shattered her ankle 3 years ago. Much worse than this and warned me of the impending depression. Try to get something positive out of this. We only down graded our private health on the 6th April so I wasn’t covered. Since this happened we have upgraded it again at cost but it’s made me think that the cost is worth while.
    Keep in touch.

  385. sheena, on June 8th, 2012 at 10:47 am Said:

    DavidR,
    meant to ask. when you wnet to A&E that night, did they put you in a cast at all or did they send you home without one waiting for your follow up?

  386. DavidR, on June 8th, 2012 at 11:01 am Said:

    A&E was St Georges Tooting, I think I read someone above mentioned they went there. The staff at the desk weren’t up to much, I was clearly in agony and they had me walking everywhere whilst others who had no injury in comparison were in wheelchairs.

    But once seen the doc was amazing, diagnosed and put in cast in under 5 minutes, then straight out of the door.

  387. David, on June 8th, 2012 at 1:19 pm Said:

    Welcome DavidR

    It’s not a fun place to be but we’re all in it together!
    I completely understand how you feel. I have been dependent on no-one all of my adult life and now feel useless and rely on everyone for getting around and fetching and carrying.
    It will get better, 3 weeks post -op I can hobble around for a bit without crutches…..a small victory!
    Families are there for support and they, more than anyone will understand that you’re not your usual self.

  388. sheena, on June 8th, 2012 at 2:00 pm Said:

    DavidR,
    forgot to ask. How are you falling down the stairs? Are you not shuffling on your bottom? Nurse told me to bum shuffle only otherwise i would fall for sure.
    Falling can be a casue of re- repture from what I have read so you need to be careful especially as you get further along the road.
    I went out a couple of days ago to a really busy place. amazing how vulnerable you feel. Felt like some one was going to take me out all the time.

  389. DavidR, on June 8th, 2012 at 2:22 pm Said:

    OK, so just before I had the op I had moved out of the parents (rental with no stairs, I’m making no use of that at all), it became clear straight away that I couldn’t stay there and had to go back to the parents. But at the time of the op I didn’t know that, so I didn’t approach the subject of stairs. Also I had to see a physio before I was discharged, and had to go up and down stairs on crutches. So to be honest that’s how I’ve been doing it. Since the op I would guess I’ve done 500 stairs and fallen back onto the bad foot three times. I won’t know anything until Tuesday when hopefully the cast comes off. I don’t really have any pain, I’m not sure if that’s a good or bad thing.

  390. sheena, on June 8th, 2012 at 3:01 pm Said:

    Let us know how you get on on Tuesday!
    I was told to bum shuffle only. Amazing how you hear so many different things!

  391. DavidR, on June 9th, 2012 at 5:16 am Said:

    Can anyone who has had the op tell me, when you go for your first post op assessment, mine is on Tuesday 2 weeks post op, do they do some sort of scan to determine how well bound the 2 ends of the tendon are? I’m just wondering how they will be able to determine the level of success/damage. Thanks.

  392. David, on June 9th, 2012 at 6:10 am Said:

    My post-op assesment was pretty rubbish. The surgeon cut the cast off, looked at the wound and then had a nurse remove the stitches and put me in a boot.
    No scan, no physio, no instructions.
    I have another appointment 13th July when I will lose the boot and go into shoes with wedges.
    I had to ‘phone to ask if I have to remove wedges over time (one every 2 weeks but was told no, leave them in.)
    Called my GP to get physio (Wednesday)
    I hope you get better treatment

    BTW I can feel a lump on my calf where the tendon has been overlapped and sewn but have no idea how well it is bonding

  393. DavidR, on June 9th, 2012 at 6:29 am Said:

    Wow that sounds awful! That had better not happen with me!

  394. hillie, on June 9th, 2012 at 6:50 am Said:

    DavidR

    You might be able to avoid David’s lack of information by going to your appointment armed with a list of questions and concerns. There is plenty of guidance around here to prepare your list, which won’t be very long anyway, and you are entitled to ask, and be given answers. Ask for the fracture clinic’s direct phone number too, for those concerns that you might have between appointments.

    The downside of knowing the answers of course, is that this blog might be shorter…

  395. DavidR, on June 11th, 2012 at 6:04 am Said:

    One thing I meant to ask, does anyone else have huge pain in their good achilles since rupture, seeing as now that one is taking all of the weight. I do.

  396. sheena, on June 11th, 2012 at 6:25 am Said:

    Hi DavidR,
    I wouldn’t say I had huge pain but it certainly feels the strain. Are you NWB at the mo? Once you can put a little weight on the bad foot I found that mine eased off in the good foot. Don’t hop about too much, that causes strain and I have been stretching my good achilles whenever I can.
    Find out if I need surgery today as had bad cramp in calf on Thursday and it yanked at the healing tendon. I wanted non op. Wish me luck!

  397. DavidR, on June 11th, 2012 at 7:12 am Said:

    Good luck Sheena. Let us know how it goes.

    I hop everywhere as it’s the only way to carry anything.

    I will be 2 weeks from op tonight, I’m seeing the surgeon again tomorrow morning. Reading about how long the recovery process is can be demoralising. 3 weeks without seeing a mate is getting to me, can’t wait for the day I can just walk into a pub.

  398. State champ, on June 11th, 2012 at 8:28 am Said:

    David,
    My son just had his 2 week follow up on 6/8. The surgeon inspected the incision, checked for infection, performed the Thompson’s test, and removed the stitches. He described what the sequence of events would be for the following 6 weeks: PT, FWB with no crutches(immediately), and gradual removal of wedges as the weeks progressed. We will see the surgeon again in 4 weeks assuming no problems arise. I understand my son will have ultra sound at PT occassionally, but as a therapeudic measure to stimulate the tendon’s scar tissue. I hope this info is helpful!

  399. hillie, on June 11th, 2012 at 8:32 am Said:

    Hi DavidR

    So far my good AT has been ok. It’s the knee on my good leg that has been very painful the last couple of days, justifying a visit to my GP today and now waiting for an x-ray.

    It wasn’t good when ATR rehab started in March, then eased almost 100%, until Friday when I took a longer walk, followed by another on Saturday. These are only about 0.5 mile each, not my former ‘healthy life 10 mile types). Now difficult to bend or turn knee without much pain.

  400. David, on June 11th, 2012 at 9:08 am Said:

    DavidR

    My good foot had been surprisingly good, I had a pretty bad sprain in August and was only able to run up stairs at the start of this year so I was a bit worried how it would be, but all seems well.
    My hip and back hurt like hell when first in the boot but I helped this with wedges for the good foot as I can hobble a bit FWB without crutches.
    State Champ, thanks for the ultrasound info. I’ll see if my PT can offer it.

  401. Xpf72q, on June 11th, 2012 at 9:49 am Said:

    David I was in a boot 6 weeks and gradually my good leg developed severe Achilles pain I nearly thought I needed that one operated on but withing 2-3 days of being out of the boot it began to go away now almost entirely. Even up as best u can with lifts or inserts I used voltaren topically it’s diclofenac anti inflammatory in suspension massaged and stretched it and used ice! Try to walk if I r pwb or fwb as normally as u can and if u can maybe get a custom orthotic if u don’t already to lessen any pronation u may have.

  402. sheena, on June 11th, 2012 at 11:46 am Said:

    David R,
    are you completely NWB? I am Non op but been PWB in cast from day one so don’t have to hop so I can just about carry stuff using one crutch. My sister’s surgeon when she smashed her ankle,said hopping was the biggest cause of people coming back to him because they had fallen over. I know it’s a mare it really is. Ask if you can PWB tomorrow and then you can use one crutch for carrying really necessary stuff only, like a glass of wine or a can of beer! My mate advised me to just carry a whole unopened bottle in a bag over my arm. Then she said sit and drink it all with out moving!

    Good news is after just two and a bit weeks I had a reaction to the Thompson test and the ultra sound showed that the tendon was healing. So fingers crossed unless I re rupture…..I am OK at the moment. Had new cast with my foot brought up as far as I could feel the stretch in my achilles and back in two weeks.
    Thank goodness the cramp hadn’t torn the tendon away…..

    Hillie,
    your knee sounds grim. Hope it’s nothing serious. Good luck and let us know.

  403. David, on June 11th, 2012 at 12:00 pm Said:

    Sheena,

    Great news on the tendon! Worry over for now.

    Off to watch footy!

  404. hillie, on June 11th, 2012 at 12:03 pm Said:

    Thanks Sheena

    That knee has had a lot to put up with over the years. It’s a little tired and is just having a bit of a cry! It’ll get over it…

  405. hillie, on June 11th, 2012 at 12:24 pm Said:

    Sheena, it was good to read that your fears weren’t what you thought possible. You must be very relieved. Most who have been in this ‘club’ for any length of time have their share of scares, which is why this can be a good place to come and talk about them. You know, before this little episode in history, I never posted, or tweeted, and still don’t Facebook, yet I do have a quite tech job.

  406. DavidR, on June 11th, 2012 at 2:59 pm Said:

    Good news Sheena.

    So you say it’s healing, rather than healed. I haven’t read far up enough this blog, but is that not frustrating that after a few weeks you’re still healing, whereas the op should in theory speed this process up hugely by bringing the two ends together immediately to heal.

    Yes I’m totally NWB. How on earth can you weight bear with a 45 degree cast? I would drop like a stone? I hope my surgeon is aggressive as I’m happy to push as hard as is safely possible to be fair.

  407. starshep, on June 11th, 2012 at 3:23 pm Said:

    David,
    The healing process for an ATR takes months. It comes in 3 stages. First the body clears out any debris from the injury and mobilizes for repair. Second scar tissue forms joining the two ends. Then the scar tissue strengthens. Just the process of scar tissue joining the two ends can take as much as 6-8 weeks. Strengthening the scar tissue can go on for several months.

    What surgery does is to provide a mechanical bond between the two ends while the scar tissue is forming. And it is not the kind of bond that can take the kind of stress a normal tendon can take so you still need a cast and a boot (some cases a boot only). The UWO study suggests that as long as the tendons can be brought together in a cast and boot, surgery in many cases is redundant. The UWO study also suggests that in most cases, surgery does little to speed up the healing or improve the quality of healed tendon. What does seem to speed things up and improve the quality of the repair is an accelerated rehab protocol.

    Sheena,
    I’m happy to hear you survived that cramp. I take it there was no evidence of a DVT?

  408. DavidR, on June 11th, 2012 at 3:28 pm Said:

    So surgery doesn’t bring the tendon together quicker than the natural process?

  409. starshep, on June 11th, 2012 at 3:58 pm Said:

    DavidR
    Correct. The tendon ends are brought together as soon as surgery is applied or the foot is cast if going non-surgical. At that point it is up to the body’s natural healing processes to knit the tendon ends together.

  410. DavidR, on June 11th, 2012 at 5:03 pm Said:

    Just took a huge tumble in the bathroom, 4th big fall, fingers crossed for tomorrow, felt it pull big time!

  411. sheena, on June 11th, 2012 at 5:15 pm Said:

    Starshep,
    there was no DVT, thank you for making sure I talked about it. I have taken lots from your PT blog for the future.

    Hillie, whatever have you been doing on thoses knees… running I’m guessing LOL!!! Ha ha. Same as me, don’t have techi job though but started to FB cos I’m bored!

    David,
    one all is better than the last time I watched them play France nearly eight years ago in the European champs whilst pregnant on the sofa and they conceded was it 3 goals in about as many minutes was it???

    David R,
    starshep is right but surgery and a good rehab brings good results too. All doctors follow different protocols. Read this blog as much as you can and then at least you’re armed with knowledge and can decide what is best for you or discuss the best possible outcome with your doctor. My tendon only just met in full equinis hence the 2nd ultra sound. I’m lucky it seems to be working but always the worry of re rupture and I’m not even 3 weeks in. I’m just happy it has even started to heal. My doc could tell before the ultra sound that it was OK but he did it just to be sure. Funny about the weight bearing thing. My foot is not in neutral as a normal standing foot would be. They pushed it until I could feel a pull/pain really and they set it like that. I can PWB with no pain though but I can’t speak for PWB with surgery. Let us know how you get on tomorrow.
    BTW I’m sure I read a lot on this blog that the tendon takes at least six weeks to “Heal”. Is that right anyone?

  412. sheena, on June 11th, 2012 at 5:24 pm Said:

    DavidR your fall…just seen it, were you hopping?

  413. starshep, on June 11th, 2012 at 11:50 pm Said:

    Sheena,
    It takes about 6 weeks for the scar tissue to finish forming and several months for the formed scar tissue to finish strengthening.

  414. sheena, on June 12th, 2012 at 6:45 am Said:

    David R,
    forgot to answer your question about “How can I weight bear”?
    I went non op so can’t speak for that but the plaster ladies built a wedged heel onto my cast which was about 3 inches high. To get around properly I had to wear a high heeled boot on the other foot to even me out. I had no pain though really. Also the built up foot, whilst standing in no shoes was about a half meter in front of me when not moving. Like wearing one very high heel shoe on one foot and nothing on the other really. My foot is a bit flatter now so easier to walk.
    Hope it went well today?

  415. DavidR, on June 12th, 2012 at 9:44 am Said:

    Hi All,

    I hope you are recovering well.

    My first post op visit was a bit like the other David’s in terms of info, I got none as the guy was seeing about 4 people at once. There was no scan or ultrasound. It went like this.

    I arrived and the nurse cut off the plaster. I had been very manly about the whole process until the point at which she cut off the plaster but nearly fanited and was on the verge of sickness, I was not prepared for what I saw, or for how delicate the foot was.

    I was told to sit upright and flex the foot, this was very painful and the wound started to bleed. Note, my stitches have not been taken out. The surgeon then came in and flexed my foot beyond 90 degrees. At this point I had to apologise to the nurse for my 4 letter outburst.

    I was then put in a boot and sent on my way. I was however told to book an appointment for next Tuesday again with the surgeon, so that’s good. I was also told I could start physio whenever I like, so have booked my first session for Thursday.

    So the prognosis is, scar and delicacy of the foot set me back, lack of information, but plenty of follow up appointments. So by no means the worst progress.

    Surgeon didn’t even feel the area or do a Thompson test even though I have had a few falls. Hopefully I will learn more through physio and my next visit to the surgeon next Tuesday.

    I have boney feet though, and the boot hurts more than the plaster, I’ve already had to have 10 minutes with the front undone.

  416. DavidR, on June 12th, 2012 at 9:46 am Said:

    Oh and with the boot the surgeon put it at angle 2 and I asked him to move it to angle 1, and he did, so guess they are happy for me to have some say.

  417. DavidR, on June 12th, 2012 at 10:22 am Said:

    Also is anyone else still wearing the DVT sock on their good leg? I’ve not been told to take it off.

  418. sheena, on June 12th, 2012 at 10:36 am Said:

    Hi DavidR,
    sounds not too bad. I never got DVT sock. Glad you’re going back next week. What sort of boot did they give to you? Does it have a hinge and a brand name? Would a thick sock help or can you not put one on due to the wound? Sounds really sore.
    I nearly threw up when I snapped mine….

  419. DavidR, on June 12th, 2012 at 10:36 am Said:

    And one thing I forgot to ask, am I still meant to have the leg horizontal at all times now? Thanks.

  420. David, on June 12th, 2012 at 10:54 am Said:

    Hi DavidR

    I took the sock off the day after I got home from the op. Overnight the damn thing nearly cut off my little toe!
    My boot does not have angles so I am 3 wedges in until 13th July.
    I’ve got physio tomorrow, could be interesting!!

  421. David, on June 12th, 2012 at 10:55 am Said:

    DavidR
    I was told to keep it up when resting and the boot on overnight.
    Do use it though as you need to get the weight on it (at your pace)

  422. sheena, on June 12th, 2012 at 11:06 am Said:

    David,
    glad to hear you got physio. How much did you manage to get and is it at the hospital.?Did you get that after asking your GP? Really keen to hear what they get you to do.
    How do you find your non hinged Boot David?

  423. sheena, on June 12th, 2012 at 11:06 am Said:

    DavidR,
    what sort of boot did they give you? Do you know the name or brand?

  424. DavidR, on June 12th, 2012 at 11:15 am Said:

    Hi Sheena

    It’s VACOped.

    David

    Let us know how physio goes. I get the impression I’m being treated reasonably agressively, which I don’t mind at all.

  425. DavidR, on June 12th, 2012 at 11:16 am Said:

    I estimate the angle of my foot is between 10 and 15 degrees.

  426. sheena, on June 12th, 2012 at 11:23 am Said:

    David R,
    that’s a really good boot with a hinge. How heavy does it feel. Is it light weight? In teresting to hear it is hurting your foot. Did they pump the air out so it fits really tightly?
    Yes, getting you into a boot seems quick and good but take it at your own pace too it seems.
    Would you let me know how you get on with that boot please as my hospital don’t use them. I had heard so many good things about them on here that I was thinking of getting one. would you mind letting me know if it gets easier please. Thanks.

  427. sheena, on June 12th, 2012 at 11:23 am Said:

    David
    How have you found your non hinged Boot? Have the wedges been un comfortable? Sounds it but I guess it’s getting easier?

  428. DavidR, on June 12th, 2012 at 11:28 am Said:

    Sheena,

    It hurts my foot because I have a really boney section on the top of my foot, this is where the plastic sits and it’s cutting in. Also it feels very tight as if blood flow may not be great. I have tried padding, but have to keep opening the front of the boot.

    Any football fans out there, the great Ray Clemence (met him 15 years ago) joined our club yesterday at the age of 63!

  429. David, on June 12th, 2012 at 1:06 pm Said:

    Hi Sheena

    My boot is surpisingly comfortable, it has a fleece sock and 5 velcro straps. I wear it day and night and can hobble about with the wedges in now I have bought wedges for the good foot (my high heels section of the shoe cupboard is a bit sparce!) As I wear it all day at work I put a pillow case over it when in bed - who knows what I tread in!!)
    My GP sorted out the physio but he is my “best friend” since not spotting my busted achilles for 2 weeks. It is at my local medical centre (Newport Pagnell, I live in Milton Keynes)
    Sounds like DavidR is getting on a bit quicker than me re physio, I wonder if that is because I was 18 days snapped before stitched and need a bit longer to bond?

  430. hillie, on June 12th, 2012 at 1:20 pm Said:

    DavidR

    I’m in my 15th week of AT rehab, and from 3rd week until the 10th, used the VACOped boot, and began exercises at the same time. Weight bearing began immediately I had the boot, weaning off the crutches too. The first 2 weeks from ATR I was in a lightweight cast, and I am following a non-op accelerated, quite aggressive, protocol.

    My first 2 weeks in the boot (30° PF, i.e. position 3) was with the Achilles sole, then the normal one. No boot in bed after week 4. Boot adjusted to ROM 30°-15° PF, then 30°-0° after 2 more weeks at each, then -30° to +10° i.e. allowing range of movement from plantar flexion through dorsiflexion (toes down to toes coming up).

    Then the move into shoes with the boot ready for ‘uncertain’ situations.

    I found it vital to get the left/right height balance correct - high heels (Sheena will advise…) might not suit you, DavidR, so you may (will?) need to get something more under your good foot. Oped UK (Vaco) sells something but you might improvise - there have been many tips in this blog previously. My ‘good’ leg has been suffering because I didn’t appreciate soon enough just how important this issue is. Also, if you have comfort issues, talk to Oped - good for product development and they may have tips for you.

    Also, ensure the vacuum cushion is smooth and even. Did the PT’s give you an instruction booklet? If not check out Oped and other web pages and YouTube too.

    I hope that this helps although by now I guess, you’ll have found out quite a lot for yourself already.

  431. hillie, on June 12th, 2012 at 1:38 pm Said:

    Sheena

    Always good to read your input here. I was a bit behind (1 day) with my reading and it took so long to catch up with just yours! As for my knees, now you’re getting personal, they’re quite good really, just a little wear and tear (like most of here no doubt), which I’m getting checked out later in the week. Maybe I really do try just too hard…

    By the way, the boot weighs under 3 kg and the sole comes off for bed. Would your fracture clinic supply you with one if you asked nicely? Can’t remember if I asked you before.

    Bye for now

  432. sheena, on June 12th, 2012 at 3:54 pm Said:

    Hi all,
    being not even 3 weeks in to my ATR this blog is the high light of my day so I wait for messages sadly!
    It’s really nice to see a bit of humour creeping in and Hillie I hope you don’t think I was being rude!

    I have a picture in my head of chaps in Achilles boots and high heels, really funny.

    David,
    good to hear that your boot works for you, it’s reassuring.
    Maybe they were a bit more careful with you, I still cannot get my head round you walking on the foot for two weeks, I nearly threw up when I did mine and then the floor felt like it was moving when I put my foot on it.
    Your GP should be going on those PT sessions with you! What sort of shoe do you wear on your good foot David? Is it a trainer and where did you get your wedges from? You may have mentioned that before…

    Hillie,
    the boot at my hospital sounds like the one David is describing. No hinge, velcro straps. I asked about a VACO and it didn’t really register. I’ll look into it more. He said he’s going to try and get me into a boot…not sure what that means. Don’t fancy having my foot shoved into a boot but Hillie you were in it early at 3 weeks so maybe I should make sure I get a boot in two weeks as I’ll be coming up nearly five weeks by then. Funny, my guy has had me PWB from the day he put me in the light cast at day 4.
    Hillie, when you say you began excercising at week 3, was that NHS physio or stuff you did at home? Thanks.

    Bye for now!

  433. David, on June 12th, 2012 at 5:06 pm Said:

    Sheena,

    I bought these http://tinyurl.com/c9gojjb becasuse the reviews were good enough (and cheap…needed something now. )Won’t see surgeon until 13th July and if they’re no good I haven’t wasted a load of cash.
    They are a bit squidgy but as you can add or remove layers I thought they might be OK.
    I have 6 layers in my good shoe and have used them in trainers, desert type and even slippers. I’m a bit wobbly on them but practice makes perfect!

  434. starshep, on June 12th, 2012 at 5:31 pm Said:

    Sheena,
    As far as that picture you have in your head, my guess would be that any guy that would be wearing high heels and an Achilles boot would wind up wearing 2 Achilles boots pretty quickly.

  435. kimjax, on June 12th, 2012 at 9:42 pm Said:

    Sheena, I also read this blog regularly unless on the road. It’s a Godsend of information and encouragement. I’m so thankful to those who continue to post their progress to give us all hope. :). There’s a humor of sorts in this kind of collective misery - some of the posts leave me laughing out loud at the antics we all go through to cope!

  436. hillie, on June 13th, 2012 at 4:00 am Said:

    Sheena

    You weren’t rude, and we do need humour, or even humor.

    My Vaco boot replaced the cast after 18 days. During the same session (NHS hospital) I did some light exercising, mostly just Theraband stuff on that day, continuing them at home typically x3 sets each day. Weight bearing too. At my subsequent fortnightly visits, the exercises list and duration increased. Now that I’m out of the boot, I’ve now started visits to local NHS physio for reviews and new stuff to do at home. Now on static bike, calf rises, simple wobble board, etc - but you (YOU) have to be patient. You are not at same stage as me, and I still suffer the occasional setback - like that dodgy knee which started after almost 14 weeks!

    Take a picture/pdf of the Vaco to your man. Ask Oped if they can supply a boot to try (under supervised conditions of course). Be bold!

    Anybody sent a link to Ray Clemence?

  437. DavidR, on June 13th, 2012 at 8:08 am Said:

    I just read about a woman who completed an ironman (or ironwoman) event 11 weeks after rupturing her achilles. It’s crazy, some people are even doing physio at that point. It’s all so different for everyone.

    How is everyone progressing today?

  438. David, on June 13th, 2012 at 8:46 am Said:

    Had physio today and all looks well, he was impressed with the wound and internal scar tissue.
    I pretty good movement all round, I have a 5 degree loss of movement when lifting my foot up compared to the good foot which I’ll get back pretty quickly now I have been given some exercises to do, once the physio has my protocol from the hospital I might be able to take wedges out of the boot.
    Onwards and upwards!

  439. sheena, on June 13th, 2012 at 9:10 am Said:

    Hi all,
    nice to hear from everyone!
    David, glad to hear your physio went well you’ll be doing the iron man in a few weeks!
    Hillie,
    thanks, I am speaking to Oped again today.

    Bye for now to all and our US friends too!

  440. DavidR, on June 13th, 2012 at 9:17 am Said:

    5 degree loss of movement sounds great to me, I’m looking at my feet and I would say mine is far more than that, well done!

  441. David, on June 13th, 2012 at 12:20 pm Said:

    Is anyone on blood thinners?
    I’m on a daily injection of Fagmin since the op and I’ve got enough for another month.

  442. DavidR, on June 13th, 2012 at 12:40 pm Said:

    I was given 3 weeks of the injections, i have 6 days left. How much did they cost you, mine were £170!!!! a lot of money just to stick pins in yourself.

  443. sheena, on June 13th, 2012 at 3:59 pm Said:

    Not a soul has mentioned blood thinners to me? Do any non oppers out there take blood thinners?

  444. normofthenorth, on June 13th, 2012 at 4:44 pm Said:

    The blood thinners are to lower the risk of Deep Vein Thrombosis. Many/most post-op patients go without, and DVT is much rarer with non-op than op, so it would be a strange prescription for us non-oppers.

    I think it’s usually a form of Heparin. (Low molecular weight??) I got a few jabs after my open-heart surgery, while they waited for my Warfarin pills to kick in. (3 months later, I got to quit. :-) )

  445. David, on June 13th, 2012 at 5:20 pm Said:

    I’ve got loads, they were free and I can’t believe that DavidR had to pay for them , surely they should.be free as they as they are a po
    tential life saver.
    I’m injecting into my stomach every day and as much of a pain it is ill carry on for the next 4 weeks
    Another example of the discrepancies of the NHS

  446. DavidR, on June 13th, 2012 at 5:38 pm Said:

    No!! I went private, medication isn’t covered. Nor is the boot. Or the consultation. Or most of the surgeons fee. In fact, why did I go privately!!

  447. starshep, on June 13th, 2012 at 7:05 pm Said:

    I’m non-op and was on the blood thinner Xarelto for a month.

  448. sheena, on June 14th, 2012 at 4:28 am Said:

    David R,
    I had private cover but like a lot of these policies the cover for out patient is so small that I couldn’t use it either.

  449. sheena, on June 14th, 2012 at 7:04 am Said:

    Took a stumble last night put weight onto foot. 3 weeks in non op. Hurt like hell in tendon injury site for about 15 minutes. Has anyone else done this? Teriffied I have damaged it yet again.

  450. DavidR, on June 14th, 2012 at 7:18 am Said:

    I did this several times. It’s very worrying, so the best thing to do is get to hospital and have them check it out. I was releaved when told mine was still attached. I felt a real tug on the tendon when I did this. The important thing is to progress every day, so I think you should have it checked out if you can, though this isn’t always easy. Good luck Sheena. I’m just leaving for my first physio session 17 days post op.

    Good luck all.

  451. hillie, on June 14th, 2012 at 12:24 pm Said:

    I never had blood thinners either and I was non-op, with early mobility. It certainly appears that ‘non-op’ and mobilisation are key to possibly not needing these drugs.

    I do remember, when I was first injured, reading a report via Google about ATR and DVT which I recall (but don’t trust my memory!) also went along these lines.

  452. sheena, on June 17th, 2012 at 10:28 am Said:

    Hi all,
    had a bit of a bad week this week. Just the thought of how long this is really going to take and not being able to do much at all for my 5 and 7 year old….Doc didn’t want to see me after my tumble said it should be OK. Mmm that fills me with hope! I think in the back of my mind I’m scared that I set myself back and I won’t find out for another week tomorrow when hopefully he said he’s going to get me into a boot. and he then may tell me actually you now need surgery…can’t bear the thought.
    Can I ask a question please, to non op people?
    Do you get pins and needles in your feet and if your foot is down too long does it feel like it’s swelling up? This didn’t start with me until this week so I’m a bit concerned. It helps if I elevate and is worse at night until I go to bed. It feels as if everything is swelling inside my cast until I elevate.
    Thanks.

  453. sheena, on June 17th, 2012 at 10:58 am Said:

    DavidR,
    how are you getting on with your Vaco boot? Is it still uncomfortable?

  454. DavidR, on June 17th, 2012 at 11:51 am Said:

    Sheena,

    I hate how long this is going to take, I know worse things happen in the world, but 4 weeks without seeing a friend and I’m depressed. I just put up with it though as the depression is directly related to the foot and as one gets better so will the other, it’s just not fun while it’s happening.

    The boot was only uncomfortable in the sense that I have a big bone on the top of my foot right in the place of the plastic bit that goes across the boot. I spend a lot of time out of the boot because of this. I have an appointment with the physio and the surgeon on Tuesday, which will be 3 weeks post op, at the very least I would like to be 5 degrees after that.

    I think if you have doubt in your mind you should see someone. I had doubt in my mind, and admittedly went down the private route, but within 7 hours of seeing the consultant I was in theatre!

    Good luck and let us know how everything goes.

  455. kimjax, on June 17th, 2012 at 12:59 pm Said:

    DavidR - I have the same high instep bone in a Vaco, and have to keep the boot loose because of it. I love the boot, but that particular aspect of the top cover is difficult when you have that high upper foot bone.

    It helped me to flatten out the foot bed into a slant under my instep- gave me relief from the top foot pain, but does affect the actual dorsiflexion of the foot. So my boot says zero degrees - but I’m actually around 3-5 with the makeshift heel in the Vaco. (my other boot at true zero degrees is still too hard to get my heel down into) I have to keep the toe and ankle strap loose to keep feeling in my foot.

    I also keep a pad right at the small part of the ankle as the liner was drooping on it’s hinge there and causing a painful and substantial lump of swelling right above. Even though I had to make these adjustments, the boot is more lightweight much better dynamically for walking than my more comfortably lined “ball and chain” boot. It’s saving me wear and tear on my knee and hip!

  456. sheena, on June 17th, 2012 at 1:39 pm Said:

    Kimjax,
    did you just buy your own vaco ped or did you buy it through a doctor? I ask because you have both. My doctor uses the non hinged ball and chain boot your describe with heel wedges. As I am NHS I don’t want to waltz in with my own boot that he has never used before and say “fit this please”. I guess what I’m saying is this. Do you have a huge benefit from having both boots? Did you fit your own Vaco-ped or did your doctor fit it? I saw ealrier in this blog that a lady in the UK bought her own off E bay as she hated the one that the NHS had given. I’m not due to get my boot for another week. David, who is also on this blog sayd his ball and chain boot is very comfortable but you say the Vaco is better for walking in?

  457. kimjax, on June 17th, 2012 at 2:35 pm Said:

    Hi Sheena,
    My doc gave me a hinged boot the day before surgery at the consult - before I really understood what was available. The first night I wore it, it caused me pain in my hip and knee because it was so heavy to lift around. I found this blog, and talked to a local friend who told me about the Vaco and I ordered it about a week later - out of pocket $$, unfortunately. If I didn’t have troubled knees (I ran 20+ miles a day when younger and have worn them out) and a small frame, I’d probably have stuck with the other boot. But the Vaco has been a Godsend in saving some already worn out leg parts!

    My doc did ask me to bring the Vaco in to evaluate it before he would ok it. (I would have used it anyway) And he thought it seemed fine. He’s had good history with the other boot which is probably fine for bigger framed people - but my joints are pretty beat up after a lifetime of “energetic living.” :)

    The other two pros were the change out liner (extra$), two removable soles (came with it) and extra protection (from my 6 kids and dog) in the plastic outer casing. If I’d been courageous enough, the big rounded sole would have allowed me to walk earlier at high angles of flexion. You can swim in it, and I live in a very hot corner of the world where you sweat as soon as you walk outside.

    Early on in this injury I had a LOT of pain post surgery as I blew my AT to pieces. With two kiddos newly adopted internationally, (home 8 weeks at time of injury) I need to be at my best as they are needing a lot of attention, tutoring, and reassurance at this point. So I’ve overspent a bit for comfort and rehab. The cryo cuff has been the best for pain alleviation - I can stick it on and go on reading stories or tutoring math while it cools. I can’t take pain killers without nausea, and doc forbids Motrin, so the lighter boot and icing/compression stuff have helped a lot. The Vaco seems to facilitate easier walking in these early PWB days due to its sole design and weight - but without all the above issues, the standard fare probably would have been fine.

  458. kimjax, on June 17th, 2012 at 2:38 pm Said:

    Sheena - One more thing - I fit the Vaco myself - it’s idiot proof! Very easy to work, although I did watch the 4 or 5 2min. videos first. The liner can be lumpy - so you have to work with it a bit. I loved changing out boots when I had hot spots - but now that I’m walking, I primarily use the Vaco.

  459. starshep, on June 17th, 2012 at 3:17 pm Said:

    Sheena,
    i had some minor tingling in my foot during the first few weeks but I tried to keep my foot elevated as much as possible.

  460. sheena, on June 17th, 2012 at 3:38 pm Said:

    Kimjax,
    thanks for the great info. I did read about your kids and that you’d adopted from China. That’s amazing and I can’t imagine how difficult it’s been for you with this injury.
    Thanks again.

    Starshep,
    thanks. To be honest. I have hardly needed to elevate at all in the first two weeks. It was only after my stumble where I put weight on it in the cast have I felt the need to elevate it. Bit worrying that? I feel the need to actually elevate it now where in my first cast I didn’t at all really.

  461. DavidR, on June 19th, 2012 at 1:50 pm Said:

    All a bit quiet here, how is everyone getting on? The metal and physical side are still getting to me big time. How is everyone progressing? Well I hope.

  462. hillie, on June 19th, 2012 at 3:51 pm Said:

    Hi DavidR

    At this moment, it is half-time in the England - Ukraine game. A number of English players also having mental and physical issues. Let’s hope that they recover quickly. I think that one of the pundits asked if the they were tired! Tired??

    You’ll turn the corner unbelievably soon!

  463. Brian Hamman, on June 19th, 2012 at 4:37 pm Said:

    Congrats to England! That should be a great game against Italy this weekend!

  464. DavidR, on June 19th, 2012 at 4:51 pm Said:

    Three bad performances and we are through, I’ll take that, Russia had 3 great performances and are home. Topping the group was crucial. Now how are all these tendons? Mine is getting me down!!

  465. Hala, on June 20th, 2012 at 5:32 am Said:

    Hi

    I’ve been reading the blogs for a little while and quite shy to join in but thought I should take the plunge!

    I’m 6 weeks in and just had my third cast at 90 degrees, which they are telling me I need to wear for another 3 weeks before a possible boot. Very conservative treatment, which is not ideal, but the consultant said it was a balance of risk of re-rupture and didn’t seem to offer any other options.

    I’ve been very fortunate to have friends and family still taking an interest but I can see how boring it is for them to accommodate me all the time! Have had quite a few down days too, staring at walls and daytime TV, so really feel for DavidR.

    I started PWB on my cast yesterday after the new cast was applied and ended up on Nurofen and rest from the pain. OK today though. Any advice for me from anyone? :-)

    Thanks

  466. David, on June 20th, 2012 at 8:28 am Said:

    Hi Achilles sufferers!

    It is all very quiet here, hopefully that is a good thing.

    I’m getting along OK, doing my exercises although I over did it a bit last night and my calf aches today.
    I managed to stand up without the boot on and it was weird. As Sheena said, it was like putting my foot on a jelly floor. I was very nervous but a bit better now (having to be careful). It makes getting dressed from the shower easier.
    I can stand OK but can’t really bend my knee forward more than an inch or 2 before my AT gets too tight so no walking by a long way.
    Only 6 more doses of Fragmin and then I can say goodbye to piercing my belly!
    My boot is showing signs of wear and tear, the bar that goes up the inside of my calf came out of the velcro, I glued it back together but may need a new one before I am freed. (3 weeks still to go)

    Hi to Hala

    I guess you are non-op by the fact you are in your 3rd cast and 6 weeks!. I was going mental after 2 weeks in a cast so good luck with that.

    Sheena,

    I read a blog where a guy kept his foot above his heart most of the time when in a cast to stop the blood pooling in his foot but I think he was op.
    I put my foot up most evenings after being on crutches and pwb at work all day.

    DavidR

    How was physio? Encouraging or frustrating?

    Tried three times to post this….copy before submit!!

  467. sheena, on June 22nd, 2012 at 9:48 am Said:

    Hi all,
    sorry I have been so quiet. Had a rotten week last week after stumbling and in the end went to hospital yesterday to make sure all is OK. The consultant took off my cast and had a really good look at it and made me do lots of pressing against his hand whilst he checked to see if my tendon was still in tact. I thought about asking him for a leg wax at the same time but thought better of it! Look like a footballer myself.

    Just to recap, I have been in cast and PWB from day 4 which is unusual. Had second cast after two weeks when doc said he’d get me into a boot at 4. Yesterday I thought boot here I come. NO he said. You have fallen, set your self back a bit, I want you in a cast for two more weeks. I looked at him he looked at me. He said he didn’t trust me not to leg it round after my kids and then the plaster girls chimed in and said keep her in a cast!!!! So I am in cast number 3 and then into a boot in two weeks time and then start physio. He said the PWB I have been doing since day 4 is physio enough and has told me to wriggle my ankle around as much as poss in the cast and wiggle my toes as much as poss too! Seems conservative but he was not backing down and said it was due to my stumble. He is the top guy at the hospital and wrote the hospital protocol so I’m listening to him, not much choice really. They have put my foot much nearer to the neutral 90 degree angle that a normal foot stands at. How do you guys measure your angles from the normal foot position? I get so confused with all the angles I see on various blogs. My foot is now very near to the angle of a normal standing foot. Boy did I feel that pull when they moved my foot up. Didn’t last too long though but felt sore last night.

    Hala,
    don’t be shy, good to hear from you. Your treatment does sound conservative but it is hard to argue with a doctor. Have you only just started PWB? Have you been NWB the whole time?

    David,
    were you much more comfortable once out of your cast? The girls in the plaster room were saying it’s a real pain to sleep in a boot and if they had a choice (they have tried all the boots out) they would choose to sleep in a cast. I think they were just trying to convince me not to argue with the doc about getting a boot.

    DavidR,
    Hi. Had such a bad week last week thought I was going insane. Hopefully at the six week mark we may improve. At least you’re in a boot. What are you doing at physio although I know you’ve had the op so different from me anyway.

    Hillie,
    hope you’re well. I guess we’re all watching the match at the weekend. Bye for now!

  468. David, on June 22nd, 2012 at 10:13 am Said:

    Hi Sheena

    Glad to hear that all is OK but put back a bit.
    I don’t mind the boot, it is more comfortable than the cast because I can take it off in the evening.
    Sleeping in it is not as comfortable as the cast, it feels hotter and bulkier. I did think of taking it off but was told NO!

    Had another physio today, great progress. He said that my healing was at week eight even though I am actually at week 5 so I am well please.
    Word of caution, “don’t get over confident”

  469. sheena, on June 22nd, 2012 at 10:30 am Said:

    Hi David,
    thanks. You sound like you’re doing really well. I agree with the over confidence thing you’re right. I will just have to just stick with the cast for two more weeks.

  470. Hala, on June 22nd, 2012 at 12:57 pm Said:

    Hi Sheena

    Sorry to hear you aren’t where you’d like to be, it’s really frustrating when your expectations have to change! It’s quite bizarre this whole process, isn’t it, how did I become this stay at home person? My husband said today I’d lost some of my personality with the injury.

    Ah well, can only get on with it. I’m 7 weeks post rupture and am in my third cast (90 degrees now, after ballerina and then 30ish degrees fir 3 weeks each). I had this cast on19th June but up till then was completely NWB. Now I seem to have gone to FWB almost at once, I just stop when it starts to ache. No idea if this is right but they gave me a walking shoe so I’m walking. Can do crutch free in the house to cross a room.

    Hopefully my very conservative protocol will cheer you up in that yours is not so bad. I asked my doctor about speed of protocol and he just said it’s a balance of speed and risk. So there you are. I also have 2 kids, although older -11 and 14 - and it broke my heart not to be able to walk the younger one to school, waving her off at the door instead, but it’s probably good for her. Surely patience will be an outcome of all this?

    Anyway, good luck to you all and stay cheery. There’s always the footie… Just the one though in our case!!

  471. sheena, on June 22nd, 2012 at 1:15 pm Said:

    Hala,
    yours does sound like an unusual protocol. NWB for weeks then FWB in a cast. You must be OK to FWB otherwise all your instincts would tell you to stop I guess? How on earth have you managed NWB for all those weeks? You poor thing. I was PWB from the moment I saw the consultant which was 4 days after A&E. There does really seem to be a case to set a proper fixed protocol for this but then not all doctors would agree I guess? I don’t think I will ever be a patient person this just makes me worse actually!
    How did you do yours, not sure if you mention that?

  472. hillie, on June 22nd, 2012 at 1:50 pm Said:

    Hi Sheena

    Great to have you back, but sorry to read that not everything has gone to plan. You know, now that I’ve been reading the replies here for a few weeks, and at week 16+ myself, it seems to even out for most of us, so that by about this time, our timelines aren’t so different. It’s only a week or so ago that my ATR leg was swelling at the slightest thing, and now it has calmed down. I do have an issue with the knee on my ‘good’ leg and now awaiting results of x-ray. As for patience, you must be better than me!

    You must have enjoyed catching up too with the blog replies - lots of encouragement and reassurance around, and ambitious targets achieved.

    As for ‘conservative’, with medicine it’s like politics - you might be on the same side but you’ll always do things differently and won’t always learn from your colleagues.

    Have a great weekend.

  473. Hala, on June 22nd, 2012 at 1:57 pm Said:

    Yes, I’m not sure if I should FWB, I just asked if I could stand on it and they said yes. I will make sure I don’t push it too hard though. NWB was really hard, carrying anything was the biggest issue, along with hurting hands from crutches and avoiding over straining the good foot. I got a wheelchair for the kitchen so I could move things around the surfaces and it’s also useful for sweeping the floor and tidying up! Hoovering I just hopped on one crutch and held on for dear life. I got a flask, cup and a bag to take my coffee into the living room. It’s so much easier now :-)

    I did the injury when playing badminton with an old friend although I had been pushing it a bit on the treadmill in an effort to get fit, so I think that may have contributed. Since then I’ve started doing Pilates in front of the TV instead, I so don’t want to ever have to do this again! I managed to go swimming on holiday the week before last (with a vacuum cast cover) so I was delighted with that. Will be sticking to low impact from now on…..

  474. starshep, on June 22nd, 2012 at 3:31 pm Said:

    Sheena,
    I did find the cast slightly easier to sleep in than the boot but not by much. Falling the wrong way is probably one of the biggest ways to re-rupture your AT with or without being in a cast, so maybe your doctor’s caution is well placed. It sounds like the worst thing that has happened to you because of your falls is a couple of more weeks in a cast. Once your a few weeks in the boot, those extra 2 weeks in the cast will seem like a distant memory. Hang in there and be careful.

  475. sheena, on June 23rd, 2012 at 9:17 am Said:

    Hi guys,
    thanks for all the encouragement!

    Hala, I too did mine playing badminton and it was only the second time I had ever played….oh, and the last!

    Have a good weekend all and enjoy the footie tomorrow if you can stand to watch the ever turbulent England team….

  476. normofthenorth, on June 23rd, 2012 at 1:06 pm Said:

    Hala, you wrote “I asked my doctor about speed of protocol and he just said it’s a balance of speed and risk.” With all due respect to your doctor — and NO more! — the evidence is pretty clear that it’s NOT “a balance of speed and risk”.

    Within the range of speed of the well-tested protocols, the fastest ones have some of the lowest re-rupture rates and the best clinical results, with and without surgery. Without surgery, we had a very long and well-documented history of ultra-slow “conservative casting”, which clearly had a re-rupture rate that was much higher than the surgical re-rupture rate. (A good 2005 meta-study summarized those results.)

    Then in 2007 the first of 4 modern studies was done applying fast protocols (like bit.ly/UWOProtocol ) to surgical AND non-op patients, and the re-rupture rates dropped sharply. In general, the non-op re-rupture rates were statistically indistinguishable from post-op re-rupture rates. I’ve never seen a randomized trial comparing non-op “conservative casting” with modern non-op treatment like UWO (and I don’t expect to see one). But the comparison of the results of the old non-op studies and the new shows pretty clearly that FASTER IS SAFER, at least as far as the studies have gone.

    That’s not obviously logical, and it’s not what most practicing Docs learned in Med School, but it seems to be true, based on the factual evidence.

  477. DavidR, on June 25th, 2012 at 6:57 am Said:

    Morning everyone. Mondays are always a landmark for me as I had my op on a Monday evening. This evening is 4 weeks or 28 days, since the op. Still hugely frustrated. Currently at 0 degrees in my VACOped and doing my physio exercise to strenthen the muscles in my leg. Next Monday will be 5 weeks so hoping then to start weight bearing. How is everyone else?

  478. richj, on June 25th, 2012 at 8:40 am Said:

    Hi all,

    Another additional to the role-call of UK ATR sufferers! Like many on here 5-a-side did it for me, a middle aged unfit weekend warrior who didn’t think anything could go wrong by having a light runaround without a proper warm-up & stretching. It’s a painful lesson to learn…

    This happened last Wednesday night, I went to A&E Thursday evening who immediately diagnosed ATR with the calf squeeze test and put me in a temporary plaster. Pleased to get an appointment in the fracture clinic the next morning, they confirmed the diagnosis, brief discussion with the specialist and agreed non-surgical treatment, then fitted up with a brace (carbon fibre - cool…) by Trulife and 3 removable wedges to be taken out over the coming weeks.

    My next appointment with the consultant is in 10 weeks, I go back to have the 1st wedge removed after 4 weeks (because I’m on holiday in the next couple of weeks to be fair) and will then go back every 3 weeks for the other two to be removed.

    Now I’m very happy with the speed of being seen by the NHS, but less so about the information and aftercare I seem to be about to get. After spending most of the weekend on the internet (and discovering this excellent resource) I’m now wondering should I be pushing for more information and a plan for my rehabilitation. It seems, from looking at other PT protocols that other non-op folk are following, as if from 2-4 weeks I should be looking to flex my ankle a bit but I’ve had no instruction on that from the hospital.

    My main concerns are about ensuring I have the right treatment / rehab regime, and understanding how long it will be before I can drive myself (manual g/box - right leg ATR) and go on a short / long haul flight.

    thanks
    Rich

  479. plummy, on June 25th, 2012 at 2:21 pm Said:

    Richj

    Not a ‘club’ that you wanted to join? Me neither. I discovered this blog (and the ‘worldwide’ version) quite late compared to you but have found it excellent, amazing, often very surprising in the experiences of those who have contributed here.

    I’m in UK too, right ATR, and, as with most others, a driver (and non-op I am happy to say, on an aggressive recovery timeline). Now at about 17 weeks. It seems that in most countries (not only the UK, where the best offer sustainable recovery as quick as anywhere in the world), rehab protocols vary enormously, partly due to differing severities of injury, more though due to the practices followed at hospitals. No doubt you will have read about this in the replies over the past few weeks - these will hopefully have answered many of your concerns(?). Ask questions here and of your fracture clinic. You do need answers, and a written protocol would be good - ask your clinic physic’s if not your consultant.

    Good luck, stay confident.

  480. Hala, on June 25th, 2012 at 2:49 pm Said:

    Hi Norm

    I worry about the point you make - not sure if I am following the best protocol so will be annoyed if it is slow AND ineffective! I do feel safe in my cast though, since I got my walking cast I have feel very similar though to the day I spent walking round a shopping centre in between snapping my Achilles and realising it was snapped, which isn’t madly encouraging ;-)

    Sheena, I won’t challenge you to a post-recovery game of badminton then!

    Rich, not sure if it helps, I am non-op and been in a cast for 7 weeks. I flew to Turkey (4 hours) after 4 weeks. The hospital split my cast to allow for swelling but since they kindly gave us the front row, I was able to keep my leg up for a lot of the journey, and my kids were delighted with the free legroom! I had no trouble really with the plane or airports, they all seem very used to accommodating us limpers. In fact, I took a wheelchair and that meant even more attention and special treatment. Not sure what aspect you were worried about?

    Hope everyone is bearing up, at least there is intermiottent sunshine in UK, and Andy Murray is playing tomorrow!

    Hala

  481. richj, on June 25th, 2012 at 2:50 pm Said:

    Thanks plummy,

    I still can’t quite believe this has happened. It also seems like an age since I unwillingly ‘joined the club’ but it’s not even a week, time has definitely slowed down drastically :(

    I am getting the picture that there are big differences in peoples rehab experiences, although it also seems the end outcome is broadly similar. As I understand it the main difference is likelihood of re-rupture, with an ‘aggressive’ regime having (surprisingly) better results.

    Out of interest how long did it take before you were able to drive again? I guess the main concern will be braking with the right leg, and avoiding the possibility of re-rupture in the event of an emergency stop.

  482. Andrew1971, on June 25th, 2012 at 3:12 pm Said:

    Hi richJ,

    Welcome to the club, my blog can be found here http://achillesblog.com/andrew1971/

    Your specialist put you straight into a boot - that’s impressive, was a full rupture or a tear?

    I am also non-op, in the UK, happened 28th May, I have an ultrasound this week with a follow-up specialist appointment the following Tuesday.

    Driving - depends on your injury, you need to be able to accelerate and do an emergency stop…….without re-repturing your tendon and not in a boot (thats the usual recommendation I think)…..8-12 weeks of no driving is the norm… so be prepared.

    Non-op flexing of the ankle depends really on the type/position of the rupture, I was put in a cast so that I could not flex and the tendon could heal a bit first…. the tendon heals in 6-8weeks, the rest of the time is teaching it how to work and build up strength again.

    Good luck man

  483. richj, on June 25th, 2012 at 3:37 pm Said:

    Hi Andrew,

    It is a full rupture, I think the specialist said a 5cms gap(does that sound right?). I must admit I was surprised when I was given the brace, I was expecting a plaster cast. I can’t remember exactly what the fitting technician said about putting weight on it but I think I’m ok if it’s like ‘treading on eggshells’ - but I probably should call to double check that!!

    Hi Hala,

    Sorry, I’ve only just noticed your reply. My main worries were getting on the plane (my normal flight uses steps rather than an air-bridge), organising a wheelchair on arrival at Schiphol (it’s a long walk to the exits) and DVT risks on long haul (typically 6 hours)

  484. Hala, on June 26th, 2012 at 4:29 am Said:

    Hi Rich

    The airports and airlines are very good at looking after you - in fact they are probably obliged to accommodate disabled travellers aren’t they? If you request assistance, the procedures will all kick in. When I was travelling, people were sent to meet me with a wheelchair (although I had my own and my husband!) - I am sure this will be the case in Schipol (which I know quite well too). Can you do the steps on your crutches, otherwise you can ask what they can do. I didnt feel at any more risk of DVT than normal since I was keeping quite active and probably wiggled and stretched more than I normally would anyway because I was so conscious of my leg.

    All in all, I was amazed at how easy it was to negotiate the journey and airports and was quite impressed with the service.

  485. plummy, on June 26th, 2012 at 6:22 am Said:

    Rich

    I drove at about 10 weeks, when I was ok with 2 shoes again, and able to do an emergency stop. I was in my boot until then. You will be able to read in the blog where one or two have driven 3 or 4 weeks after ATR but this seems to depend on their car (auto), which leg, amount of space around pedals, boot size, flexibility, etc. Police and insurance considerations? I found that at 10 weeks the strength was ok, but the movement up and down between the pedals was more uncomfortable - this soon improved though.

    I seriously would recommend that written protocol/timeline if you don’t have one already. Good for peace of mind and target setting (not only you, but hospital too).

  486. mikeev, on June 27th, 2012 at 8:56 am Said:

    Hi All,

    newbie here and wished I had found this site alot sooner! I wonder if its ok to add my story in my first blog, to where I am now and see if anyone had any similar experiences?

    Just over 5 and a half weeks ago now I was playing in a 11-a-side football tournament, it was the second half and the second game and I thought I had warmed up sufficiently and stretched to reduce any injuries. No such luck, I pushed off to run and heard a “Snap” simultaneously with pain in my left ankle/calf area. Thought someone had kicked me, but when I saw no-one was near me I immediately thought Sh*t, thats my Achilles!”.

    At A&E they did an Ultrasound and said it was an ulmost comlpete tear of the Achilles Tendon. I was really upset as thought this would mean surgery. They put me in an aircast with three wedges and no crutches, then sent me home to see a specialist in a weeks time.

    At the appointment the specialist said I had a 75% split of the musculotendinous junction, so the aircast was the correct treatment. He didn’t send me for any MRI (is this normal?) and at the time I wondered how he could be so sure. Anyway, he went on to say I should remove 1 wedge every two weeks until I saw him in 6 weeks time to begin gait therapy and physiotherapy. Great news I thought, no surgery!!!!

    Then, yesterday, I was hit for six. I had another appointment for an Ultrasound. The notes they gave me read “..almost compete tear of the musculotendinous junction with a 7mm gap between the two ends of the tendon narrowing to 5mm on plantar flexion”. I’m no doctor, but a 7-5mm gap doesn’t seem like a small gap to bridge in 2 weeks before I next see my consultant. And can it be bridged just using non-operative methods???

    Does anyone have any experience or opinions on my situation? It is really stressing me out, have I wasted 5 weeks hobbling around in an aircast where I should have had surgery?

    Sorry for long reply and thanks if you read it, needed to vent current frustrations.

    Mike

  487. sheena, on June 27th, 2012 at 12:22 pm Said:

    Hi Mike,
    the best person for you to ask on this blog about non op is normofthenorth he may pick up on your post anyway.

    Go to Norms blog and read about the UWO non op study and protocol that he followed. The only slight concern would be you weight bearing from day one, which I did but I’m in a cast.

    I would be concerned that on your ultrasound they are not seeing that it is mending. If it were me I would get the consultant’s secretary on the phone and ask if you can bring your appointment closer. After 51/2 weeks you would expect there to be no gap hopefully. I would defo get another appointment and speak to Norm.

    Let us know how you get on.
    PS did you not see the consultant yesterday?

  488. DavidR, on June 27th, 2012 at 12:41 pm Said:

    Hello Everyone,

    I hope everyone is progressing. My progress seems slow, though I guess it’s not in reality.

    richj, I did mine playing 5 a side and started on the same route as you but then went private and had the operation done after a week and I think I’m glad I did as the level of aftercare seems better, I’d be very frustrated in your position having to wait 10 weeks!

    mikeev, I don’t really know regards a non full rupture or non op, but regardless I think the most important thing for all of us is to feel that each day is progress, and so to have wasted so long would be awful. I would definitely seek a second opinion, I’m glad I did.

    Sheena, how are you going? Tomorrow is 1 month since my op, I’m at 90 degrees in my boot, but non weight bearing, it’s all so different for everyone!

  489. mikeev, on June 27th, 2012 at 3:17 pm Said:

    Hi Sherman and DavidR,
    Thanks for your replies. Booked an appointment with another specialist at another hospital to see him tomorrow to get a second opinion.

    Really surprised to see everyone with slightly different treatment

    Mike

  490. mikeev, on June 27th, 2012 at 3:18 pm Said:

    Hi Sheena and DavidR,
    Thanks for your replies. Booked an appointment with another specialist at another hospital to see him tomorrow to get a second opinion.

    Really surprised to see everyone with slightly different treatment

    Mike

  491. richj, on June 28th, 2012 at 9:34 am Said:

    Thanks everyone for the replies. I’m going to see what happens after I get back from holiday with my first appointment at the hospital, if I don’t feel I’m getting the right level of support or a clear rehab protocol (written down!) then I’ll get a referral to see a private specialist on my work healthcare plan. Talking of holidays I’m going on a touring holiday of France with my wife (she’ s now got to do all the driving and isn’t happy…), the consultant said to make sure I take enough breaks during the car journey and keep my foot up as much as possible. Is there anything else I should think about?

  492. sheena, on June 28th, 2012 at 12:58 pm Said:

    David R,
    Hi good to hear from you. Can I check, have you been NWB the whole time since your op?

    5 week anniversary tonight at 8PM…shall I be celebrating? Get my boot Monday hopefully!

  493. sheena, on June 28th, 2012 at 1:01 pm Said:

    Mikeev

    How did your second opinion go?

  494. DavidR, on June 28th, 2012 at 1:47 pm Said:

    Hi Sheena,

    Monday will be 5 weeks since the op for me, I have a meeting with the surgeon and physio and, all being well, will go from NWB to PWB or FWB. I’ll let you know what happens, good luck for Monday, big day for us both.

    Oh and on Saturday (day 39 since the injury and day 33 since the op) I finally have my first visitor!

  495. sheena, on June 29th, 2012 at 5:05 am Said:

    David R,
    funny isn’t it you have been NWB and in a boot and from day 4 I have been in a cast and PWB….

    Think you need to have a chat with some of your mates!

  496. sheena, on June 29th, 2012 at 1:02 pm Said:

    Just booked my first physio appointment…next Wednesday, assuming that I get that boot Monday that is! Fingers crossed.

  497. DavidR, on July 2nd, 2012 at 11:26 am Said:

    Hi Sheena,

    So it’s 5 weeks today since the op and I saw the surgeon and the physio today. both were happy with my progress, but it really has dawned on me just what a long road this is. I’m now allowed to try 1 crutch and no crutches in the boot, indoors and just a few steps. And I’m allowed to try 2 shoes on crutches (no real weight on the bad foot though) and it has really hit home how far away normality is. More than anything there is so little strength in the leg and the ankle especially is so weak.

    How is everyone else getting on?

  498. sheena, on July 2nd, 2012 at 12:48 pm Said:

    Hi all,

    David R,
    sounds scary….I think this is the start really isn’t it?
    I got my boot, an aircast and it’s comfy. Only one heel wedge and first physio Wednesday. Seems like your rehab is quick though. Two shoes at 5 weeks is very quick I think?

    My leg is like a hairy twig……

  499. DavidR, on July 2nd, 2012 at 1:23 pm Said:

    I’m really not in 2 shoes, once a day I can try 10 metres or so with 2 crutches in 2 shoes and no weight is going on the bad foot. The main change is that I can do 1 crutch when in the boot in the house. My main problem is my good achilles, it’s agony. How are you finding the boot?

  500. sheena, on July 3rd, 2012 at 4:46 am Said:

    DavidR,
    the boot is a dream to me actually. He told me to WB as tolerated and I began walking on it without crutches once I got home. I don’t walk far without crutches, only around the house. What is the problem with your good tendon? I would get that looked at by the physios?
    I took my boot off last night and stuck the hairy twig (my emaciated leg) into a bucket of hot soapy water because it stank of rank vinegar after six weeks in casts….sorry if that’s too much info. After that I tried a little bit of moving my ankle but there wasn’t much there and when I put it onto the floor it felt like that spongy floor moving away again. Physio will be interesting tomorrow….

  501. rusky, on July 5th, 2012 at 9:00 am Said:

    Hi Everyone
    What afantastic site this is! (a painful one i hasten to add) I came across this site whilst investigating AT injuries. To put you all in the picture i did my right AT on friday the 30th playing a works football match, I thought i had been kicked from behind but no one there! hobbled off and ended up going to A and E on saturday who put me in a temporary plaster cast. Wentto hospital on monday when they informed me i had torn my achillies. I was put straight into a velcro strap boot and my foot anged to 37.5. degrees. I go back on the 19thjuly to hopefully alter the angle. I’m told that im in this boot for 6 weeks so compared to some on here i’ve got away with it lightly. Still mega boring and fed up though!

  502. sheena, on July 5th, 2012 at 10:33 am Said:

    Hi Rusky,
    are you in the boot 24/7? Is it an aircast boot? Six weeks sounds early to come out of the boot. Is your achilles torn or is it ruptured? If it’s a tear then maybe that’s why you won’t be in it so long.
    Good luck. Yep it’s very dull!

  503. rusky, on July 5th, 2012 at 10:44 am Said:

    Hi Sheena
    Yep in my boot 24/7 apart from bath times!! not sure if its an aircast boot? foot/leg slides in and held in place by 5 velcro straps, it weighs a ton i know that much!! mine is only torn, after the thompson test their was still a fraction of movement. There is only so much wimbledon that i can put up with!!!!

  504. KarWillis, on July 5th, 2012 at 12:02 pm Said:

    David R,
    Please tell me more about your good Achilles. I am 6 weeks post op in aircast boot, with 2 more weeks in boot before I can start to wear a shoe 1 hour a day increasing over 4-5 weeks until boot free. I’m way past the frustration at lack of exercise, freedom and mobility (can’t wait to chuck the crutches on a bonfire) however I am worried about my good Achilles. It is starting to feel very tight, is that the same you are experiencing. I am very tempted to go and get some physio on the good tendon now to keep it strong whilst it is having to do all the work - have you considered this??
    NB mine snapped clean in two. Had op to repair as keen to return to sport and avoid re rupture. The key phrase my consultant keeps repeating is treat the recovery like a marathon (slow and steady) not a 5k sprint!
    Karwillis

  505. sheena, on July 6th, 2012 at 3:55 am Said:

    Hi Karwillis,
    I think you should get some physio on that good tendon. It doesn’t sound right. I am six weeks in and now in a boot. The only time my good tendon hurt was if I hopped aroung when in a cast. Stopped that. Have you and David R been doing a lot of hopping?

    Also, I have a pair of MBT trainers which have a rocker sole on them. I have always worn this on my good leg and it has really helped as they have a wedge on them.

  506. sheena, on July 6th, 2012 at 3:58 am Said:

    Rusky,
    lucky you only a tear! Make sure it heals really well as you don’t want to face a rupture in the future.
    Wouldn’t fancy sleeping in a boot although I know loads of people do. You get used to anything in the end I guess, anything. At least we all still have a leg!

  507. rusky, on July 6th, 2012 at 6:44 am Said:

    Hi Sheena
    I guess i am lucky! I was only in plaster for the weekend and that was horrid, even though the boot (CAM i think it is) is heavy at least i can take it of and rest my foot up and get air to it. My ankle and calf looks battered and bruised and not a pretty sight!! What i’m surprised about, but pleased, is that its painless, tender but painless. You are right, at least we have a leg!

  508. sheena, on July 6th, 2012 at 10:10 am Said:

    Rusky,
    yeah it’s funny that. I had more pain down the front of my leg for being in such a ballerina point with the cast for two weeks.
    Physio told me that when you snap the achilles the nerve goes along with it…….

  509. rusky, on July 6th, 2012 at 10:40 am Said:

    Sheena,
    I have the ballerina point at the moment and it’s well uncomfortable. This is until next thursday so hopefully i will be able to walk on it then, carefully. Reading up on you guys i feel like a baby moaning about a tear when you all have snapped your AT. I hope you are doing well.

  510. David, on July 6th, 2012 at 12:26 pm Said:

    Hi All,

    It’s been a while since I last looked in. My computer busted and it’s limping along the same as me.
    Sorry to see some new people joining our happy band, you’re all welcome!
    I have one more week until freedom, I am taking the last wedge from my boot and will be in shoes on Friday. I don’t know about wedges in the shoes, I can put all the weight on my foot without the boot on and walk around a bit so I’m going to see what the physio thinks.
    SO…from snapping the tendon 28th April, operation 16th May, boot from 1st June, shoes 13th July…I’ve really had enough.

  511. hillie, on July 6th, 2012 at 1:33 pm Said:

    Hi David

    I can’t remember why your op was 3 weeks after rupture, but you are certainly doing ok now. What is it, 8 weeks from op to shoes? Nothing to be disheartened about. Get some good PT and you’ll be OK.

  512. rusky, on July 6th, 2012 at 3:38 pm Said:

    Hi David
    Fair play to you! from what ive researched you have done very well!! maybe a change in our awful weather for you to be able to stroll around!

  513. sheena, on July 10th, 2012 at 7:16 am Said:

    Hey David,
    great to hear you’re on the mend……..

  514. sheena, on July 10th, 2012 at 7:17 am Said:

    Rusky,
    no matter whether it’s a fill or partial tear…still a right old pain!

  515. David, on July 10th, 2012 at 11:55 am Said:

    Hillie,
    My Doctor didn’t diagnose a snapped AT for 2 weeks (pulled muscle!)

    I wasn’t moaning about my progress, I think I was ready for shoes a week or so ago but have had to wait for my appointment. I was moaning that this is a real slow process in general. When the Doc said 8-10 weeks it doesn’t register how long that is and if it wasn’t for the terrible summer we’re having, I’d be even more fed up. To think that 3 weeks before the snap I was on top of Ben Nevis looking forward to a summer of walking holidays…..huh!
    Never mind…in 2 weeks I’ll be in the south of France (with my feet up again,glass in hand!!)

    How you doing Sheena?

  516. Hala, on July 10th, 2012 at 12:45 pm Said:

    David, did you go with heel raises in your shoes in the end?

  517. hillie, on July 10th, 2012 at 1:32 pm Said:

    Hi David

    Moaning’s allowed, and you are dead right - it is such a slow process.

    Some similarities between your case and mine. My ATR was initially diagnosed as a calf strain, and it wasn’t until 10 days later that a consultant confirmed the rupture. That week I had been intending to book a 2 week walking holiday in the mountains - next year maybe? .

    In the first few weeks ‘off the road’ I did succumb to an interesting side effect - being persuaded to start reading ‘50 Shades of Grey’ by E L James. To quote from the book “Oh my!”. As this is not a book review I’m not going to begin to comment… I am pleased to be back at work now.

    All the best for a continuing good recovery.

    H

  518. David, on July 10th, 2012 at 2:45 pm Said:

    Hala,
    I will know on Friday about the heels as I am booted until then, I shall do whatever I am told as I don’t want a re-rupture.
    Hillie,
    There is a funny Saturday Night Live video doing the rounds about ladies who read Fifty Shades.
    How is your walking? You must be around week 18??
    I can walk barefoot with a little limp but can’t get anywhere near a tiptoe yet. My bad leg can’t go behind as far as my good one yet either so I wondered how long it will be before near normal.

  519. hillie, on July 11th, 2012 at 11:48 am Said:

    David

    My barefoot walking is good thanks, and really nice to do after confinement of a boot, shoes with heel pads, etc. Can’t stand tiptoe on ATR side alone but today I did detect some slight movement. Two feet together is no problem at all and I do this as an exercise in any case.

    At the stage now when I need to add to my exercise programme so will discuss with my physiotherapist at my appointment next week, and a trainer at the sports centre.

    Not sure what you mean in your last sentence - or maybe I’m slow on the uptake this afternoon.

  520. David, on July 11th, 2012 at 12:02 pm Said:

    Hi Hille,

    My explaining is not the best! I’ll try again
    When I walk, I can take a large stride forward with the bad foot and the good foot then follows but the stride forward I can take with the good foot is not as big because my bad foot doesn’t want to do that much bending before leaving the ground to go back in front.
    I’m trying to see how much longer it will be before normality, when will I run up a flight of stairs etc.

  521. hillie, on July 11th, 2012 at 1:34 pm Said:

    Hi David

    OK , I understand. I hadn’t tried any long strides like this since my ATR (19 weeks ago) so I have just tried it as you describe. Happy to say that both sides stride equally well and I suspect that this has been the case for weeks now otherwise I would have noticed something, maybe. I’ve been doing at least some light exercise since week 3 so this has probably helped.

    How many weeks since your ATR? In my hospital PT protocol it says “not advisable to play explosive sports such as squash/badminton for 6 months after injury due to risk of re-rupture”. It doesn’t mention running up stairs but this activity must come into the same category. I would be very careful now, whilst building up the strength and mobility - remember, you want a good quality, sustainable recovery.

    You like mountain walking, as do I - I haven’t done any recently (too far away in any case) but Dartmoor is no soft touch either and I’ve been there many times since ATR (longish strides I guess?). I’m using this opportunity now to get fitter, with professional advice, before I get much older.

    You’ll get there and wonder where the time went. Keep posting.

  522. sheena, on July 12th, 2012 at 6:25 am Said:

    Hi David
    I’m good thanks but not looking forward to the kids breaking up next week and no car….
    I had my second physio yesterday and it was more of the same really. Gentle ROM movements.
    I take my last heel wedge out next Monday which will be at 71/2 weeks. Two weeks with that out and then wean off the boot at ten weeks in all.
    I know that that’s when the fun really begins.
    I don’t ever use my crutches now and didn’t from getting the boot really although I know i’ll have to use them again when back in shoes.
    My physio seems pleased and said I am in much better shape at this stage than her last ATR so that’s a small mercy I guess. There isn’t much swelling but she said that might come once I start to walk in shoes.
    It is 7 weeks tongiht since the injury.

    Hillie,
    sorry I didn’t get round to the photo of the hairy twig! It’s just a twig now as I had to get rid of that hair.
    My mate keeps telling me to read the same book……I haven’t got round to it yet but there is a real funny one I have just read called “How to be a Woman” by Caitlin Moran, very funny indeed for us ladies.

    Had my little one off all week with tonsilitis, what are we like!!!

  523. davidr, on July 12th, 2012 at 7:31 am Said:

    Hi Sheena,

    That’s amazing, we are the same day (well I ruptured my achilles before you but my op was the day that you ruptured yours). And despite having got into the boot about a month before you, and despite having been at 0 degrees in the boot for 3 weeks now, I am back to NWB having been allowed to PWB for a week. I’ve been told not to expect to be able to ditch the crutches like you have until September.

    So well done!

  524. andrew1971, on July 12th, 2012 at 8:32 am Said:

    When the boot goes, we go back on crutches? Is that due to the type of boot you are using?

    Reason I ask that is that I am using the ROM walker boot (similar but not identical to this one http://www.foothealthcare.com/shop/multicast_knee_rom_walker), which is hinged and has an adjustable range of movement in both both Dorsi and Plantar movements.

    The point being I should be able to walk with a controlled but full gait movement with full weight bearing in this type of boot. I would not expect to go to crutches when the time is right to not use it anymore.

  525. sheena, on July 12th, 2012 at 12:39 pm Said:

    Hi Andrew,
    I am not using crutches at all now to walk. I have been in my boot ten days but was in plaster for six weeks. Unusually, but I think it has worked well for me, I was PWB from the minute my consultant put me in a cast four days after my ATR.
    The only reason I MAY need crutches once I go into two shoes is just for precaution really. My physio has said that I’m whizzing about so much in my boot that I will be shocked when I go into a shoe as you simply don’t have the same support. My boot is at neutral as it’s unhinged but I have one, one cm heel wedge in it.
    I may be pleaseantly surprised when I come out of my boot but I think it will be a challenge and am taking it very easy.

    David R,
    how are you? How come you are back to NWB? Are you in pain? If not is it just the doctors telling you not to WB because if they are I’m not sure that I’d listen. Your repair should be stronger than mine at this stage as you had surgery. If you’re in pain then of course you mustn’t put weight on it but otherwise I don’t understand if you’re in a boot? I will use crutches again when I go into shoes as my physio has said I’ll need them. do let us know if you’re in pain.

  526. andrew1971, on July 12th, 2012 at 1:14 pm Said:

    Hi Sheena,

    I took about 8 steps without my boot (but in same fancing style of walking I used with it on) in my launge earlier….. with that experience and your explanation I can understand a bit more now:

    It’s simply for stability and being safe as we learn to go through that process again, I suspect how long anyone needs them for will depend on confidence and balance without them.

  527. sheena, on July 12th, 2012 at 2:30 pm Said:

    Hi Andrew,
    yes that’s it I guess. I have not even tried to take a step without my boot yet as the physio keeps telling me to be cautious. She seems dead set on me only going into two shoes at ten weeks and I’m happy with that to be honest. I know lots of people get there in eight but I figure another two weeks is not too conservative. the thought of a re rupture makes me very happy to wait another two weeks.

  528. rusky, on July 13th, 2012 at 4:44 am Said:

    Hi all hope everyone is doing ok,
    I know i have got away with with it lightly as i only partially tore my AT but is it about right that after 2 weeks of being in my boot i am putting partial weight on my foot? these last 2 days i’ve only used one crutch and am walking albeit ’straight legged’ and very slowly! i don’t want any setbacks!
    I’m not getting pain in my ankle but i do get a aching feeling in my calf when i’m sitting down and it then goes when i walk ’straight legged’ is that how it works?

  529. davidr, on July 13th, 2012 at 6:08 am Said:

    Hi Sheena,

    Basically I had a week of 1 crutch around the house, then when I went back to physio she wasn’t happy as I was moving too quickly and incorrectly and she said I could do damage to myself. So she said I would have to go back to 2 crutches and straight legged, first time I tried it there was a huge pull on the achilles and I hit the deck, it also put my shoulder out. So I went in there thinking I would be coming out with no crutches, I actually came out with a damaged achilles, back to 2 crutches, but only when my shoulder is recovered enough that I can actually use the crutches. So since Wednesday I’ve just been sat on the sofa! I’ve had to move home with the parents permanently until September as I can’t manage anymore.

    Glad to see everyone else is progressing, at least there is some hope there.

    Good luck all.

  530. Hala, on July 13th, 2012 at 7:07 am Said:

    davidr, that’s terrible, I hope your parents are looking after you!

    What were you doing so wrong on one crutch and what happened to make you fall?

  531. davidr, on July 13th, 2012 at 8:02 am Said:

    I was moving too fast on one crutch and bending my leg so they wanted me back on two crutches as they thought I would do myself damage as I was doing too much too soon. Shame that things have now gone backward, I’m really struggling now!

  532. andrew1971, on July 13th, 2012 at 8:45 am Said:

    Hi Davidr, I wish you well on recovery from the set-back - I won;t pretend to know how your feeling, but stay positive and be focused :)

    Please don’t take offence, your situation is of interest to me, but I would find it much easier to follow your timeline, I find myself scrolling up and down this thread a lot to piece together the events as they happened :)

    Good luck and stay positive :)

  533. andrew1971, on July 13th, 2012 at 8:47 am Said:

    Don’t know why it got missed ws sure I typed it - I was referring to you starting a blog to make it easier to follow your event logs :)

  534. David, on July 13th, 2012 at 10:11 am Said:

    FREEDOM!
    WooHoo I am out of the boot!
    Walking like an old man but I am free, I cannot tell you all how good it feels. Driving is absolutely fine, I even went to the supermarket. I have these wedges
    http://tinyurl.com/c9er8ha
    in each shoe but only 10mm max.
    I’ve kept the boot (emotional crutch) in case I need to do anything where I might pull my tendon, doc says the next 3 weeks are the most dangerous so I am taking no chances.
    Physio gave me a few more exercises and I can do lots of walking and cycling to build up the muscle.

    Rusky;
    I was full snap but after 2 weeks I came out of the cast into the boot and was PWB straight away, I had calf pain but taking the boot off and putting my foot up in the evenings really helped.

  535. davidr, on July 13th, 2012 at 10:13 am Said:

    I’ve not done a blog, I’ve done the timeline thing where you date your injury and op date and PWB, FWB, 2 shoes etc. I’m presently 52 days since injury and 46 days since the op. I was zero degrees in a boot after about 3 weeks so was ahead of most people, but since then there has been very little progress, if any.

  536. sheena, on July 13th, 2012 at 10:37 am Said:

    David R,
    that is really rotten…you have had a big run of bad luck I know you have. Don’t know what to say really except I hope things start to look up soon.

    David,
    yippee, can’t wait until I at that stage too!

    Rusky,
    I was PWB from day one but lots of other people were not. Really I think you should check it out with your doc?

  537. David, on July 13th, 2012 at 11:28 am Said:

    DavidR

    You must be close to shoes by now, 6 weeks from op to allow the tendon to fuse and heal.
    When is your next appointment?

  538. davidr, on July 13th, 2012 at 12:47 pm Said:

    Hi David,

    I’ve been told it goes like this.

    Op
    Cast
    Boot NWB
    0 Degrees in boot NWB
    Boot PWB
    Boot PWB 1 crutch
    Boot FWB
    Shoes NWB
    Shoes PWB
    Shoes PWB 1 crutch
    Shoes FWB

    Now I have been moved on 1 step per visit (1 visit a week).

    I’ve gone back from Boot PWB 1 crutch to Boot NWB.

    My next appointment is Tuesday which will be 50 days post of and 56 days post accident and I have been told not to bring any trainers with me as it will be Boot PWB (2 crutches) next week. I will have been at 0 degrees in the boot for about a month by then. I was so far ahead of most, now it seems it will be Sept before I’m in 2 shoes.

    My question is this. I get told by both the surgeon and the physio that there should be no pain whatsoever when I put my foot down. So if I am experiencing pain in the boot with 2 crutches they say I am a long way off 2 shoes no crutches.

    My personal opinion is that there is bound to be pain. one guy I spoke to only tore his achilles 20 years ago, let alone rupture and op, and he says he still experiences pain every day, so why wouldn’t I have pain 46 days post op!

    Also it’s hard to tell what is pain from the achilles and what is pain from the scar, although they say my scar is doing fantastically well.

  539. David, on July 13th, 2012 at 1:30 pm Said:

    DavidR

    Blimey, another 40 days. That seems very long. I am 56 days post op and in shoes. If you are in pain I would think they will be more cautious with you.
    My treatment was
    op
    Cast 2 weeks
    Boot 6 weeks remove 1 wedge after week 3,4,5
    Week 6 Shoes
    I was PWB from week 2 and by week 4 I was FWB, no pain at all.
    Once I took the last wedge out I got lot of heel pain but I think that was due to shock transfer through the boot as I has gone now I am bootless.
    Deb who was on here in May had heel pain and was going to the doc about it but there doesn’t seem to be an answer.
    Hope the pain gets better…

  540. davidr, on July 13th, 2012 at 1:55 pm Said:

    See this is where I don’t get it. I, like most on here, have ruptured my achilles and had my leg cut open and had it sown back together to heal and have scar tissue. So my view is that of course it is going to hurt and that I should just progress and take the pain.

    But many of you, as well as my surgeon and physio, are saying someone in my position should effectively have no pain when walking on the leg. i find this difficult to comprehend, I find the pain totally understandable, but all the evidence points to the fact that if I was to get up now and take a step I shouldn’t feel any achilles pain. I’m confused really.

  541. kimjax, on July 13th, 2012 at 4:23 pm Said:

    davidr - every one is different - as is every injury. I went FWB at 5 weeks - for one day. I was in such pain that I went backwards to one crutch, and kept if for another couple of weeks. I’ve never been without pain since every time I take a step I’m yanking on a very tight tendon (10 weeks and in shoes) I used to dread going to the bathroom in the morning because it was extra painful after sleeping in the boot all night!

    I went right to two shoes out of the boot this week - no crutches - no issues other than when I yank on it too hard. (it’s really healing short) It stinks that I have a more sensitive AT - others with the same surgery date are pain free.

    I was really bummed that my recovery was so slow at first - but I had a pretty severe injury. Do what you can, use the protocols for guidance, but don’t get discouraged if you’re not exactly in that order or particular timeline. Discomfort is fine, but pain is your body saying “slow down.” I’m having DF issues, but there are plenty of folks who chimed in with the same - so as norm always says - patience and small steps. As long as you’re moving forward, don’t sweat it.

  542. davidr, on July 13th, 2012 at 4:33 pm Said:

    But what I’m saying is that my surgeon/physio won’t let me progress if I have pain. But I can’t see how I can not have pain. I expect to still have pain at 10 or 20 weeks, so are they saying I can never progress to one crutch or beyond because I have pain? I have had an operation, of course I will have pain. I think I should just be getting on with it and that they should just accept that my achilles hurts.

  543. starshep, on July 13th, 2012 at 5:22 pm Said:

    DavidR

    I’ve always felt that there was a difference between soreness/discomfort and pain. On a scale of 1-10, how would you rate the pain you are experiencing? My therapist is constantly asking me if I am in pain. While I have never experienced what I consider to be pain, I have felt some soreness and discomfort, but I am quick to point out to him that I do not consider it to be pain. I was fortunate enough to be able to go nonsurgical so I have no idea how much the scaring from the incision might contribute to the pain. Sill the adage “No pain, no gain” absolutely does not apply to the recovery from an ATR, especially at your stage. It appears that you are entering into the most dangerous time period for a re-repture and I can certainly understand the cautiousness of your therapists. As kimjax points out, everyone is different and not everyone progresses in an upward, linear fashion. You really need to have patience in recovering from this injury and defer to the advise of your therapist. This injury heals when it wants to, not when we want it to.

  544. davidr, on July 15th, 2012 at 4:36 am Said:

    OK, next question, what does physio consist of for everyone else. I have physio once a week, it’s 25 minutes long, and the whole time is spent laid flat on a table with the physio massaging my achilles and showing me exercises to do on my back. I took one step in my last physio session but thats it. nearly a month and a half into physio should I be laid out on a table the whole time? I expected it to be in a gym, or at least teaching me to walk, especially as I was at 0 degrees in a boot less than 3 weeks post op, and the surgeon had expected me to be doing more intensive stuff at physio by now. I just get the impression that you walk into physio and they treat you as if it’s your first session every time. Thanks in advance.

    Also, how does everyone’s ankle feel on the bad leg, mine feels very weak. And my good achilles is agony since I’ve gone back to NWB.

    How is everyone else getting on, any success stories this weekend? I hope so.

  545. Andrew1971, on July 15th, 2012 at 8:43 am Said:

    Hi davidr, I am sure your doctor is not taking the current route out of spite again, I find myself travelling up and down this thread to find your posts……one thing you have to remember is that we’re all different (heights,weights,age,pre-existing conditions etc). … everyone’s experience is different, take advice here as points of discussion with your specialist not as a ‘This is what you should be doing’

    As an outsider it looks to me that something happened that should not of it’s a setback and you’re having to take a step back….better to regroup and try again rather than push a bad position, challenge your specialist of course, but trust in the route provided.

  546. Scott, on July 15th, 2012 at 9:10 am Said:

    David - check my latest blog post (http://achillesblog.com/skutr/) on what I did at my last PT session.

    Scott

  547. davidr, on July 15th, 2012 at 9:52 am Said:

    I do realise we all go at a different pace, I’m just not sure what they are waiting for, they say I have full range of movement in my achilles (same as my good achilles), my scar is superb, and I’ve been told they are ’shocked’ at how I’ve managed to build my muslces back up so quickly, so I’m just a bit confused. Anyway, I see the surgeon on Tuesday so I’m going to ask to be referred to a different place for physio as I believe I’m ready for some gym or pool work (and have felt that way for a month now). Thanks all for the advice.

    Scott it’s very interesting reading what you have got done, I’m very impressed and have the same attitude as you, no pain no gain. But the physio’s opinion is simply no pain full stop.

    One thing I wondered, I’ve never been told to ice the injury, and so haven’t, and stopped taking pain killers after a week. Are others icing and using pain killers and could this be why I have more pain despite my seemingly good progress elsewhere (movement, scar and muscles).

    Thanks all, feeling better at the thought of going to another physio now anyway. Cheers and good luck, always good to hear from people and read how they are getting on.

  548. hillie, on July 15th, 2012 at 11:55 am Said:

    Hi DavidR

    Most would agree about healing times differing between individuals for all sorts of reasons. However, most hospitals have their formal protocols for different conditions and vary from them as their patient varies from the ‘norm’ (no that Norm). It would be useful for you to know and understand what your provider’s protocol is and ask them why (if) yours seems to be diverging - has there been a problem or setback that you are currently not aware of?. Always ask, don’t worry about how they might look at you when you start quizzing them - you are ‘merely’ voicing any concerns and taking a very natural interest in your treatment, and what happens next.

    As for the ice, I’ve always been able to use it when there is swelling, and compression bandage, like now as I increase my exercise considerably. My new pt has told me to expect some pain in my new program - but I am ‘healed’ (well, joined up at least) and now at 19-20 weeks, looking to increase strength and stamina. Soon you’ll be able to swim, walk in 2 shoes, all the stuff that you keep reading about others doing.

    Certainly by about 10 weeks, most people seem to be at about the same place in the recovery cycle. (But not if there’s been some big problem).

    Andrew, how is your recovery coming along? Although I don’t find scrolling especially onerous, if I wanted to I’d just go to edit (I use Safari) and ask it to search e.g. for DavidR. Easy peasy. You can probably do it in Internet Explorer too, I can’t remember.

  549. andrew1971, on July 15th, 2012 at 12:32 pm Said:

    Hi Hillie, It’s going well, I have my first specialist appointment tomorrow since having the boot fitted (2wks).

    I am a little nervous, the adjustment I have is right and I can flex more than the boot allows, however, walking up the stairs at home, the whole AT tightens up (it does not do this coming down), which leaves me to wonder if it would be unwise to give the boot more ROM in the boot at this point in time - maybe this is part of the course and my nerves are getting the better of me.

    I can do heel lift in the chair, push down with some force and ROM is improving…. still using compressions socks :)

    I need to ask about physio though, there’s always a long wait for PT in my home town si if I am expected to start that in the nect 3-4weeks (or sooner) they better be looking to book me in now.

    I learned a new thing today doing that search in IE9, it is in the edit section, so that should make things easier.

    It reminded me that DavidR had a set back, a fall just a few days back and an injured shoulder and I quote it here:

    “she said I would have to go back to 2 crutches and straight legged, first time I tried it there was a huge pull on the achilles and I hit the deck, it also put my shoulder out. So I went in there thinking I would be coming out with no crutches, I actually came out with a damaged achilles, back to 2 crutches, but only when my shoulder is recovered enough that I can actually use the crutches. So since Wednesday I’ve just been sat on the sofa! “

  550. davidr, on July 15th, 2012 at 12:49 pm Said:

    Yes, Andrew. Thankfully the shoulder is all good now. The achilles is also much much better, and in fact my good achilles is now far more painful seeing as I am back to having all of the weight on my good foot. It is a setback though, 2 weeks ago my physio told me to bring a trainer for my good foot just in case, and the same last week (I didn’t use it either time), but she said not to bother bringing it next week as we definitely won’t be doing anything out of the boot. I have physio once a week and this Tuesday (17th, my 32nd birthday), is the 6th physio session. I am seeing the surgeon the same day for a check up, (50 days post op, 56 days post injury), and feel OK now as I’m just going to ask about a different physio for a second opinion.

    So Andrew, you say the achilles tightens moving up stairs, do you put your foot down when doing stairs? I’d say that’s progess, I’ve always been one leg and 2 crutches for stairs, and I’ve been at 0 degrees since week 3. So you haven’t had any physio at all, it is so different for everyone, I think I’m right in saying I started physio before everyone (2 weeks post op), but have stagnated and have the least progress, so it’s hard to say what is best. Although I know physio is important for ROM and building muscles, the week I tried 1 crutch (apparently without permission) i didn’t do any of my strengthening exercises (every other week I did them religiously) and this is the week the physio said my ROM and muscles really progressed well. So that would suggest weight bearing does do some of the building that physio is intended to do. However, everyone has a different approach and I hope you find that your recovery goes well. Mine is OK, I think I’m frustrated as I shot out of the blocks but now seem to be treading water (not literally of course, I’ve been advised not to swim, yet another example of everyone having a different approach).

    Good luck, and thanks again to all for your advice, I think a second opinion will do me good.

  551. davidr, on July 16th, 2012 at 6:49 am Said:

    How do you start a blog? I can’t work it out? Thanks.

  552. andrew1971, on July 16th, 2012 at 7:21 am Said:

    Davidr - at the very top of the page there’s link where it says “create your own blog” lcik and follow the instructions, it includes sending an email request to the site owner and takes about 24hrs to get it set-up.

    http://achillesblog.com/wp-signup.php is url in the link.

  553. andrew1971, on July 16th, 2012 at 7:34 am Said:

    Davidr - I’ve been negotiating stairs without the crutches pretty much from the start, I found crutches and stairs an area frought with danger so I’ve always used techniques not involving them.

    Going down stairs is more natural, leading with the bad leg, I can get a good purchase on the step with the heel and the good leg takes the lion share of the weight bearing each step.

    Going up - The boot is bigger than the stairs (the heel overhangs) so going up I stand sideways on to the steps and ‘crab’ up them slowly, leading with the good leg, the boot leg does take FWB for a second, thats when it feels tight… although going upstairs using the reverse of how I descend them is the most comfortable…. but I need the hand rails and can’t carry anything.

    - neither are fast (it’s slow and intentional movements), but I am useless on crutches with stairs and got fed-up of using my backside going up, although I could hop down quite easily, my aim was to work towards normality ASAP without significant risk.

  554. davidr, on July 16th, 2012 at 12:18 pm Said:

    I have an account but still can’t work out how to do a blog. What address do I have to email? Thanks!

  555. davidr, on July 17th, 2012 at 8:03 am Said:

    Hi everyone, I saw my surgeon and physio today and now have some answers.

    They said I have full range of movement (same as my good leg) and I have to stop stretching the achilles as it mustn’t go too far.

    They said my scar healing is a 10 out of 10.

    They said the way I have built up my calf muscle is incredible.

    They were happy with the strength of my tendon.

    The only negative was the strength in my ankle, I need to work on that.

    So I said with all these plus points why do I seem to seemingly be taking so long to get to FWB compared to other people. Their answer was simple.

    They said you walked in here 50 days ago with your foot flopping around (I had the surgery the same day luckily) and said to us “I want to run marathons, snowboard and play football”. All we are doing is giving you the best chance of having the things you want.

    Effectively they explained that if I was a less active person with lower expectations they would have had me weight bearing a while ago. With everything out in the open I said I felt ready now to push things and they have scheduled some physio sessions for Friday and Monday. I feel happier now just having some knowledge of why things are happening the way they are. I’m glad I pushed them for answers and told them how I felt.

    How are things with everyone else, it would be good to hear how everyone is progressing, it’s been a little quiet lately and I feel as though I’ve taken over and it’s somebody else’s turn.

    By the way, I’ve still not managed to work out how to get a blog set up.

    Good luck all.

  556. andrew1971, on July 17th, 2012 at 10:09 am Said:

    Sounds like you were definitely prepared for this recent meeting - makes sense to of expressed yor concerns, asked questions and more importanly got answers.

    Reference the blog - try logging out and coming back on as a guest, then click on the ’start your own blog’ section and follow teh instructions…. it could be you missed the opportunity.

    Happy healing.

  557. davidr, on July 17th, 2012 at 10:25 am Said:

    Andrew,

    I just read your blog from today, I can’t believe are both 7 weeks and 1 day. Having read some of your posts on here about being fully weight bearing I assumed you were ahead of me. What I read on your blog just backed up what I keep discovering,everyone is different on different aspects.

    Whilst you’re ahead of me in terms of weight bearing, other areas are very different. It’s mad just how different everyone’s approach is. I really do wish you all the best and I now have another thing my surgeon said to me ringing in my ears, that I got to 0 degrees in the fastest time possible and that is another reason I couldn’t weight bear early on. I hope you are at 0 degrees soon. Good luck mate.

  558. andrew1971, on July 17th, 2012 at 11:04 am Said:

    Zero degrees, I can do it when I stretch without the boot on or any body wieght involved - so I know I can get there PWB or FWB, but for now it’s a goal, I hope to be ahead of the suggested 4 week curve…. I got the impression both my doc and I believe it’s possible.

    But the nerves get the better of me, I am not cautious per say, but I have a lot to lose if I re-rupture. It’s also in my nature to push, but at my age and experience I now do so within limits ;)

    Embrace the madness and happy healing all :)

  559. Alison, on July 18th, 2012 at 8:33 am Said:

    A brief history, full story somewhere in the April blogs:

    ATR on 23/03/12 I had percutaeneous surgery on 27/03/12 and then in a plaster cast for two weeks.
    After which I was put in a boot fully weight bearing (it hurt!!)
    The boot had wedges in which were removed at two weekly intervals and after six weeks the boot was gone!
    I didn’t see a physiotherapist until two weeks after the boot was removed and had no real idea of what I could do apart from swimming, which I went back to straight away.
    I have now seen the therapist three times and have been effectively ‘signed off’
    I have a few exercises to do and I’ve been told I can go back to yoga and the gym.
    I quite obviously still have along way to go, and as I’m now left dealing with the rehabilitation on my own my big question is when can I wear heels??
    I fear that even when I think my ankle and calf muscle are strong enough I will still be wary about my beloved heels, anyone out there got a clue?

  560. housemusic, on July 18th, 2012 at 10:31 pm Said:

    @Allison,
    I had a full ATR and standard open surgery with a tendon graft to augment/strengthen the Achillies.
    I did four months of PT (twice a week) and went back to the gym last March. It’s been 11 months since surgery and still cannot wear high heels. If I wear anything over 2 inches I limp, I cannot walk at a normal speed, and my calf really hurts. Like you, I love wearing heels and truly hope you have better luck than me and can wear them in a few months!

  561. doryt, on July 19th, 2012 at 12:37 am Said:

    Hmm I don’t get it? In heels, we are in position the same as planter flexation and the AT is most relaxed. I walk great in heels but not so great barefoot. So can someone explain this better. Housemusic you are a AT Veteren, any other comment on this? I put heels on very rarely as I feel like I am cheating. Wearing heels over 2″ is like way better for me. I do put them on sometimes to take a break.

  562. housemusic, on July 19th, 2012 at 1:33 am Said:

    doryt,
    Yes, wearing heels is plantar flexion and the AT is relaxed in this position, but the calf has to do all the work.
    Walking in heels above 2 inches require balance and strength, I have little of both. A stiletto heel is the hardest for me, I can barely walk a few steps, a wedged platform is easier.Keep in mind my calf is completely atrophied and very weak. My balance is also a bit off which I hear is normal with all ankle injuries.
    Perhaps you are farther along in regaining your strength?

  563. Alison, on July 19th, 2012 at 7:10 am Said:

    House music, that is terrible! Is there no therapy that can help? I feel a like a fraud, compared to you I have had it relatively easy.
    Doryt I did try my heels and I agree the achilles for me does feel better, however I am really afraid of twisting my ankle and redamaging the achilles.
    Also my heel is still very sore and most of my shoes rub, I wonder if massage would help, a lot of people on here seem to get that as part of their physiotherapy.

  564. kimjax, on July 19th, 2012 at 8:23 am Said:

    I have some platform wedge sneakers (bought to even out with my Vaco boot) that have a high flat heel and allow me to walk easily and normally! (they’re very stable) BUT - the PT says not to wear them, no heel lifts, because they’re “crutches” at this point. He said I need to walk in running/walking shoes to loosen the AT up. I think he’s right because it’s not always the AT that’s catching, but the sides/front of the ankle where there seems to be tightness or scar tissue. Each day it’s getting easier.

  565. rusky, on July 19th, 2012 at 1:23 pm Said:

    Hi Everyone
    Like my previous posts have said, i ‘only’ tore my AT where you guys have completely ruptured it. Mine happened on 29th June and three days later was put into a cam boot set at 37 degrees to relieve any pressure on the tendon. Today (thursday) i had my first follow up appointment and it has gone well!! the angle of the boot has been altered to 15 degrees and next thursday it will be set to neutral, the doctor was very pleased with the healing. It felt so strange that even though its only been three weeks i could walk something like normal! I have helped it along a bit by removing the boot in the evening and walking barefoot around the house. All in all im a happy chap this evening :)

    Hope this cheers someone up who are ‘nearly ‘ there as well :)

    Rusky

  566. plummy, on July 19th, 2012 at 3:14 pm Said:

    Just past 4 weeks and going ok. If your leg or foot are swollen, try ‘contrast bathing’ - check it out on Google. I hadn’t heard of it until an hour ago when a friend told me about it, although I’d heard of ice baths - this is the budget version! I tried it immediately, it hurt a little, and now my calf and ankle feel great, almost relaxed when I walk.

  567. Hala, on July 19th, 2012 at 4:32 pm Said:

    Hi all

    Just thought I’d post my second physio session. I’m 11 weeks post injury today and out of my cast for 9 days now. I walked into my session on two crutches but with quite a long stride and easy gait, and my physio immediately commented on how much better I was walking since last week. She was pleased with my unassisted DF which has increased from -15 to neutral and my plantar flexion has increased too. She said as I was doing so well I could start strengthening exercises and gave me a theraband to work out with. She massaged my tendon before I left, which seemed to help with swelling and flexibility.

    I was pleased that she was pleased but I must admit I was doing a bit more than she suggested. I have been walking around the house with no crutches and I think this has helped my strength already. I have also been doing additional forced stretches with my foot on the floor, (in sitting position and pushing knee towards wall) which have definitely helped my flexibility. I’m finding it great to hear all the advice from the blog and the PT and then testing my ankle gently to see what it can do.

    Definitely getting better every day. Hope you all are too!

  568. sheena, on July 20th, 2012 at 5:47 am Said:

    Hi all,
    not posted for a while as we had a terrible weekend in this house, I think we are jinxed.

    My 5 year old was playing long jump in our lounge and jumped onto the rug in front of our hearth, the rug slipped and took him straight into a galss ornament which he fell onto. He literally sliced open the side of his chest and had to have surgery to close up the wound. It was horrific and I was on my own and had to pick him up, run to my phone to call an ambulance whilst trying to compress the wound to stop the bleeding. funny how I just forgot about my foot and ran.

    We are all now fine and he is on the mend with sticthes internally and externally.

    Re my ATR, I am now 8 weeks in and walking normally in the boot. My physio said she didn’t want me to walk on it but I felt I could take a few steps so have been doing a little. Hope I don’t live to regret it….I have also been doing the stretches that Hala has with my feet on the floor and pushing my knee forward to get the stretch in the tendon.

    I see my physio again on the 30th when we start to wean off the boot…..

  569. sheena, on July 20th, 2012 at 5:50 am Said:

    Sorry about the typo, that meant to say glass…

    Also, when I say my physio doesn’t want me to walk on it, I meant without the boot on. She wants me to wean of from the 30th as that is my doc’s protocol but I think I can do a little more at home so have….
    Anyone else apart from Hala and I who have not done as we are told?

  570. hillie, on July 20th, 2012 at 6:41 am Said:

    Hi Sheena

    You’re making good progress, sorry to hear about your little boy. He’ll be fine - they seem to handle these things better than us I think.

    We all take some chances don’t we? Important that we confess to our medics what we have done so that they know what works.

    Bye

    H

  571. sheena, on July 20th, 2012 at 9:03 am Said:

    Hi Hillie,
    Yes I will tell her when I see her….did you take any chances and do stuff you shouldn’t?

  572. hillie, on July 20th, 2012 at 11:31 am Said:

    Hi Sheena

    You mean like walking to the loo in the middle of the night at about 5 weeks, barefoot, no boot or crutches? Or going 2 steps up a ladder (with my Vaco boot on) to change a light bulb? Or using my leg scooter (which I had during weeks 3 and 4) at almost go kart speed on tiled kitchen floor?

    No, sorry, can’t recall anything I shouldn’t have done!

  573. sheena, on July 20th, 2012 at 3:59 pm Said:

    Ha ha, that really did make me LOL!

  574. blueross, on July 21st, 2012 at 10:58 am Said:

    Hi All,

    I am new on here and have sent my email with regards to starting my blog. I fully ruptured my Achilles whilst playing football nearly three weeks ago, and have subsequently had to cancel my honeymoon. Will write more about that when my blog is approved. The pain is okay, but looking for so many questions to be answered or thrashed out, but everyone’s rehab seems so very different. My main reason for writing on here was to meet other people from the UK. It amazing how an injury like this consumes your mind. Anyway, Look forward to hearing from you all soon.

    Best wishes,

    Ross

  575. davidr, on July 21st, 2012 at 12:24 pm Said:

    Hi Ross,

    A real shame you had to cancel the honeymoon. Where were you going? You should get the money back with a doctors note (assuming you’re insured) and so hopefully going in 2 or 3 months will be a good goal.

    If it’s any consolation, my fiance dumped me a few weeks before I ruptured my achilles playing football, and it’s resulted in moving home with the parents, so I lost the woman, the independence and the ability to walk all in one go.

    Did you have the op? If so how is the progress?

    Yes, every rehab is very very different, and I think it’s a huge mental hit for everyone, I’m really struggling with the lonliness having only had 1 visit from a mate in the last 2 months, and I’ve not managed to get out as I have no transport. So I think everyone on here has their own battle. In fact I’ve just read up to Sheena’s recent posts which sound awful. I hope all is well with you and your boy Sheena?

    So what stage are you at Rob, and what questions?

    Also I have one for you, what address do you have to email to start a blog, I’ve been trying to work it out for ages now!

    Good luck Rob and good luck all.

  576. davidr, on July 21st, 2012 at 1:03 pm Said:

    I meant ROSS not rob, apologies!!!!

  577. Sheena, on July 22nd, 2012 at 7:49 am Said:

    http://achillesblog.com/

    Hi DavidR,
    I think you can get all the info for starting up your blog at the link above.
    My son is fine now and having his stitches out tomorrow but it was horrible at the time.
    Ross,
    it is a real pain and hope you manage to move your honey moon on. I look forward to reading your blog.

  578. blueross, on July 23rd, 2012 at 6:42 am Said:

    I sent an email on Friday morning about getting my blog started, but haven’t heard anything back as yet.

    I am three weeks in today, and there is so much to write. So many short term/ lomg term goals that I now want to accomplish. I am hoping my blog email is approved so I can try and write everything down chronologically, especially as so many things keep entering and leaving my mind so quickly.

    DavidR,
    Sorry that things sound so rough for you at the moment. I plan on using this website as a bit of positive therapy and rest bite. Hope you are able to do the same.

    Sheena,
    thank you for coming back to me and I am delighted to hear that your boy is on the mend.

    Best wishes to all…..

  579. davidr, on July 23rd, 2012 at 3:06 pm Said:

    ROSS, how are things progressing? Where was the honeymoon and what’s the news with the insurance?

    Sheena, how is your boy doing now? And how are you? We are 8 weeks today. I think it’s fair to say that represents 2/3 of the way to 2 shoes. speaking of which, what is the definition of 2 shoes? I take it to mean no boot, no crutches, walking at a normal pace and hopefully with normal biomechanics. The real goal is rush hour London tubes and being forced to walk at speed up escalators, I wonder how far this comes after 2 shoes?

    Hala, how are you progessing?

    Andrew, is it 8 weeks for you too today? It would be good to see how you are getting on as you had longer in the cast than the rest of us if I remember.

    As for me, the mental effect for me is still huge, in over 2 months since rupture the only time I have left the house is to go to the hospital and I’ve only had one visit from a friend, and as I mentioned have had to move back with the parents. I ignored my 32nd birthday as a waste of time and it’s basically just a waiting game to get my life back. I think psychologically August will be big, as I intend to that to be the month of transition from crutches to walking and seeing a bit of the outside world again (there isn’t even a garden option at the moment), and then in September I move into my own place for the first time ever, which will be a big, erm, step. I’m due to be going to 3 Olympic events, so that will be my first big battles, fingers crossed. Is anyone else going?

    On the physical side, I had physio session number 8 today. 8 weeks ago at this time I was being cut open, so I guess 8 sessions in that time is progress. My next session is next Monday. I’m now in the FWB club. Again, some differences from others, we all have a different protocol. I’ve been told bare foot only, stay away from heels and wedges. I think it’s all part of my desire to return to some extreme sports, the physio and surgeon want to keep it a bit conservative, without cutting corners, and pushing me to do everything the hardest way possible. So ahead is a week of exercising indoors and trying to build the muscle. Then next week……my exercise bike arrives, and I take the first, erm, step on the ladder to my new goal, cycling London to Paris in September 2012. I always need an ambitious goal to focus on, and having watched the whole Tour de France I’ve been inspired. Also, for some more inspiration look up Alex Zinardi, amazing guy and puts what we do into perspective. I’m going to see if it’s possible to see him in London when he races in a few weeks.

    Anyway, i hope everyone is progressing and not going backwards, those backward steps are horrible. I think there should be an achilles club in London where people can meet as they rehab.

    By the way, I don’t seem to be able to do a blog as I didn’t set it up from day one, have been trying to set one up for about 3 weeks without success now. Hence such a long message on here.

    As always, good luck all.

    David

  580. andrew1971, on July 23rd, 2012 at 3:39 pm Said:

    David, all good here,

    RoM is progressing well, self adjusted the boot to 7.5degrees but think the way the boot is set up that it is closer to neutral in reality.

    Drove my car on the weekend too - see my blog for more updates.

    Like you I have been relatively housebound but I am feeling more free now - but I am not walking too far maybe 100mtrs max right now… it’s been a big weekend with the driving and boot adjutments.

    I can do the things that I really pushed to do and now I can let the rehab run itself again for a while…… until I get the next itch that needs scratching…. which will be a complete return to duty for work (currently nailed to desk duty) target is no later than August 20th :)

    Happy healing all.

  581. David, on July 23rd, 2012 at 4:54 pm Said:

    Hi All,

    Sheena, sorry to hear about your boy - glad he is on the mend. He’ll bounce back quicker than us!
    Just dropped in to see the club is still growing, I wish you a speedy recovery.
    I am not 2 weeks out of boot (9 weeks from op) and am walking fine (after a few steps with a limp) almost back up to my old speed. Walked 2 miles @ the weekend no problems - had to slow down when shopping as I realised I was pushing it a bit so DavidR you should be fine on the tube. Surgeon said take it slow for 3 weeks and then do what you like. I have a 5mm wedge in each shoe but that will go next week. Also, I am a bit tight in the calf, can’t bend at the knee to kneel down but that will come with time and I get a pretty swollen (c)ankle but no pain.
    Driving to France next week - HOLIDAY!!!!!
    Good Luck all.

  582. sheena, on July 23rd, 2012 at 5:25 pm Said:

    Hi Guys,
    both Davids!
    Well it sounds like all is going well for you two.

    DavidR,
    you sound more positive which is really great to see. Glad you have some goals and it looks like you have moved on a bit more than you expected which is great. My lad had his stitches out today and he’s fine…He has been braver than his mum!

    Andrew,
    I know where you’re at!! Had a go on the pedals myself today and may leave it a few more days before driving for real.

    David,
    your progress sounds amazing and really very encouraging, can’t wait until I can just got to do the food shoppong, which I hate hate with a passion and can’t quite believe I’m saying that. My lad is fine thanks. Has a cool scar he can sport when he’s older…

  583. davidr, on July 23rd, 2012 at 6:27 pm Said:

    I of course meant to say London to Paris 2013 in my previous post, I’m not a madman!!!!!!!

  584. sheena, on July 24th, 2012 at 4:02 am Said:

    David,
    can I ask if you still feel a lot of tightness in your tendon when you walk?

  585. David, on July 24th, 2012 at 10:28 am Said:

    Hi Sheena,

    The tightness is located where I think the tendon joins the muscle but when I walk I don’t feel any tightness even when pushing off onto my toes.

  586. andrew1971, on July 24th, 2012 at 11:37 am Said:

    Hi David/Sheena,

    I get that tightness that David just described “located where I think the tendon joins the muscle”, it most apparent when I’ve been stretching to gain more dorsiflexion, when I wake up in the morning and especially the first day after my boot adjustment.

    I don’t push past it when stretching, but I stretch/pull up close to that point and that tends to make it go away….. again like David though, it’s not a pain I get when walking or trying to push off on my toes.

    Such a local tightness rocks my confidence though, especially as I am entering the 8-12 weeks, which I consider to be the highest risk of re-rupture.

  587. davidr, on July 24th, 2012 at 11:43 am Said:

    Guys, we’re all at the same stage. As far as I can tell from conversations with my physio and surgeon the tightness is perfectly normal. I believe the scar tissue formed is the primary reason, and time, PT and massaging the tendon will all contribute to helping with scar tissue over the next 4 weeks. Degeneration in our calf muscles and obviously the initial shortening of the tendon will also contribute. Keep up with the exercises over the next few weeks and we should all see an improvement.

    Good luck all!

  588. blueross, on July 24th, 2012 at 1:35 pm Said:

    Dear All UK’ers…

    I have just started my blog today and really pleased (all things considered) to be here. Am looking forward to lots of positive banter please.

    DavidR - Not been on here for 24 hours, but hope you are feeling well?

    Cheers,

    Ross

  589. davidr, on July 26th, 2012 at 5:44 am Said:

    Guys,

    Once you have got to FWB stage what PT exercises have you been given? Also, people on the same timeline as me Sheena, andrew1971 and eva10 (I think we are all on the same day) what exercises are you currently doing?

    As of Monday just gone, I have been told no theraband, all of my exercise are now standing up, I have 3. One is to stand and transfer weight from foot to foot, lifting the other foot off of the floor (I can’t even manage 1 second on the operated leg). One is to stand with my good foot on the ground and roll my bad foot from heel to toe to get it used to that movement for when I’m allowed to walk. And the final one is heel raises on my GOOD foot only, as they have said issues with my good achilles will stop me walking if I don’t sort them. From next Monday I will be allowed three 5 minute sessions a day on the static bike with zero resistance.

    It’s very frustrating living in London nearly all of my life and being effectively housebound during a once in a lifetime event like the Olympics. I’m going to try to get to the 3 events I have tickets for, but will be missing all of the free events and sociable goings on around the city which is a shame, especially for a huge sports fan like myself.

    Ross, how are things with you? What’s the latest on the boot?

    Pauls, how are you? You seem to be progressing at a very nice rate.

    I hope all are well and recovering. It’s a slow process, but we will all get there!

  590. andrew1971, on July 26th, 2012 at 7:29 am Said:

    I was told by the junior doc who saw me last time that no physio until I lose the boot….because I choose to hang onto the boot for safety rather than necessity (I can do two shoes just read my blog for reasons why I don’t), Tuesday’s appointment will be a little forceful I hope to see the main man, display my current state and look for physio ASAP.

    At home right now, the exercise I am doing is walking more, seated heel lifts, rotational movements and walking normally up and down the stairs (each leg takes a single step and is FWB) - in the shoe I push more onto the ball of my foot and also I do a lot of flexing in the boot using the RoM provided as a resistance source and apply force against my dorsi/plantar limits each for 10 seconds :)

    I have a set of therabands here (Red, Green, Blue) but not used them yet - was not sure how to be honest lol :)

    Happy healing all.

  591. andrew1971, on July 26th, 2012 at 7:31 am Said:

    PS: David R - here’s hoping you find strength, mobility and confidence in a boot to engage in some more of the olympics than you first anticipate - listen to your body and work to those limits :)

  592. davidr, on July 26th, 2012 at 8:32 am Said:

    Andrew, walking up and down stairs sounds amazing! I hope my physio lets me try this at some point. I can imagine up not being too bad, but I can’t see how I can even be close to down yet.

    As for the olympics, it’s the crowds that are the issue as much as anything. I haven’t travelled anywhere since my injury except being driven to the hospital. I can’t see how would be able to navigate London during the next 2 weeks.

  593. hillie, on July 28th, 2012 at 1:03 pm Said:

    Power plate gym machines - advice please.

    During your rehab work have any of you used power-plate type machines in your exercise routines? If you have, have they been effective in helping to increase your strength and mobility?

    The gym that I joined recently has a number of these (Technogym in this case) machines and, as I’m at 20 weeks, my physiotherapist considers it ok for me to use with my exercises.

    Any feedback appreciated.

    Thanks

  594. starshep, on July 28th, 2012 at 4:15 pm Said:

    Hillie:
    I’ve used a variety of plate machines throughout my rehab. My blog details their use starting with achillesblog.com/starshep/2012/05/21/summary-of-first-11-physical-therapy-sessions/

  595. hillie, on July 29th, 2012 at 4:28 am Said:

    Thanks Starshep, I’ll take a look.

  596. Jaxx, on July 30th, 2012 at 6:01 pm Said:

    Hi guys,

    I’m at the ‘boot and physio’ stage of my treatment, 10 weeks in. Went non surgical (although it didn’t really feel like a choice, more a directive from the NHS). The rupture in my left tendon has apparently healed but after 9 weeks of non weight bearing my leg won’t hold any weight so I’m under instruction to keep using the crutches and wear the boot. I have an Aircast boot but find it higher than my Nike trainer, making me a bit lopsided. I’ve heard than MBT shoes are good for this injury and they even up my boot but does anyone know if they’re suitable for wearing after the boot comes off?

    There’s also loads of really useful on this site that I’ve only just discovered, can you promote yourself a bit more? I would have loved access to this when I initially caused the rupture. It’s been a long, emotional 10 weeks and the info I’ve had from the hospital has been limited to say the least!

    Also, any tips on keeping my patience and exercises for keeping my weight down when I can’t walk would really be appreciated!
    Jaxx

  597. Alison, on July 31st, 2012 at 9:25 am Said:

    Hi Jaxx,
    I’m also NHS, but in my case I was told surgery was the right option (I think more to do with the trial the surgeon was conducting) but I’m grateful none the less.
    I was FWB at two weeks after the op and consequently I probably had less muscle wastage. I still have a way to go but at 18 weeks after the rupture I feel well on the way to recovery.
    I had my MBT’s before my accident and found they were very comfortable then, and came in handy when I was in the boot!
    As for keeping patient, no idea, just keep in mind that it will get better………………….
    Alison

  598. jaxx, on August 1st, 2012 at 5:25 am Said:

    Thanks Alison, am going out today so will give it a go. Oh to wear matching shoes! :)
    Jaxx

  599. sheena, on August 1st, 2012 at 5:56 am Said:

    Jaxx,
    I have no idea why you have been NWB for sooo long.
    Why have they not let you weight bear for nine weeks?
    I was PWB from day one and most people start to PWB after two weeks. Was there a problem with your ATR?
    Re the MBT’s, I have too used them but have found that they are too tricky to wear when I came out of the boot but the one trainer is fab whilst you’re in your aircast. I’m not your doctor but I would try to bear a bit of weight on your leg using your crutches and build up a little every day. You need to use that leg. Re MBT’s again, I think they could even bit a bit dangerous once you come out of the boot as they wobble sideways and you could easily go over onto your ankle. I haven’t used them in two shoes I have stuck to a good pair of running trainers.
    I hope physio helps you regain your strength quickly.

    Patience,
    I don’t have any of that either but found once I got my boot at 6 weeks and could FWB from the moment I got it then life changed very quickly. Yours will too once you can ditch those crutches.
    I found this site just by searching relentlessly for info over the weekend that I did my tendon.
    You are over the worst now and should see benefits coming really quickly.
    Good luck.

  600. jaxx, on August 1st, 2012 at 6:22 am Said:

    Me again, thanks for the advice on the shoes, will try it. I had a complete rupture with very damaged ends but I don’t think it was particularly special. Maybe an overworked NHS…… At least I got glitter on my casts!
    Jaxx

  601. David, on August 1st, 2012 at 3:02 pm Said:

    Hi all,
    Sorry to see more new contributors here (if you see what I mean)
    I am now about 12 weeks post op and am walking fine in normal shoes but still have quite a lot of swelling by the end of the day.
    It’s almost like a sprained ankle. Does anyone else suffer this?
    I am on holiday in France so a quick visit to the doc or physio for reassurance is a bit tricky !

  602. andrew1971, on August 1st, 2012 at 3:43 pm Said:

    I can only tell you what I have found reading all the blogs on this fantastic site, it’s a really good investment in time, I recommend it :)

    From what I have read here, the swelling is something that continues for many months in varying degrees - I think it’s normal for it to subside with a good night’s sleep.

  603. starshep, on August 1st, 2012 at 5:51 pm Said:

    David,
    I’m at 23 weeks and still have some swelling by the end of he day. If you’re not already using them, compressions socks help a lot.

  604. jaxx, on August 2nd, 2012 at 6:48 am Said:

    Hi David,

    10 weeks non surgical, still lots of swelling and it gets worse at the end of the day. I put my feet up higher than my hips and it tends to go down a bit.

    Mine looks exactly like my ankle did when I had a bad sprain but without all the bruising!
    Glad you’re recovering and jealous of your shoes!
    Jaxx

  605. JamieH, on August 2nd, 2012 at 5:14 pm Said:

    Hello All,

    I’m 41 and (was) relatively fit until I ruptured my right achilles playing badminton in March (2012) on an evening when I’d done more warming-up than usual!
    My treatment has been on the NHS in York and involved surgery a few days after the injury, then six weeks in an aircast boot, non-weight bearing with three heel wedges, one of which I removed every two weeks.

    Everything went well but ten days after “losing” the boot, having started walking without crutches and cycling (on physio advice), the tendon re-ruptured when I was stepping from the patio back into the house.

    After the re-rupture, I had another op, which included a transfer of my “big-toe tendon” to the achilles.

    I’ve been in a serious of casts for the last eight weeks, with new casts to set my foot at a different angle at weeks 4 and 6. I’ve now been out of the final cast for ten days, have heel wedges in my normal shoes (one of which is very tight due to the swollen foot that’s in it!) but I’m still walking very carefully with crutches as I’m fearful of a third rupture.

    I have hardly any movement at all in my ankle and don’t see a physio for at least another week or so.

    I’ve found it very interesting just how many different ways of handling the ATR have been reported on this great blog, I myself have had two consultant surgeons telling me wildly different prognoses so it’s good to know I’m not alone in that even if it isn’t particularly re-assuring.

    Sorry this has ended up being a much longer post than I’d anticipated but I wondered if anyone had had the same (tendon transfer) op and could give me any advice on rehab etc.

    Thanks,

    Jamie

  606. housemusic, on August 2nd, 2012 at 6:13 pm Said:

    @Jamie,
    Greetings from Los Angeles. Very sorry to hear about your re-rupture, you are the second one as I saw another blogger, Hood, who also re-ruptured.
    I ruptured my Achilles last September, and had a large gap, 2.5 inches. The surgeon did a “tendon augmentation” using my Plantaris tendon. The purpose is to make the tendon thicker and possibly stronger by grafting tendon tissue onto the repair.
    I am now 11 months post op. The tendon transfer is visible, I have a very thick, bumpy Achilles, and it feels strong.
    I was in a cast for only 7 days. After that, I went PWB with boot and crutches for another 8 or 9 weeks. At that point I started Physical Therapy and went twice a week for 3 months. I compare notes with other people on the blogs and it appears I have healed somewhat slower than average, and regaind less function than others. I do not know if this is due to the tendon transfer and the graft taking longer to heal. My doctor and Physical Therapist did not order a special protocol, I just followed the standard PT for Achilles rupture. I did not have much movement for the first 5 weeks or so, but that changed quickly once I started PT.
    Good luck on your healing, keep us posted!

  607. mountainmarco, on August 2nd, 2012 at 6:47 pm Said:

    @Jaime,
    I re-ruptured my achilles tendon on June 18th. Had originally had a “severe pull” in February and opted for the conservative approach because the MRI showed no tear (should have gotten a second opinion). Fast forward 4 months and I re-ruptured in Physical Therapy on my last exercise to be discharged (one legged jump and stick of landing). I was devastated, just the look at the PTs face after that loud pop was enough to make me start sobbing. I had surgery at the Steadman Clinic in Vail, they did the Big Toe FHL transfer to reinforce my tendon. I feel your pain, and just hope I can be super careful this time around. I was doing everything they told me the first time around, sometimes shit happens.

  608. JamieH, on August 3rd, 2012 at 10:53 am Said:

    Thanks for your really quick responses. After the first rupture, I was trying to go quite quickly with the PT etc in an effort to get back to normal as soon as possible.
    Wow the Steadman clinic! Richard Steadman is even famous here in the UK for his work with British sportsmen so it looks like you’re in capable hands!
    Like you, I’m being super-careful this time round but finding it hard to be patient!

  609. David, on August 3rd, 2012 at 3:46 pm Said:

    Thanks for the reassurance, as I said I am in France on holiday so internet is sporadic, expensive and on my phone so difficult to read.
    Was just worried that I was doing harm and was in danger…..then along came Jamie!
    Jamie, I can’t imagine what you are going through with a rerupture. I feel sick just thinking about it,.
    Hope it all goes well second time around :)

  610. two4heels!, on August 3rd, 2012 at 5:25 pm Said:

    A big thanks to Sheena who has been very supportive with concerns that I have had. I am also hoping that others may also have some comments to add , especially with regard to today’s appointment.

    I will try to give a brief background (a few problems along the way - but I think it is more positive than it reads!!!):

    > ATR 5 weeks ago - non-surgery, conservative treatment (begun within 2hrs of the injury - excellent!)
    > 5 equine plastercasts in first 3 weeks - due to coldness, numbness and abrasions (I’m also a Type 1 diabetic so medics are v hot about feet!!!)
    > Wk3: Boot unexpectedly fitted with 4 wedges (sadly, without guidance from the consultant regarding weight bearing and advised that my next appointment would be in 10 weeks time : (
    > Wk 4: returned to hospital! - boot relaced with a smaller one (the first was, as I thought, too big!!!) The base wedge was removed (as it was actually a fifth wedge and not a fourth, so my foot sat mostly on top of it - explaining the pain, when my foot was put in!) The nurse was extremely helpful but unable to answer my concerns so I booked another appointment for Wk 5.
    >During the fifth week I thought I’d progressed well - going to NWB for some of the time…However…
    >Wk 5 (today). I saw a consultant (number 4 - I have never seen the same person!) asked lots of questions but I am still confused about one part! I am now removing wedge 3 (fairly ineffectual wedge 5 removed at wk 4 and wedge 4 not present!) and my AT does feel ready to be on the 2 wedges but I have been told I should use two crutches at all times, as I am risking lengthening it too quickly and should do as little walking as possible. How does this fit in with the experiences of others? As with all of us, I don’t want to do anything to jeopardize the successful healing of my AT but have gone from feeling that I was making good progress to being concerned that I will ‘over-lengthen’ it!!!

  611. mountainmarco, on August 3rd, 2012 at 6:09 pm Said:

    @Two4Heels, I can give some insight. I severely pulled my Achilles on Feb. 15th playing basketball. MRI showed no tears. Went with the conservative approach. Was in a splint for 2 weeks then moved to the Bledsoe Achilles boot for almost 2 months. I started with a very high heel lift. I did not wear the boot to sleep and I took bathes without it. I would take it easy. When I got out of the boot April 22nd, I really went after it. I built up amazing amounts of scar tissue. I thought I was doing well, but my Achilles just looked messed up and bulky. I ended up re-rupturing again at exactly 4 months from the injury. I was devastated. I would just like you to utilize my experience to be patient with this injury and take the small wins day to day. You will hit plateaus, so it can be easy to get discouraged. I think if you go the conservative route you have to have the mindset that it will take a long time. I was initially told because I did not tear it that I should be back to normal in 4 months. This was wrong. My estimates should have been double that more like 8 months. That would have set expectations in my head. Either way, my only point is that you have a doctor telling you to back off a bit, or if it starts hurting, you should listen. I did everything they told me and still popped it at Physical Therapy on June 18th. That has to be one of the lowest lows I have felt so far in my life. I hope it does not happen to you or to anyone for that matter. Some things that are different in regards to the boot the second time around. I was told to wear the boot at night and was told it was important. That boot should be on at all times except for my ROM and strengthening exercises and taking a bath. This was the direct opposite from the 1st doctor (Podiatrist). Also, transitions from two crutches to one crutch, 1 heel lift to another, boot to shoes should be taken gradually. A meticulous plan regarding these transitions will help you. I find that since this injury takes so long to heal, it is easy for your mind to get off track on what you need to keep doing. For not this time around, if I rupture again I do not know if there is a plan C. I had the FHL transfer one on my Surgery because of a re-rupture. I hope this comment helps. Take care and heal well.
    -marco

  612. two4heels!, on August 3rd, 2012 at 8:57 pm Said:

    Hi Marco - Thanks for your response. So sorry to hear that you reruptured. …and yes your comments have helped.

    I had already started being careful regarding any running or impact sports after major surgery 2 years ago, when my ATs appeared weaker - I think I now know why…I was on ofloxacin for 2 months but not told of the potential side effects!!! I don’t think there is anything that anyone will say to me that will convince me that those antibiotics have not had a part to play in my current situation.

    I think the trickiest part at the moment is that I have seen 4 different consultants and they have all said something different - or in the case of number 3 virtually nothing! This was when I went into my first boot at week 3 and was told I could go back to work full time and he would see me in 10 weeks!!! I felt totally isolated (Sheena was really supportive). I felt more pain at that time than with the initial injury - with more bruising occurring than at any other time (having had 5 casts I’d seen my leg regularly)!

    Fortunately, (despite it being really difficult in the first boot that was too big - think it was man’s size 6 upwards, and I’m a ladies 5!) I have been sleeping in my boot…that does seem to be something that the consultants appear to agree on!

    I think I just need to be a more respectful of my injury and accept that I do not wear my underpants on the outside and am not related to Superman!!!

  613. sheena, on August 4th, 2012 at 1:45 pm Said:

    Molly,
    glad I could help. Nobody knows you better than you so stick with what feels good and glean what you can from this fantastic site….

  614. badge, on August 4th, 2012 at 8:15 pm Said:

    I got a full rupture nearly 5 weeks ago and decided to go the conservative route. The cloud of re-rupture hovers over my head most days.

    My leg was in a fibre-glass cast for 4 weeks and then moved into the aircast boot after that. Been in the boot for 3 days and managing to FWB. But still take my crutch/es out when I go outside for longer walks.

    It’s a shocking thing to have happen. I’ve never been without fully working legs. I’m trying to stay positive and I hope it’s working. You have to shift your thinking to accommodate a new ‘you’. Life slows down.

    I’m lucky (or unlucky, maybe) - because I”m on annual leave at the moment and will be for the next few weeks - so I can completely shut off from work thoughts.

    Putting the injury into perspective helps. Makes me appreciate my arms and remaining healthy leg.

    Plenty of nightmares about feet though. Most nights a tendon somehow sneaks into the storyline of my dream.

    Before the ‘pop’ - I used to be a regular gym goer. And wine drinker. Both have stopped. To compensate - I’ve started exercising with dumbbells on the upper body (at home, while sitting in a straight back chair) and it helps a lot. It’s the feeling of inactivity that can be so draining. Fizzy low cal drinks have replaced the wine.

    Soon after the rupture, I watched a Ted Talk (link below) that also helped reframe my thinking. It’s definitely worth a watch.

    http://www.ted.com/talks/lang/en/jan…s_of_life.html

    My leg really starts to swell at night. Also now I’m in the boot I can wash my foot. Lots of horrible dead skin. Not the most fragrant smell of summer.

    I did leave some posts on another achilles web blog - but decided to move myself here because of more activity.

  615. badge, on August 4th, 2012 at 8:22 pm Said:

    The link to the TED talk doesn’t seem to work - a search for

    Jane McGonigal: The game that can give you 10 extra years of life

    will give you the result. I’ll also try the link again too.

    http://www.ted.com/talks/lang/en/jane_mcgonigal_the_game_that_can_give_you_10_extra_years_of_life.html

    Also while I’m back - I’ll also say I did go to the gym yesterday to do 10 minutes on my legs (leg extensions, really light weight). The doc said I should try to exercise around the injury. Legs really sore today after being pretty dormant for 4 weeks.

  616. JamieH, on August 6th, 2012 at 6:24 am Said:

    Hi All,

    Thanks again for the kind words. Yes, David, I was pretty low after the re-rupture but another short spell in hospital quickly helped put things in perspective and reminded me there’s an awful lot of people considerably worse off (healthwise) than me!

    Marco mentioned plan C after a re-rupture. Last time I saw my surgeon, I asked him what would happened my achilles ruptured a third time. He said he’d never known that happen (after a tendon transfer) but said he’d have to transfer a tendon from somewhere else, probably the hamstring.

    I don’t think I mentioned that I’m now in normal shoes with two heel pads in each shoe and PWB with two crutches. My foot and ankle are still pretty swollen despite almost constant elevation so the shoe is a tight squeeze and pretty uncomfortable so I might try some contrast bathing.

    I finally got a physio appointment for this Friday so I’ll report back on that later. Good luck everyone!

    Jamie

  617. mountainmarco, on August 6th, 2012 at 8:25 pm Said:

    Nice to know here is a Plan C. I was not told up front that I was going to have an FHL transfer, but it was not good in there. I had built up so much scar tissue from being a stubborm bastard and hiking/exercising too much. Manage that swelling is all I am saying. All about transition.

    I ended up finding out I had FHL from PT because I sucked at scrunching the towel. You literally cannot do it. So it was a bit of a surprise to me. Will be sure to talk to Doc extensively about this and will know more info soon.
    They should have told me at some point by now. New PT folks felt bad telling me. Kinda just want some good news. That big toe could be a big deal in regards to getting back to barefoot running, which I really do love.

  618. JamieH, on August 7th, 2012 at 12:33 pm Said:

    Dearie me, I thought I’d suffered with a lack of communication from (and within) the NHS here in UK, but I’ve had nothing as bad as not being told about the FHL transfer. That is unbelievable and you do have my sympathy Marco.
    I can move my big toe a little bit and a surgeon told me that some other tendons and muscles kinda help out a bit but I don’t know anything about barefoot running I’m afraid. I hope you’re OK on that score in future.

  619. davidr, on August 12th, 2012 at 10:30 am Said:

    Hello all,

    I hope everyone is recovering well.

    I have a few questions. I am 11 weeks post op, but I don’t seem to be progressing very well. I ask these questions to my surgeon and physio but just get the answer “everyone has a different recovery”. This doesn’t really help me with my work life or my (lack of) life outside the house. 3 months couped up without being able to go out is not fun.

    So, I read on here a while back about someone who could balance on their operated foot (one legged) for over a minute around the 7 week mark. I am at 11 weeks and can’t even manage a second balancing on the bad foot, not even close. I am doing loads of ankle strengthening exercises but have made no progress in over a month. I seem so far away, if I can’t do 1 second it seems like it will be months before I can balance for a minute, or even 3 or 4 seconds.

    I also read about someone at the 7 week mark who was walking down stairs using alternate steps, again I cannot even begin to get close to this, I can’t even take my good foot past my bad foot coming down stairs. And I always need to hold on to a bannister going up or down. It all just seems so far away. If there was progress I might not be so worried, but I seem as far away as I was the day I started PWB.

    Lastly walking, I see others are walking aoutside and crutch free by now, when are people able to walk normally without a limp?

    I just don’t seem to be seeing any progress from week to week but my physio seems unconcerned.

    Anyway, I must be the only person in London glad that the Olympics is ending today, it’s been hard seeing my friends pictures who have been using my tickets, and also seeing several events going past my office where I should be working.

    Good luck all and I hope you are making swifter progress than me.

    David

  620. Dollydaydream, on August 12th, 2012 at 12:53 pm Said:

    Reading this with interest, seems I have a rupture as of Thursday night keen to see consultant on Tues. Will insist on a scan or xray, real bummer never done this sort of thing before. Is there somewhere, a blog or thread that gives a step by step guide what to look /check for at my stage pre-initial NHS consultation or must I plough thru all the postings? Having read thru all this I never realised it could take so long….loss of earnings is a real worry to me now, not been here before!

  621. starshep, on August 12th, 2012 at 3:59 pm Said:

    davidr
    Yes everyone’s recovery is different. And recovery is not always linear. It often comes in spurts with periods of no recovery in between. You can sometimes measure your progress in weeks, sometimes in months. As long as your doctor and physio see no problems like a re-rupture, you are still on track for a recovery.

    While it is interesting to see the progress of others and compare it to your own, this is not a competition. I am at 25 weeks and still can’t do a single-leg calf raise while others with less time in their recovery can. Frustrating? Yes it is. So I chose not to think about it so much and work on my own exercises. As far as walking without a limp, I still have to concentrate on it and am not always successful. Hang in there and remember that for most people, it is a 6-12 month recovery.

  622. nutkin, on August 12th, 2012 at 5:00 pm Said:

    Hi David
    I had my Achilles lengthened back in Sept of 2011, I was told approximately about 1yr till recovery. However, because I had some other issues with my leg they weren’t 100% on the timeframe, and I recently have found out that it is probably about another year until I receover fully.

    I don’t think it was until about the 6 month mark that I felt I had some control over the leg I had the surgery on, and even today it still swells, feels sore and hampers how far I can walk. However, you got to look at the small things, even making your own cup of tea is a success.

    What I will say is this, you need to ensure you are provided with the info you need to keep a sane mind. After having worked with a number of physios with regards to my leg issues, the reason i have stuck with the guy I have now is that he provides me a structured plan of what I need to be doing at home and at the centre with him. He also provides me with information to help me understand how I can identify my limits better.

    I personally found going back swimming was of great relief, although I wasn’t able to use my legs for a while using a pullboy (floaty device that you put between your legs to keep the legs afloat), just being able to move at a normal rate was great. The local pools I go to have a wheelchair so that I could safely get in and out of the water, one of the life guards just had to roll me in or out (I did choose quieter times to go so I didn’t feel threathened by other people coming near my leg).
    Good luck and remember small steps.

    Karen

  623. kimjax, on August 12th, 2012 at 5:04 pm Said:

    DavidR - ditto what Starshep said. I’m at 14 weeks and go down stairs backwards - holding one to the bannister - when I’m in a hurry. I can go forward, but have to put my injured leg on the edge of the step to get the bend. I’ve got good strength - but my injury was pretty ugly and I have very little DF which causes most of my limitations. Still, my progress is always forward and I gain a little each week.

    I was the same as you with balance - but it all came back within a week or two at around the 9/10 week mark. The docs had me doing standing leg lifts (front, side, back) to help with balance. I’ve made amazing progress, and much has to do with your hip and buttock muscles - not just the ankle. Check out the rloop band thingy on my blog - it works great for balance leg lifts once you can do them alone (without hands) It really strengthens the upper leg and hips to help the ankle and foot.

  624. Andrew1971, on August 13th, 2012 at 5:57 am Said:

    Davidr,

    I can only support what other people have said - each case has it’s differences and it’s own little quirks - it’s not impossible to think that your surgical repair could of been a tricky one and it could be you are in a similar situation to kimjax and/or maybe u have some scar tissue to breakdown just to get you more RoM.

    To me it sounds like you are doing everything right so getting improvements will come with continual physio…… do you get any feedback from your ankle that there maybe other issues from the ATR incident (sprain, ligaments etc)?

    I am using therabands to stretch my dorsiflex when I sit watching TV, then when I simulate pressing down on the accelerator of the car and holding my foot in full plantar against the bands resistance (using yellow right now) and finish off with my foot in neutral then against the resistance I rotate the foot and practice inversion etc….. but to regain some balance you’ll need to work all the legs muscles and some try some core work maybe?

    I share with you the frustrations of being housebound I have been in a similar place (found freedom at around 8weeks though when I could drive) and all I can say is that I am happy that I like PC gaming online (world of warcraft), shopping online, facebook and most importantly that I found this blog.

    Stay positive, keep working at it and never give up :)

    Happy healing :)

  625. davidr, on August 14th, 2012 at 3:54 pm Said:

    Hello all,

    I have a question.

    Yesterday I went to physio, she told me to do calf raises over the edge of a step, I did 2 when there with her and said it felt tight and painful on my good achilles as if it was going to tear and it seemed counter intuative, I was given a story about how the exercise was actually discovered by someone trying to tear their achilles and it actually made it better.

    Anyway, I just tried it at home for the first time, on rep three I felt a huge tear in my good achilles along with a ripping sound. Very distinct sound and feeling. Is there any way at all this isn’t an achilles tear on my good side? Is there anything else that could give such a feeling and sound from the achilles whilst doing that exercise? If not it’s back to square one after 3 months, which would be ironic having been told yesterday that my good achilles is not the one I want to be worrying about. After everything I’ve been through I’m sat here feeling pretty terrible right now.

    Thanks in advance.

  626. ryanb, on August 14th, 2012 at 4:09 pm Said:

    Davidr… I think you know the drill:

    Thompson test: do you pass?
    Can you feel a tendon back there? Or is it a gap / puddle of mud?
    For those of us with unfortunate experience, it should be pretty easy to diagnose a complete rupture/tear.

    If you’ve got a complete rupture, then unfortunately, I think you are back at square 1.

    If you pass those tests (positive response to the Thompson calf squeeze, seem to have a contiguous tendon by feel) then I’d probably suggest seeing your ortho, and getting an MRI to try to assess what damage you have done.

    Good luck!

  627. davidr, on August 14th, 2012 at 4:25 pm Said:

    Thanks Ryan,

    As I said, it’s a tear. I’m just hoping someone can tell me anything else that a tearing feeling and sound in the achilles whilst hung over the edge of a step could be. The sound, feeling, pain etc. I know what it is, I just want someone to tell me it isn’t.

  628. Andrew1971, on August 14th, 2012 at 4:35 pm Said:

    Davidr,

    If it’s your ‘good’ ankle then something’s wrong and you should be at a&e now - if it’s your bad one and you felt tearing then, at best it could just be scar tissue from the stretch - at worst, you’ve ovecooked it and your back to square one.

    My physio assessment today recommended not to try calf raises at this point but everyone heals differently within the normal timeframe but heel raises are a big ask of the tendonfor me at 11 weeks.

    Either way, it’s best to get down to the a&e asap and start the process of diagnosis.

    Fingers crossed it’s good news.

  629. davidr, on August 14th, 2012 at 4:40 pm Said:

    It’s my good one. Since a few weeks after the left one going I have been complaining to the physio and surgeon about the right one as it has been agony, I assume from taking all the weight. When I went to physio yesterday and she asked how my achilles was I told her the ruptured one was ok, but as usual the good one was agony. She said not to worry and gave me calf raises, I protested due to the pain but was told it can’t do any harm. There was a distinct tearing sound and feeling in the good achilles. I now have pain and bruising. I called my bro in law who is a paramedic and goes to the local hospital ad he said there is no way they will be able to diagnose a tear and they would just refer me. So I will call the hospital where I had my op tomorrow. It’s very normal for the good achilles to go isn’t it.

  630. ryanb, on August 14th, 2012 at 4:52 pm Said:

    Well, here’s hoping for a partial tear/strain; not a complete tear, back to the starting line, type of injury.

    I guess the only consolation I can offer is: if it tore just hanging off of a step, then it was going to fail at some point in the near future anyway. There’s really not anything you could have done to avoid it. If it was that weak (and your other one has already failed), it makes me wonder if you had some sort of bi-lateral degeneration going on. Or, maybe the real question is: *why* do you have degeneration.

    I remember being really concerned about my good one whilst hopping around on one foot so much. Sometimes it seemed like it was getting sore- other times I thought myself just overly paranoid about it. Would I have paid any notice to that little ache before the injury?

    Do keep us posted- fingers crossed for you.

  631. badge, on August 14th, 2012 at 5:48 pm Said:

    Davidr - my thoughts go out to you and I really hope it’s not worst case scenario.

    Like Ryanb said, there really seems like there’s something inevitable about a tendon rupture, and if your body has decided it’s going to happen, it’s going to happen.

    Painfully ironic it was from advice by your physio.

    I dread a re-rupture and I’m also concerned for the hammering my good tendon now gets. This seems to be a common concern with most RT sufferers.. I suppose this sense of dread automatically comes from being part of the rupture club.

    This might sound cheesy, but I’m really trying to turn my injury into some sort of positive. This can be a soul draining time (and I”m only six weeks into it) - but I’m determined to come out of it healthier, happier and wiser. My snapped tendon has already helped me to begin re-shape my life into something less destructive. Previously, too much work, too much spending, too much drinking. Now it’s no work and no drink and no spending. Quite a liberating breath of fresh air.

    I suppose what I’m trying to say - without stating the obvious - is, even if you get bad news from the hospital, try to twist it into a positive. Hamlet’s line telling us ‘there is nothing either good or bad, but thinking makes it so ..’ always reminds me that my perspective on things will always dictate how I feel about a situation. Telling myself this injury will be for the best has helped me tremendously.

    Good luck tomorrow.

  632. DavidR, on August 15th, 2012 at 5:59 am Said:

    Thanks all for the support. I saw the surgeon this morning, suspected tear in the good Achilles, I still hope suspected is wrong. I have an ultrasound on Friday and get the results Tuesday, until then I’m NWB, which is annoying as Saturday was due to be my first time out of the house (non hospital) in 3 months. The physio commented that my food Achilles must have been in a worse state than we realised. I said WE? It’s all I spoke about throughout the whole session, especially when given the calf raises, I objecte to them several times. Still it’s done now, need to sit it out until Tuesday and keep my fingers crossed. The sound is still haunting me though, it was nastier than the pop on the ruptured side.

  633. Jon, on August 15th, 2012 at 8:14 am Said:

    Hi All

    I’ve been an avid reader since I had full ATR on my left leg 7 weeks ago. I guess these comments go to Jaxx mostly as his story mirrors my own in many ways. I was non surgical (surprised to see so few of us!), and was advised that they would use the 4-4-2 method with casts , ending witha further 4 weeks in a boot. I am just about to have my third cast with my foot moved to a 90 degree angle. A question I had in advance of having my boot in approx 5 weeks is:, does the boot have wedges in it as standard?, or is it just like a reinforced boot that can be taken off at night?. Also , it’s rare to see on here what happens fter the 4 weeks in a boot, would I be expecting FWB in normal shoes?, all guesswork for me at the moment I’m afraid!!. And to Jaxx, I hear your story and try and remain positive, every stage is a chapter that closes and brings us closer to the end !!! ..cheers..

  634. Oz, on August 15th, 2012 at 12:23 pm Said:

    Hi, Im 38 have a good level of fitness.
    Did my right achillies playing football July 18th 2012.
    Decided to go with the Operation which happened on the 2nd August under the NHS, and woke up with a heavy cast on.
    Went back for my first post op visit at the hospital on the 13th August. Sticthes out, leg cleaned and put into a fibre cast with my toes poiting downwards. My surgeon said id been in this for 3 weeks (not 2 because of the bank holiday coming up). Followed by another 2 and 2 weeks with my foot put into different positions until 90%. Asked him about these boots so many people talk about in these bloggs, and all he said was they didnt use them and he preffered just using a cast. So no weight bearing for at least 7 weeks. and then phsio starts. Anyone else come across this ?

  635. rogerg, on August 15th, 2012 at 1:47 pm Said:

    Hi Oz, my ATR happened 29/6 (i’m 65 but very active)
    Hull Royal Infirmary, after various scans and ankle in pointed pot (Equinus) for 3 weeks; after I had read up on this shocking injury, declared that they neither supplied VACOped type boots or enhanced rehabilitation, 12 weeks in pot !!! I found myself a new Orthopod (specialist knee and ankle man: NHS) in an adjoining area, bought myself a VACOped boot and presented myself clutching it on my first appointment ! He hadn’t seen one before, but liked the principle; his protocol: 3 weeks None weight bearing in the boot; then large clumpy clip on sole with full weight bearing for 3 weeks (subject to pain) then coinciding with my next appointment, into flat sole FWB. He thinks that, subject to healing, I should be out of my boot in a total of 9 weeks, when physiotherapy can start. Hope this helps you. Haven’t seen the term recently, but there is a lot to be said for making yourself ‘The patient from Hell’, to get things moving. A comment re VACOped; I called them, discussed my situation; they couldn’t have been more helpful with advice etc, bought one, next day delivery ; after 3 weeks in their ‘boot’, yesterday, one of their partners came to my home to check on progress; excellent service.

    rogerg

  636. rogerg, on August 15th, 2012 at 1:50 pm Said:

    Just to confirm; after reading up on different options, I went the non operation route

    rogerg

  637. badge, on August 16th, 2012 at 5:53 am Said:

    Just to confirm, I went non op because I was a bit of a coward and didn’t fancy having surgery. The nice and easy approach seemed suit me fine. Doctor did quote the 13% RR rate, compared to 3 or 4% operative, so I hope it’s not a case of buy now pay later.

    7 wks since rupture, my first heel wedge from the air boot came out the other day. Every little thing, like a 1cm reduction in incline, seems so significant. A slight burning sensation felt in the back of my leg, but nothing major.

    I can press the ball of my foot in the boot and can twitch/tense my calf a bit. Not sure if this is good or bad practice - but it’s good to see some life after feeling as if my calf was made out of soup.

  638. Hillie, on August 16th, 2012 at 10:51 am Said:

    Hi DavidR

    Sorry to hear about your current setback.

    There’s nothing worse than uncertainty so why don’t you ask for a verdict on the scan tomorrow, either as it is being done, or immediately after? It is there on a screen after all. Most places can do this, especially if you request it.

  639. davidr, on August 16th, 2012 at 11:54 am Said:

    Hi Hillie,

    Yes the uncertainty is horrible, seems private healthcare isn’t always best.

    Effectively, my surgeon said he wanted me to have an ultrasound that day (yesterday) and then headed off to theatre for a few hours leaving me in the hands of his secretary. But the first appointment she could find was the afternoon of August 21st, but my appointment with the surgeon is on that morning, so I couldn’t have the ultrasound after the appointment. So I was able to get her to book me into another hospital tomorrow, who will send the information through to him to view on the 21st. The ultrasound is performed by a radiologist right? Is he likely to be able to diagnose?

    Thanks,

    David

  640. davidr, on August 16th, 2012 at 11:55 am Said:

    Oh and I wasn’t being sexist saying he, it’s definitely a man as I know his name!

  641. rogerg, on August 16th, 2012 at 12:23 pm Said:

    Hi David,
    since my ATR, I have had two US scans,
    one by a specialist muscularskeletal Dr and another by a standard radiologist. Both sent results to my orthopaedic surgeons who decided on none operative
    treatment. I am first day fwbearing today, after three weeks in VACOped, with large clumpy sole and no crutches: still in pointed (equinus) situation. This is ’subject to pain’ which thankfully I have not had. Hope this helps.

    rogerg

  642. Oz, on August 16th, 2012 at 12:28 pm Said:

    Hi rogerg,

    Thanks…. i think i should have had my girlfriend with me when i went to hospital…. she’s a lot more vocal then i am and definately could be the patient’s gf from hell :)

    So at least for the next 18 days and counting im stuck in my 1st fibre cast. The one good thing is 2 weeks post op and the amount my leg swells up has started to reduce. I can now sit for a while with my leg hanging down of the chair with out my leg feeling like it would explode. Although now out of habit i have it stretched out on the sofa elevated. I was told by the guy who did my cast to try and move my foot around a bit within the cast… i guess it cant get higher then a certain point as its a fairly snug fit. Any one got any other excerices they’ve been told to do at this early stage or is it just sit on your backside and look pretty.

  643. Hillie, on August 16th, 2012 at 1:32 pm Said:

    DavidR

    If you’re lucky, there’ll be a consultant radiologist around, or a senior physio - check at the time.

    I was lucky when I had my scan and was still on the couch when my consultant came in, looked at the screen and confirmed his earlier diagnosis.

    Within 15 minutes I was on my way home, armed with a 6 month protocol, and fortnightly appointments booked to week 11, primarily with a physio, but ortho doctors available at all times.

    So at least I knew where I stood (wrong word?) rather than have a few days of uncertainty.

    All the best.

  644. RipTorn, on August 16th, 2012 at 3:48 pm Said:

    Know your pain well.

    I had a splint for week after surgery and then a full-blown cast. Yes, while in the splint with leg in a non-elevated position swelling put pressure on shin and ankle. Not good. So figured that I wanted my leg to be well swollen up before I got the cast. I made appointment late in the day and did everything possible to increase size of leg. It worked, cast didn’t hurt for the next five weeks. And, when I was good and leg constricted to normal size I could move leg inside of cast.

    Hang in there - every day will be better than the one before.

  645. davidr, on August 17th, 2012 at 10:14 am Said:

    Thanks for those who gave support. I hopefully have just had my first bit of good news in 3 months. The radiologist believes it’s a muscle tear and not the achilles. I am seeing the consultant on Tuesday to discuss. If this is the case it probably just means a short time back on crutches. No more calf raises for me during my recovery though, I never want to hear that tearing sound again.

  646. badge, on August 17th, 2012 at 10:35 am Said:

    Really glad to hear that things might be looking brighter. I’ll keep my fingers crossed for Tuesday.

    I’ve just been to the gym to work on my good leg and while I was doing calf raises, I was thinking about the tear sound you’d described. It’s scary enough reading about it, never mind hearing it.

  647. DavidR, on August 21st, 2012 at 7:21 am Said:

    Hmmm, pretty tough news today. Tomorrow is 3 months since rupturing my left Achilles, I have been totally housebound for the entire time aside from hospital visits. Was looking forward to getting my life back, but after today’s visit to the hospital the Achilles I ruptured is now considered my good Achilles. Apparently I have tendinitis in my right Achilles, which came about following a tearing sound and pain during heal lifts at physio. The pain in the right Achilles is worse that any pain I had in the left one and I have been told that the recovery is LONGER and that I will be totally non weight bearing on crutches for many weeks. Following being dumped by my fiancé and having to move back with the parents aged 32 it has been one constant misery this year. In 3 months I’ve had 3 visitors. Rupturing my Achilles was not how I saw myself getting over the break up, and going back to non weight bearing after 3 months is not how I saw myself getting over my rupture. They’ve said I absolutely cannot go out except in a car (I don’t have one), I can’t do any exercises, and I won’t be back at work in September, I don’t think they will be happy. Anyway, just needed to vent, onwards and upwards and I hope everyone else is progressing a little better.

    David

  648. ryanb, on August 21st, 2012 at 4:51 pm Said:

    That’s bad news DavidR, terribly sorry to hear it. If you’re in it for the long haul, I think you’ve got to try and find a way to get mobile, get out, and resume some normalcy. I made a point of getting out of the house - to do *something* - every single day. Hopefully, at 3 months, your left side is getting strong enough to start supporting more weight, though crutching on it would be asking a lot (maybe with a boot?). Perhaps even a wheelchair for outings?

    Who said you can’t go “out” except in a car? Your doctor? That seems kind of bonkers to me. There are safe ways to go out. Heck, paraplegic people “go out”, all the time. Have you gotten 2nd and 3rd opinions?

    Good luck, and keep us posted-

  649. Andrew1971, on August 21st, 2012 at 6:25 pm Said:

    @DavidR,

    It’s not great news to read that all this is going on and am sorry that you are on the receiving end of this rotten set of circumstances.

    As Ryan said, you need to look at coping - find way to get mobile, take the time to plan ahead and keep up with re-hab on the healing ATR, tendonitis sounds bad butlets hope that with the reight level of care and rest, you can recover ahead of their predictions.

    Just a question - why can’t you go back to work in September?

    I hope for some better news for you in the near future and beyond.

  650. nutkin, on August 21st, 2012 at 7:12 pm Said:

    Hi David
    Sounds as though you are going through a pretty hard patch at present. I haven’t had an ATR, I had to have my Achilles lengthened in 2011. My leg issues started in 2008, and while another person can never appreciate another’s individual circumstances, I do understand what it is like to consistently receive news you don’t want to hear. Because my leg issues are still not “fixed” and because I wasn’t dealing with it that well, I sort spoke to my GP who placed me on a course of multi-vitamins which are high in vitamin B, which is good for increasing serotonin levels (the happy stuff). Please check with your GP before you take any ‘vitamins’ as other medication you might be on might counteract the effects of them.
    I also sort advice from a clinical psychologist, and a lot of what the guys have said on the site is really important to maintaining a sane mind.
    There is a simple, but effective model of stress called the bucket model. Imagine your psychological resources are held in a bucket, and things like ATR’s punch great big holes in your bucket. You need to do things to help top up your bucket, because sometimes the holes in the bucket just stay there for a while. The ways I have topped up my bucket is:
    Getting into the sun
    Organising getting out - hire a wheelchair if you can it is so freeing to even get out of the house for 10 mins. If you can’t get out, perhaps find some time just to sit outside in the garden.
    Organised a masterchef party - My husband and I like to cook so with we organised a masterchef party where everyone got into pairs and then each pair had to prepare a course (I wasn’t much help in the kitchen, but I was great at the planning of our course)
    I set myself a daily things to do list - this helped as it made me realise how full I could make my day (it is amazing how long it takes to decide which book to read)
    I decided to learn something new - I was born in the Uk but know very little about the history, so I decided to learn about that
    Exercise _ I took up pilates about a year ago, I do it with a physio and he accomodates the exercises around whatever is going on with my legs at the time - I have found this is great as it has helped keep my other muscles in good condition
    Laugh - I found you tube, pets and friends a great source of joy
    Don’t be to proud to ask for help - I have read so many of the other blogs on this site and a constant theme is that everyone has had to ask for some help to some degree. I am not ashamed that I have had to ask for some “extra assistance”, because quite frankly this has been the biggest challenge I have ever had to face, and I just didn’t have the tools to deal with it all.
    I hope you find some of this info helpful, I wish you all the best of luck,

    Karen

  651. Skutr, on August 21st, 2012 at 7:20 pm Said:

    @DavidR

    Andrew is right. I recommend getting together with your buddies, pay for the beer & figure out ways to get you out. If you can only go out in a car then have your buddies drive you to (& them) to the beer. I would not recommend anything stronger than ice water for you.

    The point I’m trying to make is that even though it seems life is pretty tough right now - its still your life and I completely understand your vent. I went through a period like this during my recovery. My 6 week post went like this “I’m mad at myself for wanting to do more.  It’s been so damn long since I felt normal and able to do the normal everyday things that everyone else gets to do (like wear two shoes) that it’s hard for me not want to more. Sorry I’m bitchin. No excuses.” So I figured out how to do more with what I was physically capable of doing and never looked back.

    Take charge of your own recovery!

    Scott (aka Skutr @ http://achillesblog.com/skutr)

  652. badge, on August 23rd, 2012 at 5:41 pm Said:

    David - sorry to hear about the bad news on your other foot.

    Advice can seem all too easy to give - but I’d really try to get out of the house more. I’m not sure of the situation but i can’t see why you’ve been given the advice not to go out the house (except by car). 3 months stuck inside will drive anyone to distraction - no matter how positive you try to be. It all depends where you live and what’s around you - but I did make a point of getting out every day from day 3. It breaks the monotony of sitting on a sofa and it’s good to be reminded of normal life, being surrounded by plenty of people with healthy tendons. I live in a city centre, with plenty of coffee shops, so maybe it’s easy for me to suggest getting out. A cafe latte is the day’s oasis.

    Exercise is also good. I’ve changed my gym routine to a sitting in a chair routine using dumbbells. Spending an hour a day exercising makes me feel so much more vital. I dreaded the thought of being inactive after finding out I had a rupture - so I ordered some dumbbells straightaway. They’re lifesavers.

    Luckily, I’ve had my son around for the whole duration of the summer (he’s 13 and on school holiday) - so it’s been good fun and I’ve had it pretty easy. Divide the day between reading, watching, talking, exercising, eating, resting and whatever else … and soon the days will seem much less oppressive.

    I did manage to finish the whole six seasons of the Sopranos the other day. A dvd set I’d had for years but never got round to watching. Not sure if that’s a good thing or not - but it certainly passed the hours in the evening.

    Hope your bosses at work are understanding about your situation too.

  653. sheena, on August 24th, 2012 at 7:23 pm Said:

    David R,
    just read your post. Crappy. If it makes you feel any better and it won’t I have just re ruptured. Maybe we should meet up and cry on each others shoulders….
    I was just walking up a slight hill and pop. I have been in A&E all night and they have sent me home in plaster. Fracture clinic Monday and I’m guessing surgery next week. You’ll have to give me all the tips on surgical recovery.
    On a serious note, I feel for you, it is crap, really crap. I try to be strong by thinking there are people out there much much worse off. I know it doesn’t really help but there really are people who are much much worse and I think of that.
    I had just told my boss I would be back at work…I work weekends and they will get rid of me this time for sure.
    Did you ever set up your own blog in the end?

  654. sheena, on August 24th, 2012 at 7:26 pm Said:

    Badge,
    Sopranos……ace!

  655. dollydaydream, on August 25th, 2012 at 7:38 am Said:

    This site is excellent. I like my own company but yes there is no substitute for being with others (only 8 days post op) & having a lovely
    Iced water..
    So… I have hired a w/chair, longterm from British Red Cross donations accepted, have booked myself in to man a charities reception desk as a volunteer, post follow up (maybe leg not elevated at this stage!) , it will help take mind off my worries, and made time to contact friends I haven’t seen for ages. Pilates friend is on standby ..made lots of lists and ideas galore about a new project. I work in therapeutic field but this is a shock and real role reversal but can only be of value for future. I work with young people who spend their lives in a w’chair, inspiring people.

    I also wanted to thank those that have also shared ideas on how to cope and what can be done to occupy time.

    David, something positive has to come out of all this, take it from someone who is older , having this time to think and assess your life is a luxury, not to be wasted. My advice for what it’s worth, ask for help, look outward and try to find something everyday to be grateful for. Oh and maybe acquire a punchbag!

    Anyone recommend something they heartily laughed out loud at recently? Mrs brown’s boys is hard to beat..

    I do feel for you DavidR, with everything else going on, you must dig deep. You are too young to be indoors without regular likeminded company and living with parents, oh doubly tricky.

    One idea for you, try some voluntary work in an alternative field, contact local volunteers bureau, the local buses 4 us or dial a ride can pick you up and it will take your mind out of yourself who knows it may be the catalyst for a change of direction while/post recovery. You WILL get through all this & be all the better for it.

  656. Hillie, on August 25th, 2012 at 11:57 am Said:

    Hi DavidR

    Really sorry to read about your position. What do you do for a job normally? I just wondered if there’s anything that you could do at home. Much of the time for me I was able to stay in touch by email and phone, but mine is an office job so no problem linking in to the office server.

    H

  657. Hillie, on August 25th, 2012 at 1:39 pm Said:

    Hi Sheena

    You know, surgery isn’t inevitable. Surely it will depend on the damage and the location. I’m pretty sure that I’ve read here that non-op is a serious consideration for reruptures too.

    Good luck at the hospital, ask lots of questions…., especially “why?”. (Not “why me?” of course!).

  658. davidr, on August 26th, 2012 at 6:01 am Said:

    Sheena - I was unable to set up a blog. Gutted to hear about your re-repture. I was wondering where you had been recently. I didn’t realise you were walking. I guess for me it’s very tough now not having a good foot, I can’t really crutch around much, toilet and bed are the only times I move, my mum brings me food. It’s now 14 weeks since I left my parents house for anything other than a hospital visit. Firstly surgery is a good thing in my mind, essentially every day from there forward is a day of recovery. The thing with my latest injury is that it could get worse for months, the low point could be way in the future, so each day feels like a waste rather than recovery, and they have no idea if I will need surgery in the future. I’d rather just know things now than spend 7 days sitting around waiting for a 20 minute appointment once a week with someone I have no faith in. I guess it doesn’t help that the flat I bought keeps being delayed, originally June, now October, I really need to be in there as it’s all one level and has an open plan kitchen and lounge. I am absolutely gutted you re-ruptured, there’s nothing I can say to help. You must be thinking why me. I have to admit, I’m a stats man, if I had the choice of op or non op (I didn’t), I would have gone op as the stats were better, and as I have said, you know from that very second that the ends of the tendon are together and will start healing. You are London based yes? Do you have the option of going private? I can highly recommend my surgeon, highly highly highly. I rocked up at midday one day and was being operated on 7 hours later. Also you would be able to say hi as I’m bound to be down there too. People are important, the support of a husband or family will help, but there is nothing like meeting someone who has gone and is still going through the same thing. The work issue is a big one, what do you do? I have been lucky with work, I had 2 days off for my surgery, and I have a half day each week for physio, but to be honest I’m normally sat on the laptop working all hours anyway so I easily make this up, I will be working today. Please let me know your work situation, there must be a solution. I have been trying to avoid this site this week as I have been very very low, but I will check in as you need advice and support. 3 months in and we are both in a bad way, it seems never ending. Not sure I will be going on the date I had arranged for tomorrow!

    RyanB - Thanks for the support and advice. My physio told me not to go out. Thing is when I heard the word tendonitis I didn’t think it would be a big deal. But then when I thought about it, someone who had not had a rupture with the other foot and thus wasn’t seeing a physio would probably not even realise if they had tendonitis and if they did what would the advice be, take it easy? Well a normal person’s idea of taking it easy os probably my idea of doing a lot. I’m sure people walk with tendonitis. Ironically I have the ability to ‘walk’ now, I’m 3 months post op. So I will be going for a second opinion as you say, because I’m not so sure that everyone with tendonitis is on crutches.

    Andrew - I hope all is well with you. The physio has said I can’t go back to work. I work on the 20th floor at a cramped desk, I currently need 2 legs elevated and have been told only to leave the house for hospital visits. Work are getting annoyed though and I do have to go in for a meeting with occupational health. Luckily my office is opposite my hospital so I can do a 2 in 1 trip.

    Karen - Thanks for the advice. I wish it was that easy, especially persuading people to visit me. I am however taking the vitamins now, so thank you.

    Scott - Unfortunately I can’t rely on my mates, they are rubbish. In London you can quickly become a forgotten stranger, and not everyone is as good a friend as you or I. I do want to take charge of my recovery though. I will soon get to a point where I decide what is right, and if I want to throw away the crutches and walk maybe I will, but I’m giving things a few more weeks. Once I move into my flat (the first ever property I have owned), I can do things more my own way. And once I’ve moved in the monetary situation will have improved which will help, buying a flat is EXPENSIVE, especially in London!

    Badge - I’m now doing the dumbell thing. I have put on 2 stone since my ATR, all on my gut, the way I figure, if I work on the top half at least I will be in proportion. And yes work have been great. A guy on my floor did his ATR 15 years ago, at the same sports centre as me, and the day after my injury he told people to not expect to see me for 4 months. Now clearly treatment has moved on since then, but with the issues his 4 months could be right, so good job here was there to back up how long this takes.

    Dollydaydream - Thanks for the wrods of support, but Mrs Brown’s Boys!! No way!! Ha ha. I will be watching the football today though, at least football is back, important for a 32 year old man. I hope something positive does come of this. In my boredom I decided to join an internet dating site (sad I know, but I was dumped by my fiance just before the ATR), perhaps I will meet the love of my life, ha ha.

    Hillie - I have been working from home and actually look forward to it as the week days are when I have the most contact with the outside world. Conference calls, emails, office communicator. I miss a lot of the fun of being at work (And the lovley views from my desk of Tower Bridge and the Thames and London in general, would have been good during the Olympics, I would have been staring straight at the rings hanging from the bridge) but I still get some of the banter.

    Anwya thanks all who gave support and advice. Good luck all who are recovering, and Sheena, get in touch, it should all be uphill from Tuesday - NO EXCUSES!

  659. davidr, on August 26th, 2012 at 6:07 am Said:

    Oh and Sheena, you will ultimately do as you wish, but surgery for me gave me a very good feeling of certainty, the uncertainty of non op would drive me mad (as the current uncertainty is). There is nothing to be scared of in the process of an actual operation, I’d be happy to discuss if you want to call. that way you get the experience of an opper and your experience and can begin to balance the 2 views. I would not try to talk you into anything and would provide a balanced view, my job title is Catastrophe Risk Analyst, maybe that will set your mind at ease. Let me know if you would like to discuss.

    David

  660. sheena, on August 26th, 2012 at 12:57 pm Said:

    David R,
    thanks so much for your offer of a chat. I may well call you but I think my mind is made up to have surgery, just to know that it has been sewn together.I am going to take more control of my protocol though and if there are no problems with the surgery I’m going to insist on going into a boot at the latest week two. I’m not using crutches for six bloody weeks again.
    We do have private cover but unfortunately we had down graded and it doesn’t cover this, we have since upgraded it. We actually paid for my non op protocol as it was just docs fees really but we won’t be able to push to pay for surgery so it will be NHS.
    I left a big job last year to stay ay home with the kids but worked at the weekend as an estage agent. I have just told them I was going back….they may well let me go now as I was only there for a couple of months.
    I don’t think you should cancel your date, it might be really good for you?? I haven’t read over all of your posts but have you always had the tendonitis or has it come on because of over use of your good leg. I’m so glad you can work as it will be keeping you a tad sane.
    Keep in touch and I’ll post next week. How come you were not able to set up your blog?

  661. davidr, on August 26th, 2012 at 1:27 pm Said:

    Sheena,

    My feeling is that yes, with surgery there is certainty that the two ends of the tendon are together and there is some strength artificially holding them together (the stitching) whilst the tendon naturally binds.

    Obviously every rupture is different, but based on my experience, I think there is a chance of the boot at the end of week 2. I hope very much that I don’t need my VACOped anymore, if so then you are welcome to it. It came with a spare inner lining that I didn’t use as I intended to sell it. The boot was £250, so if I do need it (I hope so much not) I would want it back. Where are you based? I’m in north London, and meant to be moving to Islington at some point, and I go to London Bridge Hospital weekly for physio.

    Regards the crutches, you will have to use them for at least 6 weeks, early into the boot does not mean that the crutches go any sooner.

    Regards your job, are you not able to maintain the company website, take calls and look after everyone’s diary, just offer something to keep your role even if at a reduced wage? Not that you’d really want to, I expect you’re far too fed up.

    I don’t think you can set up a blog after you set up your profile.

    Regards my tendonitis, the physio had me doing heel raises, I complained that it felt counter intuitive and it felt like it was going to damage my good achilles, I was told I’m far too cautious and this won’t happen, next thing a horrible tearing sound. I’m very unhappy, I now technically don’t have a good leg, but I’m going for a second opinion, I’m just fed up of crutches after 14 weeks.

    All the best,

    David

  662. David, on August 26th, 2012 at 3:24 pm Said:

    Blimey! A lot can happen in a couple of weeks….
    DavidR you must feel like the unluckiest of people, I can’t imagine what went through your mind when you thought you’d ruptured the other leg, I feel sick at the mere thought of it let alone feeling like it has gone with the pain that goes with it. You must feel like this is never going to end:(
    Which leads me onto Sheena, my heart goes out for you. When I read your post I was pretty close to tears, just the thought of going through all of this again is petrifying. I wish I could help the pair of you but that job belongs to time and patience.
    I’m pretty much back to 100% now and have been for a couple of weeks so from 16th May to about 14th August is about 3 months as I was originally told.
    My wound is still not right but that’s my fault as I picked up an infection in it by paddling in streams but I can run, jump, squat, run up stairs and pretty much everything else I could do before - it’s still scarey but thats in my head and gets better day by day.
    One downer is that what was a tendon the thickness of a pencil is now as wide as a ruler so I have a bit of a cankle from the back and a bit of discomfort in certain shoes as they don’t fit around the wider tendon.
    Sheena, if you go with the op, once you are out of a cast and into the boot do try and get some weight on it as soon as you can. It will be a couple of weeks on 2 crutches but I was able to stand on 2 feet within a couple of days, walking was another couple of weeks.
    As I said, a lot can happen in a couple of weeks :)

  663. sheena, on August 26th, 2012 at 3:29 pm Said:

    God David that is crap….you felt it was wrong and it was. What did your physio say, was there any remorse? I will always keep that in mind. I live in sunny Berkshire although originally from not so sunny Manchester….The offer of your boot is incredibly kind. I’m not sure that it would fit though as my Aircast is a small which goes up to a five and a half. Did you buy your own boot?
    I only work on Saturdays and the guys want me specifically for showing people around houses and I can’t do that at the moment. Your job sounds pretty high flyish, is it?
    Is the tendonitis becuase of the wear on the good leg due to the ATR or did you maybe have it in the ATR leg too but didn’t notice?
    Are you cancelling that date????

  664. sheena, on August 26th, 2012 at 3:35 pm Said:

    Hey David,
    thanks so much for your kind words…I am going to opt for surgery if that’s what they say is the best thing to do. I’m so glad to hear that you’re good as it makes me think it won’t be too long. It’s just the kids with me that make things hard. I always have that thought in my head, what if I don’t wake up from the anaesthetic….scares me to death for them not for me they need a mum. I didn’t have one from 12 and I know what that feels like. Ooo I’m getting morbid I must stop. I’ll keep you guys posted and David do keep posting now and then even though you’re better….

  665. normofthenorth, on August 26th, 2012 at 3:48 pm Said:

    Wow, you Brits have been busy here! Glad there’s a bit of good-news success sprinkled in with the bad.

    @DavidR: I’ve never heard of a case like yours. I’ve reassured several ATR patients that most of us worry about rupturing or seriously injuring our “good” AT during ATR rehab, but I’d never heard of anybody actually DOING so — and now I HAVE! :-(

    Achilles Tendonitis (and lots of other tendonitis) is a diagnosis that has fallen out of favor, at least here in North America. It describes an inflammation, something that anti-inflammatory meds (NSAIDs and steroids) can cure, at least short-term. But they don’t usually help with Achilles pain (or elbows, or some others), so many researchers have concluded that these problems usually are not tendonitis but a different pathology of the tendon, which they usually call tendinosis. This site isn’t a huge hotbed of expertise on those ailments, but I’m not sure there’s a better one. But I bet there’s a lot of info online if you look. Good luck and good healing, with both sides.

  666. ali, on August 26th, 2012 at 5:09 pm Said:

    daveR - I was thinking the same as Norm earlier today. You really need know if you have tendinitis or tendinopathy/tendinosis. The management is different. Are you waiting for a scan? What have you been advised to do with the right one except ‘rest’? Ive been through the bilateral tendinopathy route, not quite as bad as you but happy to advise any way I can. You gotta get out….can you hire a wheelchair? I used to get taxis all over (hell get a wheelchair taxi if need be). Im in the UK also, glad you are on the blog - it was a life line for me.

  667. ali, on August 26th, 2012 at 5:22 pm Said:

    DaveR - sorry I think I misunderstood. I had tendinopathy and split my achilles months before I deterioated, I didn’t quite pick up your second one had actually ruptured.I really hope you can get out anyway. I hired a wheelchair with elevating leg rests, stopped me going nuts anyway.

  668. starshep, on August 26th, 2012 at 6:08 pm Said:

    Sheena,
    If your main concern is the anesthetic, there are probably things they can use which don’t put you completely out like a spinal block combined with other drugs. Hopefully you’ll have a chance to discuss your concerns with the anesthesiologist.

  669. davidr, on August 26th, 2012 at 6:36 pm Said:

    For those who are asking it essentially went like this. From early on my good achilles hurt. I told the surgeon, he said that’s normal due to over compensating. I told the physio several times, she said it’s normal and not to worry. I even made an appointment with a different physio at the same hospital as I didn’t trust her, but when I turned up for the appointment the original one turned up assuming I had made a mistake. I continued to complain about the good achilles. It fell on deaf ears and I was told it was normal. So I had just got to taking some steps no crutches and the physio said we would be getting rid of the crutches next session. So I turned up and she said we could chuck them. She then started me on heel raises. I said I felt this was counter intuitive as it felt as though I was going to tear my good achilles which was tight from 3 months of taking the strain. She told me I was being too cautious and it couldn’t do that. Very soon afterwards an horrific tearing sound. the sound was worse than the rupture, and ever since then the pain has been worse than the rupture. I was certain it was torn. I left that session on the crutches just as I had come in, but now NWB on my other achilles, as I have been ever since. I had an ultrasound which showed nothing, I went to see the surgeon, he found nothing, so they said carry on as normal. I had physio the next day so got on my exercise bike, it immediately hurt and I felt a lump on the achilles. Went to physio, she took a look and said I have tendonitis and a torn achilles sheath, stay full time on crutches, no standing on the now bad foot, no going out of the house, total rest until it clears. I asked how long that would be, I was told weeks to months. I find this hard because of the uncertainty, I’d rather just have an op and a recovery timeline than months in limbo. I’ve had 14 weeks just sat in the same place. But it’s been made clear to me that any activity will cause problems down the line. My head is messed up, this was the worst year of my life pre achilles problems. I moved in with my fiance on new years day, she dumped me 3 weeks later and I had to move back with the parents and I have never heard from her since and don’t know why it happned. Then after a few months I moved into a mates spare room, straight afterwards I rupture my achilles and am straight back with the parents. So I bought a flat (I know lucky I could do this, but no Sheena my career isn’t high flying, I changed careers at 30 and had to work for free for 5 months to get this job, often until midnight), which was due to be ready in June, but keeps getting put back and the latest date is October. And now this latest set back. I think everything at once has been a lot to take, losing the girl, the mobility, the independence and my own space. It’s very very lonely and it has destroyed the person I am. I used to be a nice happy guy, now I’ve all but given up. I need to be socialising, out and about in London, this summer especially, but all I do is sit int he same seat seeing everyone living a dream life via Facebook, going on holidays I organised to get over the ex, days at the races and cricket and Olympics and gigs and festivals with my tickets. It seems never ending, and it seems this way because after 14 weeks of solitary I feel as though I’m in a worse position. I’m in 24 hour 7 days agony, but I get 20 minutes a week with a physio who’s only advice is to do nothing. They don’t see the remainder of the 7 days, it’s miserable. Days seem like weeks and weeks seem like months. The parents want me to go on anti-depressants, but it’s fairly obvious why I’m depressed, a pill won’t fix my leg, get me in my flat, allow me to go out and socialise and get me a woman. I need help with my legs, I need to not be left to get worse week after week by my physio, I need somethign proactive to happen and someone to want to get me better. I’m going to get a second opinion, when I don’t know, but I need to. I can physically walk, part of me thinks I should start living, wait for it to rupture, and accept 3 months of poor mobility. The current approach could have me sat here forever. And I cancelled the date, I’ve not been in the outside world with 1 good leg yet, so trying to make a best impression to a total stranger with 2 bad legs and crutches, that’s not happening. I can walk, I want to walk, I refuse to believe that everyone with tenonitis is sofa bound, but until someone backs me up on that, I’m pretty scared to do the wrong thing as I can’t continue to live like this. I realise how selfish this all sounds, there are so many people worse off than me, I just don’t feel my life should be miserable just because some others are, but maybe that’s just my selfish take on things.

  670. normofthenorth, on August 26th, 2012 at 9:37 pm Said:

    DavidR, have you had a Thompson test? I’m still not clear on whether your second AT is continuous or not. If it’s ruptured, there are two successful treatments available — and they both usually clear up tendinosis, too. If not, it’s important that the diagnosis be correct, of course.

  671. Hillie, on August 27th, 2012 at 4:49 am Said:

    Hi DavidR

    Your words to others are very supportive and very helpful. Now you need to do more for yourself.

    Yesterday you recommended your surgeon, “highly highly highly. I rocked up at midday one day and was being operated on 7 hours later”. And it seemed that you either paid for private treatment or were suggesting it as an option, which of course it is. That surgeon isn’t going to be simply someone who cuts you up, puts the bits back together, and stitches the incision. Talk to him. If he is so good, surely he can help you and put you firmly on track. You said that you want something proactive to happen - isn’t this it?

    You know as well as the rest of us that everything isn’t handed to you on a plate and I know that you don’t mean that. Your future is in your hands. Make some calls and stop only when you have an acceptable plan. You are an analytical guy - stay calm and use your inherent ability. You will be ok - although the timescale is largely down to you. You also have many supporters here, so keep communicating.

    Anyway, got to go, let’s see that plan come together! Oh yes, I know, Bank Holiday today. No need to take the day off from the planning though.

    H

  672. ali, on August 27th, 2012 at 4:58 am Said:

    Hey DavidR, its tough now but Im reminded of something else Norm said recently which is that bloggers come and go, its hard right now but it is temporary. Go back to your GP as soon as the bank holiday is over. If you are supposed to be ‘resting’ the right one do you need a boot or splint for that one, or maybe your PT could tape it up for you. Do you have orthotics for you shoes when you are back to weight bearing. Something contributed towards this problem in the first place and you may need the biomechanics sorted out. You need to see an orthotist/podiatrist and go privately if need be.

  673. Hillie, on August 27th, 2012 at 5:23 am Said:

    Ali

    Great point about orthotics, and one that I sometimes forget.

    I started wearing a custom-made pair about 5 years ago but got out of the habit just a few months before my ATR. I am convinced that this was a contributory factor in my injury. OK I was putting a lot of strain on the tendon but it was weaker than it needed to have been - my fault, I’m sure.

  674. Hillie, on August 27th, 2012 at 5:51 am Said:

    Take more water with it!

    “Insufficient rest, dehydration and poor ergonomics will accelerate the development of the condition”.

    Dehydration mentioned on the net many times as a contributory factor of tendonitis and associated conditions - now there is something that we can all do something about, right now, just mind the diuretic type drinks.

  675. rogerg, on August 27th, 2012 at 8:05 am Said:

    Hi Everyone, ‘patience’ on my anti spam says it all !
    On the subject of tendonitis/tendonopathy etc. I’m sure that pre ATR, I was being treated for tendonopathy, with massage Ultra Sound and even cortisone (A no no I know now). My GP put me off seeing an orthopod by saying that it would eventually get better and then pop ! I have come across a very interesting article on tendinopothy treatment, tucked away on this blog . Use local anaesthesia, insert a scalpel in the most degenerated part of the tendon, have the patient extend and flex their ankle then repeat
    the process just above, below, to the left and to the right of the original incision: ‘70% of the long distance runners who underwent this procedure were cured’
    This was a 1997 study by Maffulli, N., Testa V., Capasso, G. Bifulco G.Binfield. A long time ago I know, but 70~% sounds good

    rogerg

  676. ali, on August 27th, 2012 at 1:56 pm Said:

    Hi Hillie - same here. I was asking for trouble with no orthotics but easy to be wise after the event :( . The ones I have right now are wearing down so I need to take a bit of my own advice and get some new ones!

  677. sheena, on August 27th, 2012 at 2:43 pm Said:

    DavidR,
    how are you feeling today? Any better?
    xx

  678. sheena, on August 28th, 2012 at 3:29 pm Said:

    http://achillesblog.com/sheena/2012/08/28/re-rupture-not-confirmedi-need-an-mri-scan/

    Guys,
    if you get a moment please take a look at my blog, the link is above. The re rupture has still not been confirmed……..need an MRI scan.

  679. davidr, on August 28th, 2012 at 3:41 pm Said:

    All,

    Apologies for the delay in getting back, I had physio today, then saw the podiatrist, then went to a second physio for a second opinion.

    So Sheena - I have read your blog. I hope the news is good for you. However what drives me insane is uncertainty, I feel that until today I myself have had uncertainty and it feels like treading water and is horrible. Potentially 2 weeks for an MRI scan, there must be a way to get this done more quickly, you deserve it. I really hope there something you can do to get confirmation of what has happened this week. Regards the Thompson test, forgetting the issues and confusion there, are you able to push against things with your toes. I’m sure you will have had a doctor push against your toes and get you to push back at some point in your recovery in order to test the strength of your tendon. Now I’m not suggesting you get an untrained person to push your foot, but sit up and see if you can push against the floor with your toes. I’m not expert, but if you can does this not suggest that you still have a tendon that is in some way still in tact? I have done this whenever I have had concerns.

    Regards the sheath, it has been confirmed to me today by some FANTASTIC physios in Middlesex that when I had the incident on my ‘good’ achilles it was a tear of the sheath and tendonitis (though they called it a different name. Now have gone through the process of tearing the sheath of one achilles and rupturing the other one I can tell you that the sounds are very very different. The rupture was of course a pop, the tearing of the sheath was a distinct creaking tearing sound, like a ratchet. This was not picked up on my initial ultrasound (in a very distinguished private hospital where had I not been lucky enough to have private cover from work I would have been paying over £100 for no more than 5 minutes treatment). Yet today a great guy, only 27, found the tear within seconds. In fact, for £35 I was in there for 45 minutes and had an ultrasound, shockwave therapy, tendon manipulation and what amounts to a large tens machine all on the ‘good’ tendon, I’m very pleased. Aside from the ultrasound I have never had any of these treatments before in my £100 (covered by insurance again) 25 minute weekly physio. However, credit where credit is due, they believe that the physio I have been seeing has been doing the right thing with the tools she has available to her. But the point is, the tearing of the sheath was a distinct experience and it was easy for them to find as they knew what they were looking for. For you to have to sit around and wait a potential further 2 weeks for diagnosis is wrong. This is as much a mental thing as a physical thing and you shouldn’t have to live with the uncertainty.

    Again, having experience of rupture and sheath tearing I am happy to offer advice on my experiences in order to allow you to make your decision on where to seek advice and help.

    My first (usual) physio session this morning was OK. she said the swelling in my good achilles was less than last week (we no longer even bother looking at the side I ruptured). The podiatrist was fairly efficient, a little gloomy on the outlook and it does make you wonder whether they do it for a reason when you discover that they are then charging you £300 for what amounts to a pair of shoe insoles, and that isn’t covered by the insurance (oh well, it’s not like I’ve been out spending for the past 3 months).

    I then went for my second opinion physio in Enfield, Middlesex. I was impressed, they seemed excited to be treating me as they say to see a case like mine is rare, so everyone was happy. The first thing he said when I arrived on crutches 14 weeks post rupture was that he has been known to have people back playing football at my stage in the process, and there’s me hobbling in on crutches!

    I had made the decision that if I didn’t hear what I wanted to today then I was taking charge myself and getting rid of the crutches in a month, walking and if anything happens on my head be it, but at least it would be a result of actually trying to live my life. I now feel that despite having had a rough ride I will get better. I am going to continue to see both physios, and I believe that some time in September the crutches will go in the bin, either when I’m told to do so or I make the decision myself. The prognosis is that with the treatment I’m having the sheath issue could be a 6 week affair. Following that I should be back on the post rupture recovery timeline, I may have lost a couple of months, but I can’t help that. I just want to walk, I’m less concerned about the things I was at the start, marathons, football, snowboarding etc. But, one day, I WILL do these things, I’m not going to live in fear, I’m going to take it on, and I believe I can have the life I want once again. I will be going to one on one pilates once I am able to do so, and then we will take it from there.

    I have been a mess, right now I’m in the same position, crutches, feet up, living with the parents and lonely. But today I was given a degree of certainty about what is going on with my body. You deserve the same, I really hope the MRI scan comes soon. If in the meantime you want to talk to someone at the place I went to today, they are happy to help. I called them this morning, and saw them this evening. Don’t let people push you aside and make you wait, if nothing else it will help the mental side, and maybe even the physical!

    All the best Sheena and everyone, your continued support means the world to me right now, thank you.

  680. sheena, on August 28th, 2012 at 4:08 pm Said:

    David R,
    so pleased to hear that YOU are sounding so much more positive, I really am.
    Funny, even though I have to wait for maybe two weeks I am happy because I can walk again. If I need surgery I need it. The doc said walking in my boot won’t make any difference so at least I wait in peace, It makes little difference really whether I need surgery now or in two weeks so long as I can walk around the bloody house!!! It has made me grateful for small mercies.
    Who are ther guys that you have seen today?
    I think you are right about ditching those crutches fairly soon but only you can make that decision of course but you know how it feels.
    BTW, it was a pop and not a tear………

  681. sheena, on August 28th, 2012 at 6:42 pm Said:

    Personally, I think it’s hanging on by a thread and that’s why the squeeze test has failed but an MRI scan will give a good picture and if I need surgery it’s back to square one…..yuk!

  682. davidr, on August 29th, 2012 at 3:20 am Said:

    Sheena - It’s impossible to tell without the scan, but yes it sounds like what you have said in the previous post. I really feel for you, and the offer of any help/advice is always there.

    To be a bit more accurate with the diagnosis in my ‘good’ achilles. I have a torn tendon sheath and peritendinitis.

    Good luck all.

  683. DavidR, on August 30th, 2012 at 3:51 am Said:

    100 days since rupture and still on crutches. Looking forwards now not backwards, here’s hoping September is a great month for all!

  684. Rob, on August 30th, 2012 at 6:32 am Said:

    Hi Everyone,
    I ruptured my achilles tendon back on the 22nd July. I went for the surgery option and have now just been fitted with an air-cast which I’ll adjust evry two weeks by removing the three wedges. This all seems pretty standard from what I’ve read.
    However, I have been prescribed blood thinning medication (Fragmin) and was told i would need to continue taking this for the whole time I’m not weight bearing. however I’ve now been told that I should only take this medication for a maximum of 6 weeks only. Does anyone have any experience of this to share please?

    thanks. Rob

  685. Darlene, on August 30th, 2012 at 6:59 am Said:

    Rob — I took the blood thinning shots for 2 weeks, post op. None since that time. Not sure why you would need to take longer. You might want to ask more questions. Blessings!

  686. davidr, on August 30th, 2012 at 7:44 am Said:

    Rob,

    I injected myself with blood thinners for a month, you’ll probably find that we all do the same things throughout the healing process, but often for different amounts of time depending on how our doctors and physios work.

    All the best with your recovery.

  687. sheena, on August 31st, 2012 at 3:50 am Said:

    Rob,
    after how many weeks did you go into your Aircast, was it four and how many wedges did you start with please? Can’t help with the blood thinners as I went non op sorry. Good luck with the healing, hope it doesn’t drag too much. I’m waiting to find out if I have re ruptured so don’t over do things hey!

    Hi all,
    have an MRI scan booked for Monday…in boot. I still think this has gone regardless of what that surgeon said on Tuesday…….

  688. rogerg, on August 31st, 2012 at 11:16 am Said:

    Rob,
    I have posted on the Anticoagulant thread before, but it seems to have disappeared ! My first hospital and orthopod, after two weeks in cast (non op)
    gave me the choice of self injecting or Pradaxa tablets, I chose the latter. After three weeks, I bought myself a boot and found a new Orthopod (NHS). He said I didn’t need strong anticoagulants and suggested an aspirin a day. Must stress that this was none op.
    rogerg

  689. Rob, on September 3rd, 2012 at 9:12 am Said:

    Hi Sheena,

    How are you doing?

    Yes the aircast was 4 weeks after the op and there are three wedges, Taking the first one out this Thursday.

    I’ve realised that resting and elevating the leg is essential, I know I have overdone things at times and now I’ve learnt that lesson the swelling in my foot and ankle has definitely reduced which is encouraging.

    Take care

    Rob

  690. sheena, on September 3rd, 2012 at 10:48 am Said:

    Hi all
    the re rupture is confirmed and I now wait for surgery. There were fibles of the tendon all around but a gaping hole in the middle.
    Guys, remember how and where you walk………..

  691. David, on September 3rd, 2012 at 12:16 pm Said:

    Hi Sheena,

    That is proper sh*tty, I’m not going to ask how you’re feeling as I can guess.

    My heartfelt sympathies.

  692. sheena, on September 3rd, 2012 at 3:44 pm Said:

    David,
    thanks and yes you know the deal! Hey it could be much worse just a pain in the arse really! Hope you’re good. Oh and don’t always trust an ortho surgeon…the guy I saw last week looked at me as if I was daft and told me to go home and put my trainers on…he was a consultant! Hope he doesn’t get to do the op….knowing my luck it will be him!

  693. sheena, on September 3rd, 2012 at 4:48 pm Said:

    David R,
    thanks for the sweet comments! How are you getting along? Do you think your boot would fit me?

  694. davidr, on September 4th, 2012 at 4:28 am Said:

    Hi Sheena,

    My operated foot is decent, the other one not so, but fingers crossed.

    Your news is the pits, and I know you had job worries and external worries are the last thing you need going through this, so if the boot fits and I don’t need it then anything that can help financially must be good!

  695. Hillie, on September 4th, 2012 at 2:26 pm Said:

    You know, I keep thinking to myself that, now that I’m 27 weeks, I’ve very little new to say, and that I’m repeating myself, that I’m repeating myself… Then I see yet more examples of apparently poor advice, and fellow ’sufferers’ destined to have a longer recovery period than they deserve, some of it due to poor practice, some of it due to being practiced on, some of it I have to say, due to patient apathy - you do have a say you know, and with this blog and much more since the internet began, the research is easy (although sometimes conflicting). At first, perhaps when in A&E or whatever you call it where you are, you are going to end up in a cast for hopefully only 2 weeks - use that time fruitfully. It is your body, your leg. Do the research, make some calls, you don’t need to lie down all day.

  696. Bonny Mikhaiel, on September 5th, 2012 at 11:37 am Said:

    Enough is enough with this austerity measures

  697. davidr, on September 6th, 2012 at 12:27 pm Said:

    Wondering if radio silence from Sheena means she had the op today, she may be smiling away on morphene right now!

  698. sheena, on September 6th, 2012 at 3:37 pm Said:

    Hey David,
    just wrote on my own blog! Nahh not a bloody word!

  699. dollydaydream, on September 11th, 2012 at 4:36 pm Said:

    Anyone any advice on bathing with a cast? Daft question I know but used a plastic sleeve for first time (no it isn’t the first wash! Honest… :-) but plastic seemed to sweat a lot, ballooned up and left cast damp, significant condensation on inside of sleeve..well it was a real treat so had water bit hot. Are some leg sleeves better than others? Just need reassurance I don’t need to worry, didn’t seem wet inside.

  700. crutchesintx, on September 11th, 2012 at 4:58 pm Said:

    Dolly - I am not sure if you have a Walgreens near you. They have a cast cover there that works great! I got it the first time water leaked into my splint with a garbage bag and ties. This sleeve has never even left a drop of water inside the bag. it is nice and roomy also. Plus the price was right. I think it was only $15. If you wanted, you could probably take a bath with it on and put your leg under water and no water would go inside. It does a good job of seeling itself at the top.

  701. starshep, on September 12th, 2012 at 1:41 am Said:

    dollydaydream,
    I would not recommend you take a bath and immerse your cast in the water no matter what you use to seal it. The problem is if the seal breaks and water gets into your cast, you will need to get the cast cut off and replaced. A wet cast can cause all sorts of skin problems and even lead to an infection of your wound if you went surgical. I did use a Walgreens cast cover but I still kept my leg out side of the shower.

  702. Hala, on September 12th, 2012 at 3:22 am Said:

    Hi Dolly/starship

    I am afraid I must disagree with starshep on this one - a hot bath is such a treat when you’re stuck in a cast! I even went swimming on holiday every day for a week with one particularly good vacuum cover I got from the Internet! I think they recommend not staying in the bath for more than 20 mins due to the condensation issue you mention, and squeezing the air out before you get in is also a good idea. Other than that, I had my leg fully submerged when bathing in hot bubbly water throughout my 9 weeks in plaster, those cast covers work really well!

  703. sheena, on September 13th, 2012 at 5:56 am Said:

    Hi all,
    I use a Limbo cover. Recommended by the NHS bought from the internet. I do put mine into the water but don’t stay in very long like Hala says and you do have to be careful of condensation. The infection issue is slighty worrying though.

  704. click here, on September 16th, 2012 at 6:24 pm Said:

    I really like it whenever people come together and share thoughts, great blog, keep writing.

  705. sheena, on September 17th, 2012 at 10:45 am Said:

    David R,
    where are you and how are you feeling? Long time no hear.
    She.

  706. davidr, on September 17th, 2012 at 2:06 pm Said:

    I’ve been checking in every day but nothing good to report, I’m in a worse state than I was 2 months ago!

    How are you going with the re-rupture?

  707. sheena, on September 20th, 2012 at 5:43 am Said:

    Jeez,
    what stage are you at at the moment with your recovery? are you FWB in shoes yet or are you still nursing the other leg?
    I am OK just bored and frustrated you know the deal very well don’t you…
    My mum has been fantastic which has allowed me to keep my leg elevated most of the time. She gets up and takes the kids to school for me. It has taken the starin of me and my other half which would have been tremendous. Having young kids and being immobile doesn’t add up with kids as you can imagine. seeing consultant next Wed. I guess a cast for two week then I’m going into my boot whether he says I can or not…so long as it feels right to me of course. I know my leg well now.
    Not much pain really, only when I over did it a few days back and boy did it let me know. Time blooody drags on….
    Keep in touch hey x

  708. davidr, on September 20th, 2012 at 8:33 am Said:

    I hope you are recovering well.

    For me I have been too busy working from home to think about my legs (18 hour days this week). 2 big things are coming up though. I am moving into my flat on Saturday (parents are away and have nobody to help so I have booked some removal men), and work want me back in the office from October the 1st as our busy period is coming up. So when I go to physio next Monday and Tuesday (one for each leg), I’m telling them I’m dumping the crutches. I will have been on them for 18 weeks by then, that’s more than double the time of most people. The initial leg is getting worse as the muscles are just fading away from so long on crutches, and the other leg isn’t improving, so the way I see it I need to walk to start building the legs up. So, the start of week 19 I’m saying goodbye to crutches and it’s my choice. Fingers crossed.

    You must be VERY bored!

  709. sheena, on September 20th, 2012 at 8:54 am Said:

    David R
    good for you for taking control. You must have a good idea about what’s going on after all this time. Just don’t go running up any hills or stairs and don’t jump without thinking about it. Those are the things that load the tendon more than anything else I think walking will do them both some good now.
    Good luck at the weekend. Maybe this is your new start!

  710. dollydaydream, on September 21st, 2012 at 3:52 am Said:

    Sheena, hope you get your boot next week - my consultant doesn’t seem to go down this route until out of cast 10/12 weeks. Your mum sounds a star.
    DavidR sounds like your flat is a real driver and best tonic right now, good luck with the move.
    Thanks for replies on leg cover, leg floats and turned temp down condensation less, no leaks and yes well worth the treat. Feeling more confident.

    Found good site askSID for mobility equip etc mad keen to get hold of a scooter to get out, nearly got free one just missed out, then I’d pass it on to someone in need. A whole new fraternity has emerged…come across very kind people out there that have family members that use this stuff and never get better. Made me think, remain cheerful folks!

  711. badge, on September 23rd, 2012 at 9:52 am Said:

    Update on my ATR: I went the conservative route and had the first meeting with the physio a couple of days ago. This will be 11 weeks since the rupture.

    Recommended to take boot off anytime now. So it comes off in the living room for a gentle walk-around. Not dared brave the scary streets without boot. Physio said wait till he sees me next , so we can go over ‘walking’ stuff. During the first physio sesh, he just prodded the tendon and asked questions. Said it looked like a good heal, had good flexibility in the ankle, no swelling - but the calf had as good as gone.

    He handed me a latex band for stretching and strength exercises to do at home. I’ve been good doing them, and it’s good seeing life returning to the calf and the string of muscle beginning to twitch back into the land of the living.

    Physio said to do as many ‘band’ exercises as I want, as there’s little chance of damage happening during such a gentle workout.

    Like I said before, I’m going to miss my boot. It’s been a good friend to my foot for the summer.

    Started work again last week. Doctor said I could take till at least the middle of Oct - but a phased return might be for the best.

    Good luck to all the other ATR’ers - esp. those at the beginning. It seems like a long time to the first steps - but it does go pretty quickly. For me, anyway.

  712. sheena, on September 24th, 2012 at 7:35 am Said:

    Badge,
    do be careful. I re ruptured at 13 weeks after physio said all the same stuff. I was walking up a gentle slope. don’t rush the calf raises and don’t walk up hills!

  713. davidr, on September 24th, 2012 at 8:13 am Said:

    Sheena,

    How are things?

  714. sheena, on September 24th, 2012 at 9:37 am Said:

    Hi David R,
    I’m OK how did your move go? stressful? You walking yet?
    I have first appointment with surgeon on Wednesday and I’m going to take my boot along. will wait to hear what he has to say but so want to get into my boot and not another cast.

  715. davidr, on September 24th, 2012 at 9:45 am Said:

    Well the boot offer is still there. I moved house at the weekend into my first ever own place. I put the crutches in the storage cupboard last night, this morning I got the bus to the dentists, came back and carried a few boxes around and tidied the flat, and now I’m going to ‘walk’ to the tube and get a tube and bus to physio. Then I have more physio tomorrow elsewhere which is 2 tubes away. Then I have the rest of the week off to get things like shopping deliveries and sky fitted, then I start back in the office a week today. It seems like so much to take on, my legs and feet are hurting already, seems like one extreme to the other, I just have to remember I havent walked properly for 18 weeks and try to take it as easy as I can. It’s all very new and different. I’ve already come across countless problems like getting down stairs (impossible, I use the lift), buses, uneven pavements, and even getting in and out of the new bath. And trying to stand on a bed to put a lampshade up, bad idea.

    Wednesday should be good for you hopefully. Coming out of the cast is always a relief. And you get to see your cool scar. Mine is so prominent still, nothing like the pictures I see on here. Good luck, I think everyone is pulling for you.

  716. sheena, on September 26th, 2012 at 4:43 am Said:

    David R,
    I would love your boot but I think it would be too big.
    Thanks again.

  717. sheena, on September 26th, 2012 at 11:30 am Said:

    Sheena,
    got my boot hurrah!

  718. Rob, on September 26th, 2012 at 1:22 pm Said:

    Hi Everyone,

    INext week I’m due to go back to hospital and hopefully leave my air-cast behind after 6 weeks of dragging it around and 10 weeks since my op.

    No one has yet told me what happens next, surely not straight into ‘normal’ shoes?

    What experiences have others had please?

    Cheers

    Rob

  719. badge, on September 28th, 2012 at 8:00 am Said:

    Hi Rob - It might be back in shoes for you. My aircast came off today after having the ankle shrouded in the boot/cast for 11 weeks. It was a sad goodbye to the old contraption so I took a photo of it before I headed up to the hospital. It felt like having a dog put down.

    I’d read so many posts about physical therapy - and I was expecting something quite intensive from the hospital - maybe a deep tendon massage, a bit of hydro therapy, cardio leg machines and whatnot …. but all I got was:

    ’stand on your tip toes…’
    ’stand on one leg …’
    ‘okay, put your shoe on and give us a walk’.
    ‘Good - I’ll see you in a month.’

    And that was pretty much it. He said the tendon had healed well and there was a bit of strength/motion in the foot. So all was as well as could be. I’m okay with this no-nonsense approach, it makes me feel like I’m now returning to normality.

    I’ve just spent the last half an hour walking in big circles outside to try and get myself ready to tackle the hustle and bustle of the city pavements. Calf is a bit sore now.

    I’m allowed to keep hold of my crutches till the next physio in a couple of weeks. But the recommendation is to dump them asap.

    Hope your day at the hospital when okay.

  720. sheena, on September 28th, 2012 at 1:05 pm Said:

    Hi Rob,
    having re rupture at 13 weeks when in two shoes I would firstly say be careful until at least 16 to 20 weeks.
    Ryan, who is a really smart blogger on this site wore hiking boots for a while to support his ankle and with winter coming once I’m out of my boot for a second time that’s what I’ll be wearing. Then a good pair of trainers with heal wedges in to take the load of off the tendon.

    Badge,
    I don’t think that’s good srvice you have had. Stand on your toes? Don’t think you should be doing calf raises straight out of a boot like that? My advice FWIW take it easy and wear the boot again if you’re on grass or sand. I re ruptured walking up a gentle slope.

  721. Rob, on September 28th, 2012 at 1:43 pm Said:

    Thanks Sheena and Badge for your words of advice. My foot feels strong and ready for the challenge ahead. It’ll be great to get out of the house unaccompanied. Our local hospital is in financial difficulties so I may have to demand so decent physio, we’ll see.

    Cheers

  722. badge, on September 28th, 2012 at 3:41 pm Said:

    Sheena - yes, when he said stand on tip-toes, I nearly suffered the additional complication of a heart attack.

    It’s odd how we just do what people, who are in a position of authority, tell us to do. But in situations likes this, part of me feels I just need to trust him because that ’s his job and I’m just being timid about the whole thing.

    But when he asked me to do this, I was reminded of DavidR’s story of the calf raises and how that turned out badly.

    I ended up asking the physio if I could hold onto something support and then I managed to do a feeble attempt, with my good leg taking about 99% of the weight.

    I must admit, I did try a few more calf raises this afternoon at home - but my leg doesn’t seem ready for it. So, I’m going to go easy on them for a little while. Regular walking probably seems like the most logical way to get the foot/calf back into a reasonable shape.

    I don’t have to go back for another 4 weeks, so at least I’m safe for a while from any scary physio requests.

    Stairs are what I really can’t manage. Going down with my good foot first looks like I’m trying do something out of the Monty Python Silly walk sketch.

  723. Sheena, on September 28th, 2012 at 4:46 pm Said:

    Hey badge we have all been there! Trust your instincts. Good old NHS!

  724. RichJ, on September 28th, 2012 at 5:06 pm Said:

    Hi all,

    I’m now at 14 weeks since my ATR. I was non-surgical and had a removable brace with heel wedges, I had no help or support from the hospital during this phase so relied on the internet for information and mostly followed the UWO recovery protocol, but listened to my Achilles and if it started hurting I let up a bit on the intensity. I was PWB (with crutches) after 4 weeks and FWB (no crutches) by 8 weeks. I went to shoes with a heel insert at 11 weeks and started physio a week later. I was told by the hospital to keep the insert in for 6 weeks but my physio seemed a bit doubtful about the benefit, and I found it difficult to walk with them in, so I’m now not using them at all. I’ve been doing tip-toe stand ups and rubber band exercises twice a day but lately have reduced that to once a day after I got a few painful tweaks. I can walk reasonably well although still with a slight limp. I’m very conscious of the risk of re-rupture so am taking everything slowly and carefully and not trying to rush my recovery.

    Wishing every a good recovery, it does get better eventually!

  725. normofthenorth, on September 28th, 2012 at 11:15 pm Said:

    Badge, there’s a simple trick to walk down stairs “normally” when your ROM is limited and/or your calf strength is bad, and I’ve described it many times, including on kne of my recent blog pages. Basically, you plant your “bad” foot fairly far forward, so half your foot is sticking out past the stair. Then when you step down past it with your “good” foot, the injured foot rolls over the nose of the stair. The ankle doesn’t have to flex at all, and almost all the weight’s on the heel. Safe and easy, but it’s fast and looks normal.

  726. Dollydaydream, on October 2nd, 2012 at 1:00 pm Said:

    Well I am still a tad surprised…went in 2 days shy of 7 weeks post op to be told it’ s the boot for me! So pleased but also never been so nervous in my life! Nothing fancy basic NHS £12 Breg boot hope it will do what with everyone talking about VacoPeds etc!
    Had brief explanation from consutant re exercises - namely toe points, toe flexes and roll side to side while PWB 30 - 40%. Then back 4 weeks for review..
    Back of heel and slightly up from there below calf is a bit sore burning but I guess this is normal. Heel nearly on floor but no inserts supplied told this will gradually get to 90 deg with time but keep pointing toes & doing alphabet til review. Does this sound acceptable given other experiences on site?
    Scar looks like healing really well. Can I massage leg and scar at this stage, will it help rehab and with what? Comfrey/hemp oil…?
    I can only bring myself to go thru the motions of putting foot on floor no weight thru, any tips on how to get confidence back - will it just come? Looking forward to a bath with leg out of cover..so is my other half!

  727. Jon, on October 4th, 2012 at 2:29 pm Said:

    Hi everyone. I have just joined the exclusive re-rupture club!, 11 weeks in cast, then on my third week in two shoes and I fell up the stairs and tore the achilles again. Gutted!!. I have just had surgery and now in a cast for two weeks before hopefully a boot for a number of weeks. RichJ I was at the same recovery stage as you are now and can only say that my weakness was over confidence, it really is so easy to forget that even simple things like stair climbing can be disasterous!!, when I did it all i felt was a tear rather than a pop like my first time , made me realise how weak it really is after 14 weeks. I’ll certainly be taking more care when i hit 14 weeks this time round, I’ll keep you all posted.

  728. 21ach, on October 4th, 2012 at 2:43 pm Said:

    Jon, what a cool club … UGH! I kid! Keep your head up. It is what you make of it! I am at the end of week 5 since surgery. Whoo Hoo in my boot from cast! I cannot imagine doing this again. LOL! Good Luck!

  729. Jon, on October 4th, 2012 at 3:45 pm Said:

    Hi 21, good to hear you’re progressing well, my first rupture was treated conservatively so surgery does knock a couple of weeks off recovery and believe me you get used to the crutches and the quirky routines pretty quick. I get married in 3 weeks so bit of a dissapointment to rupture again but like I said before its so important to take it easy, even at week 14 ..the tendon is so weak yet your confidence will be high, not a good mixture!, good luck with the boot and I hope to get one soon, one question though, I havent had boot before , you reckon I can get trousers over it?

  730. badge, on October 4th, 2012 at 7:09 pm Said:

    Jon, really sorry to hear the bad news.

    It really does act as a terrible reminder. I’m nearly touching week 14 since the rupture - I’ve been out of the boot a couple of days, so I’ll be sure to be careful. It’s so easy to forget.

    I did have an Aircast boot - and did manage to get most of my trousers over it most of the time. Obviously depends on the width of the cut though.

  731. Jon, on October 5th, 2012 at 7:51 am Said:

    Thanks Badge, you take it easy at week 14 :), stairs that go round corners are the worst!! :). I’ll keep reading on your progress and keep you all updated on mine. Jon

  732. 21ach, on October 5th, 2012 at 8:10 am Said:

    Jon, YES, no problem getting ‘trousers’ over the boot so long as the ‘trousers’ are a ‘boot’ cut … I laugh at the word ‘trousers’ as we call them ‘jeans’ on this side of the pond and/or ‘dockers’ and/or ’slacks’/'pants’ :-)

  733. Cambrelle, on October 5th, 2012 at 8:15 am Said:

    Cambrelle is a very good fabrics to make boots and safety shoes. If anyone need shoe materials and footwear materials, welcome to contact us.

  734. Hillie, on October 5th, 2012 at 8:42 am Said:

    Jon

    What’s the big deal trying to cover your boot?

    Good way to spoil your trousers and you’ll see all sorts of lumps and bumps around your leg. Wear the boot on top - nothing to be ashamed of, and might encourage others to give you some space. I can’t imagine many Vaco boot wearers hiding theirs.

    H

  735. normofthenorth, on October 5th, 2012 at 12:40 pm Said:

    Jon, your first rupture was treated non-op (which is sometimes called “conservative”) AND with a super-slow old-fashioned rehab protocol (which is ALSO sometimes called “conservative”). I dislike the term “conservative” in ATR-speak, partly because it’s so ambiguous and confusing, and partly because it implies that going super-slow is safer, which it clearly is not according to the evidence. Super-slow non-op treatment has always had a high rerupture rate — 15-20% in many studies over the years. In contrast, fast new-style non-op treatment like bit.ly/UWOProtocol has shown a low rerupture rate — 3 out of 75 in the UWO study.
    The new non-op schedules are faster than many post-op schedules, so there should be no lost weeks, either. But either the doctor or the patient has to be “up to speed”, and many still aren’t. The first of the modern studies is now FIVE years old, so you now have to be near the bottom of your class in Med School to have missed all the memos…

  736. californiaguy, on October 5th, 2012 at 1:12 pm Said:

    @normofthenorth

    I’ve heard you mention slow vs UWO protocol for non-op several times. I’ve been following UWO, but do you have a link to the so-called slow protocol? I’m curious to know what the difference is. Thank you.

  737. ryanb, on October 5th, 2012 at 1:51 pm Said:

    Norm-
    Are you aware of any studies that have looked at accelerating surgical patients faster than UWO? UWO shows good - and fairly equal - results, using the (much faster than old school) UWO rehab protocol. But, I’m wondering if anybody has looked at going even faster yet; especially for surgical patients. Have the doctors found the line- beyond which re-ruptures or other complications start to rise?
    One might ask what’s the point of taking such a risk with a faster protocol. But, 20 years ago, you might have asked the same question about trying something like UWO. Who knows what you might find…

  738. RichJ, on October 5th, 2012 at 3:23 pm Said:

    Jon, I’m gutted for you mate :( wishing you a good recovery 2nd time around
    Re-rupture is my nightmare so I am being careful, particularly on stairs where I’m still putting the whole of my foot on the stairs when going up, and rolling it down the step as Norm said. I’d echo Norm’s comments about being too conservative, I really feel that early and regular stretching of my ankle helped my recovery. I’m also being told by my physio not to slack on my exercises as the achilles is ok but the main problem now is the muscles are weak, and exercise helps both the muscles and achilles get stronger.

  739. Hillie, on October 5th, 2012 at 3:58 pm Said:

    Good questions to ask, Ryan, and you are right, medical science and the demand for its advances must be pushed.

    However, at present the really big message needs to be addressed at those medical facilities (most it seems from the random sample exhibited through this blog) where progress is way too slow due to not following the protocols from even the past five years or so. Any marked improvement here would way exceed the few days now to be gained with ATR recovery techniques. Already, because of the internet, and blogs like this, some of us have been pushing the boundaries - some successfully, some less so.

    ATR is not life threatening and there is a limited pot of money. Walk through the fracture clinic of your hospital and then on to oncology and paediatrics - they too would like faster advances in medical science, but the research and drugs bills are massive.

    The message therefore for ATR recovery is yes, continue with the research but reinforce the message of its effectiveness. Money and people’s time are being wasted because we have the procedures but not enough notice is being taken of them.

  740. normofthenorth, on October 6th, 2012 at 1:14 am Said:

    Hillie, you sound just like I think! :-)

    CaliforniaGuy, we’ve had lots of bloggers & posters here who’ve spent 15 weeks NWB in a cast, vs. UWO’s 8 weeks total in a boot, half of it FWB. On my “studies” page, I link an excellent 2005 metastudy that summarizes all the previous op-vs-non-op studies. I don’t recall whether or not they give any detail about how slow the “conservative” non-op protocols were in the studies they referenced. But typically, both kinds of patients went slower than UWO, and the non-op ones went slower than the post-op ones, because logically they needed more time to heal without precise apposition of the tendon ends and without sutures.

    IIRC, the UWO study itself (and the NZ study from 2007) refers to the sharp difference between their speed and that of traditional non-op treatment. On this site’s Studies and Protocols page, there are several studies (links) that compare faster and slower post-op rehab. None of them shows a benefit from slower rehab, as I recall.

    Ryan, our own doug53 successfully experimented on his own post-op leg with a much faster protocol. He and I and others discussed the likelihood that his results could be successfully replicated on a larger sample, without unacceptable rerupture rates.

    The only thing close to a “study” that I can recall that went faster than UWO was a report from two Japanese surgeons — linked from my studies page — who got blindingly fast recoveries from their patients (~3 dozen in the report I saw) using an unusual and extra-strong suture technique. Among other things, their average patient returned to their own sports so quickly that David Beckham would have made it to the World Cup if he was only THAT fast, as fast as the Japanese surgeons’ AVERAGE patient!

    One possible effect of a significant acceleration in post-op rehab times — along the lines of that Japanese study — could be to undermine the pro-non-op force of the recent studies (including UWO) since 2007. Assuming that non-op patients can’t recover much faster than UWO, but post-op patients can (either with improved surgery or maybe with today’s), that would effectively turn all the dumb bottom-of-their-class Doctors — the ones who say that surgery shortens rehab time — into honest professionals, if not prophets!

    Mind you, as Hillie suggests above, the gains may not be especially important in the total cosmic scheme, or even to many patients who DON’T have a World Cup match to play in. But a significant acceleration in rehab would at least be a benefit that might justify the cost, pain, scar, and extra risks to many people, maybe including me.

    Of course, as Hillie ALSO suggests above, proving it’s possible is very different from getting the average surgeon or clinic — even in advanced countries like the US, Canada, and the UK — to notice, care, and adopt.

  741. Hillie, on October 6th, 2012 at 3:48 am Said:

    These last couple of posts actually illustrate how progress can be moved a little faster, even in non-op as I was. UWO’s NWB time is now often reduced to only the first 2 weeks (which may be in a cast or boot). As soon as I had my Vaco boot I could weight bear as much as was comfortable with no further delay. From memory (it was 6 months ago) FWB was within a week or less, for increasing durations of time. Much of this ability to weight bear will, however, depend on the patient and his or her pre-ATR strength.

  742. davidr, on October 7th, 2012 at 3:56 am Said:

    Hello all,

    I’m just wondering, how long was it before you were able to walk down steps alternate steps. I’m at 20 weeks and have been told it will probably take another 20 weeks before I can do this, which is causing huge problems on the other legs to the point that it is deteriorating fast due to taking all of the pressure. I need to find a way to do alternate steps quicker than the 40 week mark as it’s causing serious issue right now.

    How is everyone’s recovery going? I see a few new names on here.

    Thanks,

    David

  743. Kim, on October 7th, 2012 at 6:59 am Said:

    Hey davidr - good to hear from you! I am able to do the steps now (about 22 weeks)- with a bit of accommodation because of restricted DF. I have to bring the heel of my injured foot off the stair as I step down with the good foot. But I carried a wheel chair up and down the stairs yesterday (slowly) for a friend, etc. I have to be careful, and I started with holding onto the railings. I have to conscientiously point the injured foot down to land on my toes and then heel down as well. It’s getting easier as my calf gets stronger. If I’m in a hurry, I still cheat and fly down backwards, lol. I’m trying to stop that. I just came down forwards at 6am which made me happy since I’m generally pretty AT tight in the morning. Try the rolling over the side of the step thing to get started, and match exactly what your other foot is doing (pointing, etc.) to get started. Just do a few each day and it gets easier.

  744. Hillie, on October 7th, 2012 at 7:40 am Said:

    Ryan

    Just remembered a recent research paper, released earlier in 2012, just before my own ATR, from University of Warwick. Titled “Current concepts in the rehabilitation of an acute rupture of the tendo Achillis”, I don’t have the link to hand but you should find it ok. Might give you a little more info into the routes being taken by researchers looking at earlier and more reliable rehab protocols.

    H

  745. normofthenorth, on October 8th, 2012 at 12:08 am Said:

    Hillie, UWO’s NWB time already is only 2 weeks. The next 2 weeks are PWB — which they call “Protected” WB, but I think it’s the same as Partial WB. At 4 weeks they prescribe(d) “FWB As Tolerated”, which does suggest that going FWB at 3 weeks in is a bit faster than UWO. Mind you, once I was PWB, I found the whole transition to FWB to be pretty gradual, continuous, and seamless — i.e., I kept bearing more and more weight while I was PWB, “as tolerated”, and that progression got me to FWB at pretty close to 4 weeks, just a couple of days later, IIRC. (My blog always remembers these sequences and details a smidge better than I do! :-) )

    DavidR, have you tried my technique for walking down stairs “normally” with restricted ROM, reduced calf strength, and a vulnerable AT? I started using it while still in my fixed boot, then continued in a hinged boot, and then straight on in two shoes with no interruption — LONG before I could walk normally without a (big) limp, much less do 1-leg heel raises, etc. If you have trouble finding it (I think I’ve posted it here ~20 times, including on my own blog a couple of times!), I’ll post a link or just type it out again.

  746. Jon, on October 8th, 2012 at 10:36 am Said:

    Hey Hillie

    No real need to cover my boot permanently, I’m getting married on the 27th October so was just hoping to cover with trousers for the photos etc :), afterwards I’m all about showcasing the boot, you’re right it keeps people at arms length!! :). I’ll update you all on what happens , fingers crossed for a boot at the 2.5 week mark on the 22nd October. :). (p.s the anti spam word today for me was optimism, I can live with that !!!…)

  747. Oz, on October 9th, 2012 at 5:30 am Said:

    Hi All,

    Im now 9 weeks post op and have been in 2 shoes for 1 week. Amazing feeling walking again after so long. Dropped both crutches after 4 days of walking and forced the surgeon to give me an air boot for when i need to walk a longer distance, mainly into work as it give some protection for being on a crownded london tube. By the way he said it was over kill and i didnt really need it, but after a week of being back at work full time id say its a must! and i change into my other shoe once im in the office. I think its an NHS cost issue, the cast tech told me that it cost £120. But how can the expect someone who has been in a cast for 8 weeks to suddenly walk fine in a normal shoe with a heel insert ??? I guess you get what you pay for.

    The Only issue i have at the moment is that my heel hurts like hell when i walk too much. I found that the NHS heel insert really kills as well all the time, So much that ive stopped using it in my shoe. Its just too hard. Not sure if i should have stopped using it, the problem is that i dont see the physio for another 2 weeks, as reffered by the NHS.

    Anyone have any suggestions how to help ease the pain, i guess once this goes the limp i walk with will also.

    Oz

  748. sheena, on October 9th, 2012 at 12:02 pm Said:

    Oz,
    I had exactly the same problem with the Aircast heel wedge. It made my foot flare up with really bad eczema. I have got used to it though now. I do believe you can buy gel heel inserts but I haven’t bought any. Have a look online and I’m sure you’ll find something. Keep that boot on as long as you feel the need. I re ruptured at 13 weeks walking up a very genlte slope. The London underground- you need a boot.

  749. Hillie, on October 9th, 2012 at 1:38 pm Said:

    Hello Oz

    Both my heels began to hurt a little at about week 6 so I used the gel inserts that my hospital physio had given me ready for the ‘2 shoes’ a little later on.

    There was an almost immediate improvement and no discomfort there at all within a day or two. From memory (it was 6 months ago) I stopped wearing them soon after and the pain didn’t recur. Used them again only when I went into 2 shoes.

    Definitely worth a try. I don’t know what make they are - they are a mostly translucent white, wedge shape, with blue colouring inside.

  750. David, on October 9th, 2012 at 4:57 pm Said:

    Hi all!

    Been away for a while as I’m all fixed.

    I had the heel pain, it stopped once I was out of wedges. That was mid July and have been 100% since.

    My scar is a little wider than I would have liked considering how the initial cut was a thin line and my achilles is thick so I wondered if an ultrasonic thingy might be useful in breaking down scar tissue, haven’t seen one mentioned on here.

    Other than the above I can run and jump and swim and cycle as before, I can run up and down stairs at full pelt which amazes everyone at work.

    Just popped in to see what was going on and ask about the ultrasound and it seems that we all go through the same procedure one way or another. Good luck to all, it will be alright in the end, even for DavidR (who has been through hell) and Sheena (who has been through it twice!!)

  751. normofthenorth, on October 10th, 2012 at 12:54 am Said:

    Oz, I have no idea why NHS thinks its a bargain to put ATR patients into multiple casts, instead of buying them a boot ONCE! There’s no accounting for tastes, or bureaucracy, or maybe featherbedding. Soreness under the heel is very common during ATR recovery, and usually responds to two tricks: (1) a squishy gel layer under the foot — heel pad, full footbed, Crocs or similar gel shoes; and/or (2) massaging by rolling your foot over a small ball — a tennis ball will do, but bigger or smaller usually works OK, too.

    David, everybody’s initial incision is extremely thin, but some of us scar more or less neatly than others. I doubt that ultrasonic gizmos or any other gizmo will help with the size of your scar. Some people on my other blog-addiction — valvereplacement.org — swear by various scar-treatment ointments and creams, generally available from good drug stores (apothecaries?).

    If the problem is internal scar tissue with or without attachments, then it’s possible that ultrasound gizmos or lasers, or electrostim, or Graston massage will help break it up. I got the first three from my PT, and others here have sworn by (and at) the last, which is reported to be effective and painful.

  752. Hillie, on October 10th, 2012 at 2:15 am Said:

    Norm, Oz

    From my own experience I know that you cannot make a blanket statement like that about the NHS. Many times in this blog, posters have mentioned our postcode lottery - how the money is spent is largely down to the individual area trusts.

    For an ATR many of us have been given one of the better boots, paid for by the NHS Trust - in my case the boot was Oped’s excellent VacoPed. It is not only my hospital that is using these - an increasing number appear to be realising the overall cost and recovery benefits of a boot that offers improved mobility earlier, and no recasting, just a simple, fortnightly adjustment. When one patient has finished with it, it can be refurbished and put back into store.

    It appears that standards vary enormously across all countries, and even in the more ’sophisticated’ you are not always sure of receiving the optimum treatment.

    H

  753. sheena, on October 10th, 2012 at 7:43 am Said:

    Hi David,
    good to hear from you. I use bio oil on mine but have done since week three. Like Norm says don’t think the gadgets will work but you might as well massage bio oil into it for 3 months twice a day.
    Good to hear you’re doing so well. Gives me hope!

  754. normofthenorth, on October 12th, 2012 at 12:47 am Said:

    Hillie, you’re absolutely right about my over-generalization. And Canada — heck, even the city of Toronto and even individual hospitals — can be completely inconsistent and semi-random when it comes to ATR treatment and rehab protocols. But in an age when health-care costs seem to be mushrooming, and the funds to finance them seem to be shrinking, AND in an age when relatively inexpensive orthopedic boots seem to produce better results and more “user-friendliness” than labor-intensive casts, it puzzles and frustrates me that so many institutions and professionals still haven’t “gotten the memo”.

    Even some places that have figured out that they can save a bundle (for public or private insurers) by encouraging non-op treatment often use casts (and slow rehabs, a Bad Idea), and can also be as pushy and authoritarian as the ones rushing their patients under the knife as if there’s no alternative. AAARGH!! Sometimes it seems as if it’s easier to read the evidence and arrive at a reasonable treatment schedule if you have NOT gone to Med school. . .

  755. Hillie, on October 12th, 2012 at 1:14 am Said:

    Just watch that blood pressure, Norm.

  756. davidr, on October 13th, 2012 at 8:45 am Said:

    Hello David,

    Glad to hear things are good. I’m improving slowly. The side that ruptured is OK, not where it should be at 20 weeks due to the problems with the other leg, but it will improve. The other side is a little more difficult to manage as it should be rested, but due to the rupture it is being worked far more than it should be. It’s pretty painful, but I just have to see how it goes. I went back to work 12 days ago, and stopped using the crutches, my mian aim is to build the calf in the side I ruptured enough to be able to manage stairs, that will help take the load off of the other side, but it could be a while in coming. Getting into work is hard, yesterday I tried going in late on the tube on a route that doesnt involve stairs, i was the only person on the escalator, some guys came running up, tripped 3 stairs behind me, and went face first into my achilles, you couldnt script it, he was really badly hurt though, not another person around though. Being out and about is hard and daunting, but also nice. I’ve still not been out socially in 5 months, but I hope it’s not too far away. I’ve been working crazy hours and had not time to get on here lately. How is everyone? Sheena, how is the progress?

  757. badge, on October 13th, 2012 at 4:59 pm Said:

    Hi All - just to say things are going good. ATR in early July - and I’m now okay for long, limping walks. I’ve started being a bit more aggressive with my calf raises.

    I went back to my regular gym today for the first time since the injury. I did a ride on the stationary bike, a slow walk on the treadmill, and some sitting leg extensions.

    The gym has got one of those fancy electronic data systems so when you exit it shows you your gym activity history. Seeing today’s date right next to the date of my last visit - which was the night before the tendon break - was quite a powerful moment.

    Walking home, for some reason, I felt all teary eyed.

  758. normofthenorth, on October 13th, 2012 at 11:44 pm Said:

    Hillie, I actually have lower-than-average blood pressure, and my resting HR is often below 60, even when I’m ranting here. So these things only make my blood boil figuratively speaking! ;-)

  759. Oz, on October 16th, 2012 at 4:14 pm Said:

    Well i ordered my self a Gel insert which made a big difference from the rock hard once provided on the NHS… funny thing is that the heal pain has reduced some what as well at the same time of the inserts arriving… the body is a strange an wonderous thing !
    My new Compression socks seem to be doing the trick as well, as my foot doesnt seem to ballon like it did before. My new contention is the massive scar left from the operation which after a while of rubbing against my walking boots kills. If only i could use my flip flops to work :)

  760. davidr, on October 17th, 2012 at 5:20 pm Said:

    Sheena,

    How goes it, long time no speak.

  761. dollydaydream, on October 19th, 2012 at 3:33 pm Said:

    Just wondered are the compression socks necessary 10 weeks post op?

    Also Sheena do you recommend bio oil then?

    PWB only slightly at mo but v ginger! Ankle really hurts at end of the day. Anyone recommend which sort of gel inserts to use?

  762. sheena, on October 21st, 2012 at 10:04 am Said:

    Hi Dolly
    yes I would use the Bio Oil. It’s really nice and my wound looks great actually. I have really started to massage it quite heavily now at six weeks post op.
    Re the socks, people on here use them for swelling but I don’t think you need them re a DVT now if you’re weight bearing. Not used gel inserts use the hard aircast ones but I wouldn;t recommend those.

  763. Rach, on October 21st, 2012 at 1:51 pm Said:

    Hi I’m 8 weeks post injury, having ‘conservative treatment’. Consultant told me to kneel on chair then squeezed my calf. Had no advice just sent to a bored physio who told me to tap my feet and stretch up,down, left, right. My foot still gets really swollen & a funny purple colour even thougjh I’m out of the robo boot. Cant get into any shoes due to swelling apart from wide walking shoes but heel wont flatten and comes out of shoe. I was expecting to be able to walk a bit but its agony if I touch it down with a tiny bit of weight-help is this normal?

  764. normofthenorth, on October 22nd, 2012 at 3:46 am Said:

    Having a thicker AT when recovering is common. Being swollen is too common, but should be resisted, with RICE — rest, ice, compression, elevation. (I mostly used rest, elevation, and ice, though others loved compression socks.)

    Is the agony because the bottom of your foot is sensitive, or because it hurts your leg to dorsiflex your ankle enough to touch your heel to the bottom of your shoe? The former is common and relatively harmless, usually treated with squishy shoes (like crocs) or footbeds, and rolling your foot over a ball while seated.

    The latter is scarier, and suggests that you should take a few more days before applying full weight while stretched/flexed all the way to neutral. One way is to “gimp-walk” with your ATR foot leading, only stepping up to it with the other, or as far as you can without discomfort or heel-lifting. Another is to sleep in the boot, in the neutral position, to help condition your leg to the neutral position. A third is to use a heel lift in your shoe.

  765. Sheena, on October 22nd, 2012 at 10:25 am Said:

    Rach,
    it makes my blood boil when the NHS give you so little advice. Make sure you get something out of your physio and take Norms advice.

  766. Dollydaydream, on October 23rd, 2012 at 7:39 am Said:

    Thanks for info Sheena, my other half bought me some Bio Oil I thought it would be more Bio than it is, I steer clear of skincare products containing petrochemicals (eg Liquid Paraffin) so will have to take it back. I do appreciate advice though and yes it does seem to work by all accounts. I’ m just funny that way! Trying Comfrey oil with knitbone, first thing in morning and at night before bed I get a tingly sensation up back of scar, slight pain - is it healing?!!

    How are you getting on with physio? I had poor minimal advice from hospital so persuaded my own doc to write a letter to local NHS physio clinic - better but am seriously thinking about seeing a private physio. 10 weeks PWB slightly more weight now only sightly but ankle swollen at night, only purple first thing in morning. Not followed the RICE procedure but elevate it when at computer every other hour and take boot off.
    I have found the whole thing quite tricky with my elderly parents being so far away Oop North I haven’ t seen them at all for weeks!
    When can I drive? Any ideas of timescale anyone?

  767. Rach, on October 28th, 2012 at 6:40 am Said:

    Thanks Norm, I finally got to see a proper physio after going mental on the phone with central bookings then the hospital physio department. When I asked to speak to a manager because I couldnt walk &had no proper advice a magical appointment appeared. Got a great masssge, and yes it appears the AT has heeled very tightly with thick scar tissue.The consultant said to expect pain from scar tissue connecting the tendon to the sides of the sheath containing it. The pain is subsiding after doing the new excercises.I actually took a few steps 2 days ago- yes gimp like! its like being a toddler again-except I walked no problem at 10 months old.

    I might try a shoe lift rather than sleep in the awful boot- its so heavy I just wobble over at the slightest touch. Got another appointment next week, the physio seems worried I might complain- ha ha you can bet on it.

    Does anyone know how long it will take before I can drive as its driving me crazy being cooped up?

  768. normofthenorth, on October 29th, 2012 at 3:01 am Said:

    Rach, just to be clear: the heel lift in the shoe is for daytime, and sleeping in the boot is for night time. The boot could keep your AT-and-calf from shortening overnight, and the heel lift would let you walk around even if it’s a bit short.

    My impression is that most non-op patients escape the problem of scar tissue binding their adjacent layers together (including the AT and the surrounding sheath). The sheath (”paratenon”) is usually undamaged by “ordinary” ATRs, though it always has to be sliced for a surgical repair. That slicing-and-stitching of multiple layers — layers that are normally separate and slide over each other — is what prompts the wild and widespread frenzy of healing that creates attachments that have to be broken up later. I suppose a madly healing non-op AT could also form an attachment to the paratenon, but since the paratenon isn’t also healing, I think it’d be more like “the sound of one hand clapping”. . . I think.

    I still have a little tiny harmless attachment left over from my 11-yr-old post-op ATR #1, and no trace of any from my ~3-yr-old non-op ATR #2. (When I plantar-flex my post-op leg as far as I can, I can see the skin at the very top of the almost-invisible scar pucker a smidge. “If that’s your biggest problem, you have no problems!” :-) )

  769. xaviereo, on November 17th, 2012 at 10:19 pm Said:

    I’m wondering if someone can help me as i’m experiencing a great deal of confusion with my ATR at the minute.
    Quick summary of events;
    ATR dancing on Sat 7th Oct- Attended hospital after I realised something was seriously wrong on the 8th so approx 40hrs later.
    NHS walk in centre diagnosed ATR and said it would need stitched- sent to A and E @ Blackburn Royal Infirmary.
    ATR Confirmed-but said it was partial - straight into a cast and ultrasound booked.
    5 Days Later - Serious Pain in the calf and lower leg - advised to return to the A & E as suspected foot was in the wrong position- Indeed it was- cast not put in equinus.
    Cast Changed to equinus.
    5 days later - attended fracture appointment where the consultant removed cast, re did the thompson test and sent me to orthotics where I got a vacoped.
    I had read, and to be fair it was mainly american info that surgery produced superior results and had a lower re rupture rate however, both orthopeadic specialists and my orthotics specialist said the Vacoped was just as effective.
    Got the boot, followed all the instructions, after 4 weeks in the boot im allowed to fully weight bear and I take it off 2 x per day to do 10 reps of movement excercises- ALL GOOD….NOW..here’s the bombshell!
    Attend an ultrasound on weds 14th where the ultrasound woman tells me a) i’m about 5 weeks too late for the ultrasound b) My tendon is 20mm apart and will never re heal - sends me to A & E where I wait for hours to see a Junior and then a registrar who tell me to continue on the conventional treatment.
    The next day, I’m back seeing the orthotics specialist - (who has been consistent and re assuring throughout) who tells me he has treated bigger and smaller gaps and he is happy to continue to treat me.
    The problem is….I dont know who to trust now.
    Has anyone had experience of a full rupture with such a gap being treated the conventional way??
    I have requested the Orthopedic Specialist re look at the case for a 2nd opinion…I didnt even need to tell the guys secretary my name!
    I will hear back from them Monday. Im just HOPING that after 6 weeks I get to continue with the same course of treatment or im back to square one.

  770. ryanb, on November 18th, 2012 at 1:58 pm Said:

    xaviereo-
    My personal (not a medical professional) opinion is that if after 5+ weeks (a couple days to diagnosis, +cast time, +4 weeks vacoped) your two tendon ends still haven’t found eachother and you still have a (2cm) gap… then you probably should have the surgery.

    Non operative protocols can be very successful, but there is a limited window during which they are effective, and you’re probably out of it. Who knows if improper initial casting is what caused things not to work out… but at this point, it really doesn’t matter.

  771. xaviereo, on November 19th, 2012 at 2:17 pm Said:

    Hi Ryan, thanks for the reply. Today Ive been told that I must continue on the non operative route..without seeing the consultant. I spoke to his secretary who said the consultant had looked at the info and that this is the plan. Im following quite an aggressive route…FWB at 4.5 weeks and apparently out of the boot in 3 weeks so now i’m praying to god that the ultrasound woman was wrong and in fact it is healing!!!

  772. upbeat48, on November 20th, 2012 at 12:45 pm Said:

    Hi everyone, I have spent hours reading all your atr stories which has helped me no end to get my head round what’s happened. I fully ruptured my achilles on monday 12th november 2012 at gym class end of session doing step ups, however had played hockey previous day and cycled day before that (too much i fear!). Straight to A&E and assessed (thompson test ow!) put in plaster cast. Saw Surgeon 3 days later lots of discussions decided surgical route for me, fortunately he could do the next day - much relief. now 4 days post op in cast for 2 weeks and told can weight bear just on toes. That said when moving about in crutches for too long pay the price as experience swelling sensation which only alleviated when elevated for laborious lengths of time! patience is a virtue! Keeping spirits up and remind myself lots of people have to deal with far worse. Trying not to take anymore pain killers managed for first time today, it’s through the night that’s tricky. Was given co-codamol initially but brought me out in a rash, so just taking paracetamol asked about ibruprophen in hospital and told that this can sometimes hinder the healing - anyone any thoughts on this?

  773. leonard8, on November 24th, 2012 at 4:47 pm Said:

    Just thought I would share my story:

    I am a 42 year old male who plays Squash Five a side and go to the gym on a regular basis and have a 4 year old who doesn’t give daddy a minute.I also have very well controlled type 2 diabetes.

    Suffered rupture of my achilles on Friday 19th October just as I walked into the office made me fall over graze my knee and rip my favourite pants. Felt it snap embarassment and adrenalin kicked in got up from the floor walked upstairs to my first floor office and one of the girls took me to hospital.

    For a few months before the full rupture I had warning signs, my achilles started aching but I just carried on as normal, then one night whilst running felt an incredible pain in my calf pulled up like a snper shot me could hardly walk for a couple of days, it eased over a couple of weeks n I upped the activity again. I played squash and it was a bit sore but I managed then the following week felt the calf go again playing squash but not as bad, rested a bit following week gym monday and thursday taking it easy on legs and it snapped going into work on the Friday.

    Went to local walk in centre who confirmed ATR they told me to go to Wigan infirmary orthapedics they would do a referral. I saw 2 junior doctors who confirmed ATR and discussed surgical v conservative treatment. As soon as my diabetes came up they seemed to go right off the surgical option and talked about slow wound healing and infection risk. They had me put in a cast and gave me an appointment for the followoing week.

    In the next week I researched ATR thouroughly and decided that surgery was my preferred option due to being very active. Again I saw the junior doctors and a new junior doctor the consultant was on leave. Again they were totally focused on my diabetes being a risk to surgery and seemed scared to commit to surgery, despite knowing nothing about my individual diabetes. Had a lengthy discussion with them quoting lots of research, showing evidence that someone with good control of diabeties was no higher risk of getting infection or slower healing. They said they had checked and the surgical list was full so fitted me with an aircast boot and gave appointment for the following week.

    I was livid at this and thought the next week they were going to tell me it was too late for surgery. On 30th October I finally saw the organ grinder himself the consultant Dr Karski. He examined me asked about my lifestlye explained there were two options but was already aware of my preferance. He asked relevant questions about my diabetes and told me he had no problem referring me for surgery. Which I had next day 1st November. I have not used any pain killers as they slow the healing process but it does ache a little and when I have been active bottom of my calf stings for a bit.

    I had a cast fitted when I came round from surgery this stayed on for 2 weeks before going for stitches out Dr’s very pleased with wound healing. An air cast boot was fitted again. Junior doctor told the nurse to take all the wedges out of it but I couldn’t get my heel down. The consultant intervened and said the wedges need to be in and removed gradually.

    Now 3 weeks 2 days post op I can fully weight bear for a while in the boot. Today I put a couple of the wedges out the boot into my trainer and have walked a little in my shoes but feel better using crutches. Keep trying to move my foot when I have it up on the recliner but there is very little motion there yet. The operation scar is almost fully healed the graze on my knee is worse. Can’t wait to be able to drive and walk again.

  774. normofthenorth, on November 25th, 2012 at 3:12 am Said:

    Weird preliminaries, leonard8! I don’t think I’ve heard of a case of multiple pseudo-ATRs (or partial ruptures, or whatever they were), interrupted with high-risk activities like squash and 5-a-side soccer, then a full ATR while you’re walking in your office?!? Your story may not be unique, but I think it’s pretty unusual!

    I’m glad your Consultant saved you from that junior Doctor, who should be retrained, IMHO!

  775. leonard8, on November 25th, 2012 at 6:07 am Said:

    Thats only the half of it with the junior doctors, at my first appointment at the orthapedic clinic a week after doing it they had booked me in for an ultrasound scan at 11am then the orthapedic appointment at 2pm. I had the scan lying face down on a bed so couldn’t see anything. Went to the orthapedic appointment made by the junior doctors, they asked me if I knew what the scan had showed as they would not get the results for 2 days. I pointed out I was face down and couldn’t see anything, also pointed out that with that in mind they should have booked the scan for 2 days earlier then. Honest to god they were like the three stooges gave me no confidence what so ever. However the real consultant was a different kettle of fish he was good thank god.

  776. normofthenorth, on November 25th, 2012 at 2:07 pm Said:

    Leonard, I can think of two very different possible outcomes for your medical system: EITHER there’s a very high attrition rate for junior doctors, and only the non-Stooges “survive” (or the ones that become non-Stooges with training), OR the Stooges are going to take over the whole system as the good senior doctors progressively retire. . .
    I know which one I hope is going to happen. . .

  777. leonard8, on November 25th, 2012 at 6:29 pm Said:

    Thought I was on crest of a wave till today, 3 week 3 days post op spent 15 mins walking around at home in the boot no crutches felt fine. So decided to go shopping with other half once in car it started to ache from my spurt of activity. I spent 2 hours walking around using 2 crutches with the boot and now am sat with my leg elevated aching, oh well seems you just can’t rush some things.

  778. darryn, on November 25th, 2012 at 8:06 pm Said:

    Wow, walking with no crutches after only 3 weeks. I am same time from surgery but still NWB, and foot still swollen / sore. I think you are well ahead of schedule, so might be wise to take it easy for a few days.

  779. buzz, on November 27th, 2012 at 7:23 am Said:

    Hi - I had an Achilles reconsitruction two weeks ago, go the cast off yesterday and am in my boot with raised heel (I only need one crutch) - going to be like this for about 8-10 weeks.
    My Op was done by Professor Maffulli - he is a lovely bloke - and is pleased with my progress.

    Amazing op really he took a tenton from a metatarsal and screwed it into my heel to attach it. The screw will dissolve over time and the tendon will be attached naturally.

    I only have two tiny scars on the side of my foot. I am staggared what modern technology can do.

  780. rusty74, on November 28th, 2012 at 11:07 am Said:

    Hi all
    I ruptured my left Achilles just over a week ago whilst playing on a scooter! Pushed back and pop!
    I went to A&E straight away and after just a few tests they convinced me the conservative route is best and gave me an aircast with 5 wedges which I have to remove over the next 8 weeks.
    I,m a little confused as my heel feels fine and I have no pain! I can wriggle and push down with my toes fine and lift my heel slightly. The only thing hat is stopping me from lifting my foot up is that the doctor told me to keep my toes pointed so it can repair.
    Has anyone had the same symptoms? Is it perhaps a partial tear?
    Russell:)

  781. leonard8, on December 8th, 2012 at 4:25 pm Said:

    Rusty74
    Don’t be tempted to walk on it without the boot. Your foot is in the boot at the optimum ange for recovery if you start messing around the ends of the tendon could move apart. This will lead you to have long term problems with it such as less power and more discomfort.

  782. leonard8, on December 8th, 2012 at 4:31 pm Said:

    Quick update on my recovery, 5 weeks and 2 days since my op. I have been doing my own research and started doing bit of my own light physio.
    Not using the boot anymore I can walk around in my trainers with one wedge out of the boot in my trainer, last week was using 2 and was still using crutches. I can walk without crutches but it is easier with them. After prolonged periods standing and doing light chores my leg will ache and swell a bit. Furthest I have walked without crutches in my trainers so far is about a mile took a while and ached after but hey ho its progress.

  783. normofthenorth, on December 9th, 2012 at 2:24 pm Said:

    Rusty, it’s easy to point your toes down (or lift your heel) even with a full rupture, because of one or two smaller (and much weaker) sets of muscles and tendons in the ankle area. But it can’t be done with big force without an AT. One smart sports-med surgeon hereabouts (Toronto) told me 11 years ago that whenever a patient tells him the story I told about stair-walking, he knows they have an ATR (and in those days, he automatically scheduled them for surgery).

    The story: soon after my injury, I faced the flight of stairs up to my bedroom. Initially, I put my injured foot (still in my volleyball shoe) on the first step the normal way, with my heel hanging over air. Then, as I just barely started shifting my weight to that leg, “my life flashed past my eyes” and I stopped. Then I splayed my toes out to the side so my whole foot — including the heel — fit on the step, and climbed up the stairs that way.

    I had already driven myself home in a car (standard transmission) with my injured foot on the gas pedal, adjusting my foot position only a bit to avoid overloading my foot. But I could essentially push the accelerator pedal with the muscles I had left, I just couldn’t lift my body weight.

    Diagnosing full vs. partial tears is often tricky, and also often useless, since the choice of treatments doesn’t seem to change. The new studies showing non-op results essentially (and statistically) just as good as post-op results, were all done on total ATRs (they think!), and it’s logical (though not necessarily true) that the non-op results would be even better with partial ATRs.

    Because I got 3 PRP injections for my second ATR, I got 3 weekly Ultrasound exams, too. And when I asked the Doctor — SAME Doctor — to tell me what he saw, I got 3 different stories!! First time he said it looks like a complete ATR. Second time he said a partial one. Third time he said “partial but multiple”, with a second tear higher up. I have no idea which of those 3 descriptions (if any!) is correct. He was the head of the Sports Medicine clinic and the Chief MD of our local professional hockey team (OK, it’s just the Toronto Maple Leafs, but still. . .), so he’s well trained, well respected, and very experienced.

    Leonard8, make sure you’re not learning abnormal ways of walking, doing what you’re doing. The research and the light physio are great, but you’re stretching it by going FWB in shoes at 5 weeks. It might be fine, but it might not. I walked just as fast in a boot as I ever did in shoes, and I had a lot of protection if I blew it. At ~7 weeks, I set the boot free to hinge, which made my gait even more natural, but still pretty safe. For sure, Watch Your Step!

  784. apowell, on December 11th, 2012 at 9:02 am Said:

    Hi There,

    My ATR happened on 29/11/2012.

    After playing 5-a-side football during my lunch time for 20 minutes, I went to go for a header and nothing happened.. Didn’t think anything of it and went to play on. Rapidly found out that my left foot wasn’t working properly! I had a numbness/sinking sensation in my heel. I didn’t hear any tear or snapping noise. I managed to hobble back to the office. Then I went home to see my GP (walking/Train and bus!!!). She got me to do the Simmonds test (positive on my left foot).
    I went to hospital the next day. Apparently non op treatment is preffered. I’m now in a cast with my feet pointing downwards with crutches, in lots of pain and I have to inject myself with blood thinners every day. Absolutely GUTTED :-( I wish a SPEEDY recovery to all!

  785. badge, on December 11th, 2012 at 9:41 am Said:

    Update on my darned foot: it’s been about 20 weeks since my rupture and the non op route.

    I’ve been in physio for the last 8 weeks or so and have been handed plenty of paper sheets, showing me the types of stretching exercises to perform. Not much attention has been paid to the tendon itself besides a cursory glance and prod.

    They were due to sign me off physio - but I had some questions to ask about the pain and bulges in the heel and lack of calf strength. My physio, who’s recently trained couldn’t answer so she got her boss over to shine some light on my question. It took the expert about 2 seconds to diagnose all is not well - my tendon is much too loose, giving me a rather limp foot with no real push off.

    Told to really try to build the calf - so I’m doing about 1 - 2 hours a day to try to get it to correct itself. Started on the running machines last week - 10 minutes run, followed by a walk, run another 10, then leg machines and stationary bicycle.

    Has anybody here had a ‘loose’ tendon? My worry was that my tendon would be too tight, not too slack. I now feel as if I’ve got some sort of baggy lasso attached to my calf.

    As a foot note, footnote - it felt quite scary starting to run again. After the leg being so dormant by comparison, suddenly doing lots of foot pounding gave me a horrible sense of anticipating a re-rupture or tear - but the fear soon goes and after a couple of minutes the confidence is back.

    Hope I’ve not jinxed myself saying that.

    Good luck to all the people here - and happy Christmas too. This site was such a support for me during the injury.

  786. apowell, on December 17th, 2012 at 3:16 pm Said:

    Update:

    Had an appointment today at the hospital. After an ultrasound and more “simmonds tests” they confirmed I do not have a full rupture!

    They explained that the tendon is made up of 5 smaller tendons. I have ruptured one of them.

    They have replaced the plaster cast with the lighter type.

    My next visit is in 4 weeks. They reckon I could be walking by then!

    Cheers.

  787. hillie, on December 23rd, 2012 at 2:47 pm Said:

    Over the 9 months since my ATR it has become obvious that very many are treated non-op, not only in the UK but around the world.

    There used to be regular op v non-op posts too.

    Currently though it is almost completely op related posts on the main achillesblog.com page.

    During my successful non-op recovery has the medical world suddenly gone more pro operative treatment when it had once seemed that medics were increasingly appearing to favour non-op aggressive treatment and rehab protocols?

    Or are there simply less issues to post about when someone has been non-op?

  788. normofthenorth, on December 24th, 2012 at 2:13 am Said:

    Hillie, I think the sample of ATR posters here naturally varies randomly from month to month. Math-awareness studies always show that “normal people” overestimate the regularity of random events, which often oscillate all over the block. A little while a go, I was shocked at how many people here were advised — even excessively pressured, by my standards — to go non-op. I found it hard to believe that the “new normal” had changed that radically that soon — even with the great awareness that springs from our posts here! ;-) I think that was a bit of anomaly, and we may be seeing the opposite anomaly in the past few weeks — though several of the posts directly above are from non-op posters.

    What does seem to have changed is that some doctors in some regions are advising their fit and active athletic ATR patients to avoid surgery. 5 or 10 years ago, I think that was almost unthinkable almost everywhere. But the old, formerly-universally-held belief that surgery gives better results is hardly gone, and may outlive some of today’s younger surgeons. . .

  789. hillie, on December 24th, 2012 at 8:52 am Said:

    Hi Norm

    Thanks for the follow up.

    You’re correct about the responses above this being from non-op posters and this will partly be because it is the UK arm of the blog. Operative treatment for ATR not so heavily promoted here it seems.

    Have a great Christmas and a happy New Year.

    H

  790. normofthenorth, on December 24th, 2012 at 12:47 pm Said:

    It does seem that some public medical systems may have done the math on op vs. non-op sooner than the private insurers. One of our recent NZ posters got seriously bullied into non-op. I think the answer is clinically fine, but the approach seemed as biased and heavy-handed and disempowering and wrong as the pro-surgery bullying we see here so often.

  791. apowell, on January 11th, 2013 at 7:15 am Said:

    Heya all!

    I hope everyone’s recovery is going well :-)

    I got up this morning for work doing my usual thing (I can Work from home), got my bad foot elevated and noticed that I’ve lost about 1/3 of the mass in my leg! O_O I knew this would happen, but not that bad!! Anyone else had it this bad? Feeling kinda sick now :-( This is my 6th week in a cast non op. :-(

    Good luck all!

  792. normofthenorth, on January 11th, 2013 at 1:44 pm Said:

    Apowell, the slow non-op treatment you seem to be getting is associated with the worst ATR outcomes. I’d fight hard to get on a modern treatment path ASAP, like bit.ly/UWOProtocol , which produced much better results.

    More details in my “studies” page on my blog — also linked from the “studies and protocols” page that’s near the top of the Main Page here. An excellent 2005 meta-study summarized all the op vs. non-op studies ’til then. The non-op studies were overwhelmingly “old school” and “conservative”, much slower than UWO and the rest of today’s Best Practice. Using casts not boots, extending NWB far past UWO’s 2 weeks, and crutches far past its 4 weeks. And delaying exercise and PT far past UWO’s 2 weeks — naturally, if you’re trapped in a cast. BOTTOM LINE: Non-op patients in those studies suffered with 15% rerupture rates or worse, and didn’t do great on strength or ROM either!! DON’T GO THERE!
    By contrast, UWO’s non-op patients followed their fast, aggressive, modern (& BTW, CONVENIENT!) protocol and had a 3% rerupture rate!! GO THERE!! They also had strength and ROM outcomes that were statistically the same as the surgical patients, following the same fast protocol.
    For me, the evidence is clear that fast booted non-op protocols massively out-perform slow, conservative, casted non-op protocols. Govern yourself accordingly, it’s worth some effort. A few extremists here have cut off their own casts and/or bought their own boots. I wouldn’t chop off your cast, but please do what you can to get on the modern evidence-based track.

  793. alton2012uk, on January 11th, 2013 at 8:14 pm Said:

    apowell, agree with Norms comments. Get yourself comfortable with the evidence on early weightbearing and mobilisation, and if you buy into it then fight hard to get your treatment changed. I am UK non-op, now at 8 weeks. I was given a boot and put onto a slow conservative protocol, which didn’t require me to do anything for the first 8 weeks other than move from 30 degree PF to neutral over the 8 weeks.

    I wasn’t happy with this approach, did my own research and adopted a faster approach. It has been straightforward for me as I have a Vacoped (Vacocast) boot which is easily adjusted, however this boot is expensive. A lot of other NHS patients here have used the Aircast successfully. Both are easy to get hold of.

    I have summarised my own experience with NHS treatment at: http://achillesblog.com/alton2012uk/nhs-treatment-plan/

  794. nome007, on January 13th, 2013 at 7:08 pm Said:

    Hello again.
    I tore my achilles in sept 2011. I was advised by the consultant to go down the conservative route. well 18months later and I am going private for a debridement and decompression operation. The scar tissue is causing issues with movement and it’s not healed as well as it should have :-(. I am only 34 so want to get back being active.
    Has anyone had this surgery?
    Thanks

    Naomi

  795. apowell, on January 14th, 2013 at 3:14 pm Said:

    Hi

    Thanks Norm/Alton for your replies :-)

    I will read up on your blog alton.

    I had a hospital visit today and finally they’ve taken off the cast and given a boot.

    I normally am a fan of the NHS, but today was just a JOKE.

    STUPID doctor signed me up for the boot WITHOUT telling the nurses to put the wedges in to raise my heel.

    The poor nurse tries to put the boot on at neutral. After some “arguments” :-) , I finally convinced her I need wedges.

    I think the boot I have is an Aircast one?

    I’ve had no guidance what-so-ever. When do I take the wedges out? Every week? Every 2 weeks? Do I still need to inject myself with the blood thinners? So un-organised!!!

    Seems like the best advice is on here!

    Take care all and I wish you a speedy recovery!

  796. hillie, on January 14th, 2013 at 4:40 pm Said:

    Hi Powell

    It may be subtle of me to raise it here but as you have probably been pretty well informed through the blog, why did you not raise these issues while you were still in the hospital?

    Excellent though this blog is, and most do find it a great source of advice (and ammunition when necessary) none of us have sight of your injury and we cannot prescribe the most appropriate treatment.

    It looks as though you are getting a poor deal - you (YOU) need to get it sorted. Take a friend, write a list, see a good physio privately. It’s not going to get sorted by blowing off in this column alone.

    Best wishes for a speedy recovery!

  797. apowell, on January 14th, 2013 at 5:47 pm Said:

    Hi Hillie,

    You’re right. My mistake is that I did not write down my Q’s b4 I went to the hospital.

    I’m kinda gob smacked at the level of incompetence (this particular) doctor showed.

    My post was not meant to show me “blowing off”, but only to show my annoyance :-)

    I do take your advice though squarely on the chin.

    Cheers !

  798. normofthenorth, on January 15th, 2013 at 1:49 am Said:

    apowell, the AirCast is a fine and lightweight (though basic and fixed=non-hinged) boot. It’s the one the researchers at UWO used in their very successful “UWO Study”. You could do a lot worse than trying to emulate their successful protocol — e.g., at bit.ly/UWOProtocol . If you’re behind its schedule (and I’m guessing you are), don’t “jump ahead”, but catch up gradually, “tapering on”. E.g., if you’re several years behind, try to do 3 or 4 weeks of their schedule in 2 weeks, until you catch up. The steps and transitions matter, because they’re part of the healing, so don’t skip any of them.

    If you find your AirCast liner gets soiled, I found it easy to wash it out and wring it almost dry after wrapping it in towels or chamois cliths or microfibre cloths. Sometimes the tiny Velcro attachments came undone, but it was easy to put it back together. And MAKE SURE you never rely on the boot without that L-shaped “tongue” piece strapped inside the big Velcro straps, because it’s way too flexible without it.

    Various protocols and medical centres use quite different transitions from deep DF (”equinus” or “ballerina”) to “neutral”. Some make a long smooth transition, starting pretty early. Some wait for “neutral” before going FWB (which I’ve never understood). And the +/- most successful of the lot (UWO) stays in full DF (tho’ just 2cm heel wedges) for a full 6 weeks, then takes them out “cold turkey” at 6-weeks post-whatever.

    I found the “cold turkey” part too abrupt, even after a night in the boot without wedges, so I spread it out over a couple of days.

    My impression (from the evidence — but not exactly direct evidence) is that post-op ATR patients (and legs) are relatively forgiving of non-optimal protocols, while we non-op patients suffer more problems on sub-optimal protocols. And again, I think the results suggest that UWO works the best so far. That’s no guarantee that every part of their protocol is better than the alternatives, but it’s the best whole package that’s been put to the test so far.

  799. hillie, on January 15th, 2013 at 2:28 pm Said:

    Hey, Powell

    Pleased to see that after my little banter, Norm came back much more helpfully than I did. He’s more technical than me too.

    I am in the UK, and know that your treatment can be better. My own experience of an ATR last year (I’m past 10 months now) was perfect. A good fast modern protocol (similar to the frequently quoted UWO stuff but enhanced with a Vaco Achilles Pro boot - hinged with ROM most of the time, NHS provided) helped to ensure a relatively trouble-free rehab.

    After the initial ortho consultant’s diagnosis it was over to the fantastic physios. I was non-op (but almost a surgical case) and on the same protocol as surgical would have been but with less unnecessary drawbacks. Fortnightly visits, direct phone line, printed protocol. The only time I saw another doctor was when the knee on my good leg was hurting badly maybe due to a bit of imbalance between right (bad) and left leg. Very short term problem and mostly down to me trying too hard to regain acceptable mobility too soon.

    Lots of external physiotherapy (still on NHS) available after hospital release, and still able to go back now, without a referral, for follow-ups if I have any issues. I am walking the high moors of SW England much the same as pre-atr, including at minus whatever with heavy frost on the ground.

    Whereabouts are you located? Are you intending to start your own part of this blog - dead easy, and I think that you will having a lot to say.

    Good luck

  800. alton2012uk, on January 15th, 2013 at 2:56 pm Said:

    apowell, understand your frustrations with NHS. I am only at week 8 but have seen 3 different Orthos Consultants at my Fracture Clinic follow ups. All 3 have different views on the timings for weight bearing, settings for the boot, and when to start ROM.

    It is not too late, get your questions together and email or call the Clinic for responses. Additional questions, due to my own NHS experiences, would be :

    -do you have a written rehab protocol ? can I have one ?
    -will I have the same Consultant throughout my treatment?
    -when to book the next Consultation & boot wedge change ?
    -can I speak to a physio now to agree what exercises are allowed ?

    I expect the NHS Clinic will give you answers if you ask.

  801. joya, on February 7th, 2013 at 7:47 am Said:

    Hello all, I ruptured my Achilles last Tuesday. Surgery on Saturday and now nearly half way through two weeks in a cast. Off to see the surgeon next Friday for a review and who knows.

    I’m in the UK, 35 and was playing netball.

    I set up a blog before I found this site, as a way to document my recovery to my friends/family around the country and keep me sane.

    So far, I am pain free. Leg is uncomfortable raised as it feels almost ‘numb’ and then sore when lowered as the blood rushes down. Can’t win.

    I will be on here for the foreseeable so would love to hear from anyone my age in a similar position.

    Joy

  802. leonard8, on February 22nd, 2013 at 5:19 am Said:

    Not posted since 5 week post op, now at 16 week just thought I would update. I am currently seeing a sports physio twice a week for treatment. I am going to gym twice a week now doing half hour of cardio on bike and cross traine, also going to pool twice a week. Still can’t run properly yet though but walking all day is no problem.
    My injured leg doesn’t swell like it used to although sometimes does swell a little, like on Sunday when I did 4 hours work digging on my allotment.
    When I get up in the morning my ankle feels stiff so I do stretching exercises and some free standing squats and lunges which helps, I repeat this little routine a few times a day.
    Despite this my injured ankle still doesn’t have the flexibiltiy of the other one and putting a sock on in the morning is still difficult. Hope everyone else’s recovery is going well.

  803. trin74, on March 18th, 2013 at 3:01 pm Said:

    I ruptured my Achilles on thurs 21st Feb at a dance class. I am 38 year old female and fit, being a dance teacher. I knew almost immediately what I had done, so went straight to the hospital and was in a fibreglass cast in under 2hrs after a failed Thomsen test. Surgeon recommended the non-operative route, no boot. At the cast test the next morning ask to get a 2nd opinion, who also recommended non-operative and a cast… (NHS). So started my research, and managed to book in a week later at the private hospital. Surgeon also recommended non-operative, with casts, if I wanted surgery would have to wait 3 weeks! Managed to convince him to put me into a Vacoped boot, he didn’t even know they existed, but strictly no early mobilisation or physio. Ordered the boot myself, and had it fitted 11 days after the rupture. Day 14 had a follow up with the surgeon who had obviously done more research, and allowed a 5 degree move up to 5 degrees that day, and another 5 the week after, and also allowing physio, not for the Ahilles yet, but for knee, hip and other leg. But allowed to PWB. I have another appointment this week, plan is another 10 degrees over the next few weeks to 10 degrees, then 2 weeks at 0, before moving into 2 shoes.

  804. hillie, on March 18th, 2013 at 3:23 pm Said:

    You have a good surgeon there. He may not have been up to speed with the technology at first but he is now, although he is understandably being just a little cautious still. You could probably be weaning off crutches by now and increasingly able to weight bear, but good to see that he is looking after the other areas that suffer during rehab. Are you level right and left though, or is the injured side higher (especially if you have the achilles wedge sole, but you perhaps don’t have that). This need for being level is really important.

    My injury was just a year ago and I was provided with my Vaco Achilles boot by the NHS. I saw the surgeon once (at diagnosis) then it was a physio once a fortnight when we adjusted the boot and added new exercises. Great treatment.

  805. normofthenorth, on March 18th, 2013 at 4:14 pm Said:

    Trin, I’m confused about your ankle angle. The earlier part of your post made me think you already went to 0 degrees = neutral (really 90 degrees). But the latter part sounded like you’re still waiting. Where did I go wrong?

    Ryanb and I had an exchange a while ago on his page about our both-aggressive-but-different protocols, and he ended up drawing a graph to illustrate. Basically UWO — bit.ly/UWOProtocol — moves pretty quickly to PWB & FWB, but keeps the same DF angle for 6 whole weeks. Ryan’s protocol and yours changes angle sooner (and more gradually) but waits longer for WB. They converge around 6 weeks post-whatever. They’ve never been tested against each other, and I’m not sure if yours has been tested in a big group, the way UWO’s has.

  806. trin74, on March 19th, 2013 at 2:48 am Said:

    Cast as in equine position, when I moved into the boot it was to 30 degrees, moved at end of 2nd week to 25, then 20 a week later. When I go back Thursday the plan is another 10, not sure if I’ll be doing it in 2 lots of 5.. I am very happy that I have a surgeon/consultant who is willing to adapt to the new technology, he was pretty impressed with the boot! I am hoping he will let me start to ditch the crutches soon. I have minimal swelling (been elevating all day at work, and when at home), and the Achilles is apparently very pliable (had reattached by end 2nd week, it was a full rupture) and my leg/Achilles look like my good leg. So the surgeon and physio are very happy with my progress so far. I have had no pain at all with the injury, even when it happened, just then heel numbness and pins and needles. I’ve been using a knee walker at work, mostly when I was not PWB, but great if I need the use of my hands e.g. Going to get a cup of tea! Just wishing my house didn’t have o many stairs..

  807. trin74, on March 19th, 2013 at 2:51 am Said:

    Meant to say also that I am not level yet, so the FWB may have to wait a little.. I have an even up, but with the rocker sole it’s pretty high.

  808. hillie, on March 21st, 2013 at 1:39 pm Said:

    Hi Trin

    I was in a fibreglass cast for my first 2 weeks then had the Vacocast Achilles boot. During the first 2 weeks (i.e. weeks 3 and 4 in the program) with the boot I had the big wedge sole but after that the flatter sole (and much easier walking).

    During weeks 3 and 4 I was able to weight bear, and weaned off the crutches at the same time. That was with the boot static at 30º PF.

    Weeks 5 and 6 were with the boot ROM set 30º PF to 15º PF.

    Weeks 7 and 8 the rom was 30º to neutral. Then a few days with a range of movement from 30º PF to 10º DF, in effect preparing me well for the next move, 2 shoes. Once I had found a pair of shoes (my hiking shoes and boots) which allowed for the swollen foot this was an easy and comfortable progression.

    H

  809. trin74, on March 23rd, 2013 at 3:25 am Said:

    Thanks for that hillie, I have been moved to 10 degrees now (well, actually hinged from 30 to 10), and told to move to neutral next week for 3 weeks. The brochure for the boot says to have the rocker sole on from 10-30 degrees, so have kept it on. I have been given clearance to move to FWB, it’s just a mental jump I think I need to make to put all my weight on the injured side. Physio tested strength of the ankle this week, and was surprised in a good way with the strength I have and my ROM. Just need to make a “step” of faith now…

  810. lorne, on April 5th, 2013 at 12:36 pm Said:

    Hi, I’m posting from Ireland but hoping it’s still relevant to all the UK folks out there. I’ve recently ruptured my Achilles in a toboganning incident where It was a full rupture. Severe force caused this one where my foot caught the ground at 60mph and forced up to my shin! Scan showed it was 2cm apart. Flew back home to Ireland and went in for immediate surgery. All up was maybe 7 days between injury and surgery. Surgery seemed to go fine, in a cast and gettting it removed at the 2 week mark next Friday, along with stitches removed. I’m getting a bit of pain in my upper calf muscle, almost right under my knee where the calf connects to the back of the knee. Any ideas on what this might be? Any advice would be greatly appreciated.

  811. normofthenorth, on April 5th, 2013 at 2:39 pm Said:

    Probably normal and no problem, Lorne. And probably not the last tingle or twinge or discomfort or cramp you’ll experience, either. You’ve taken one of the strongest and normally-busiest muscles in your body, flexed it to the max, then asked it to sit perfectly still for a few weeks, for the first time in its/your life(!). That’s all!

  812. micah1, on April 7th, 2013 at 10:24 am Said:

    Hi Lorne,
    I ruptured mine the week before you I think, I was given a choice and decided on conservative treatment. (Sheffield UK) I had 3 weeks in a cast( due toEaster falling on the 2 week clinic) and returned to fracture clinic last friday and had an aircast fitted. I too have had some pulling or tightness in my calf usually when straightening my leg, I was a bit paranoid about DVT’s, however the Dr in clinic had a prod of my leg, checked for tenderness and implied that it was fine.
    I am now apparently weigh bearing on the foot, with crutches and that pulling feeling has gone, instead I have pains in my base of my foot which I think is all normal. I’ve started a blog so I can remember what happened when, I’ve found other peoples accounts invaluable so far . http://micah1o1.tumblr.com/
    Best wishes with your recovery. Micah

  813. micah1, on April 9th, 2013 at 3:33 pm Said:

    Hello, Could I have census of opinions about my dilemma please. I am due to go to New York for a 5 day break,(Silver Wedding celebration actually). However this will fall at 10 weeks following ATR. i am in the UK having non-op treatent, ie 3 weeks in a cast, then 4 weeks in aircast boot, so by week 10 I should be in 2 shoes for 3 weeks.
    How will I be at walking by then?
    I did ask the Dr in clinic, but he was a man of few words and could not be pressed in to saying yes or no.
    My husband is still keen to go and says we can just get taxis and not do any substantial walking.
    I’ve been reading lots of blogs on here, but its so difficult to gauge when you all have had different recovery paths.
    any discussion valued thanks
    Micah

  814. ripraproar, on April 9th, 2013 at 4:27 pm Said:

    Hi Micah
    Congrats on your 25th we went for our last year fantastic.
    I’m non Op and will be going to Spain hopefully in 2 shoes will also be 10 weeks, I’m 7 weeks now, what I will be doing is taking boot just in case, I’ve been in boot since week walk so I’m ok walking in it now no crutches, however ill take one crutch just in case paving is poor, I’m happy to take boot and crutch as a precaution , it is a signal for ther to be cautious around me, but also because I’m on hold I should imagine ill be walking much more than I do at home and work. Hope this is of some use to you

  815. trin74, on April 9th, 2013 at 5:05 pm Said:

    I agree with Ripraproar that you should probably take you boot just in case. Even if it is just so others can see you are injured. I am 6 weeks 5 days post ATR, with the boot coming off in 8.5 days (not that I’m counting). The consultant seems to think I will be driving a manual a week after the boot comes off. I’m expecting that l will be quite limited with my walking distance for a while, trick will be to make sure I don’t walk too fast. Ripraproar how are you going with the flat sole? I can’t get a nice gait in it yet myself.

  816. Lisa, on April 9th, 2013 at 5:56 pm Said:

    I actually injured my first one in New York City. There’s A LOT of walking on uneven surfaces and a lot of people stepping all over your feet. So it’s not a matter of how you’ll be walking so much as how everyone else will be walking! I would bring a boot and I wouldn’t hesitate to consider renting a wheelchair depending on what you’re going to be doing (museums usually have them too). Something like the Guggenheim or Museum of Modern Art is nothing but walking.

  817. ripraproar, on April 9th, 2013 at 6:06 pm Said:

    Hi trin
    When you say flat sole, I’m in the boot 7 more days, I have one wedge, the boot hasaslight curve to allow rolling, hey I’m great at walking down stairs normally , great tip from Norm, did struggle with walking on flat, I kind of couldn’t get my good foot to pass my bad, so another tip of norm, had straps tight, and allowed my foot to roll shin pushed against the front, I practiced in mirror and can now get a good but slow stride, my workmates noticed this improvement. Anyhow bit of a set back today, i demanded pt , went which was good , however the physio did some real hard massage on the tendon, it’s now really painful and swollen and there’s now a lump, I just hope I’m worrying about nothing, but in hindsight I don’t know if tendon as joined so I shouldn’t of let her go at the tendon I’m kind of wondering if it wasn’t attached could she of stop the healing. Ill keep you posted, by the way I felt great having the pt excercise

  818. ripraproar, on April 9th, 2013 at 6:08 pm Said:

    Trin, forgot to mention I packed the shoe of my good foot to balance the height difference of robo boot

  819. ripraproar, on April 9th, 2013 at 6:14 pm Said:

    Hi Micah
    I went to Spain week four I hired a mobility scooter ,made a big difference, stopped me being confined or dependent on others , I went zipping around on my own.
    I’ve set my self a target I will be 50 sept 2014 want to do half marathon by then and full year after, I’m looking at this as an inconvenience albeit a temp life changing one, but I’ll beat the bugger no matter what,
    Rrrr

  820. normofthenorth, on April 9th, 2013 at 8:49 pm Said:

    Micah1, by the time I came out of my boot, I was walking faster in it than most of my frineds, and maybe me pre-ATR, too. Going to 2 shoes slows you way down at first, and full speed can take (too) many weeks. My fave protocol says “Wean off boot” at 8 weeks in, and that certainly allows for using it several weeks later in scary spots.
    The boot will protect you from harm from clowns who want to trip you. Alternatively, if you’re moderately comfy and fast in shoes, but still vulnerable, a cane (or new-fangled walking stick, some of them folding and cheap!) can keep them away — or at least let you poke them if they do come too close! :-)

  821. trin74, on April 10th, 2013 at 4:16 am Said:

    Go the walking stick! I have mine folded in my bag at all times just in case. I expect to be wearing the boot occasionally once I move to 2 shoes. My indoor scooter goes back today, it was such a lifesaver, for work but especially because I live on my own. Ripraproar, I am at neutral which might be why I am having trouble with the flat sole, but it is improving (just using it at home, wearing the bigger one at work). I shall try to do what you’re saying up pushing into my shin.. Thanks for the tip (via Norm).

  822. micah1, on April 10th, 2013 at 4:59 am Said:

    Thanks Norm, Lisa and Riparoar for your thoughts on the NY trip. I’m going to try and speak to a physio to see if I get any further insight. Considering trying to cancel/rebook via the travel insurance although I realise some admin costs will be involved . However your take the boot/ use the wheelchair suggestions are uplifting, this morning I have carried my own cereal bowl using 1 crutch on day 5 of the boot which has brought a smile to my face for the first time for a couple of days.
    I don’t want a set back, maybe hobbling with the boot is the answer?

  823. micah1, on April 10th, 2013 at 5:05 am Said:

    oh and I will investigate folding sticks thanks trin!

  824. hillie, on April 10th, 2013 at 9:11 am Said:

    Trin, something wrong here I think.

    By neutral I assume that you mean that you have a hinged range of movement from 30º PF to neutral, which is about right at 6 or 7 weeks. At this stage, the flat sole (as opposed to the wedge sole) is the correct choice, and as you know, is specified in the handbook for the boot. If you are healing correctly then the wedge alternative (which is very acute), meant for the earlier stage recovery, should certainly be incorrect and your flat sole is the right one.

    If your hospital doesn’t have the technical expertise to resolve your questions, why not call Oped, the Vacoped manufacturer. Its UK office is in Devizes. I had questions that they resolved first of all by email, then with a visit to me at home - very helpful. In my case they swapped my boot for the next size down - sizewise I was borderline, and the smaller size made a big difference.

  825. lorne, on April 15th, 2013 at 6:45 pm Said:

    Hi All, I’m currently almost 3 weeks post op and on my second cast (first one removed to take out stitches last Friday) for the next 4.5 weeks.

    My dr said I will then go into a shoe with a heal insert.

    Is this ok, or should I be going to a moon boot?

    I certainly DO NOT want re-rupture.

    If the heel is ok, any idea on where I can source a good half inch heal insert?

    Thanks
    Lorne

  826. alton2012uk, on May 15th, 2013 at 8:52 pm Said:

    Lorne, just noticed no reply to your post. Hopefully this response is not too late……… going into 2 shoes around week 8 is not unusual. I went into 2 shoes with 5mm heel insert in week 9.

    I assume the doc will check you out when the cast is removed to clear you for 2 shoes. Just be careful as your balance and strength will be low in the early weeks out of cast and in shoes.

    I bought an adhesive heal insert strip from a local podiatrist. Just cut the strip to size and its long enough for 2-3 pairs of shoes. Alternatively google E-thotics heel raises.

  827. davidr, on May 22nd, 2013 at 5:33 am Said:

    A year today, wow. For all those put there get good support and good medical advice. The first few months are hard, I have had a complex recovery, but there is a life on the other side. The next challenge is making it an active life. Good luck all. And thank you to all on this site, invaluable.

  828. martin1987, on June 3rd, 2013 at 10:32 am Said:

    Hi, my 1st post but I’ve been reading through over past weeks. ( very usefull)

    I ruptured my right AT on the 2nd April 2013, I was put into a cast for 2weeks while I waited for my op. went it a new full cast for 4weeks post op and then down to a front cast for 2weeks. All were positioned in the toe down. I’m now cast free as of last Tuesday (28th may) after reading most ppl stories, I was very surprised when I was not offered an air boot! And when I asked the reply I got was “they take 5 weeks to order so you might as well go straight to two shoes with a wedge!”

    I had limited movement from the toe down position, lifting my foot no more than 10mm upwards. Started physio the next day, they said because of my age they wanted me full weight bearing ASAP! They gave Me my exercises and within 1 week I can stand without crutches with both feet nearly together, standing straight! Can walk a little but not much flex in my foot!

    I can flex my foot from toe down to 90, but no more! Just wont budge! Really stiff up my shin and slight pain in my AT (any ideas?)

    The main problem for me is whilst being of work (builder) ive got a new job, I start on 17th June and whilst still being in the construction industry it’s more office based so I’ve been signed fit to work! I need to drive!!! Quickly! Has anybody got any ideas/tips how I can achieve this? It’s going be mainly for an emergency stop ( hopefully not needed!) all advice would be much appreciated!

    Thank you :-)

  829. alton2012uk, on June 3rd, 2013 at 1:57 pm Said:

    martin1987, I posed the “When can I drive ?” question on an earlier post. Have a read of this, it received a lot of responses, click on link :

    http://achillesblog.com/alton2012uk/2013/02/24/week-8-when-can-i-drive/

    There is no easy answer or consensus on when to drive. It comes down to weighing up the risks to your own recovery and the view police & your insurance would take if you were unfortunate to be in an accident.

    I am right ATR also which doesn’t work for using or hiring an automatic vehicle either.

  830. martin1987, on June 3rd, 2013 at 2:57 pm Said:

    Thank you alton, will have a good read through. I’m back in for physio on friday so I will hopefully know how far i am away from driving!
    Thanks againm

  831. alton2012uk, on June 3rd, 2013 at 5:38 pm Said:

    Martin, I built flexibility in my foot gently using AROM exercises. It took me about 10-12 days to get to neutral comfortably ( ie foot 90 degrees to shin). I have posted some videos showing my progress in Week 4 & 5.

    Note the rehab I followed avoided dorsiflexion (ie going beyond 90 degrees) during those early AROM weeks as the tendon is not ready to take it. Your physio should have advised on how far to go with the flexing whilst exercising. Are you doing active or passive range of motion exercises ? Did your physio tell you limit the range of motion exercises in any way ?

  832. martin1987, on June 4th, 2013 at 6:40 am Said:

    Hi Alton, I was just given a range of active exercises, mainly to stretch the tendon. My physio didn’t limit the range of motion, just said I needed to get as much movement and weight bearing as quickly as possible. I started physio in week 6 (last Tuesday) and have got to 90degree to my shin but can’t get any further, I get pain in my At if I try to push past it and then It’s a mental block! How do I see your videos please? Thanks

  833. alton2012uk, on June 4th, 2013 at 5:06 pm Said:

    Martin, the following link should show you my posts that have video on them :

    http://achillesblog.com/alton2012uk/tag/video/

    or alternatively go direct to http://www.youtube.com/user/alton2012uk

    Have a look at my early videos, I think you are doing ok getting to neutral/90 degrees in a week. Many of the accelerated protocols I have seen limit ROM from 30 degrees PF to neutral in weeks 6-8, and then moving to a -30PF to +10DF range in weeks 8-10. I think your physio may be unusual in not placing a limit at week 6 on ROM. I personally don’t think you should force the foot beyond where it is happy to go at this stage and would recommend reviewing info on this site regarding limiting ROM exercise to neutral upto week 8.

    As always with ATRs, there are differing physio views on how long to protect against tendon lengthening. My sports physio was very cautious on this and didn’t want me doing passive dorsiflexion stretches or walking barefoot until I reached approx week 16.

  834. musimaster, on June 11th, 2013 at 2:35 pm Said:

    Hello All.

    My story so far, Monday evening 20 May 2013 playing football, 55 minutes into the game, not really moving or jumping, sudden pop and to the ground feeling like i had been shot, no-one around me!

    Knew someone very wrong had happened, friend had to drive my car home for me. Decided to read up at night having elevated it and taken Ibuprofen, icing at the same time. Quickly realised what had just happened and mortified at the same time.

    Following morning, went to hospital and diagnosed almost immediately by A&E Dr as ATR. Sent swiftly for an Xray, then to Orthapaedic Consultant who confirmed ATR, discussed options with me (Conservative / Op route).

    I knew i would be going to Operative and decisively told the consultant of this, despite him trying to steer to towards Non-op route. I had indicated to him i am very active, play sports twice a week and generally very active, hence, re-rupture rate being lower via op route was the preferred route for me.

    Was sent to Orthotics, Vacoped boot placed on me straight away. Admitted to hospital with surgery booked for the following day.

    22 May - ATR Surgery and placed in splint.

    4 June - To see surgeon, wound healing well, staples removed, discharged from surgeon who all but saw me for 2minutes saying ”OK” to Orthotics dept.

    Orthotics, placed me in Vacoped boot again, toe fully down 30degrees and NWB (but allowed to simply use boot to balance if standing still).

    11 June (3 weeks post op) - Went to see Orthotics, they took boot off, cleaned wound, advised all looking OK, advised i can PWB (although he kept the boot at the same angle and did not bring it up).

    Been given scheduled appointments to go and see Orthotics every Wednesday for the next 7 weeks ! I therefore think i will be in the Vacoped boot for some time yet.

    After reading up a fair amount on this site and everywhere else, i note, treatment rapidly varies on where you are and who is treating you. When i told the Orthotics chap i was doing gentle ROM exercises, he was very clear not to do anything at this stage, he was against, me even taking the boot off to air the foot !!

    Will wait and see what next weeks appointment brings, hopefully will update after weekly appointments.

    My question to all of you is, i continuously have sharp tingly feeling behind the heel under the bottom of my scar, the pain is getting better and as it does, i have noticed i am slowly seeing the swelling on my toes and fingers beginning to come back. I have not really seen many people mention this on any site. It is extremely annoying and painful at times which makes wearing the boot very uncomfortable!

    Any views and comments on this would be appreciated.

    Failed to mention i have religiously kept the foot up for almost all of the time for healing purposes. Feels like toes will burst when i bring the foot down, although Orthotics chap has said can keep it down now as much as i want.

    Desperately want to get back into shoes but i know it is the long haul and must get this right as cannot afford a re-rupture, i think would have a breakdown if that happened !!!

  835. rickuk, on June 28th, 2013 at 11:28 am Said:

    Hi all

    What a great blog for an ATR newbie.
    My tale: I’m a 57yo weekend wallier who got hit by the invisible slammer at tennis last Monday 17th .
    At first I thought it was a calf pull or tear; just managed to hobble off and drive home.
    Spent 7 days doing RICE and walking at home on it. No pain after first day; I just thought it was getting better!
    Day 8 - I realised it was an ATR; went to GP to confirm.
    Day 9 - Went to Reading RBH hospital. Brief exam by nice orthopaedic doc. She did calf squeeze test and could feel a gap. No scan offered.

    Treatment will be 2 wks in equinus cast then straight to boot for 7 wks; then raised shoes. This sounds fast to me, although no PT offered till boot comes off. I think that’s what she said.

    So I’m now at ATR+12; no bad pain; discovering the joys of hobbling round a 3 storey house with crutches, yet to discover the best way to do a no2.

    This blog has been great for answering most of my concerns so far. Thanks everybody!

    My only concerns are:
    - after walking around for 8 days, will my tendon ends actually find each other and mend? What progress should I expect when the cast comes off at ATR+20 ?
    - I’ve started getting cramps in the ATR calf - like a nagging muscle pull under the cast
    - Should I look to getting PT when I get the boot?

    Cheers
    Rick

  836. superjewgrl, on June 28th, 2013 at 12:25 pm Said:

    Rick welcome! You and I have the situation except I went 15 days before treatment. I was just casted today and my follow up is in 3 weeks. I started falling before I was casted and the pain was horrific.

    My doctor told me that I will heal and the tendons will find each other but I could heal long. If I had surgery that wouldn’t be a risk..

    I am not sure I’m getting PT which kind of shocks me. He said we would be doing exercises though. I told him I wanted aggressive treatment non surgical and although he doesn’t like my decision he supports me. Which now makes me happy.

    There are a lot if terrific people here who will gladly offer assistance.

    Welcome to the club. Happy Healing.

  837. badge, on July 3rd, 2013 at 4:30 pm Said:

    Hi people,

    It’s one year to the day that my tendon went pop - 3rd July 2012.

    A year ago I was given the option of surgery or natural healing. Didn’t take me long before I decided on the conservative approach. A cowardly nature meant I didn’t fancy the idea of having my calf cut open and restitched.

    To let you know where I’m at with it now: I’ve still got a bit of a limp, that tends to disappear after I walk for a while. Still sore, generally when I walk without shoes. And my calf still feels like spaghetti compared to the other one. There’s two lumps on the tendon - one in the middle and one at the join of heel bone.

    Hopefully things will improve shortly, because I’m going to use the summer to really try to build strength back into the leg. After having an injury like this, I’m happy just to be walking again. The fear of re-rupture looms heavy still - especially if I trip or twist the foot, or try to do calf raises at the gym.

    This injury does test your patience. But for those who feel the frustration of a recent rupture, believe me when I say that the time will pass quickly. The first couple of days, when the shock of the injury was making its first impact, is what exhausted me the most. Once I’d accepted the idea, life began to shape itself around my immobility.

    If I’m to pass on advice for newly ruptured people, it would be to try to keep fit and work around the injured leg. For those into working out, the upper body can still receive the benefit of a good workout. The fear of being immobile, sitting for hours on end in a chair, prompted me to relocate my gym activity to my home; using a chair and dumbbells to satisfy the need to exert some energy. Still being able to work out was a great counterbalance to the restrictions forced on me by the injury.

    I think I’ve mentioned this before, but there’s a great YouTube blog from a man who opted for conservative treatment. His name’s Brady Browne and his positive approach to the injury is inspirational and, I remember, provided great comfort and hope for me.

    Good luck with the heal - at whatever stage you’re at.

  838. ripraproar, on July 3rd, 2013 at 5:37 pm Said:

    Hi badge, thanks for your update it means a lot to many, a year out I was hoping you would of ditched the limp , however it does sound your sensible with your attitude

  839. badge, on July 4th, 2013 at 3:51 am Said:

    Hi Rip - it’s the general feeling of the tendon feeling sore gives me the limp - but, hopefully, it’s not really a noticeable limp and it does disappear quickly after it warms up. But yes, it’s not good.

    I’m sure a lot of it has to do with the psychological reluctance I have to really push off on the repaired foot (partly due to it still feeling sore still).

    Also, I haven’t been good with my own physio work. I returned to the gym early (still in boot) to keep the upper legs and body healthy, but I never managed to really get the confidence to bring the calf strength back to anything even remotely like it was.

    At home, I haven’t been using the theraband to work the calf or by building supported calf raises into a daily routine at home. I had phases were I’d do calf raises when brushing my teeth, but this phase tends to be short lived. This is partly because I had a belief was that if I just walked - the walking would naturally build the leg back to strength.

    Recently, instead of using a stationary bike at the gym, I’d go for a long walk (1 and a half hours), to really try to build a confident motion back into my stride. With the summer weather arriving, this was quite a pleasant way to work the leg (a perfect opportunity to listen to an audiobook) - but things have been really busy at work recently so that soon died a death.

    I have 8 glorious weeks off work in 2 days (I’m a teacher), so I’m determined to use the time to get my leg fitness back.

    The only thing that I really want, is a negative - I don’t want to re-rupture. I’m out of the danger zone but it does feel as if my tendon is a time-bomb, waiting to pop. But like I said, that’s a psychological barrier I need to deal with and overcome.

    Oddly, I do see this injury as one of the most positive things to have happened to me. It forced me to change many bad habits I’d developed over the years and gave me the time to reassess the priorities in my life.

  840. ripraproar, on July 4th, 2013 at 2:34 pm Said:

    Hi badge
    I get what you mean about the at being a time bomb , I’m 5 months have pain sometimes feeling lie the at is going to rip, however some potential bad news last week helped me, by this I mean physio then consultant said at look really great and strong , so the pains stabbing burning etc could be chronic regional pain syndrome which is uncommon and not curable, so when I feel the pain instead of backing off , I know it’s not the AT and this really really helps, what am I doing about the possible crps ? I just tell it to !”;:/- off , this also really really helps, I also get what you mean about walking instead of gym , I thought pre ATR I got my leg strength by walking I wasn’t ever what you call a gym bunny, so thought walking and standing would soon get the strength back, however I concede the gym does help it makes massive difference. Re you limp I also get one you mean, my friends tell me my limp is no more, but I can tell its there slightly and I can tell the lift is a bit sore I can also see I need the foot to warm up in the morn, but I will beat this of that I’m confident, finally I also relate to the positive things from this miserable injury

    RRR

  841. lesley99, on July 7th, 2013 at 3:37 pm Said:

    I’ve been reading a lot of posts on here over the last 12 weeks, so thought I’d say hi, and hope someone can give me a little info based on their experiences on my worries and fears!

    12 weeks ago today I partially ruptured my right Achilles tendon, and fully ruptured the left. Initially I was sent home with a moonboot on the left, and a plaster cast on the right (thanks A&E), the next day I was put in casts on both legs, and the day after that, following a meeting with a consultant, I was put in hinged boots at 40 degrees. I was allowed home from hospital after 5 days, complete with wheelchair.

    I was standing at 6 weeks and taking little steps in my boots, which by then, were at 15 degrees. It took me 10 days of walking a little at a time before I could do it pain free. I spent a further 4 1/2 weeks in the boots, getting to neutral, before I was back in my own shoes.

    I had my first physio session on Thursday. I’m doing stretches (leaning against the wall) 5 times a day, and standing on my toes a couple of times a day. Thing is, it hurts, and it worries me that I’m doing more harm than good. Then I remember how much it hurt to walk at first and I got over that. I get a burning pain sometimes where I think the tendons were damaged. Is this normal?? I’m walking now in trainers with a tiny heel lift, once I get going I have a slight limp on the left leg, but I’m walking pretty good with the right, although it takes a bit to get going.

    My other issue is driving. My right leg, having only been partially ruptured, has healed better. I could driving an automatic, if I had one! But the left leg is not good with the clutch yet. It would be good to get an idea of how quick you guys were driving after an ATR.

    Any advice/comments would be gratefully received.

    Lesley

  842. lodinpdx, on July 7th, 2013 at 4:22 pm Said:

    Hi Leslie,

    First of all. WOW - I am so sorry - both achilles at the same time. That is horrible!!

    I am certainly no expert but here for what it is worth are my two cents. I have had other injuries and was always willing to work through the pain. With this injury however I think slow is the way to go (and I am an impatient person!) I have read about re-ruptures and would do anything for that NOT to happen. I think that if it really hurts back off regardless of what the PT tells you. You can always back off and try again in a day or two. I am thinking 2 steps forward 1 step back is better then 2 steps forward 12 steps back! :)

    As for driving - I know we live in different countries but my doctor told me NOT to drive until I could confidently slam on the brakes. If I were to get in any kind of accident and the other person found out about my injury then I would be liable no matter what. He even told me a story about a patient who was hit while driving in his boot. Even though not at fault he was liable and that was that!

    I hope this helps! Good luck to you!

  843. lesley99, on July 8th, 2013 at 2:56 am Said:

    Hi and thanks for your reply.

    I’m thinking along the same lines, I need to give the left leg a day or two of rest and then I’ll try again. The right one seems to be coping fine and I’ve got loads more movement there, I think the left one, being a full rupture is just going to take a bit longer to recover.

    I can’t wait to be driving again. 3 months of being reliant on other people is frustrating me, I’m normally so independent. My boss is currently paying for taxis for me to get to and from work but I can’t keep getting away with that. I think I may have to consider getting an automatic at some point soon if there’s no real improvement. When I asked my consultant when I could expect to be driving again he just said when I was comfortable with the pedals. I tried last week but I know that left leg is just not going to cope with an emergency stop and its not worth the risk.

    Wish I had a crystal ball!

    Lesley

  844. paulfea, on July 8th, 2013 at 7:47 pm Said:

    Hello fellow ATR-ers…

    What happened to us is a really nasty injury. I don’t know anyone who has had this…other than professional sportsmen whom you probably know: Beckham, Kobe Briant and…especially (I’m an Inter Milan fan) capt. Zanetti…

    This blog really helped me as I realised there are a lot of other ATR people out there…

    I’m 4 weeks post-ATR, non-op, nearly full rupture (2.7mm tendon left…) while playing football 5-a-side. I’m 38 yrs old, fairly active. NHS doctor advised me to go for non-op treatment. Got a second opinion in private and was recommended operation…

    Followed the non-op route…

    Thanks to this blog I became aware of early mobilisation protocol and “suggested” use of Aircast boot (against initial advice). After two weeks in plaster in equinus, I’ve been in Aircast with 5 wedges for 2 weeks. Tomorrow I’ll remove the first wedge… Next appointment with NHS to (hopefully) get rid of boot in 5 weeks.

    I’ve been walking with no crutches for a few days with no pain…it feels good!

    I’ve got a small bump on my tendon…though doc said it’s normal.

    I was advised not to do any active or passive PT for the time being.

    Has anyone had a similar experience/treatment? Any tips?

    Thanks and good luck!

  845. badge, on July 9th, 2013 at 8:12 am Said:

    Hi Paulfae - I chose non-op, but I was in boot for 12 weeks or more. Looking back, it was a non-aggressive approach and it did make me a bit timid about walking on the foot once the boot was finally removed.

    But, so far, I’m happy I went non-op. I can’t see the point of invasive treatment, if it can be avoided: apart from that that scary re-rupture rate, which is much higher compared to the figures for the operative people. But I’m sure the re-rupture for non-op is deceptive (12% or something) - because it doesn’t show the age/how it happened, when it happened, etc.

    I’ve got 2 lumps where there never used to be lumps - one near the heel bone/tendon join (this is sore still) and another mid-way up the tendon (not sore, but I assume this is where it snapped). The tendon has healed much thicker than my other one, but there’s flexibility in it.

    The boot is a miracle worker; you can really get life back to normal once you are booted up. Although, I did keep a crutch (when I went out on the street) for longer than I needed, mainly to signal to other people to give me room or not to expect me to dash across roads.

    I’d do what your body/mind tells you to do - and listen to any pain you might feel when entering into physio. I remember when I was out of boot and into physio, there was a need for me to test the limits of my tendon (tip-toe work, calf raises) - almost like to prove it’s back to normal. Looking back, it seemed like a psychological need to prove to myself all is well with the foot. But now that time has passed, it seems unnecessary to do this. I’m a believer that time itself is the healer. And that’s where patience plays a big part.

    I’m just over 1 year since the rupture, and - late as it may seem - I’ve been following a strict physic/exercise routine for the leg/calf. And it is beginning to feel much stronger and my stride is nearly back to normal. My boredom threshold is low, and part of my problem is I get really impatient doing the foot warm-ups, calf-raises, etc.

    As a side note, I’m sure the NHS encourage the non-op approach because it makes less impact on the costs. I don’t know much about how their financing works, but it seems much cheaper to boot someone up and send them home with removable heel inserts for 8 weeks or so. But, like I say, I’ve got no complaints about the conservative route.

    I’m back in physio next week (private) - it’s a bit like taking a car for an MOT - just to check everything is okay. I’ve noticed my ‘good leg’ has been taking most of my body weight when I stand still, which could be affecting my back and alignment.

    Good luck with the heal - take it easy, and let your foot appreciate the unexpected time off.

  846. hillie, on July 9th, 2013 at 11:55 am Said:

    badge

    Have confidence! Even for non-aggressive treatment, 12% seems high. Take a look at the newly issued Exeter (UK NHS) results study which used an aggressive protocol and VACO boot for both op and non-op (including me) cases.

    I posted information on this on Suddsy’s blog on 24th June including http://www.bjjprocs.boneandjoint.org.uk/content/95-B/SUPP_18/16.abstract. Check out the re-rupture rates for Exeter’s patients there.

    My NHS physio treatment was excellent and I supplemented this after 16 weeks with visits to a sports physio in order to up the pace of strengthening. 18 months on, the key physical difference is an improvement in strength - I do mountain and hill walking so it was important to at least get back to where I was.

  847. hillie, on July 9th, 2013 at 12:02 pm Said:

    badge

    a ps to my post earlier.

    As a tax payer, I am (as you are too probably) pleased that the NHS looks closely at costs. The VACO boot chosen by Exeter’s ortho team costs around £200 (although that is full retail) but is almost completely recyclable, replacing the linings (2) and the Velcro straps, after which it can be moved on to the next incoming ATR case.

  848. normofthenorth, on July 9th, 2013 at 2:37 pm Said:

    Lesley, I’m a wimp when it comes to stretching a healing AT, like against a wall. It’s almost unheard of for a non-op ATR to heal short (though common post-op), but healing long non-op is a serious threat. It’s also easy to do harm by overdoing heel raises and similar strength exercises, post-op or post-non-op. (On my blog, I document a painful MONTH-long setback in my first — post-op — rehab after I let my PT talk me into doing too many 1-leg heel raises too soon. I DID know better, but she persuaded me that she did.)
    Unfortunately, even “listen to your body” might not save you, because overdoing may NOT cause serious pain at the time. (Mine didn’t.) So I preach INCREMENTALISM. If an exercise or activity felt OK and still felt OK a day later, try 10-15% more, but don’t jump headlong into something new and different.

  849. normofthenorth, on July 9th, 2013 at 2:51 pm Said:

    Hillie and Badge, 12% rerupture rate is NOT very high for an old-fashioned non-op “conservative casting” approach. Some studies (and maybe even meta-studies) came out at 15% or even higher. Conservative casting is NOT a sensible treatment for ATRs. (I discuss the excellent 2005 meta-study on my Studies page, and the same author has recently done a newer version for Cochrane — unfortunately still lumping fast and slow non-op studies together as if they’re comparable. In 2005 there were ONLY slow non-op studies, so his analysis was excellent; his recent one is worse than a waste of time.)

    This is so tough for so many “otherwise intelligent” health professionals to learn, believe, internalize. . . but evidence is evidence, and truth is truth. Especially for non-op ATR patients (full ATRs for sure, and very likely partial ATRs and reruptures too), going fast is SAFER than going slow!! By “fast” I mean the speed of bit.ly/UWOProtocol or even 2 weeks faster, like the UK and Vaco protocols Hillie and others have been discussing here and on Suddsy’s blog.

    There’s a whole generation of OSs out there who are used to telling ATR patients to go slow and spend more time on crutches in one more cast, because “we don’t want to have to do this all over again, do we?” And it’s all spectacularly WRONG, just like believing that gastric ulcers are caused by stress and spicy food, and all the other medical errors that we’ve discovered from the evidence.

  850. lesley99, on July 9th, 2013 at 5:54 pm Said:

    Normofthenorth thank you for your thoughts, I will certainly keep them in my mind. I’ve given my left leg a rest and will start very gentle stretching again tomorrow given that all feels good. It’s so hard to know what’s right or wrong. I’ve read of incidents where rerupture has occurred during physio, rare or not they happen.

    On the plus side I changed my car today for an automatic so I’m back in the driving seat again :)

    Lesley

  851. chris90, on July 23rd, 2013 at 12:38 pm Said:

    Hi all,

    I’m glad I found this site. I ruptured my right Achilles whilst on a football coaching course. Luckily, my tutor suspected the rupture and took me straight to hospital. They diagnosed the injury and put me in the cast. They gave me the Patient UK handout and the first thing I focussed on was the early mobilisation part. I had this in mind when I went to the fracture clinic at the hospital nearer me. I had already decided on the non-op route as I had given up playing football before the injury as I have had the cartilage removed from right knee and at 38 I was getting some pain. Although I would like to keep cycling and playing golf I don’t think not having an op will prevent this. I might have to take it easy in the coaching sessions though.

    I go back to the hospital on Thursday to hopefully get into a walking boot and start PWB as soon as possible. I have been getting some discomfort in my left heel and am wondering whether an air cast wrap might provide some support? Any one used one of these and get any benefit?

    I will post after my next appointment.

    Chris

  852. normofthenorth, on July 24th, 2013 at 3:20 am Said:

    Chris90, non-op ATR treatment is no longer just for non-athletes, as you can see from Brady Browne’s YouTube videos and those of other “jocks”! But the key (as you can read above and elsewhere) is to follow a successful modern fast protocol — like bit.ly/UWOProtocol or a bit faster (like the ones we’ve been discussing on Suddsy’s blog page).

    Going slower than UWO is associated with inferior outcomes, so Don’t Go There. Period.

    You don’t mention how long you’ve been in the cast. Start a blog if you can, and install the ATR Timeline Widget and we’ll all know your FAQ info.

  853. chris90, on July 24th, 2013 at 5:30 am Said:

    Thanks Norm, I’ve been in the cast 2.5 weeks. When I met the quack I was quick to point out the early mobilisation. When I speak to him tomorrow I want to get the walking boot and get moving. My biggest worry is re-rupture but I know I will need some patience!!

  854. chris90, on July 25th, 2013 at 9:39 am Said:

    Back from the hospital and have an aircast and 6 wedges. Was meant to be 5 but I couldn’t put my foot down and had another put in. I’ve got my first physio appointment in 2 weeks after my holiday. I have to say that I fell better in the boot and have walked supported with the crutches.

  855. pollyanna, on July 28th, 2013 at 4:45 pm Said:

    Hi All
    It’s so good to find this site! I’m currently still in my first cast and counting the days till I get a boot! Four weeks since injury. I seem to have a very rude Doctor who accused me of walking on it as my heel is dirty! Which is physically impossible the angle it’s at! Anyway I shall keep an eye on blogs here, good to feel you are not alone hopping along!

  856. superjewgrl, on July 29th, 2013 at 3:02 am Said:

    Pollyanna,

    Your post gave me a good chuckle. I started walking on my cast because it didn’t hurt and I detested relying on my crutches.

    I’m not even sure my doctor noticed I smashed the bottom of the cast. I’m going to try to follow directions and pay attention from now on, but even if you did walk on it, it’s not the end of the world.

    Happy Healing. xx

  857. robertogalardo, on July 31st, 2013 at 4:18 am Said:

    Hello all,

    I ruptured my achilles tendon on the 3rd of march this year. Full tear.
    I am 19 years old and i am a personal trainer.

    That evening after it had happened whilst playing football, i went to A+E at the royal berks in reading. There were 4 people in the a+e on a sunday evening and it took them a total of 4hours to see me, even though my foot was just hanging there.

    The nurse then did the thompson test and stating the obvious it was a full rupture.

    I was then put in a cast (Not in full plantar flexion as it should be.) and told to come back on the friday later the next week!

    Friday came along, i saw the consultant who took off the cast and slated who had ever put it on the previous sunday.
    My foot was black and blue, swollen to the max.

    He tried opting me for the non surgical route, i was having none of it and managed to get the surgery i was after, that was booked for the Monday 11th of March.

    Went in for surgery, the waiting room was around -2 degrees, the anesthesist had to tap my arm for around 5mins in order to find a vain.

    Woke up after surgery, then sent to the in-patient room. Couple of hours later had a little physio (showed me how to walk up and down stairs effectiveley).
    Not once did i see the surgeon who operated on my achilles to tell me how the procedure went.

    Follow up appointent was for three weeks later, this time i saw a new young consultant. They didnt even realise i had surgery yet, untill i told them. He then checked my foot all seemed to be well.

    Had a re-appointment again 2 weeks later, they took the cast of and put me in a moon boot. Again not reading my notes and thinking i was still to go to surgery. On top of that another new consultant came and checked me out.

    So this same scenario happened for all the re-appointments up untill i was out of the moon boot last month around the 22nd june.

    All in all the treatment that i had through out was DIABOLICAL.

    Even though now i aback up and walking without a limp, ive made this happen myself.

    Ive lost my respect and trust in the NHS.

    i opted for private physio, as the nhs pt offered it only once monthly.

    All in all its been a very frustratijng injury, more so having been given a shambles of medical service.

    I feel they shun the young people aside and prioritise others.

    Roberto

  858. hillie, on July 31st, 2013 at 7:27 am Said:

    You need to read up some more through this blog and take charge with solid evidence and ‘best practice’ to take to your surgeon (if he won’t see you soon enough, check your GP for interest and his involvement).

    To save you some time check out the UWO protocol and other info on the main Achillesblog home page, and also recent info posted by Suddsy (/suddsy), Norm, me and others, especially about accelerated protocols and early mobilisation. Suddsy’s ‘2 weeks’ blog page could interest you most, and includes the latest results from Exeter’s (UK NHS) work over the past 5 years.

    Shame that you had the op though…

    Good luck.

  859. pollyanna, on August 7th, 2013 at 5:13 pm Said:

    Hurray! In my boot! Bit giddy with little things like carrying a ( half full) cup of coffee! Got a air cast boot which inflates either side but can anyone enlighten ten me as to whether I deflate when not walking or leave it inflated? Thanks for your posts, they are a real help!

  860. pollyanna, on August 8th, 2013 at 6:12 am Said:

    Hello all! I deflated my when resting last night . What’s bugging me is when I went for appointment yesterday 5 weeks since ATR and still in first equines pot the guy in plaster room said it should have been on two weeks then onto airboot. I’ve now got a copy of their protocol and to get back onto this he’s said to remove two wedges in two weeks then three weeks later one wedge. I’m concerned that removing two wedges may be a stretch too far, and am thinking maybe doing one wedge in a week then another the following week. What do you think. The doctor at the hospital doesn’t seem to really be on the ball.

  861. micah1, on August 8th, 2013 at 11:27 am Said:

    Hi Pollyanna, how annoying that you are behind schedule. As regards deflating, I was advised to deflate to sleep in the boot, but I did sometimes deflate it a little to get comfortable when resting, but always inflated to a comfortable level when walking.
    As regard to removing wedges from the aircast, I think its normal to remove 1 wedge per week anyway, mine had 3 that I took out at weeks 4,5& 6 followed by shoes with heel inserts. So if your boot is similar then 1 wedge next week should be fine, make sure the remaining ones are well attached though! What does anyone else think?

  862. normofthenorth, on August 8th, 2013 at 2:43 pm Said:

    Pollyanna, I did it the way you’re proposing, gradually. I was following bit.ly/UWOProtocol , which calls for removing both wedges (they used 2 1cm wedges) “cold turkey” at 6 weeks in. Turns out I’d accidentally been given THREE 1cm wedges not two, and when I tried going to neutral “cold turkey” it felt uncomfortable, so I spread it out over a few days. I was already at 6 weeks, so I didn’t want to add much time to that step. IIRC, I just removed one wedge pre day (or so) and was soon where the rest of the UWO-study’s patients were.

    I had a standard AirCast boot, and I found I could get a pretty good fit just using the Velcro straps and leaving the bladders flat. With them inflated, the plastic bladders were snug against my foot, which felt like wearing plastic bags as socks, not my fave.

    It’s important that you get enough support to do 2 things: (1) stabilize your ankle angle and (2) transfer your weight when walking, from the ball of your foot/boot to the front of your shin, by way of the top of the boot shank. That lets the boot’s structure take the load that’s taken by your calf and AT on your uninjured side.

    If you can get the boot to fit well enough to do both those jobs without pumping up the bladders, I’d do it, because I think you’ll find the boot is more comfortable. If not, keep ‘em pumped for walking. There’s much less need for a boot, or a snug-fitting very supportive boot, while you’re sleeping — unless you get up during the night and walk somewhere! And if you sleep with somebody, there is NO chance that you can adjust those huge Velcro straps without waking them up!

  863. pollyanna, on August 8th, 2013 at 5:10 pm Said:

    Thanks for your replies! I feel much happier now going down the one wedge a week route! Made me laugh normofthenorth as last night I was up till all hours trying to get comfy adjusting the Velcro! Needless to say both myself and other half are bleary eyed today! Might try not inflating bladders tomorrow as boot is really tight against the top of my foot and when I checked had left a lovely dint there.
    Has anyone inflicted damage with these boots cos they are seriously chunky?! I’m off to a cocktail party on Saturday, a Little black number, le boot and chunky trainer. Crutches on standby tho for stairs!

  864. chris90, on August 13th, 2013 at 5:13 am Said:

    I’ve just returned from my first physio appointment and it didn’t quite go go as expected!! When I had the boot put on I thought I had six wedges put in. it turns out that the orthotics dept had put the wedges that go in to your shoes at the end of the boot period! So i had two sets of those, one of which I took out after 3 days. The physio showed me what I was meant to have and I was surprised as they are quite big!! So thats two weeks with no wedges. Luckily, the physio has said that I am healing well but still not allowed to take the boot off. I asked if I was slightly ahead of schedule and a lot ahead was the reply! Got lot of exercises and have been invited to the Jane Fonda’s class run every Friday by the physios. Lets see what happens next.

  865. grimfoot, on August 13th, 2013 at 2:30 pm Said:

    Just reading through the ATRs in the UK and feeling ever so slightly sick. It worries me immensely the range of experiences that people have had - it does affect one’s faith in the NHS - but I have no choice, I can’t afford private :( I’m now nearly 2 and a half weeks post op, I was given the choice and opted for the op as I’m a runner (or at least I was). I was swayed in that direction by the apparent lower re-rupture rates, as and when I start exercising again I’ll need to make sure that I stretch and warm up thoroughly. I’m considering yoga - I’m not the most flexible of people at the best of times. I’m in one of these Darth Vader type boots with 4 wedges under my heel. I’m due to go back for a follow up in three weeks time and then another a week after that. I’ve also been told to expect to be in the boot until late October and on crutches until Christmas but we’ll see. I don’t want to risk further harm so will be listening to the doctor’s advice - but tempering it with information from this site. I’m 49 and had been running since January this year after a 20 year lay off. I’d built up to between 20 and 30 miles per week at about 9 minute mile pace.

  866. chris90, on August 13th, 2013 at 4:30 pm Said:

    Hey Grimfoot, Sorry to hear about your achilles. I’m surprised you will be on crutches for so long. I fully ruptured mine and didn’t opt for surgery. Although I’m quite active I decided that conservative treatment would be right for me. The research shows that it can be just as effective. I ruptured mine in July and was in a pot for 2 and days and then in the boot. I have been fully weight bearing for 10 days so thats just over 5 weeks since the injury. Even with the cock up with the wedges the physio says it’s healing OK. You are right about the different experiences but in my opinion that is down to regional variations and patient recovery. My biggest concern is re-rupture so patience is the key!!! There are some great posts about recovery but most agree that early mobilisation is the best way forward.

  867. pollyanna, on August 14th, 2013 at 9:56 am Said:

    Hello Grimfoot. It is a long recovery, as I’m finding out ( week six non operative ) but don’t get too downhearted. As chris90 has said this is a great place to find out about ATR, get support and share your experience. As for the crutches did he mean when you are out of your boot? I’m not that far yet, still in my boot but I am able to walk without crutches. It’s a slow walk but miles better than the first weeks of cast and crutches. All the best.

  868. chris90, on August 14th, 2013 at 11:27 am Said:

    Anyone any thoughts on not having the right wedges fitted. It’s bugging me a bit because when I asked the physio terrorist she wasn’t quite sure how to answer. It was obvious this hadn’t happened before. An over long tendon springs to mind but I haven’t suffered any pain or discomfort.

  869. kellygirl, on August 14th, 2013 at 2:16 pm Said:

    @chris90: It’s hard to say. I’m surprised that you were able to get your foot to seat in the boot with the lower wedges. My foot was quite tight when I first got fitted with about 3″ of wedge at 5 weeks, non-op. Were you casted to start or did you go straight into a boot? I was worried about healing long as well, but my Dr seems to think it’s usually not an issue for non-ops–or at least that is what he tells me (probably to get me to stop talking so much.)

  870. chris90, on August 15th, 2013 at 5:45 am Said:

    @Kellygirl, yes, I was casted for 2 weeks and 5 days. The cast was put about 2 hours after it happened. Then redone 4 days later at the fracture clinic. I’ve been in the boot for 3 weeks now. I suppose I will have to wait until the Jane Fonda class next week and see what they say. I’m sure there will be some questions asked of the Orhtotics department!!

  871. sammiej6, on August 19th, 2013 at 5:51 pm Said:

    I ruptured my Achilles’ tendon on 18th July - now week 5 of wearing a cast. My consultant didnt really give me a choice when it came to surgical and non-surgical procedures. He said that the non-surgical approach was far better and safer?! I had my foot re-positioned (not a pleasant experience) at week 4 and was then told I would need another 9 weeks from week 4 in a plaster cast! The last 3 of which I would be weight bearing but no mention of a boot? Was told that I would have some sort of heel attached to my plaster cast? After reading some of your comments I’m kind of worried that I’m not getting the best treatment and I’m really concerned that it will not heal correctly or I will re-rupture. Has anybody else been recommend this same course of action? It still seems to swell unless elevated at all times, feels really hot inside the cast and is very achey at night. I’ve also lost a significant amount of muscle on my injured leg and am concerned about being able to walk after this cast is finally removed!! I’m only 26 and am wondering whether I will ever be able to be as active and do as much exercise as I used to do before this horrible injury! This blog really helped and made realise that I’m not the only one!

  872. abyss, on August 19th, 2013 at 6:36 pm Said:

    I ruptured my Left achilles on 20/6/13. was put in plaster overnight then into an aircast with 5-wedges.
    Having 1-wedge out every 2wks so now down to 1-wedge.

    Have been able to manage without crutches for last
    5-6 wks or so and haven’t removed boot at all.

    So far apart from the first 10-15mins after the injury I’ve been pretty much pain free.

    Salutory experience as in real life I’m a GP !

  873. kellygirl, on August 20th, 2013 at 12:52 am Said:

    @sammiej6: Is there any way you can get a second opinion or see a different doctor? That sounds like WAY too long to be in a cast. Most of us are in a cast less than a month before getting into a boot of some sort. In fact, many people are PWB as early as two weeks–you shouldn’t have to wait until week 10 to start that.

  874. kellygirl, on August 20th, 2013 at 12:54 am Said:

    Welcome, abyss! Are you treating yourself or are you under the care of an Orthopedist?

  875. abyss, on August 20th, 2013 at 5:25 am Said:

    Went to A&E like a good little soldier and have followed their instructions to the letter !

    Only seen by Orthopaedics once (day after the injury) due to see them once I’m out of the boot.

    As I don’t do much exercise apart from walking the dog decided to go down the non-surgical route. Like my Professor used to says “The best way to avoid operative complications is not to operate”. Plus like most doctors I’m a hypochondriac, worrier and a control freak so surgery ain’t my bag !

  876. abyss, on August 20th, 2013 at 5:27 am Said:

    I’m thinking about getting a Baurfeind AchilloTrain® support for when I get out of my boot.

    If anyone has any experience / views on these I’d appreciate the feedback.

  877. sammiej6, on August 20th, 2013 at 5:35 am Said:

    @kellygirl: Thats what i thought - reading these blogs i seem to be the only one who has had a cast for this long period of time. I would like to get a second opinion but not sure how i would do this unless i go private! NHS doctors seem to run 2 hours behind at my clinic and arent really bothered when you do see them - just want to get you out!
    Cant deal with yet another 5 weeks or non-weight bearing cast! Ill have no muscle left at all by week 10!!

  878. kellygirl, on August 20th, 2013 at 10:12 am Said:

    @sammiej6: There are many NHS patients here. I’m sure one or more of them will chime in. I’m in the US so I can’t really help. Good luck.

  879. kellygirl, on August 20th, 2013 at 10:15 am Said:

    @abyss: Lol. You’ve confirmed my suspicions about most Dr.s–re: the control issues :) Lol. Sounds like you are progressing well. I’m sure you will be walked by the dog very soon!

  880. chris90, on August 20th, 2013 at 11:15 am Said:

    @samiej6. I think you need to go back to the quack with with the protocol. Your other option is to buy a boot but I think you should try for a second opinion. Reading your post it looks a little “old school”. Whereabouts in the UK are you?

  881. hillie, on August 20th, 2013 at 1:20 pm Said:

    Sammiej6

    I am in England, had a complete ATR, went non-op. You are legally entitled to a second opinion. Google “how to get a second opinion” and you’ll see just how easy that will be - apart from taking a few days or more to get a fresh appointment. Your treatment to date appears to have been appalling and many years behind the times. Where do you live? As you will know, one NHS Trust can be completely different to the one down the road.

    Here’s what the NHS can do, posted by me on Suddsy’s blog. Suddsy was a UK surgical case but had very similar protocol to me and has posted lots of useful information:

    Royal Devon & Exeter Hospital (NHS) treated 246 patients over 3+ years (2008+), non-op and surgical. Amazing low rates of re-rupture and speed of mobility. Google the report. I’ve asked Dennis to add to the info on this blog’s home page but haven’t seen anything yet.

    The protocol follows below, is the same for op and non-op. I had 1st class NHS physiotherapy from week 3, and after week 16 beefed this up by visiting a top sports physio.

    Week 0 – 2 Full equinous i.e. 1st period of 2 weeks. In plaster, colour choice, toes pointed down. Mobilising NON-weight bearing, using crutches or frame. May use toes to balance.

    Week 2 – 4 review. Into Vaco Achilles boot set static at 30º PF
    i.e. 2nd period of 2 weeks. Into boot at 30º PF i.e. toes still pointed.

    Able to weight bear “as comfortable”, begin to wean off elbow crutches but probably use outside. Wear boot at night. Can remove for very gentle ACTIVE exercises.

    Week 4 – 6 review. Boot ROM 30º – 15º PF.
    Can remove at night and to wash. Mobility improving. Increase number of sessions of exercises.

    Week 6 – 8 review. ROM 30º PF – 0º neutral. Theraband exercises (some start earlier, I did at week 4, and static bike).

    Week 8 ROM -30º to +10º.

    i.e. Adjust boot to ‘step-through’ walking. May start gentle swimming if safe to get in and out of pool without using rung ladders. No pushing off from sides.

    Week 9. Shoes ok indoors with heel pads.

    Week 10 review. Out of boot indoors and out. Use heel pads as comfortable 4 – 6 weeks. Can take boot outside too as a precaution if desired or ‘hazardous’. Should be able to drive within couple of days of being in shoes – IF YOU CAN DO AN EMERGENCY STOP!

    Increase exercise tolerance with gentle and frequent walks, cycle, swim.

    Arrange for additional physio work in coming weeks if required.

    If reviewing between weeks 10 – 16. Start to increase exercise tolerance, concentrating on non-impact, non-explosive activities, such as swimming, walking, static bike or bike on the flat (nothing strenuous).

    Aerobic gym work as comfortable e.g. x-trainer, treadmill walking, stepper (you may not be able to do some of these).

    Not running or jogging for 4 – 5 months post ATR.

    OK to make the calf ache, but rest before carrying on. Change activity frequently to avoid fatigue and rest when and if you get tired/ache or ‘burning’ feeling around injury site.

    Good luck - get that referral!!!

  882. sammiej6, on August 21st, 2013 at 8:14 am Said:

    @chris90 @hillie

    I live in Dartford, Kent which is half an hour from London so its not like i’m in a tiny village miles away from anywhere! Anyone else receiving treatment from the dreaded Darenth Valley hospital by any chance?

    I had no idea that I was the only one like this until reading this blog. But I will take this information to my consultant if I can ever get an appointment. It took them 2 weeks just to give me a scan and identify whether it was fully ruptured.

    Thank you so much for all your help!

  883. chris90, on August 23rd, 2013 at 4:51 am Said:

    I’ve just returned from my 2nd physio appointment which was done whilst at the rehab class. To say I am annoyed is an understatement. Due to them not putting the wedges in I am still being forced to follow the non-existent, one size fits all protocol. When being shown the generic exercises by another physio, he asked how long since my injury. When I said nearly 7 weeks he questioned why I was not still on crutches. To re-enforce this, another guy was still on crutches and he’d been in the boot for 8 weeks!! He asked me how long I’d been FWB and I told him nearly 4 weeks which didn’t go down well. I’m all for ensuring that you get the right care and appreciate the work the physios do but I can’t understand why there can’t be any deviation from the protocol if you are showing good progress. I think the final straw was that the physio didn’t even look at the ankle! I think I may go for a private physio appointment and do the exercises at the gym. Then I will attend the final Ortho appointment in September.

  884. sammiej6, on September 5th, 2013 at 7:13 am Said:

    I went to see my consultant again yesterday and he confirmed that i can start partially weight bearing on my cast! im not at week 7. Next week i will go back for them to move my foot up to a full 90 degrees then i can weight bear fully for 2 weeks - then my cast will be removed! Ive been told that i will need heel pads in my shoes for a good few weeks and plenty of physio but at least my cast is being removed and is only on for 10 weeks rather than 13 weeks.

    Im really trying to partially weight bear today in this cast but am finding it pretty difficult and to be honest its easier to NWB. Anyone got any advice about this?

  885. hillie, on September 5th, 2013 at 1:46 pm Said:

    Hi

    You were going to show the above Exeter (UK, NHS) protocol to your consultant. What did he say about that? A plaster cast even at your stage must surely be unusual these days. As you are cast, I guess that you aren’t receiving any physiotherapy. Seeing a physio, using a boot, early weight bearing, basic exercises (alphabet, theraband, etc) are important for a sustainable recovery. I saw a consultant right at the beginning for a scan and diagnosis, and not again - but I did see an NHS physio every 2 weeks, then, at about 16 weeks began a program with a private sports physio.

    You’ll be in shoes only about 2 weeks later than current best practice, which isn’t much out of a lifetime, but your leg is getting more and more weak with continuing atrophy.

    Did you take any of the advice above about how to get a second opinion? Or asked your consultant to phone the guys at Exeter?

    You have the time, you deserve better. Go to the Exeter link on Suddsy’s blog. The report and the protocol above are based on reality, not guess work.

  886. chris90, on September 6th, 2013 at 9:25 am Said:

    Sammie, I can’t offer any advice about walking in a cast but I imagine they will give you one of those soles that strap to the cast. I have to agree with Hillie though, did you get any feed back regarding the protocol. I’m nearly 9 weeks in and the private physio I went to see this week has recommended coming out of the boot at week 10 two weeks earlier than the NHS have said. His reasoning is that the leg needs a lot more work although the tendon would be OK and that two weeks makes a difference.

  887. sammiej6, on September 7th, 2013 at 1:02 pm Said:

    I did ask my consltant about wearing a boot but he confirmed that he thinks it is more dangerous as you can take the boot off and it can be re-ruptured easily? He did say that once my cast is removed in a few weeks i will need to wear heel pads in shoes and start my physio. My left leg is ridiculously weak now - i fell the other day and put all my weight on my left leg as i fell. My achilles did not hurt at all when i did this, but my thigh completely gave way and in turn hurt for three days after! I may go private when it comes to physio rather than rely on the wonderful NHS for any longer!!! I think im too far down the road now to try and get a second opinion as I was told i would need to wait up to 4 weeks for this and i dont want to delayit any longer. I should be excited for the cast to come off but im actually dreading it as i can feel how weak my left leg is!

  888. normofthenorth, on September 8th, 2013 at 9:46 am Said:

    Sammie, boots are better than casts EXCEPT that a patient can do stupid things with a boot that can’t be done with a cast. My suggestion is to get a boot and don’t do stupid things with it, but if that’s not an option for you, then lock yourself in a cast and throw away the key! ;-)

  889. hillie, on September 8th, 2013 at 2:25 pm Said:

    Who’s the customer here? You are!

    I was treated by the NHS in Exeter using what is currently proving to be one of the latest and most successful protocols anywhere. Tell your doc to trust you or to use the Vaco boot with its optional security fastenings secured - most people don’t know about this because their medics trust them more than yours trusts you. Call Oped in Devizes for advice - or Exeter’s fracture clinic for a protocol.

    Just don’t give in.

  890. clarky, on September 9th, 2013 at 11:34 am Said:

    Hi there,

    Just stumbled across this site as looking for more info on achiles ruptures.

    Mine went last Thursday night at football. Routine tackle and then heard the sound of an air rifle popping off a shot and then the excruciating pain down my left leg. Went to minor injuries unit at local hospital on the Friday morning and nurses diagnosed the rupture by doing the test of pinching the calf plus there was also what looked like a gap/hole about two inches or so above the back of my ankle.

    From there i got put in a back cast from the toes to below the knee with feet at an angle pointing towards the floor and advised that the orthopedics department from local hospital would be in touch today (Monday). All that happened today is i got a phone call advising to attend next Monday - which will be 11 days since the initial injury - at the weekly clinic the consultant holds and then we take it from there.

    I know every NHS local authority is different but does that sound normal routine for this kind of thing to be put in a cast and then have no initial consultation or follow up for over a week?

    Another question i have is the pain itself is definitely at it’s worst nearer the bottom of the calf than the ankle itself; is this a normal feeling?

    Comments above have been helpful so appreciate the input from others. Sorry for all the questions just curious !

    Regards
    Steven

  891. pamg, on September 9th, 2013 at 12:09 pm Said:

    Hi Clarky
    sounds pretty normal to me for the NHS! I ruptured mine at the end of May and I only saw the A&E doctor (and 2 students) who did the Simmons-Thomson test. I was put in a cast for 4 weeks.and that was it until 4 week later when I got the cast off and was given a boot for another 4 weeks. At the 4 week appointment I had to insist on a doctor examining my tendon to see if it was healing (it was) and I didn’t get to see the consultant until week 8, when I was discharged! Had to wait 2 more weeks to see the physio.
    I didn’t have any pain until I started physio and pushed it too hard too soon, kind of wish I hadn’t seen the physio now!
    I hope you’re managing to rest and elevate your leg as much as possible.

  892. nicky, on September 9th, 2013 at 12:29 pm Said:

    Hi Clarky,
    If you are foot down in a cast then you will be healing from now. Just keep your foot up as much a possible to avoid a DVT. Your next decision is whether you would like an operation or not.
    11 days is not ideal but it will give you some time to look up info on op and non op. Some surgeons like to wait for the swelling to do down before they operate anyway.
    And yes bottom of the calf is where mine hurts not the ankle.
    Good luck with the choice and don’t let the weeks NWB get you down.

  893. whoknew, on September 9th, 2013 at 3:37 pm Said:

    Well…. I am more than thrilled to have located this site!!!! No matter how much help you have at home it’s always nice to talk to folks in the same boat as they say. I’m 5 days post op and not doing to badly. My short leg scooter has been a God send! Almost killed myself on the dang crutches. LOL. Had my 1st shower yesterday. Heavenly!!!! I have a couple of autoimmune issues to deal w along with the surgery. I have Celiac Disease and Raynaud’s so I must take extra care in eating and watching my circulation. Hate the pain meds. Don’t like feeling odd at all. I was weaning off of them pretty good but had a drs appt and while out had a slight mishap on the scooter. Nothing major but enough to make me want the meds and get into the bed foe the day. I haven’t really had any pain in the incursion site, just a kind of painless tight feeling. A tad of depression because I’m a get up and go gal…..who now has to be a sit and heal gal. Going for a nap……catch y’all later.

  894. clarky, on September 9th, 2013 at 3:38 pm Said:

    Nicky & Pamg thanks for the responses so quickly.

    I actually took a DVT in the same leg three years ago after long haul flight which broke off and resulted in a double pulmonary embolism so i am super concious about it at the moment to be honest. I made sure they knew about it when i was in so they have given the cast a few extra millimetres to let me wiggle about a bit plus taking 75mg aspirin each morning.

    Should i be keeping my leg elevated as you mentioned? Nobody in hospital said anything about that!

  895. nicky, on September 9th, 2013 at 5:04 pm Said:

    Yes Clarky keep it up within reason, especially in the first 2 weeks (especially if you have had a DVT before) .
    Blood travels back to your heart in deep veins that run through the centre of the calf muscle whose tendon you have just ruptured. So normally every time you contract the muscle, blood is pumped back. You can’t contract this muscle properly so the blood can pool in the calf veins.
    If the blood flow is stagnant it can clot ( that’s a DVT). By lifting your foot above the level of your heart the blood will flow back with the aid of gravity. DVT’s are really common in this injury. I was offered low dose heparin injections although there is no evidence that this reduces the risk.
    Keeping well hydrated also helps. Not smoking helps.
    Once you are in a boot, you will be able to contract your muscle a little and your risk of DVT will fall.
    I hope that makes sense!

  896. sammiej6, on September 10th, 2013 at 6:05 am Said:

    Hi Clarky,

    I had the same issue. I went to A&E the night I did the rupture and was told that I had pulled a muscle in my leg and to go home and rest and id be able to walk by the following day! No crutches given! Had to be carried out by my boyfriend!! Obviously the following day I was 10 times worse - went back to A&E (and waited another 5 hours!) to be told that were pretty sure that I had ruptured it but weren’t ‘100%’. Put in a back slab and sent on my way! Couldn’t get an ultra sound done on it for 15 days after the injury! So didn’t get a full diagnosis until over 2 weeks from injury. NHS for you.

    However as said above, it will be starting to heal from now. The consultant counted those two initial weeks in a back slab as part of my recovery so its not a complete waste of time. Just keep it elevated and rest as much as possible!

    Good luck

  897. normofthenorth, on September 10th, 2013 at 11:07 am Said:

    Sammie, I’m the local head of the go-non-op “choir”, but your case makes me nervous. Specifically “The consultant counted those two initial weeks in a back slab as part of my recovery so it’s not a complete waste of time.”
    The issue is not just the risk of wasting time, it’s also the risk of missing the most important period of non-op ATR repair, when your body is madly throwing blood and healing and rebuilding chemicals at your injury. I don’t care how your consultant counts those weeks, I care how your torn tendon counts them!! ;-)
    If that back slab really kept your ankle immobilized at an appropriate angle (around 20-30 degrees plantar-flexed) AND it was really immobilized — secure and NWB on crutches — for those two weeks, then I think your AT will agree with your consultant, and you should proceed with confidence. But if you were padding around on it, or otherwise deviating from a good successful non-op protocol (like bit.ly/UWOProtocol ), then your AT and your psyche may both be better off if you get it repaired surgically.
    Also, make sure your treatment from here on conforms to UWO or one of the even faster protocols we’ve been discussing hereabouts, including on Suddsy’s second blog page (esp. Hillie and me). Non-op treatment works great PROVIDED that a number of conditions are met, including a prompt start and a fast (modern, aggressive, proven) protocol. Without those two conditions being met, the re-rupture rate is much higher than post-op — a fact that STILL confuses some people into thinking that GOOD non-op treatment has a higher rerupture rate than post-op, which it doesn’t, according to the evidence.

  898. hillie, on September 10th, 2013 at 12:56 pm Said:

    Hi again, Sammie

    I hope that I’m wrong but despite all the advice given above and on other blogs within achillesblog, you seem resigned to accepting apparently poor, ill-informed care.

    Remember, our posts aren’t based on hypothetical situations - they are real examples (read again my protocol above) of what we have found to work, and who is leading the way. Have you contacted your consultant to ask him to talk to Exeter’s? I’ve suggested this to one or two here before but I doubt that they have.

    People will complain here (and the NHS gets a lot of stick in SOME locations) and then they get lots of advice, then they still lose heart and they feel bad about it all. Don’t be one of those - put your plan together, make some calls, check out that 4 week wait for yourself. I doubt you’re ‘rushed off your feet’!

    If you do feel that it’s now too late to do any of the above, you will rely considerably on the physiotherapists (most of us do in any case) to get you going again - and if you are lucky you will get someone very good. There are plenty who are incredibly skilled and you should do well.

    Good luck.

    H

  899. abyss, on September 10th, 2013 at 8:00 pm Said:

    5-days out of boot!

    Learning to walk again is a swine. Had brief chat with physio at fracture clinic and given non resisted exercises to do. Waiting to get a further physio appointment.

    Getting a fair bit of swelling after a few hours.

    The variation people get is depressing but not surprising for someone’s who’s spent 32yrs working in the NHS.
    Sure some consultants are going to want to do things their way but in this day and age they should be able to produce an evidence base for what they are doing.

    I p’ve spoken to a range of clinicians locally and they told me that it had taken some heads bashing together before the local protocol was agreed (11wk in boot with 5 wedges to start and one out every 2wks then 1wk in boot with no wedges).

    Even then because I turned up at A&E at 10 pm I was put in plaster that night only to have it removed and the boot put on at fracture clinic the next day. Which begs the question as to why the boot wasn’t applied straight away saving the NHS the cost of putting on and removing the plaster and freeing up the clinic slot.
    The reason was that after 10pm the orthopods don’t come down to A&E so all my treatment was by nurses and had to be signed off by orthopods the next day.
    This is of course rubbish as in a university teaching hospital there must be at least 1 resident on call orthopod 24/7.

  900. sammiej6, on September 11th, 2013 at 12:47 pm Said:

    Hey guys,

    Thank you for your posts. I went back to see the consultant again today - i spent about 45mins doing exercises to stretch the tendon out. Its now almost at 90 degrees. They put me back in a cast and have attached a shoe to the bottom of the cast so i can now fully weight bear. Im in a lot of pain now though where i have been pulled about today so will give the walking a go tomorrow. Im meant to be having my cast removed in two weeks time now and am strongly relying on a lot of physio to get me moving again. Ive been told that they do not follow that protocol and think that the ‘cast way’ is better. Im so far along with my treatment now im just going to go with it and hope for the best! I willl need heel wedges in my shoes for a while and physio at least three times a week. Im very scared and nervous about having my cast off and learning to walk again now.

    The first two weeks of wearing a back slab - i was completely NWB and to be honest it felt as secure as it does with a full cast - so hopefully ill be ok in that respect. I spoke to one of the orthopedic assistants today (who seemed to have more time for me than the consultant!) and he confirmed that they treat at least 5 of these injuries a day and in 99% of the cases, the tendon mends well and does not re-rupture. Im just hoping that im not in that 1%!

    Also - ive started smoking again since ive had this injury (not good i know but as you all know, you start to feel very down and i buckled!) I smoke probably 5 a day - will this effect my tendon repairing?

  901. hillie, on September 11th, 2013 at 1:06 pm Said:

    Hi Sammie

    I suppose that we all hope for the best but it seems that many don’t receive it. The cast way has been proven not to be better - and in the UK too in the past 2 years. Which hospital did you attend?

    However, in the hands of a good physio you should be able to still achieve an excellent outcome, back to ‘normal’ probably.

    I don’t smoke but have heard that it can slow down recovery. As I say, it is only what I have heard. My own addiction of the moment is coming back to this blog and posting too often…

    All the best.

  902. sammiej6, on September 11th, 2013 at 1:24 pm Said:

    Hi Hillie

    Its in Dartford Kent.

    I was thinking of going private for physio in the hope to get the best treatment possible!

    Im kicking myself for starting again at such a stupid time! But it seems to be keeping me sane at the moment! hahaha - your advice is appreciated.

    Many thanks

  903. hillie, on September 11th, 2013 at 2:32 pm Said:

    Sammie

    Before you spending lots on private treatment, have a couple of sessions with your hospital’s NHS physio’s. I saw a physio at my local cottage hospital for this and she certainly knew what to do and especially in those fairly early weeks.

    After about week 16 I did up the pace with a private sports physio for a couple of months but that was to improve my overall condition as much as to improve the AT - at this stage it was well worth it in order to receive the guidance to enable me to get back to where I had been.

    Ask the physio’s about the smoking! The response you can probably guess…

  904. martin1987, on September 19th, 2013 at 8:28 pm Said:

    Hi all

    Had a ATR to my right tendon in April, had the op, Put in cast for 8 weeks all in all, 2 weeks later was driving n back to work on a building site!

    All was going well apart from I kept getting an infection in my scar! Went to see my consultant who was worried about it so booked me in for a MRI scan! The day after I knocked my foots against a railing at work and POP!

    The pop however was a little different n not as painful and i had a bit of movement in my foot but I was back in a front slab toes pointed. After a week I started to get more movement and can stand and walk (with a big limp)

    Had an MRI scan on Wednesday this week and I’m just waiting for the outcome. Hopefully because i have descent movement it’s not a re-rupture

    Has any body else had similar?

    Thanks

  905. martin1987, on September 20th, 2013 at 1:18 pm Said:

    Well it’s official, it’s a re-rupture

    Gutted, can’t believe I’ve got go through it all again!

  906. hillie, on September 20th, 2013 at 1:35 pm Said:

    Hi Martin

    That is so tragic! Sorry to read this bad news.

    I hope that it all works better for you this time round - if not you’ll be upsetting the pro-surgery sufferers here who were hoping that surgery offers a more secure solution.

    Do you know yet what might have prompted it to fail so early - not climbing ladders too soon on the building site or anything like that were you?

    Best wishes for a more sustainable recovery.

    H

  907. martin1987, on September 24th, 2013 at 5:18 pm Said:

    Hi H, thank you

    Sorry for late reply, I was waiting to see my consultant to know the full details,

    Was told that nothing i did physically would have caused the re-rupture, just that I have really weak tendon and its not fused together.

    I’ve now got a gap between 4-5cm

    The next step is, because of my week tendon, I’ve got to have tendon reconstruction using tendons from my hamstring to reinforce my AT. Been told its a major operation in terms of limbs and will take over two hours!

    Recovery time is a little longer than a “normal” ATR repair but I should be on two feet by January if all goes well.

    Ps
    Has anybody got an experience of this operation? Or info that would help?

    Thanks

  908. chris90, on September 26th, 2013 at 7:04 am Said:

    I had my discharge appointment this morning. It was a different consultant from the one I initially saw. I explained the issue with the wedges and the lack of a more informed protocol and he agreed that he would write to the physio dept. He also stated that he had written a few papers on Achilles rupture and thought that week 8 would be a good time to come out of the boot. I couldn’t help thinking why this consultant didn’t re-write the protocol!

    Anyway, officially back in two shoes (although after advice from the private phsyio its been 9 days). Told not to use wedges and keep up with the physio(private). This has been a hard 3 months and I know there is still work to do.

    If I can offer any advice to those newly ruptured it would be:-

    Get to hospital ASAP
    Get casted and whilst waiting get a VACO Cast ordered (I wish I had)
    Ensure your hospital has a protocol and don’t be afraid to question what the protocol is.
    Be armed with some stats (UWO Exeter and Devon)
    Be patient, it will be worse if you rush it.
    Do your exercises.
    Put your thoughts on here, there are some great people who will offer support.

    Remember, it wont last for ever!

  909. zara21, on September 26th, 2013 at 7:29 am Said:

    Hi,

    I have a quick question and wondered if anyone had experienced the same.

    I tore my left achilles 29th of august doing gymnastics and i have had 2 casts on for 2 weeks. I have just been fitted with a walking boot and told that i should be weight bearing with minimal use of the crutches.

    However, when i put pressure through my foot there is a sharp stretching pain at the bottom of my achilles. ( I havnt previously had pain here as torn my achilles near the calf muscle not in the usual place.)

    Does this sound normal for someone weight bearing for the first time after injury or should i be concerned. I plan on partially weight bearing for now and seeing if it eases up at all.

    Has anyone else experienced this?

    Thanks,

    Zara

  910. mwest, on September 26th, 2013 at 9:48 am Said:

    Hi there it’s been so helpful reading people’s experiences. I am new to site although have been reading it for a while! I ruptured my left Achilles’ tendon in June this year followed with surgery a week later. I am exactly 15weeks today ( yes I’m counting the weeks like all you others!!). I am in two shoes and walking with a limp. I am receiving weekly physio at the moment and trying to do exercises in the pool at my local gym. It feels slow the progression, I see improvements but wish it would all speed up abit. I have two children so it was quite tough in the start, having been so active and independent it really knocks you. Best wishes to all you going through this, it feels reassuring to here about others out there as it can feel like you are the only one going through this. I

  911. paulfea, on September 26th, 2013 at 12:13 pm Said:

    Hi,

    When I started reading this blog I never thought I would become one of those few unlucky people who has experienced the drama of a re-repture…devastating….

    I’d like to share my experience as I hope this may help to prevent other re-ruptures.

    After 3 months post-ATR (non-op) last week I re-reptured my Achilles by stepping on a pothole or curb while I was crossing a road in NYC….ONE fatal distraction… This happened after spending a whole week walking all day long… such an amazing city…

    I believe it’s not a coincidence that the day of my re-rerupture was the first day I felt my foot was almost back to normal…no or little limping…fairly strong leg… I probably became too confident and effectively forgot that my tendon and leg were still recovering and VERY WEAK…

    My simple advice is therefore to be very cautious even if you feel your tendon and leg are “fine”.

    I had surgery yesterday and, after several dark days, I now feel ready to tackle this, once again…I may become a philosopher!

    Good luck and…be careful until you have not fully recovered!

    P

  912. sammiej6, on September 26th, 2013 at 1:21 pm Said:

    Hi all,

    Im hoping somebody can give me some advice!

    After 10 long weeks i finally had my cast removed yesterday. I was given some heel pads and referred for physio but my first session wont be until next week. Ive been given a few exercises to do in the interim. But what now?! I can not fit put my foot in any of my shoes as my foot and ankle is still pretty swollen. I can put a small amount of weight on my (bare!) toes but thats about it and obviously strongly dependant on my crutches! I can put my foot flat whilst sitting only. Im scared to go out of the house! Does anyone have any advice on what i should be doing now? The consultant said i should be walking about without crutches (house only) in a few days but i cant see that happening some how! He said that my tendon has healed nicely but i need to take things slowly but am worried about the lack or protection and feel like im going back to square one where im basically NWB. Is this normal or am i expecting too much too soon?!

    Im meant to be going to work tomorrow and its also my birthday so have arranged a meal but im worried about slipping over or hitting my tendon! Im quite happy stayiing locked in the house!

  913. jamie89, on November 8th, 2013 at 8:30 am Said:

    Hi,
    My name is Jamie new to the site and looking for some advice. Ruptured my Achilles playing rugby on the 21st of September and had surgery to repair it (nhs) on the 4th of October. I then had the standard 2 week visit and then weekly visits to gradually move my foot up. And now I am here 5 weeks post op and have just been told that I’m going to be in a cast for another month, although I have this shoe sandal thing for my cast so I can pwb I was expecting a boot as the majority of the stories and studies I have read recommend this. So I am little confused as to why I have a cast for another month????
    Anyone else had this???
    Can anyone offer any advice???
    Many thanks Jamie

  914. chris90, on November 8th, 2013 at 11:36 am Said:

    Hi Jamie,

    It seems every trust has a different way of doing it. I think SammieJ6 had the same treatment. I does seem that most go into the boot. I did at 2 weeks and 5 days. I was treated conservatively and I am now 5 months since I ruptured. I think casting slows down the healing process. If you read thru peoples blogs the recovery does vary. If you are going back egg chasing I would certainly look at how you rehab. I used an alter G treadmill last night and ran for the 1st time since injury. I am still along way off running normally.

  915. jamie89, on November 8th, 2013 at 1:02 pm Said:

    Hi Chris

    Yeh I guess they do, I’ve already tried to contact the consultant to question the reasoning of the time in cast but not in the office until Monday, so I will have to wait until then.Just seems a long time to be in a cast considering by the time I have it off it will be 9 weeks post surgery and from the stories I’ve read people have it off way before then. And seeing the studies that ewb Improves your overall recovery just angers me more to think I’m still n a cast. Definitely getting back on the rugby pitch sometime in the near future, plan to hit rehab hard and possibly even get physio privately. You sportsman yourself? Bet that was a good feeling being able to actually run.

  916. hillie, on November 8th, 2013 at 1:55 pm Said:

    Hi Jamie

    Always interesting, disturbing too, when firing up the desktop, to log into achillesblog and read the latest sad stories.

    You appear to be on an ultra-conservative, ‘pwb for too long’ protocol. With modern treatment you would, at 7 weeks as you are, be almost finished with your boot. I don’t know that being in a cast long term like you slows down the actual healing of the tendon, but it will be drastically slowing and limiting the strength, flexibility and mobility of the foot, ankle, calf and even your hips. For the NHS it probably works out almost as expensive to recast every 2 weeks (changing angle - is this happening?), rather than simply adjusting a boot. Many boots have replaceable straps, liners, soles, etc so boots can go from one patient to another as treatment progresses, almost certainly saving money and time. Apologies for the length of the following, but as you are NHS too, it may be especially relevant.

    Royal Devon & Exeter Hospital (NHS) results with Oped’s Vaco boot (2008 - 2012) are evidenced at http://www.bjjprocs.boneandjoint.org.uk/content/95-B/SUPP_18/16.abstract.

    246 patients over 3+ years, non-op and surgical. Amazing low rates of re-rupture.

    As a rugby player you’ll be wanting to contact Exeter Chiefs and Cornish Pirates teams who successfully used (and probably wrecked in training) these boots. It did feature on Oped UK’s Facebook - if not there now, cal Jason there in Devizes for contact info and advice. However, don’t expect to be doing anything serious on the pitch for a while yet, unless you are looking to re-rupture.

    The rehab protocol follows below and all I can say is that it worked for me. Check out also the information on Achillesblog home page including the now infamous UWO stuff.

    I had physiotherapy from week 3 and after week 16 beefed this up by visiting a sports physio.

    Week 0 – 2 Full equinous i.e. 1st period of 2 weeks in plaster, toes pointed down. Mobilising NON-weight bearing, using crutches or frame. May use toes to balance.

    Week 2 – 4 review i.e. 2nd period of 2 weeks. Vaco Achilles boot set static at 30º PF
    Into boot at 30º PF i.e. toes still pointed.
    Able to weight bear, wean off walking aid as comfortable, probably use outside. Wear boot at night. Can remove for very gentle ACTIVE exercises.

    Week 4 – 6 review. Boot ROM 30º – 15º PF i.e. the range of movement within which your foot can move. Can remove at night. Mobility improving. Increase number of sessions of exercises.

    Week 6 – 8 review. ROM 30º PF – 0º neutral. Theraband exercises (some start earlier, I did at week 4, and static bike).

    Week 8 ROM -30º to +10º. Adjust boot to ‘step-through’ walking, i.e from PF to DF. May start gentle swimming if safe to get in and out of pool without using rung ladders. No pushing off from sides. Some swim earlier with the boot on…

    Week 9, Shoes indoors with heel pads.

    Week 10 review. Out of boot indoors and out. Maybe use heel pads as comfortable. Can take boot outside too as a precaution if desired or ‘hazardous’. Should be able to drive within couple of days of being in shoes – IF YOU CAN DO AN EMERGENCY STOP!

    Increase exercise tolerance with gentle and frequent walks, cycle, swim.

    Arrange for additional physio work in coming weeks if required.

    Between weeks 10 – 16 start to increase exercise tolerance, concentrating on non-impact, non-explosive activities, such as swimming, walking, static bike or bike on the flat (nothing strenuous).
    Aerobic gym work as comfortable e.g. x-trainer, treadmill walking, stepper (you may not be able to do some of these).

    No running or jogging for 4 – 5 months post ATR.

    OK to make the calf ache, but rest before carrying on. Change activity frequently to avoid fatigue and rest when and if you get tired/ache or ‘burning’ feeling around injury site.

    Not advisable to
    • Play explosive sports e.g. squash/ badminton (or RUGBY?)
    • Do maximum resisted weight work for lower legs, or use rowing machine
    • Go up and down rung ladders
    • Horse ride (heels go down in stirrups)
    • Do loaded passive stretching of calf (heel hangs on step)
    FOR 6 MONTHS AFTER INJURY DUE TO THE POTENTIAL RISK OF A RE-RUPTURE!

  917. normofthenorth, on November 9th, 2013 at 12:31 am Said:

    +1 to Hillie’s — except that she likes to refer to the UWO study and protocol as “infamous”, primarily because I refer to it so frequently. There’s nothing ELSE “infamous” about it, I assure you. I’ve uploaded the protocol at bit.ly/UWOProtocol , and the full-text study is available on this site if you follow the “studies and “protocols” bread-crumbs.

    Simply put, both UWO and Exeter seem to be top candidates for “Gold Standard” treatment, both with and without surgery.

    The good news for post-op slowpokes like you is that slow rehab post-op doesn’t seem very harmful — unlike slow rehab post-NON-op. It still has no benefits, so it’s a bloody waste of time and nuisance all for nothing or a slight DISbenefit, but it doesn’t lead to the seriously inferior results (mostly high rerupture risks/rates) that non-op plus slow rehab produces.

    But it’s still worth the time to try to educate your docs to the best evidence, so you can speed up your own rehab — and that of the next several dozens of ATR patients behind you — closer to the state of the art.

  918. hillie, on November 9th, 2013 at 2:58 am Said:

    No, Norm, credit where it’s due. I wasn’t being cynical and UWO would not have figured so heavily, and enormously usefully, here if it hadn’t been so promoted. I say “might not” because we’ve had keen bloggers and home researchers here who would have eventually discovered it at some time. I should perhaps not use words like ‘infamous’ and keep the posts neutral…

  919. hillie, on November 9th, 2013 at 4:13 am Said:

    After just googling a number of search phrases, and UWO not appearing readily apart from via Achillesblog, it is increasingly obvious that without the promotion by a prolific Canadian, many more would have taken a long time, if ever, finding UWO. +1!

    Is “prolific” an OK word?

    H

  920. jamie89, on November 10th, 2013 at 8:20 am Said:

    Hi hillie,

    Thanks for all the useful information . Very frustrating to know that I could be and should be in a boot by now and that I could be beginning to walk again.
    I intend too try to contact the consultants secretary tomorrow and question the reasoning behind this ultra conservative approach. Any suggestions on how to go about this?, as I can imagine doctors don’t like being questioned on there treatment methods. All the points about the flexibility, rom and strength I totally agree with!!! I already feel that I am miles behind in my rehab especially reading your rehab protocol. Yes I have been having weekly cast changes since the 2 week visit. Its crazy to think that some hospitals are so behind in there treatment methods compared to others. Anyway hopefully I can get myself some answers tomorrow. Many thanks again for your help and useful information
    Jamie

  921. clarky, on November 11th, 2013 at 4:28 pm Said:

    Hi again folks,

    I am now 8 days out of cast after the non-surgical route via the NHS.

    After having three casts (toes down for 3 weeks, toes up slightly more for 3 weeks then finally foot in it’s normal position for 2 weeks) i was sure i would be then going into one of these moon boots for the remainder of my recovery………..

    However i was instead given a pair of self adhesive wedges to insert into my shoes for 4-6. At this point i was discharged from the fracture clinic (Glasgow Royal) and told i would be referred to physio.

    Now the query i have now is the physio doesn’t start till this Friday which will be 10 days since i was discharged with these wedges however after just a couple of days of moving about the house and a moderate 15 minute walk around the village with my little girl in her pram i have HELLISH blood blisters developing in both my heels; not helped by the hard skin but the wedges obviously are causing this as i’ve never had problems with this sort of thin in my life.

    So the situation is i am now going about in normal footwear (ie: no wedges) as i’m afraid it was a case of the lesser of two evils balancing up ‘good practise’ with the wedges against chronic pain from the blisters they have caused.

    There is no way i could handle another day of them let alone 4-6 weeks and was looking for advice or if this is normal if anyone else experiences similar problems?

    Obviously i will take it up with the physio but just advice in the meantime would be appreciated.

    Finally i’ve noticed since i got my last cast off that my ‘bad’ ankle is still very noticably swollen from the back of the calf all the way down in comparison to the healthy leg it’s about one and a half times the size at it’s widest…….must say i have no pain but the difference with the swelling it’s noticable and a few family members have also commented on it……..anything to worry about?

    thanks again !

    Steven

  922. normofthenorth, on November 11th, 2013 at 6:39 pm Said:

    Hey, Clarky! I haven’t experienced or heard of blood blisters, but many of us experienced various kinds of irritation and sensitivity and discomfort while sliding back toward normal walking.
    If you were totally NWB the whole 8+ weeks you were casted, then your foot has a huge transition to make to get to FWB in shoes. While heel wedges are often prescribed in shoes to ease that transition, they are not always prescribed, and at least some of the most successful modern protocols — like bit.ly/UWOProtocol — go into shoes with NO wedges. Mind you, that’s after 2 weeks of FWB walking in neutral (no-wedge) position in a boot, plus another 2 earlier weeks of FWB in the boot with wedges. Your history seems different, so it may make sense for you to be less aggressive.
    My general advice to people who find themselves behind the best schedules is to slide or taper up to them. Don’t jump ahead, but do (maybe) 2 or 3 weeks of rehab each week, until you catch up.
    OT1H, going slow non-op has been shown to increase re-rupture risks, so you want to keep moving; OTOH, you’re at about the highest-risk period in your rehab, so you need to Watch Your Step and stay incremental in your activities.
    About your fat leg: It’s perfectly normal and healthy for your recovering AT to be bigger than your uninjured one. It’s also normal, but less healthy, for your leg to get inflamed, aka swollen. Make sure you can distinguish those two kinds of enlargements. Fight the swelling with all the usual (R-I-C-E-) tricks, and accommodate the healthy enlargement with appropriate footwear. (At 17 weeks post-non-op, I went to Whistler for a ski week, and had to buy some thin ski socks for my enlarged left leg — a small price to pay for the fun I had!)
    Finally, if you do end up re-inserting those same wedges in your shoes later, make SURE that they’re stuck securely to your shoes. We’ve already had one person here re-rupture when the peel-and-stick heel wedges in her boot slid out of place, under her instep (apparently because they were never peeled-and-stuck!). And one is enough. Some new 2-sided tape is a small price to pay. . .

  923. sammiej6, on November 13th, 2013 at 7:22 pm Said:

    Help!! Cast removed 7 weeks ago now and am still using two crutches. Can’t fwb yet either or drive :-( wearing shoes with a small heel and am seeing an improvement but still have a way to go. Having hydrotherapy but don’t see this as that beneficial at the moment and am not being assessed - just get in a pool and do my exercises! Any advice? Looking at everyone else recovery time mine seems excessive! Am desperate to be walking by Xmas - even a little bit! Just want to lose the crutches now - been on them for 17 weeks! Any advice would be great!

  924. normofthenorth, on November 14th, 2013 at 4:38 am Said:

    Sammie, did you go straight from a cast to 2 shoes? Give us the whole story — op, non-op, boot, no boot, timing, etc. (Post it on a blog of your own, too, if you have the time and energy.)

    Most protocols get ATR patients to FWB long before they get out of a boot or walking cast — e.g. bit.ly/UWOProtocol , which got excellent results with and without the op. At least with a boot for confidence and protection, most of us went from PWB to FWB in a couple of weeks, even without the pool. It sounds like you’ve got a problem. Have you seen a knowledgeable doctor recently?

  925. jamie89, on November 14th, 2013 at 9:06 am Said:

    Hi all

    Just looking for some advice on how to approach my consultant about coming out of my cast as I’ve been in it for 6 weeks and I fear I’m on a ultra conservative protocol. I’m 24, so I just wanna get back on my feet as soon as possible. And I feel this ultra conservative treatment is just holding me back as most people are in a boot!!!! Also I was told by the consultant that surgery is generally a little quicker recovery time and less time in a cast!!Anyone else experience this ultra conservative treatment? Anyone else questioned there consultant on coming out of a caste earlier?
    Jamie

  926. sammiej6, on November 14th, 2013 at 9:31 am Said:

    normofthenorth - I posted on here previous about the procedure that was under took but basically went non-op route, 10 weeks in a cast and moved up slowly every few weeks - foot wasn’t quite at 90 degrees before cast was taken off. Then yes basically went from a cast to two shoes (well couldn’t get a shoe on for about a week!). No boot at all. As far as im aware no specific protocol followed. Cast has been off for 7 weeks now. Am going to hydrotherapy once a week. Went today and they have referred me back to physio department to be re-assessed. Saw my consultant about 3 weeks ago. He didn’t say too much - just said that its healed nicely and it will take time - he has asked to see me again in January. Have seen an improvement but not much. I can stand up (no FWB) with out my crutches but foot is still not flat to the floor when I walk - am wearing shoes with a heel to try and have some normality when walking.

    Jamie89 - get yourself in a boot - you don’t want to end up like me!!

  927. tord, on November 14th, 2013 at 10:22 am Said:

    @Jamie89 and Sammiej6:

    That sounds like the kind of treatment my grandfather had when he took his first one. Like 40 years or something…

    Get a boot, the sooner the better. May I also suggest you get a new consultant?

    The best of luck to both of you!

  928. jamie89, on November 20th, 2013 at 8:22 am Said:

    Hi guys,

    Basically I got hold of the consultants secretary regarding getting out of my cast early than he has planned. She said that from the looks of my notes the consultant has a strict plan and she can’t see him wanting to risk getting me out of a cast earlier. In her words don’t run before I can walk!!!!! So I’ve definitely confirmed my fears that I have an ultra conservative doctor. My question is where do I go from here? I’ve tried to get an appointment with my consultant but the earliest he can see me is 6th of December my scheduled appointment anyway! I live in torbay which is around 45 mins away from Exeter is it worth contacting Exeter hospital as that’s where the study was done? Any help would be much appreciated
    Jamie

  929. hillie, on November 22nd, 2013 at 9:57 am Said:

    Hi Jamie

    November 20th and no replies. Come on guys…

    ‘Simply’ ask your GP for a referral to Exeter - you should get it ok and I believe that you are entitled to this second opinion at an alternative hospital, and it is so close to you. I doubt (and would like to be proved wrong) that Exeter will see you without the referral, and I don’t know what the waiting list is, especially as you are not a fresh case requiring treatment asap.

    H

  930. Ross, on November 27th, 2013 at 1:10 pm Said:

    Hello All,
    I’m a 43 year old “reasonably” active male living in Newcastle (upon tyne). I have just ruptured my left A.T. last Sunday (24/11/2013) while kicking a ball around with my family. The consultant I’ve been alocated is obviously pro the natural healing process as oposed to operation, and I’m currently in a full leg cast.
    I’ve not actually been told to rest or keep the leg elevated so have returned to work (desk job anyway) today. DOes anyone have any advice on if I should be resting? as far as I can see the cast is keeping my foot in position so as long as I don’t put any weight on my left legs hopping around on my crutches shouldn’t really be causing any issues.

    I also would like some more info on my options, as other people I know who have been through this say they would have opted for the operation in hind sight (if given the option). As such I’m hoping to talk to my GP about this tomorrow. I’ll try and keep you all updated.

  931. hillie, on November 27th, 2013 at 2:06 pm Said:

    Hi Ross

    Do you really mean a FULL leg cast i.e. above the knee? Foot pointed down around 30º? Only in my first 2 weeks did I rest the leg and that most definitely was with the leg elevated and using the RICE principle.

    I’ve just posted a reply to another ATRer and quoted http://achillesblog.com/suddsy/2013/06/24/end-of-wk-2-wow-progress/ as a great blog to go to for more advice. Some of it is quoted higher up this string of replies.

    Jamie89

    Did you get that referral?

  932. micah1, on November 27th, 2013 at 4:26 pm Said:

    Hi Ross, bad luck with your achilles injury. I’m 8 months non op and I would certainly make the same choice again should I have to. I’m limp free, doing a bit of running, able to do a single heel raise which has come on really well in the last month or so. I’m very happy that I avoided surgery, anaethetic, a wound, pain etc. I don’t think my recovery has been hindered by being non op at all.
    Elevation is really important as hillie says, it prevents swelling, congestion and reduces the risk of DVT from what I remember.
    How long are you in a cast for?

  933. Ross, on November 28th, 2013 at 8:12 am Said:

    Hille; -
    Yes a FULL leg cast right up to just below the groin, in the full “equine” position foot pointed down and knee slightly bent. My consultant is saying 4 wks in this before going to a below knee cast for 4 weeks and then a further 4 weeks in an air-cast (I’m only just beginning to understand what that is) so a ful 12 weeks in some form of support.

    GP wasn’t much help she basically said that the consultant is the speciallist and I should re-contact him whith the “reasonable” questions I have (pro’s & cons of op and r&r with the cast). She did say that if I’m still not satistified she can refer me for a second opinion.
    My job is such that I can sit with my cast “raised” (but not above my heart level)

    Micah1;-
    Thanks for the reply it’s good to hear sombody being positive about the non-op route, everyone I’ve spoke to here have sort of suggested they would have done the op with hind sight.

  934. hillie, on November 28th, 2013 at 1:26 pm Said:

    Ross

    You’ll find that most non-ops are more than happy with their choice but their results are likely to based on their rehab protocols. Read the posts and the links contained in them, then get that referral that’s being offered.

    H

  935. normofthenorth, on November 28th, 2013 at 2:49 pm Said:

    Ross, you can also check my page “The case for skipping ATR Surgery”.

    Basically, fast modern non-op ATR treatment works great, arguably better than surgery. Slow old-fashioned non-op ATR treatment never worked great, with lots of atrophy and rerupture rates of 15% or more. Any Doc or hospital that still uses full-leg casts fails big-time. Crutch-walk as fast as you can to somebody who has at least HEARD about the evidence — and hopefully somebody who has READ it and understood it too.

    As a bonus, the new non-op protocols are convenient and painless, as well as effective and also safer from complications than surgery. Go THERE!!

  936. micah1, on November 28th, 2013 at 6:42 pm Said:

    Hi Ross, Although I am happy with the non op treatment that I had, it was significantly different than what you are being offered. I had nearly 3 weeks in a below knee equinus cast (would have been 2 but easter got in the way), followed by 4 weeks in a boot, removing a wedge each week. Then straight in to shoes at week 7. From everything I have read the key to a sucessful recover appears to be early weight bearing to encourage a good blood supply to the otherwise poorly perfused ligament, and also early mobilisation to keep the leg muscles from atrophy. This method gives a low rerupture rate similar to operative treatment.
    I would deffo seek a second opinion armed with evidence.
    Very best wishes.

  937. tord, on November 29th, 2013 at 2:14 pm Said:

    Hi Ross. Sorry to hear about your bad luck with the consultant and following cast. I would have followed Allan Weibel promptly:

    http://achillesblog.com/dapdapdap/i-cut-off-my-cast-at-home-video/

    But, perhaps I would have cut the cast slightly below the knee instead of removing it completely :)

    Study the evidence, and go for the second opinion. I had an op 6 months ago,and if I ruptured again - in an uncomplicated way - I would have gone for a non-op and an aggressive rehab protocol.

    BTW: Not that my op was unsucccesful. But I have some annoying side-effects, like scar tissue issues, very slow progress on swelling, lots of pain the first weeks, and so on. Stuff that I’d avoided with a non-op treatment.

  938. Ross, on November 29th, 2013 at 2:39 pm Said:

    Thanks again everyone,
    Some great advice on the “fast modern non-op” method. I’ll look into this and get back to my consultant to see what he thinks, he might be willing to go down this route without needing a “second opinion”

  939. hillie, on November 29th, 2013 at 3:03 pm Said:

    Ross

    Good idea, and if he can be convinced, it may be quicker than getting that referral appointment. Plus you convert a medic and save others from torture by cast. Before you contact your consultant, check the Exeter study (see above) and get the names of the consultants there in the Orthopaedic Centre and get their phone numbers to give to your man.

    Make it Monday, every day counts!

  940. normofthenorth, on November 30th, 2013 at 4:27 pm Said:

    Good luck, Ross. At this point, you know what you need to know, and you know what you have to do — especially if you’re going to get onto the slopes at 15 weeks!

    Tord, it’s not surprising that I wholeheartedly second your support for “a non-op and an aggressive rehab protocol”. I certainly hope you DON’T rupture your other AT, but I agree with your choice if you’re unlucky enough to join me in the “both sides” club. BUT. . .

    I think you’ve over-sold it in one small regard: You attribute “some annoying side-effects, like scar tissue issues, very slow progress on swelling, lots of pain the first weeks, and so on.” to your surgery. Obviously, your scar tissue issues and your lots of pain the first weeks really are post-op results that you really would have skipped if you’d gone non-op. But AFAICS, “very slow progress on swelling” seems to be a crap-shoot, with little or no correlation with op vs. non-op. During my own non-op ATR#2 recovery, I started one blog page here called “This swelling and elevation is getting OLD!” (And I recommend DOING that, since mine faded soon afterwards! ;-) )

    The initial post-op inflammation — and the feeling that every drop of blood from your whole body is pumping up your leg when you put it down — is clearly a post-op result, but the lingering swelling later seems to strike all over the block, AFAICS.

  941. coachbob, on December 3rd, 2013 at 5:27 pm Said:

    Hello all,

    Nice to find you all, just a pity of the circumstances, for me I partially ruptured my right AT coaching football on 13th October. I thought I had just pulled a muscle really badly, it was my wife (bless her) who insisted on taking me to A&E that evening, and after waiting around for an hour or so, I ended up in an equines (don’t you learn some new words) back slab from my toe to thigh and was told to come back to hospital in 3 days.

    3 days later, in a heaving ortho surgery, the cast came off and I was sent on my merry way with just my crutches and told to come back in 3 weeks only if it was still a problem. Well 3 weeks later I wasn’t going to bother going back as I was starting to be able to partially weight bare on the outside of my foot, but again the wife insisted.

    So there I am sat with the consultant who has a look asks me to stand on my toes, which I cant, and then decides to put me in a NWB below knee equines cast for 2 weeks, to come back after another 2 weeks to get my foot moved and be recast again.

    So here I sit, having just found this lovely site, “preparing” to go back to hospital tomorrow to see what the next instalment will bring having hobbled around for the first 3 weeks to then be NWB for a month - to find from here that treatment is all a bit of a lottery really. One good thing though is should I know or meet anyone else who has an ATR in the future, I know where to point them for advice.

    Yours (hoping to get a funky boot tomorrow)

    CoachBob

  942. normofthenorth, on December 3rd, 2013 at 10:53 pm Said:

    Hope it works out OK, CoachBob. Treatment is definitely a big lottery — even without leaving the UK!! — but your experience is on the “outlier” side of normal even for this lottery. If you don’t end up heading for a result you’re content with in a few months, you’ll be choosing between “hanging in” and insisting on repair surgery. Non-op can work great, but those great results seem to depend on staying pretty close to Best Practices — at least on average. Every study has outliers, too, so predictions are always dicey.

  943. coachbob, on December 4th, 2013 at 1:41 pm Said:

    Well, back from the hospital and the good news is I’m now out of the cast. Not so sure about the total lack of follow up treatment though, no physiotherapy planned & no additional support - I had to ask if they thought I would still need my crutches.
    So I’m just going to take it slowly and try not to put too much weight on too soon and check out other advice on here regarding rehab

  944. snowball040, on December 6th, 2013 at 1:01 pm Said:

    Hi all,

    I ruptured my AT on the 30th Sept 2013 playing basketball. I wasn’t even doing anything explosive or strenuous at the time. After 45 mins of warming up and training for a bit passed the ball out on a 3 man weave started to run out and BAM who kicked me……..i’m sure we all know the rest of that feeling.

    After 2 weeks in a toes down cast I was the progressed to a Aircast with heel wedges to remove every 5 days then 5 weeks total in the Aircast.

    I came out of the cast last week and and am able to walk albeit the tendon is so tight (Weird feeling it hurts but it doesn’t hurt anyone else get this?) so its not easy. I have quite a bit of swelling and zero muscle. I am just stretching at the moment with a towel around my foot and usual calf stretching positions.

    Has anyone tried the Bauerfeind AchilloTrain Pro Achilles Tendon Support??

    Such a pleasure/pain feeling at the mo happy the cast is off but its a long road back to recovery!

    Regards and I feel your pain (literally)

    Chris

  945. kelliblw, on December 6th, 2013 at 9:27 pm Said:

    Yes, I wore this same support after my achilles surgery. I liked it, but it seemed way tight. I like how it was padded around the achilles. I did like it, but it was priced rather high.

  946. Ross, on December 9th, 2013 at 10:14 am Said:

    URGENT HELP/KNOWLEDGE REQUIRED… UK Based.

    After failing to confince my Consultant to put me in a VACO boot. I am asking for a “nd opinion, but obviously want to maximise my chances of getting the medical assistance I want.

    Does anyone know of a Consultant in the North East of England who will be willing to support me going into a VACO boot?
    I’d rather not do it myself without themedical back-up.

  947. hillie, on December 9th, 2013 at 1:47 pm Said:

    Hi Ross

    I know that I suggested you contact the consultants in Exeter but I appreciate that they are a little too far for you to visit easily.

    The most authoritative source of information for which consultants, hospitals, etc use the Vaco products is Oped, the Vaco maker. Start at the website http://www.oped-uk.co.uk/meet-the-oped-team.html, and maybe its Facebook pages, then call Jason Caulfield or one of his team at the UK HQ in Devizes.

    When I first had a boot I had a couple of issues and promptly received a home visit! They were new here then and might not have the time now but I see from the website that there is a new guy for the north of England.

    You just have to give this a try. Tomorrow?? Anything less means that you are not doing the best for yourself.

    Exeter’s guys will also have peer contacts across the UK.

    Looking forward to reading about your success.

    H

  948. Ross, on December 10th, 2013 at 6:05 am Said:

    Hillie,
    Thanks for that, I’ve already done both these things, VACO by e-mail (I’d made a contact finding out costs and deliveries) and the consultants secretary I’d contacted at Exeter didn’t work Mondays, I’ll try again today.

  949. hillie, on December 10th, 2013 at 9:49 am Said:

    Exeter Chiefs and Cornish Pirates rugby players have used the VACO boots - might be interesting to call their physios or coaches for a chat. I’m sure they won’t mind. I did hear, don’t know if its true, that some players trained in their boots for extra support as the rehab moved on.

  950. chris90, on December 11th, 2013 at 6:43 am Said:

    Well I didn’t think I’d be returning to this site in the situation I now find myself in! 5 months since my initial rupture and bang! There she goes again! I thought I was healing ok with one or two minor set backs but it seems the question I asked back in August has been answered. What will be the effect of the NHS not putting the heel wedges into the boot? Answer, a failed healing and re-rupture!! I had an op to repair on Sunday but luckily straight into the boot. NWB for two weeks but I will be able to weight bear as tolerable just before Christmas. I couldn’t find enough evidence to support a second conservative treatment and was advised the op was the best a chance of decent recovery. So, the road to two shoes starts again but with less trepidation as I know what to expect.

  951. coachbob, on December 12th, 2013 at 5:05 am Said:

    chris90

    That must be soul destroying, as you say (and its cold comfort) at least you know what to do this time around.
    It could be worse you could be sat just on the sofa watching Christmas TV repeats…
    Makes me think more about my injury, I’m going to phone my doctor today and see what more they can do
    All the best, Keep calm and keep hopping

  952. chris90, on December 12th, 2013 at 8:09 am Said:

    Thanks Bob,

    Luckily I can work from home so I’m safe from the Morecambe and Wise and Two Ronnies Christmas specials!! Just finding it hard to come to terms with the 2nd rupture and the underlying causes. I notice you coach football. I did my initial rupture on the YA Mod 2. I was meant to be attending the LCC Conference on Saturday but will have to miss this year! If I can offer any advice, I would say make sure both parties follow the treatment protocol and that it is an accelerated protocol. This should give a better outcome.

  953. thesingularity, on December 13th, 2013 at 1:42 am Said:

    Hello. After my rupture, I went non-surgical in a cast for 6 weeks. Then a boot for a week. I decided to get into two shoes FWB in week 8 (around 7-9 days ago) despite my doctor telling me to wait at least another week.

    Everything was going super, and yesterday, I was feeling wonderful with barely any limp at all. Then, I did something foolish…I forgot my right leg was injured and lifted it up to push something down while in my shoes. Don’t ask why…just an old habit or relflex action.

    Anyway, instead of a pop sound, I felt a more prolonged sound like threads untangling or like when you pull a carpet with adhesive at the back.

    That was yesterday night. I slept in a boot again yesterday…and today there is still some itching and discomfort around the tendon area. The gap is hardly visible when I have been in bare feet for a while (but very visible if I am wearing a small sock for a while and remove it).

    Anyway, I am scared stiff. Am not sure if I should wear the boot when going out tomorrow (have an urgent appointment) or drive myself in my two shoes to the appointment. Do not feel like going to the doc until I am certain that this is a rupture or if there is further swelling.

  954. normofthenorth, on December 13th, 2013 at 2:51 pm Said:

    O shame in babying a healing ATR after a scare/setback, whether it’s a rerupture or not. Your long immobilization post-non-op puts you in a high-risk group, so this is no time to rush or be over-confident (or even confident!). No way to diagnose your setback from here. Get a friend to give you a Thompson Test?

  955. thesingularity, on December 14th, 2013 at 12:31 am Said:

    Hey norm why do you say long immobilization? I was in a splint and then cast for a total of 6 weeks. Then boot for week, then two shoes starting week 8. is that too long by modern protocols? I thought I was pushing it slightly!

    Also, out of curiosity, does anyone get into a boot FWB immediately with the nonsurgical option? In case I do have a partial re-rupture, I was thinking of just staying in the boot with PWB/FWB combo rather than go back to a cast. And when I say FWB, it would only be for 15 mins a day…generally I would be sitting in front of my computer or PWB.

    I suspect that a partial re-rupture or partial scar tissue tear would heal faster than the original rupture. Anyway, hopefully its neither.

  956. normofthenorth, on December 14th, 2013 at 4:33 am Said:

    Getting into 2 shoes at 8 weeks is not late (though also not “pushing it”), but being completely immobilized in a cast for 6 weeks — no PT, no exercise, no WB — is way slower than the most successful modern protocols, especially non-op. E.g., bit.ly/UWOProtocol and Exeter. Those started PT and exercise and WB at or before 2 weeks, a month before you got out of your cast. The results from older studies that used “conservative casting” for non-op treatment are pretty consistently inferior, including rerupture rates in the 12-20% range instead of the 2-5% range.

    Most successful published protocols do use a boot for non-op patients immediately. But I don’t think I’ve seen any SUCCESSFUL protocol that used immediate FWB, post-op or post-non-op. On one of my blogs, RyanB and I discussed a study he found that used ultra-fast rehab for a number of post-op and non-op patients. I think they started with immediate FWB, and went pretty fast from there. Both kinds of patients did significantly worse than the patients in the UWO and Exeter studies, and the non-op patients did quite a bit worse than the post-op patients. High re-rupture rates post-op, and even higher post-non-op. So we have finally found a study that did fast aggressive rehab that was TOO fast and aggressive. (Had to happen eventually.)

    There’s no evidence showing that partial ruptures or reruptures heal faster than full ones. Most reruptures, post-op or non-op, are treated surgically, though we’ve had one or two people here who went non-op and did OK. All the big studies looked ONLY at FULL ATRs, not partials.

    It’s also logical — but apparently false, based on the only study I’ve seen — that small-gap ATRs should heal better non-op than big-gap ATRs.

    Your reference to “a partial re-rupture or partial scar tissue tear” covers too much ground, since a healing AT is significantly harmed by any rerupture, and a patient with scar tissue in the wrong place (”adhesions”) is significantly helped by breaking them up.

    In short, your rehab from here should be guided by your current diagnosis. If you did rerupture, you’re more-or-less back to square one, including the choice of -op or non-op — except that the evidence showing excellent results in large groups of non-op patients following fast modern protocols is ALL about “primary” ATRs, not reruptures, so you’re not following a proven path if you go there. (We could speculate on mechanisms either way, but we don’t have the facts.) If you did NOT rerupture, then you should stay the course, or follow your Doc’s sensible-sounding advice, not to jump straight from a long period of casted immobilization straight to 2 shoes, but to spend some time building up strength in a boot first.

    Good luck. I hope you don’t have a rerupture, and that you Watch Your Step from now on.

  957. thesingularity, on December 14th, 2013 at 3:25 pm Said:

    Thanks a lot for that detailed answer Norm. Was quite depressed for the past several days since I was progressing so well once in two shoes.

    Anyway, do you know why we rarely hear of re-ruptures after one year? Also, why is a rupture in the second good leg more common than a re-rupture in the once ruptured leg many years later?

    It seems like I have read a ton of posts about someone rupturing one leg playing a sport, and then rupturing the second leg years later playing a sport! Yet you rarely hear of a re-rupture of the same leg years later. almost seems like the ruptured leg heals so well that it is better than the non-ruptured leg that might also have a genetic predisposition for tendon issues.

  958. normofthenorth, on December 14th, 2013 at 4:22 pm Said:

    Your “almost seems like” is the leading theory, AFAIK. After 4-ish months, reruptures are virtually unheard of. The “rebuilt” tendon is usually thicker than new, and by 6-12 months post-whatever, it seems to be stronger. The other one, OTOH, is not unlike the ATR AT pre-ATR. In the first few years post-ATR, we have ~200X the background risk of tearing the other AT according to the article linked in the Studies & Protocols page. And the elevated contralateral ATR risk obviously persists after a few years too. Me, I have 0 regrets about returning to the exact sport that gave me ATR#1, despite the fact that it gave me ATR#2 8 yrs later. I love the sport, and loved the 7 years of playing it between the two — and the subsequent years too. Very personal decision, of course, and I’ll defend to the death the right of ATR survivors who choose to switch to swimming or golf or even TV or reading!

  959. thesingularity, on December 14th, 2013 at 11:51 pm Said:

    Norm you are very brave, as are others such as that ice skater (Ryan)? I wonder if their is a genetic component to the risks one is willing to take.

    Just read this:

    How to Avoid a Ruptured Achilles Tendon

    If you think you’re at risk for a ruptured Achilles tendon, here are some things you can do to help reduce your risk of injury.

    – Wear shoe inserts to redistribute the forces placed on the Achilles tendon.

    – Wear shoes that have added cushioning in the heels.

    ….and more here:

    http://www.coreperformance.com/knowledge/injury-pain/ruptured-achilles-tendon-what-you-need-to-know.html

    But the above two pasted reasons were the ones that struck out…wonder if I should try those to reduce re-rupturing and stressing the tendon?

  960. normofthenorth, on December 15th, 2013 at 3:12 pm Said:

    TS, there’s definitely a genetic component to risk-taking, and very young kids vary greatly in that and many other personality traits.

    Good shoes that fit well are always a Good Thing, and it’s Logical that they might prevent or delay ATRs. Of course, there’s no good evidence (AFAIK), and many logical hypotheses turn out to be false or even backwards, else we’d never need experiments, randomized trials, or data. It’s logical that stretching before sports would increase performance and decrease injuries, but it seems to neither and DEcreases performance(!). Damned facts…

  961. thesingularity, on December 15th, 2013 at 11:08 pm Said:

    Posted this somewhere else, but seems like this part of the site is busiest, especially for non-surgical:

    ”

    I am curious about what happens to people in villages in developing countries who often do nothing after an achilles tendon rupture. Considering that collagen and scar tissue grow in the gap between the ruptured edges when in cast irrespective of gap size, why would a person who does nothing (i.e., no cast, boot, immobilization or surgery — ever), not also heal over the long term even if it takes longer?

    I assume that if you do nothing, you could limp forever, but it seems like there can be no studies done on this in the developed world to prove it. It would not be allowed for a doctor to tell a patient to do nothing to see what happens and if scar tissue and collagen still form despite immediate two shoes!

    “

  962. normofthenorth, on December 16th, 2013 at 2:39 am Said:

    We’ve had people here who ignored-misdiagnosed their ATRs for a long time. Something healed, alright, but they did “limp forever” — or at least until somebody diagnosed their “stale” ATR. At that point they usually opted for surgery, which sometimes (usually?) worked OK. Some OSs feel strongly that stale ATRs need reinforcement with something extra, usually an extra auto-harvested or cadaver tendon. Judgment and logic rather than evidence.

  963. thesingularity, on December 16th, 2013 at 2:06 pm Said:

    Thanks Norm. However, I still find one thing confusing. It seems like there was a study in which non-surgery worked even if the ruptured gap was a few inches long. This is hard to believe, but I assume the study was legit and replicated again?

    So, if someone in a poor country has a small 1cm gap, does nothing, and the tendon only moves a further 1cm or 2cm away, we are still only talking about a 2cm-3cm gap. You would think that the body would still put in scar tissue and collagen even if this person was never immobilized (assuming he/she does not jump or run around, but just walks and limps around). But it seems like the consensus (with no study backing) is that if you do a “just walking and limping and sleeping in two-shoes from the get go” kind of (non-)treatment, it WILL NOT work and you will always limp? And this agreement is based on no studies to back it up.

    Am just trying to understand the science of why the body repairs a large gap when in a boot, but not a small gap if just walking and limping around in two shoes with no jumping and running. Unfortunately, it seems like there will never be any study to see this and we just have to assume that non treatment does not work, while rapid mobilization non surgical treatment does work due to enough proof.

  964. normofthenorth, on December 16th, 2013 at 3:29 pm Said:

    TS, I think there’s a simple analogy: If you put slow-drying glue on the torn ends of a rope or belt… AND stuck the ends together, AND didn’t tug on it while the glue was drying, you’d have a good chance. Add amazing biological healing, and you’d have a great chance. But if you neglected any 1 or 2 of those steps, your chances drop near 0.
    One remaining mystery is how good non-op treatment heals big-gap ATRs. Immobilizing in equinus partly explains it, and the usually-intact paratenon(sheath) that surrounds the AT may explain the rest. (That sheath has to be cut (& sometimes? Always? repaired) in a surgical repair.)

    The only evidence that this is true — that good non-op treatment DOES heal big-gap ATRs as well as small-gaps — comes from a sub-analysis of the 75 non-op ATRs in the UWO study, specifically the 25 that had good UltraSound gap measurements pre-treatment. Not a huge sample, but they found no sig relationship betw gap size OR location (high, middle, low) and clinical outcome (strength, ROM, rerupture rate).

  965. thesingularity, on December 16th, 2013 at 4:09 pm Said:

    Thanks Norm. But if you do not put the two torn ends together, can the body not still add new collagen (and some scar tissue I guess is inevitable) in the gap is my nagging question/curiosity? Or can the body not put 100 percent new type III or whatever else number collagen in the gap (after scar tissue dissolves if that is possible)? In your analogy, the rope can clearly not grow back so has to be connected…but in the body….?

    Wish I was a doctor in India or Africa and could find thousands of people who did nothing and see the final results after a few years.

    Mostly just my curiosity, plus if there were proof that doing nothing results in no limp after say 3 years, then that would make me more comfortable in going to two shoes even after 5 weeks if i were to re-rupture, irrespective of the studies suggesting 7 or 8 weeks is best! i would risk the higher chance of re-rupture for lesser calf atrophy by going to two shoes in week 6 if I knew that even doing nothing has significant success chances.

  966. thesingularity, on December 16th, 2013 at 7:16 pm Said:

    For those on the nonsurgical route, how long did it take for the gap in the tendon to fill up? Did you still have an obvious gap when you got into two shoes and rubbed your fingers in the general vicinity of the rupture?

  967. normofthenorth, on December 17th, 2013 at 2:14 pm Said:

    TS, doing nothing (after a “primary” ATR or a rerupture) works reliably poorly, with a limp that never goes away. Typically the two ends heal but not together, mostly because the torn AT isn’t left alone long enough together to heal together. (Imagine you had a big cut that you kept rubbing, scratching, poking, tugging at.) Once the inflmation and rush of blood and other fluids tapers off, what you’ve got is what you’ve got.
    You describe another variant, where an ATR is immobilized but with the ends apart. In that case, the ends CAN be connected, but the length will be greater than before, which creates predictable problems.
    BTW, Scar Tissue is a blessing, unless it connects tissues that should not be connected (”adhesions”), as is typical among post-op ATR patients. When they point their toes, their incision skin usually slides up and bunches up, maybe a little maybe a lot. Non-ops have only one torn tissue to mend — the AT itself — so we usually escape that problem.

  968. thesingularity, on December 19th, 2013 at 2:57 am Said:

    At what point after your non-surgical recovery does the Thomson Test no longer stay postiive for most people?

  969. hillie, on December 19th, 2013 at 10:28 am Said:

    A little light reading for those of you with a yearning for information, and time on your hands.

    http://wrap.warwick.ac.uk/46776/1/WRAP_THESIS_Kearney_2012.pdf

  970. roar87, on January 28th, 2014 at 11:56 am Said:

    Hello everybody, I would first of all like to say I wish you all a full and relatively painless recovery!!! I will apologise for the length of this post, I have documented my progress so far (6 months post-injury). I have been treated at the Lincoln County Hospital.

    At the age of 25, I ruptured my right achilles tendon (fairly close to the heel bone) on the 19th July 2013 playing football. Something seemingly innocuous as accelerating to sprint, and then I heard the dreaded ‘pop’ and fell like a sack of spuds. I was fortunate in that I suffered no pain whatsoever, akin to a mild muscle strain. My teammates told me to jog it off and so I proceeded to hobble off the pitch but I was concerned with my foot slapping on the floor when I tried to walk.

    3 hours later, I admitted myself to A&E at Lincoln County. I was given the old squeeze test as a demo to a junior doctor, and then it was promptly ultra-sounded to confirm the dreaded news of a rupture. As it was a Friday evening, I was given a leg plaster in the equinus position and told to return 3 days later.

    With the aid of two crutches I gingerly attended the appointment, nervous to ascertain the full extent of my injury. Patiently I waited to get ultra-sounded again (this was perhaps the most painful experience I have felt during the recovery). The specialist confirmed the complete rupture by looking at the ultra sound and offered me the choice of surgery or conservative treatment. I had already read-up about the rerupture rates and recovery times etc… and elected for conservative treatment as the tendon had not retreated at all and was cushioned conveniently next to the other ruptured end. The specialist agreed that he would have elected conservative treatment if he was in my position, as I am fairly young and active and that there significance of rerupture rates was nothing to be greatly concerned about (it would have been different if there was a 20% chance it would happen again!). I was informed that my recovery would be anywhere from 6-9 months.

    Once I had decided to elect the conservative treatment, I was given a full leg cast (a lovely smurf blue) in the equinus position and that remained for roughly 3-4 weeks NWB with use of two crutches. I returned 4 weeks later to be told that the tendon was healing nicely and I was given a below the knee cast (sky blue this time) but with the angle of my foot being raised by 5 degrees. The new cast remained again for roughly 3-4 weeks NWB.

    Upon my return to see the specialist (8 weeks post-injury) I was hopeful to be given a boot, to which they obliged. The specialist was happy with my progress and I was fitted with an Aircast boot (which is incredibly sweaty so I bought extra socks as I was only given two with the boot) with 3 wedges in, this time I was PWB still with the use of two crutches. I went back two weeks later to check-up on my progress and I had one wedge taken out and told to FWB.

    The Robocop boot remained for a total of 6 weeks, in that time I removed the final two wedges upon the specialists orders.
    I returned to see the specialist (14 weeks post-injury) and he told me I had developed a flat foot… But he was positive with my progress and slowly weaned me off of the boot by having 1 day without the boot, 1 day with, 2 days without, 1 day with, 3 days without etc.. At this point, I was very nervous to walk in shoes, fearful of any trip. My tendon had been stretched so my foot was finally at a neutral position but due to the excessive time spent in the casts/boot my right leg was skeletal.

    I waited impatiently to be given physiotherapy but due to an admin delay I was told to wait a month (even though it was flagged as important) so I phoned a local sports physiotherapy and simply had a referral from my GP (for the NHS to pay for 3-5 sessions with them) so I could start physiotherapy as soon as possible.

    16 weeks post-injury I attended the physiotherapist and I was given basic range of motion exercises and calf raises (lean weight onto uninjured leg, lift body weight up, then slowly centre the weight and lower the weight on both legs) with core/leg strengthening exercises.

    18 weeks post-injury I was given stretching exercises (mini-squats and lunges) with the added bi-lateral calf raises (straight up and down) and the use of an exercise bike. I had a horrendous limp and I looked like a toddler who had soiled their underpants. But I endeavoured and walked as much as I could. These exercises slowly increased in intensity, with emphasis placed on stretching the tendon and getting my cardio up to standard.

    20 weeks post-injury I had almost regained the full range of movement in my foot. I was still unable to push my right foot down that extra 1cm, compared with my left. But the right calf was now ½ the size of my uninjured leg and very receptive to any foot movement.

    I’m currently about 6 months post-injury and my injured leg is now ¾ the size of my uninjured leg. I’ve been given a wobble board to strengthen the ankle. My right ankle is still seizes up, but eases off once I can get it to click. The stretching exercises still remain and I’ve been told to do bi-later jumps and small running drills to get the tendon used to fast movements. The jumping exercises were terrifying at first! I walk with a slight limp but it seems to be improving every week. I feel like I could jog but I’ve not been given the all clear yet by the physiotherapist.

    I see the specialist again this week but I can only assume that my progress is on course. The injured tendon is still double the size of my uninjured one, but has no knots or divots in it and thankfully it has some good elasticity. There is however a noticeable amount of fluid which remains either side of the tendon but I expect that will take time before it disappears.

    I hope this will give some insight into one of the varied NHS protocols. Best piece of advice I can offer, keep your mind active and don’t rush and overdo anything in excitement!

  971. hillie, on January 28th, 2014 at 1:47 pm Said:

    Hi

    A good post describing your rehab to date. Protocols certainly vary don’t they, worldwide, not only NHS. There is little sharing of ‘best practice’ and many here literally suffer as a result.

    6 weeks in a boot is quite normal these days but without 8 weeks in a cast first (full leg too, wow). I had problems with swelling for a few months but this was helped with compression socks and contrast bathing.

    The good thing is that, despite your ultra-conservative treatment you are likely, by somewhere between 6 and 12 months to be at a similar level of recovery to those fortunate to have had the benefit of modern protocols, whether non-op (my choice too) or surgical. You have work to do, and you need to keep at it, not just until it ‘feels better’.

    All the best.

    H

  972. normofthenorth, on January 28th, 2014 at 2:48 pm Said:

    +1 to Hillie’s comments! Your clicking ankle surprised me, because I’ve only heard of that post-op (including my own post-op ankle). But I guess long immobilization and natural healing can make some alignment changes too.
    It’d be great if there was a way to bring Lincoln into this century…

  973. hillie, on January 28th, 2014 at 3:59 pm Said:

    My left (non-atr side) ankle has clicked for many years. I have never had any surgery or trauma to that leg.

    Sometimes when I change gear in a manual shift car, the ankle clicks once then for the rest of the journey it’s ok. No pain and can’t feel it happen. Fine when walking, exercising, etc so leaving it as it is.

  974. nate47256, on March 24th, 2014 at 9:26 pm Said:

    After reading through decided to sign up for an opinion.

    Was playing Basketball & suddenly felt the dreaded ‘kick in back of foot’, was ready to get angry at whoever did it, and realised I was alone. Due to there not being much pain, thought it was a typical ankle roll, so attempted to carry on playing, which failed as I felt I was standing on an uneven surface. Stopped playing, and drove home (about 10mins away), then got convinced to check it out (luckily).
    After 6 long night hours in A&E had an Xray & then doctor said I had an Achilles Rupture. This is where the problems began.

    Doctor didn’t look at the X Ray, but said he knew the injjury & I was to go in a plastter cast, toe pointing downwards. The person who fitted my cast fit it with my smallest toe tucked under the rest, which became painful as days went on.
    2 weeks on, went back to Fracture clinic, cast was taken off.

    Clinic was amazed at the fact I didn’t have a scan to assess the rupture, and had already been put down to take the surgical option. They said that it may not indeed be a rupture and may be a minor tear. Also at the time, realised I’ve lost most movement in the tucked toe, and my whole foot has swollen quite bad.
    At this point they put me in the boot (ran out of heel wedges so have placed some cotton there which I personally see as VERY dangerous), and booked me for a scan. 5 days on, had the scan, & have now been confirmed an Achilles Rupture.
    I’m now currently waiting for my next Fracture Clinic appointment in 3 days time, but feel as if they’ve already wasted close to 3 weeks in which I could have used to recover. All of the surgeons are advising me to go the surgical route (although none have seen the results of my scan yet), but I don’t feel comfortable with having surgery with any organisation that can make mistakes on small details, what’s to say they won’t cock up the surgery?
    On arriving to the hospital I did explain my worries at the fact my current job is cash in hand, and if I don’t work, I don’t get paid. I don’t need much movement but need to be able to stand, and the longer they delay, the longer I’m out of work.
    As 3 weeks have already passed, I’m now leaning towards the conservative route of treatment. Just wanted to get opinions on here of whether I’m in the right frame of mind, or indeed over reacting.

  975. whippet999, on April 4th, 2014 at 2:15 pm Said:

    Hi there

    I’m new here. What strikes me reading the other comments is the varying treatment people get depending on where they live. Here is my story…

    I’m 38 yrs old and Love the outdoors i particularly love cycling and Geocaching. I work as a Paramedic in Plymouth, Devon

    On 15th Feb I stepped out of the side door of the Ambulance at an RTC (Road Traffic Collision) In front of Police, Fire Service etc

    I put one foot down on a Kerb stone i continued going forward and my foot just stayed in the same position and ping! my Achilles ruptured.

    They then had to call an Ambulance for me!!

    Anyway i got pain relief almost immediately from my crew mate!

    In ED at Derriford Hosp I had a Equine cast on my leg and was sent home on crutches. Three days later I had a new blue plaster applied in the equine position which i had for 3 weeks. Non weight bearing and daily clexane injections.

    After 3 weeks i was put into an Airboot with 3 wedges. taking a wedge out every 5 days. Until in a neutral position.

    I have now been in an air boot for two weeks and need to wear the air boot for two more.

    I visited fracture clinic this week and the consultant said after about 3 feels and a slight pause that my achilles is healing well, although he didn’t fill me with confidence.

    as you are aware i am a nhs paramedic and i always strive for high standards. i don’t believe i am a special case but i guess with the job i do i expect the same sort of treatment as i give. As i say the consultant gave me no confidence and it was all very rushed.

    i needed more.

    Anyway the next phase in two weeks time is a wedged shoe for a period of four months 4! FOUR!! Then physio

    Just thinking about that is depressing me. When will i next be able to go Cycling or Geocaching across my beloved Dartmoor or the south west coast path??!

    What about work? I only get full pay for 6 months!

    Why does it have to take so long?!!

  976. whippet999, on April 4th, 2014 at 2:23 pm Said:

    Hi nate47256

    I think your concerns are very normal. My hospital said they don’t carry out surgery at all for achilles rupture. there are a lot of arguments for and against surgery. I didn’t have a scan at all. Just a simmonds test where the squeeze your calf to see movement or no movement. also because of the way i described the injury they were satisfied.
    I can’t help but think though that the lack of scans and surgical treatment is more down to cost than anything else.

    interestingly Christian Benteke (AVFC) ruptured his achilles yesterday and has had surgery.

  977. whippet999, on April 4th, 2014 at 2:25 pm Said:

    In my air boot i walk the dog to my local corner shop everyday. The walk is normally 10 mins but at present more like 20.
    Is this good for me or not? Ive had no guidance to the amount of walking i should do.

  978. normofthenorth, on April 4th, 2014 at 3:39 pm Said:

    Whippet, I think walking in your boot is great, as long as you don’t suffer from it — pain, excessive swelling that doesn’t respond quickly, etc. And you must even up your two “shoes” so your hips are straight, or your walking may threaten other body parts OR train you to walk abnormally.

    There is a big movement in Canada and the US recently to avoid excessive scans and tests, and the main justification they’re stressing is not money. But scans and surgery certainly do cost a bunch more than calf-squeezes and a boot, so penny-pinching systems may be the quickest to “get the memo” about the excellent new results from new-fangled non-op ATR treatment.
    Have you looked at the recent ~1000-patient report by Wallace et al from Belfast? He reserved surgery for the ATRs whose ends could not be “approximated” by immobilizing the ankle in equinus. A few tens of patients out of almost 1000, IIRC. I’m not sure there was any “informed consent choice” for the others, but the satisfaction rate (and the rerupture rate) are very impressive. If we’ve reached a point where non-op results are as good as surgical results — and we’re either there or we’re pretty close, depending on how you “lean back and squint” at the evidence — there may be a case for refusing surgery to insured patients who qualify for non-op. That’s not my style, but we don’t offer patients a surgical option for lots of minor problems that don’t need it, even if they ask.
    Yes, pro athletes are still overwhelmingly getting ATR surgery, though the first few exceptions have recently surfaced (and one — Brady Browne? — posted a bunch of knockout videos on you-tube). How much of that is from “force of habit” or old myths, and how much is from some small (”insignificant”) strength differences in some studies (including UWO), I don’t know.
    My OS for my second ATR is the Chief Surgeon of Toronto’s pro football team. He told me he’d completely stopped doing ATR repairs after meeting with the UWO authors at AAOS2009. He also told me he would TRY to convince any ATR patients on that football team to go non-op. I’ve only noticed one in the past 3-ish years since then (not a big football fan), and that player got the surgery. This may pass.

  979. hillie, on April 5th, 2014 at 7:45 am Said:

    Hi Whippet

    You mention “the varying treatment people get depending on where they live”. Your case is one of the best examples that I have seen here in the past year or so.

    You talk about going into shoes with wedges for 4 months. At RD&E in Exeter, just 40 miles up the road from you in Plymouth you would typically be treated non-op whenever possible, as you were, and start physio after about 3 weeks from start of treatment, then work up to 2 shoes by week 8 or 9. Driving by 9 or 10 weeks. A good boot at an early stage, early mobility and weight bearing, losing the crutches at around 4 weeks or so, may have negated the need for clexane in my case.

    Check out Suddsy’s (/suddsy) many blog pages which includes links to the Exeter and UWO studies, as well as protocols, and the experiences of many others.

    By the way, is “What about work? I only get full pay for 6 months!” said tongue in cheek or are you pleased to be paid for that long? In the private sector, most of the public sector, and most of the rest of the world, you’re quite likely to get 0-8 weeks sick pay. But you did say it tongue in cheek didn’t you?

    Change the rehab schedule, get yourself some light physio, and by 6 months you’ll be further on than you anticipate now. BUT bear in mind that for you do to your job in full you may well need the 12 months for full strength. You can help to fast track by seeing a sports physio when the more basic treatment needs augmenting, but you will have to work hard, very hard.

    Dartmoor - no problem after about 10 - 12 weeks, and in good walking boots. Choose the gradients to suit, and build up. Perhaps leave the geocaching for a while (most fans leave their boxes in rockier places).

  980. normofthenorth, on April 5th, 2014 at 2:03 pm Said:

    The question of getting clexane (injectable heparin, I think) or other anticoagulants (Warfarin=Coumadin, ASA=Aspirin, etc.) to prevent post-ATR clots - DVT and PE - is an interesting one, and practice varies all over the block.
    Post-op patients are generally at higher risk than non-op, but not hugely. Something like >1% of the patients in the recent 975-patient Irish non-op study by Wallace got DVT, after getting no anticoagulants. The Heparin is $$$ and a nuisance, needing a daily jab in the stomach. Warfarin needs monitoring and can have serious side-effects, esp if blood levels get out of range. ASA (baby or adult) is cheap and pretty safe, but much less effective, I’m guessing.
    SO, the judgment call is “simple” but not easy: should maybe 200 ATR patients be subjected to one of these treatments to prevent one case of this rare complication - one which is usually easily treatable but can be serious (or occasionally worse)?
    I’m not surprised that practice varies hugely.

  981. whippet999, on April 9th, 2014 at 11:12 am Said:

    Hi Hillie

    I Appreciate the encouragement. I realise that reading on here others experiences that my treatment hasn’t been too bad but when i mentioned about half pay at 6 months it is a real anxiety. Of course i know it could be worse i could be self employed or similar. But I have never been off sick for more than 2-3 shifts in 17 years with the ambulance service. so being off for over 6 months would not only be a financial worry for my family and i but being such an active guy the solitude and confinement at present is doing my head in.
    I posted about the pay also as this is a support/experience site for others in the same situation. In the hope there is some kind of support / Top up that the govt provide??
    I would love to be back at work at 6 months but I’m guessing that is unlikely.
    my other concern is transport. For the last 7 years i have cycled the 5 miles to my place of work.
    How long before i can cycle again?
    I am no longer on the clexane! woo hoo!

    As for geocaching i realise i won’t be hiking on dartmoor for a bit but maybe i will be able to at least drive to a few soon!

  982. hillie, on April 9th, 2014 at 12:29 pm Said:

    Whippet999

    Have you checked Suddsy’s Achilles blog yet? All of it I mean, there is a lot.

    I can understand your financial concerns very well but I cannot see what you are doing to improve on the consultant’s schedule. That is is the beauty of this blog - you can see what is achievable, and in your case the ‘best in class’ (or equal best at least), is 45 minutes up the road in Exeter.

    You should be receiving physiotherapy instruction by now, doing some simple exercises, getting mobile, etc - or atrophy will rule. I’ll stop there, just remembered that I said it all before, sorry!

    See your GP, explain your work concerns, ask for a referral to Exeter if you can’t do better at Plymouth. Exeter is seriously good and at one time had a dedicated AT clinic, probably still has. You never know, they might even loan you a hinged boot with a range of movement, which I am convinced helps with atrophy reduction and ankle flexibility. Wedges I wore in my shoes for 2 weeks max.

    You can be back at work with the Ambulance Service in 6 months I’m sure, at least with one of the fast response cars (no stretchers). NHS physio for as long as you can get it, then a session or two with a sports physio if you can (your next birthday present?), a good pair of boots.

    Geo-caching - try around Saddle Tor. <100m to some, after a gentle grassy slope with no rock climbing.

    H

  983. chris90, on April 29th, 2014 at 11:17 am Said:

    It’s been 5 months since my re-rupture and have started jogging again. I have completely managed my rehab this time and have not used an NHS or private physio. My last OS visit was at the end of March who told me not to do any explosive sports for 6 weeks but I feel that with the calf atrophy it will take longer. The jogging has felt good and it really helps with the stretching of the tendon. I like reading the blogs of people who concentrate on the protocols and still think that a national (UK) rethink is required. My neighbour ruptured his a couple of weeks ago and he was treated completely differently to me and they’ve made a bit of a mess of it. If you do rupture don’t do it in Wakefield!!

  984. pixie, on May 6th, 2014 at 4:07 pm Said:

    HI everyone! I ruptured my let achilles last July…was treated conservatively in a vaco-ped boot…and long story short, it didnt work and I am due FHL tendon transfer and achilles reconstruction surgery next week! Anyone in the same boat as me? Good luck to everyone with their recovery! Alicia. x

  985. coachbob, on May 7th, 2014 at 4:13 pm Said:

    Whippet, FWIW my ATR was in October 2013 and I have been back on the road bike for about 6 weeks building up the miles each week and last week was my first off road excursion. Whilst the strength is coming back, it still aches & still swells up if I spend too long sitting, driving, etc. But 7 months after the injury, I am still doing the exercises my physio gave me it is progressing & improving, its a long, slow, depressing (at times) process, but it does get better
    Alicia, I cant even contemplate how fed up you must be, good luck with the OP

  986. raj29, on May 8th, 2014 at 10:11 am Said:

    Hi all,

    I’m also a new member to the ATR club unfortunately. I completely ruptured my achilles on 13/4 playing indoor soccer & had surgery on 24/4. I burst forward off my left foot, felt the pop & down I went. & this journey has begun. I’m Australian, but live & work in London and have been doing so for the past 2 years. However, I actually did the injury in Australia whilst visiting for a wedding.

    I had my first post op meeting last Monday (10 days post op) at which my surgeon initially said he wanted keep my cast on for 8 weeks! After reading through this site, I said I’d prefer to get into a boot much sooner (with the knowledge of wanting to get back to UK). As such, he agreed to get my cast removed & into a boot after 3.5 weeks, and currently planning to fly back 4.5 weeks post surgery. I’ve asked a couple doctor mates of mine & they told me to get an injection so hopefully this alleviates the risk of DVT. Also decided to not use the boot the hospital gives & instead buy the Vacocast pro direct due to the feedback I’ve read on this site.

    I’m going to be doing all my rehab work in London & have contacted a physio to commence the week I arrive. I know I’ll be a bit late on the UWO protocol as I’ll hopefully start weight bearing at about 5 weeks once I arrive back into London, but best I could really do with the surgeon I had.

    Just have a couple of queries I’d love to gain some insight on:
    1. Has anyone flown such a long haul flight after Achilles surgery? If so, did you experience any major problems?
    2. I work in central London At this stage, I’ll be coming back to work about 5 weeks post op. Has anyone had experience with taking London public transport a month or so post op? I’m planning to take the bus to work, as I want to avoid the busyness/stairs involved in catching the tube.
    3. My flat in London has 3 flights of stairs. How long does it generally take to walk up stairs fairly independently? I’ll be in a boot just when I arrive in London, but would have had little to no weight bearing at this stage.
    4. Recently, towards the end of the night my injured foot seems to be getting quite hot (feels like it’s all most sweating). Has anybody had experience with this?

    Any help in these queries would be great.

    Cheers,
    Raj

  987. badmintonrupture, on May 8th, 2014 at 9:19 pm Said:

    Greetings from the US! I am a serious badminton player, who ruptured in 2013. I am almost fully recovered now and went the non-surgical route. I did have a partial or full re-rupture though, and it was hard to find similar re-rupture cases on here and keep a track of them. Hence, I have created forums for all the various iterations (i.e., surgery, no surgery, surgery twice due to re-rupture, no surgery twice, surgery and then no surgery, no surgery and then surgery etc..) on a forum here:

    http://www.achillesbusted.com/forums

    I try to come on here (especially the UK section where no surgery is more popular) regularly and at least track the non-surgical stories, but it would be nice if some of you posted on my forums too….especially those who had re-ruptures, and those who went conservative.

    No surgery works! I can do one heel raises on my bad foot in the pool….hope to do the same on level ground in another month or two.

  988. nick19, on June 24th, 2014 at 9:29 am Said:

    Raj, Only just seen your post. I took a flight in my AirCast boot at post op week 4, was fine, some swelling but nothing excessive. I went back to work in London week 5 post op. Train was ok, Tube less so. People just want to barge you out of the way as you’re not going fast enough. Per Norm’s recommendation, crutches helped - see my blog and Norm’s comment. I found stairs relatively easy once I was weight bearing in the boot. Going up easy than coming down though. And yes mine does feel very warm after spending a night in the boot. Nick

  989. ukjayne, on July 27th, 2014 at 6:35 pm Said:

    Planned Haglund’s surgery here, for pain in my right heel for the last 3 years. Probably within the next 6 weeks.
    I have had the works over the last 3 years, including
    (private) shock wave therapy, which gave me about 6 months of relief before the pain returned and further deterioration occurred.
    I’ve got complicated feet and I have had other (very successful) foot surgery in 2012 due to an injury in a car accident in 2007. I’ve had extensive physio, looked at my footwear (always worn sensible shoes) and my shoes now have arch support and thick soles to reduce impact.
    I’m taking diclofenac and paracetamol and I ice and elevate frequently. I’ve run out of non surgical options and detaching the Achilles to do the surgery appears to be my only option.
    Looking forward to ditching the painkillers and walking properly again. In the meantime, trying to get ready for the surgery by filling my freezer and creating a nest for myself in my bedroom upstairs as relocating downstairs isn’t an option due to the design of my house.
    I have no idea how I’m going to get upstairs after the surgery and foresee a period in a rehab place.
    Nice to meet you all, this is a really helpful resource. Is there anyone else here who has had planned surgery?

  990. kimc, on July 27th, 2014 at 7:22 pm Said:

    ukjayne - I had planned surgery for Haglund’s and achilles debridement in October 2013. This blog provided several helpful tips that helped me prepare for coming home after the surgery: 1. A bench/stool for the shower. 2. a scooter for getting around the first floor of the house. 3. a backpack for carrying things with me when I used crutches. 4. Refreezeable ice bags and wraps to secure them. My sleeping options are also upstairs. I just did the sit ‘n scoot the first few days. After that, I sometimes went up on my knees, or hopped holding onto the railing. Using the crutches on the stairs is way too risky. The knee scooter really helped in the kitchen because it left me hands free. Best of luck to you.

  991. normofthenorth, on July 27th, 2014 at 11:10 pm Said:

    Rehab or convalescent hospitals can be an option if you can’t make your home work post-op. We hear a lot around here from people who have trouble with crutches, and especially trouble with crutches on stairs. But there are also a lot of us (including me) who used crutches OK and walked stairs OK on crutches for the ~4 weeks until we were FWB and could walk stairs in the boot.
    It’s not something that anybody is born knowing how to do well. And some people get crutches that are the wrong size or adjusted wrong. But if they’re the right size and adjusted properly, and you have the right technique — and maybe you’ve padded the parts that bear the most pressure or rub — they work fine. Some hospitals give good crutch training, or a PT can help. And then there’s YouTube, and some nifty technique variations videos on RyanB’s blog here.

  992. tanja90, on July 29th, 2014 at 2:11 pm Said:

    I am a 23 year old female and ruptured my Achilles on Sunday June 8th whilst playing netball. It was totally unexpected as I have never had any problems with my Achilles and I am young!!

    I felt the kick in the back of the leg and knew it was my Achilles. I had to be driven home and called 111 who told me to go to hospital. I told the nurse that I thought I had ruptured my Achilles and that seemed to speed things up. I was seen very quickly. Had I just said that I hurt my leg I may have been waiting hours! I was fitted with a plaster cast which was so heavy and given an appointment to see a consultant.

    I saw a consultant the next day and was told that I may have to wait two weeks to see the orthopaedic consultant but due to my age and activity levels he would see whether he could fit me in. I got a call on Friday morning telling me to come in for surgery. My stay in hospital was terrible and the few days after that was hell as they put the cast on too tight…

    I was told I would be in a cast for 6 weeks and every two weeks I would need to come in to get it changed. I got my cast off last Wednesday after almost 6 weeks and was put in a boot and discharged to a physio - doctor said it would be 2 weeks before I saw one but I got an appointment for the following Monday.

    At first I was still using two crutches but on Thursday I was on one crutch and by Saturday I was on no crutches. I saw the physio who massaged my calf and got me to do some exercises to test my strength and at first he seemed horrified that I wasn’t using my crutches but then told me that I could walk in my trainers at home as long as I had a crutch. I am not able to walk without a crutch but my tendon is still very tight and my walking is not fluid. He told me I can use a stationary bike so I signed up to the gym and look forward to doing that.

    I will continue to see the physio and he says I will also get hydrotherapy. I really can’t wait to get my fitness back. This has been the worst thing ever and I hate that my whole left leg is 1.5 inches smaller than the right.

  993. normofthenorth, on July 29th, 2014 at 2:27 pm Said:

    tanja90, as you can read above, parts of the UK are World Class in ATR treatment, and other parts are Third World or worse. Unfortunately, your treatment has been far from World Class. The good news is that you should finally be able to progress pretty quickly, now that you’re out of the @#$%^& casts and getting some PT. Just remember to Watch Your Step (literally and figuratively) and to keep your activities INCREMENTAL. I.e., keep progressing, but if you do anything you haven’t done before, just do a wimpy amount, and wait til the next day to do more. And add resistance and reps and time gradually, not in huge jumps.
    Good luck, keep posting, start a blog if you have time.

  994. blondie, on August 10th, 2014 at 8:47 am Said:

    Hi all
    One week !!! I fully ruptured left achillies last Saturday have been put in cast for 8 weeks. I am keen to hear from others the type of pain they experienced in the first week. I am having a lot of calf pain in particular if I stand or sit. Not so bad when lying down. Had high rupture and have A really sore calf all the way up is that all normal in first week

  995. matt22, on August 11th, 2014 at 10:14 pm Said:

    Hi, I’m Matt, I ruptured my right achilles playing cricket on August 2nd and went to A&E at Lewisham hospital the next day. They diagnosed a rupture, put me in a boot & made appointments to have an ultrascan, and to see a consultant, which I did today.

    The consultant said that I’d need surgery, as the tear was too big to heal on its own so I’m in for that tomorrow. I live alone so am in a bit of a dilemma about whether to stay in my flat, or go down to Kent (one hour in the car) and stay with my parents. I’m swayed by the latter, as I wouldn’t have to get up to make food, etc., and could rest it better.

    So that’s where I am right now. Slightly nervous about the op and more about what comes next. I’m pretty active and I think I’ll find the months of inactivity quite hard to bear. Also, I have the fear of doing something out of ignorance/stupidity and rerupturing, putting me back at square one.

    I’m planning to start a blog after the op and if I can work out how to do it - I’m quite untechy).

    Cheers and good luck to everyone out there

    Matt

  996. pegleg, on August 12th, 2014 at 4:51 am Said:

    Hey Matt

    Sorry to hear you have joined us in the ATR world and very much hope that your op goes well today!

    Firstly try and not worry about the op, the fact is that you have ruptured your achilles and it needs to be sorted, you have been advised you require the op to ensure a better recovery, so accept that and it will help you move forward in the long run. Don’t waste your energy on the negative, use it on positive thoughts and this will aid your recovery and how you handle it - that is what I have done and am still doing 13 weeks on.

    I can’t and won’t deny that ATR is absolutely rubbish, but you will find that the achilles blog will provide you with valuable support and advice/experiences. It has helped support me through the many ups and downs of this journey and shows that recovery does happen even if in the early days that seems unimaginable - I know, as that’s exactly how I felt! It will also help ‘fill in’ the first few weeks as you elevate your leg and rest.

    Why don’t you go to your parents for at least the first week/two weeks as this is the hardest time, having their company and help will be invaluable and help you in the long run.

    Take care and look forward to hearing how it all goes.

  997. matt22, on August 14th, 2014 at 1:03 am Said:

    Hi pegleg

    Thanks for this, it made me feel much better about surgery, which I had yesterday (there were complications with the patient before me on Tuesday so they pushed my surgery back).

    I’m glad that I’ve had the surgery but can see that the road ahead will be long. I’m already nervous that I might have done something stupid - I woke up this morning and without thinking, I stretched my calves. I felt something stretch in my right leg and now my achilles feels sore and a bit numb - and now I’m worried I’ve damaged it. Is that kind of thing normal?

    Speaking of normal, my post op instructions said to put full weight on my ankle (which is still in my boot). Is that usual?

    Matt

  998. pegleg, on August 14th, 2014 at 4:11 am Said:

    Hey Matt

    Glad to hear your op went well :-)

    I very much doubt you have done any damage by simply stretching, more likely have aggravated tenderness in the surrounding area which has just been operated on - but if ever in doubt get it checked or ask your OS. From the way you have written I assume you were sent home so can’t ask a nurse?
    I will be honest a say over the next few weeks you will probably experience a few frights/scares but it is more often just a scare than anything bad happening - we all go through the fear of re injuring the achilles but fortunately most of us get through just fine. (I had a terrible fall at two weeks but everything was fine!)

    With regards to walking immediately in the boot I can’t comment with any real knowledge, but my OS told me that when he does the professional footballers he has them up walking in a boot the very next day so I guess it isn’t out of the question!! I am sure you will get a few comments from the guys on here (normofthenorth, hillie, davidk, stuart to name a few!) who are supper informed/read on the various forms of modern protocol/rehab. Although I am sure the OS wouldn’t be giving you instructions that hadn’t been proven in the past though!

    I look forward to hearing of your progress and wish you luck in this long term ‘character building’ experience. Take it easy for the first few weeks, let the body start healing. Pegleg

  999. matt22, on August 14th, 2014 at 12:48 pm Said:

    Hi pegleg

    You’re right, I was sent home yesterday, probably about four hours after coming out of surgery.

    I think you’re right about the damage too, from reading this blog, it sounds like a few of us have had a knock or two and the panic that accompanies it.

    A friend of mine is a nursing sister at another London hospital; she talked to a colleague who said that walking on the boot should aid recovery as the muscles are less likely to get stiff and tense. Though my ankle’s a bit sore at the minute so am resting it for now.

    I’ll certainly keep logging on and updating my progress. It certainly will be character building and will have its ups and downs - but I think I’ll get through it. Matt

  1000. lindadp, on September 13th, 2014 at 4:27 am Said:

    Hi everyone, I am joking the ATR club! I did mine skipping with the kinds using a loom band rope! I think that may be a first on here :-)
    I did not see a doc for 24 hours as I thought it was a pulled muscle. When I did go to A&E I was put in a cast following the Thompson test and an x-ray, which showed a small fracture. I saw a locum consultant two weeks later, who said he could put his finger in the gap where the tendon was ruptured and described my tendon “completely gone”. I have had no scans and am now in a fibre glass cast. For such a cheerful positive person I have never been so miserable, it’s the thought of the recovery time and the lack of control over time scales. I see my own consultant on 29th and plan to plead for a boot! I would be reassured by a scan too. This blog is fantastic and very much appreciated by me.

  1001. lindadp, on September 13th, 2014 at 5:41 am Said:

    What I should have said is the fracture is to my outer ankle and it all happened three weeks ago today on 23 August.

  1002. arman79, on October 16th, 2014 at 6:40 am Said:

    Just remembered this section was here. I fully ruptured my left achilles 6.5 months ago and ws treated non-op on the NHS. I’m pretty much back to full activity now. This is the link to my blog: http://achillesblog.com/arman79/2014/10/15/6-and-a-half-months-almost-back-to-normal/

  1003. heeling, on October 19th, 2014 at 1:51 pm Said:

    lindadp - I totally empathize. I ruptured my AT on 6th October and was in an equinus cast for a week and SO miserable. I hope you got your boot on Sep 29th. My advice would be to PUSH for everything you can on the NHS - demand an ultrasound, ask to be referred to physiotherapy immediately, look at some of the advice on this website about non-operative recovery and go to your appointments informed. I had an ultrasound on Friday, 10 days after my injury, and was told it looked good; my tendon is mending itself and then broken ends are in line, which is good. Out of interest, was the cast you were put in first in equinus position (toes pointing down)? My friend had the same thing happen to her and was put in a flat cast for the first week - this is wrong and will not aid recovery. You can read what’s happened to me so far here: http://achillesblog.com/heeling/

  1004. heeling, on October 19th, 2014 at 1:53 pm Said:

    PS Good luck to everyone in the UK (and elsewhere) recovering from this horrible injury.

  1005. badmintonrupture, on October 21st, 2014 at 3:00 am Said:

    FYI since there is no chat on this site, I added one on my blog and hope it helps some (I could have badly used it when I was going through this)!

    http://www.achillesbusted.com/achilles-tendon-rupture-chat/

  1006. lindadp, on October 21st, 2014 at 7:01 pm Said:

    Hi heeling- I am much better now thanks, I spent six week in equinus for six weeks and got my boot two weeks ago. I have gone from four down to two wedges. I have walked a few steps boot free. I am please to be mobile and get around even driving my car which is automatic. Hope you are doing well.

  1007. danielowenuk, on June 2nd, 2015 at 4:31 am Said:

    Well… managed to Rupture my left Achilles about a month ago now.

    Had been to the gym the day before and ran 5k pretty hard for me (23 minutes). Was showing off to a girl I was dating. Ironically no injury there.

    Fast forward a day, playing 5 a-side football, and it felt like I was shot in the back of the leg, at first I thought I was kicked but it appears not.

    Managed to drive home (in 3rd gear), got back to parents and said I thought I had broken my leg. Hospital very quickly diagnosed ATR. Had a few days in plaster then straight to boot (said they wouldn’t operate), a week later I went in and they said “When is your ultrasound booked”…. I hadn’t been informed of this at all, fortunately I work at the hospital and knew the Sister on the trauma clinic who got me an immediate ultrasound. They found a 3.5cm gap in my tendon and operated the next day.

    Post Surgery was no fun at all, although IV morphine is certainly interesting!

    Had nearly two weeks in plaster now and going back for a wound check tomorrow.

    Hoping they will take the plaster off and put me in a boot but not sure?

  1008. badge, on July 5th, 2015 at 7:54 pm Said:

    It’s just over three years to the day that I ruptured my tendon, so, for old times sake, I thought I’d pop back to the forum.

    I’m not sure if this is going to be any consolation to anyone who’s freshly ruptured their tendon - but I remember thinking that the healing time of the injury was huge - but, now as I look back, knowing that over 150 weeks have since come and gone … 3 or 4 months healing seems like a lightning flash of time.

    For me, the slower heal was regaining my confidence - for a year at least, I was terrified of tripping over and slamming down hard on the ‘tendon’ foot. My calf still is nowhere near the size of the other, but that doesn’t bother me much. Now I don’t worry about it. My confidence isn’t 100%, but I’ve lost any undue worry of a re-rupture.

    One thing that might be connected to the tendon injury, is my bad back. I’m not in agony - but it’s a nagging and constant lower back pain, and after much physio - it was revealed that my leg with the tendon snap was much weaker than the good leg - so perhaps I’ve got a dodgy push-off on the weaker leg and, as a result, I’ve become a bit mis-aligned in the spine.

    Maybe it’s too too late for me - but on my summer ‘to-do’ list, is to finally try to get my calf built up again and get some pilates lessons.

    Best of luck to anyone who reads this and has ruptured recently. I still see my tendon snap as a hugely positive experience: Taking time off work, slowing down my life and having 3 luxurious months to re-evalute things helped me to make some significant and on-going changes for the better. If you can, in some way, turn the injury to a positive - it really helps to convert the ’slow’ journey to recovery into something so much less frustrating.

  1009. shaf1, on July 7th, 2015 at 3:02 pm Said:

    Hi All,

    I popped my ATR on 8th June playing football. At the time I thought it was just a calf strain but 4 days later when things were worsening I thought i’d better get it checked out. Went to local walk in centre where the triage nurse diagnosed me correctly and referred me to a fracture clinic a couple of days later and sent me home in a cast. At the fracture clinic they did an X-Ray and Ultrasound and the consultant had a very brief chat with me but didnt really explain anything. I was then put in some new plaster and told to come back in two weeks. I had to prise it out of another consultant walking past me what they had actually found and what the prognosis was.

    I do have private healthcare so thought i would go for a second opinion a week later. 2 consultants seen privately later and an MRI later and it turns out I had a full rupture and the gap did not seem to be closing. They both very strongly recommended surgery but did let me make my own mind up and also highlighted pros and cons of both surgical and non surgical approaches. They both seemed to disagree with the long cast time saying this made things worse and also had a higher risk of clotting and DVT. They both do NHS time as well and did explain that given the sheer volume of fractures and injuries the NHS consultants simply do not have time to consult with patients effectively so I couldn’t really knock the NHS for that.

    Anyway to cut a long story short I’m not a fan of surgery (who is?!) but did elect for the surgery which I had 6 days ago and I was terrified. I had it done privately and the surgeon and anesthetist were fantastic, really spent time explaining the procedure, making jokes and generally putting me at ease. The surgeon also recommended ‘internal bracing’ which apparently is quite popular now and helps to really strengthen the joining together of the tendon. The night and day after the surgery was absolute agony, worst pain i’ve ever experienced in my life but got much better day 3 onwards. Now one week to my follow up to have stitches out and check wound healing. 4 weeks post op I’ll begin PT and hopefully PWB in a boot.

    Being quite active and also with two young kids I’m pretty frustrated at the moment but finding this blog was a godsend. It’s great to read all the other ATR stories from people who’ve been through this before or are still going through it. I love the advice and also just the general positivity. I’m going to use that in making the most of this situation and taking recovery slowly. As my other half keeps telling me “it could be worse!” Cheers

  1010. richardk, on August 26th, 2015 at 2:28 am Said:

    Tried to register to blog on this site, but seems perhaps the moderator is on a break so read my blog here: https://ukachillesblog.wordpress.com

  1011. adamc, on August 31st, 2015 at 7:20 am Said:

    Dear All,

    I’m 38 and live and work in Newcastle upon Tyne. I ruptured my right AT on 19th August playing cricket. Saw consultant next day + ultrasound. Scan showed significant gap even in full equinus, therefore open surgical repair on 21st and into a below knee equinus cast.

    No problems so far. Due to have cast removed and replaced in 3 days. Current plan is a cast for 8 weeks, getting back to neutral. I don’t think my hospital has a fixed AT rehab protocol (although a major trauma centre). My surgeon did comment my tendon did have signs of chronic tendinosis -delaminated etc and that he felt we need to proceed ‘gently’.

    I can see the potential benefits of the ‘boot’.

    Questions!

    1. Which of the UK based rehab protocols is the most useful/established in post-op patients?
    2. Is the VACO-Ped boot the best choice of boots available?

    Ultimately, my priority is to ensure the tendon repairs as well as it can to minimise risk of re-rupture. the time this takes is secondary to this point.

    Many thanks for your time.

    BW Adam

  1012. hillie, on September 1st, 2015 at 11:40 am Said:

    Hi Adam

    As part of your research, you could do worse than take a look at Suddsy’s achillesblog at achillesblog.com/ suddsy/2013/06/24/end-of-wk-2-wow-progress.

    Suddsy added a lot of information in this and other posts but this one is directly relevant to your questions. It is mostly UK-based, it includes relatively recent and successful protocols, is relevant to surgical (Suddsy) and non-op cases (such as mine), and it does include use of the Vaco hinged boots.

    Good luck

    H

  1013. hillie, on September 1st, 2015 at 11:42 am Said:

    Adam

    Start your own blog within Achillesblog?

  1014. classictextbook, on September 2nd, 2015 at 5:31 am Said:

    Hi everyone. I just signed up for an account on this site. I’m logged into my profile dashboard page but don’t see where I can create my own blog entries. Can anyone help?

  1015. chronicphil, on October 7th, 2015 at 5:34 pm Said:

    Hi, I’m 45 now and I’ve had Achilles tendon problems for about 15 years. I don’t remember any sudden event that started it. But I’ve always ran so I’d imagine it is caused by classic overuse. There is a point in my left Achilles, mid way between the heel and the calf, that can suddenly feel painful when I run. When it happens there is no warning and it feels like it has just ripped a little bit. It is always the same point. I have had a two year period of grace in that 15 years where I could run trouble free. Other than that I might get 6 months if I’m lucky.But is much more likely that it happens within 2 or 3 runs of feeling brave enough to start again. I do calf raises all the time. The odd thing is that I can do triathlons, I guess the cycling warms it up perfectly, but not train.

    It seems to me that the right thing to do would be to get a scan of the left Achillies and some advice on the next step based on that scan. The NHS (quite rightly) wouldn’t do that since I can live perfectly well without running. I wondered if anyone had any experience on the best way to get that doen privately in the UK?

    Thank you in advance for any advice. Phil.

  1016. chronicphil, on October 7th, 2015 at 5:40 pm Said:

    @classictextbook. This is from the main page and I think is what you are looking for:

    To create a new blog, please create a user account first. And then, please send me an e-mail (achillesblog@gmail.com) from the e-mail address that you registered with, and I’ll create a blog for you. Please tell me what your username is, and mention briefly how your injury was caused.

  1017. ade515, on February 12th, 2016 at 7:30 am Said:

    Greetings everyone.
    I have just signed up, although I ruptured my AT 12 weeks ago.
    Went non-surgical, as I am not 25, or an elite athlete.
    Had no real problems with pain, since having the boot fitted. Now full load bearing in the Aircast boot, so better than crutches and the Knee scooter.
    Still not driving the car, but had the good fortune to have an Invacar laying fallow in the front garden, passed its MOT back in November, so have been mobile. Don’t throw anything away, you never know what’s ’round the corner.
    I see the consultant at the end of the month, I have been given exercises to do to strengthen up the calf again, so fingers crossed.
    If it gives any solace to those that have just ruptured, - from the times of doubt as to whether you will ever walk, and get back to normal, there is definitely progress and improvement over time.

  1018. Manny, on February 12th, 2016 at 8:42 am Said:

    Welcome to our eclectic team, ade515, and don’t worry about the 12 week delay…. I found this site via my wife, so I could easily have missed joining the team, too! :-D
    It was fascinating to research the Invacar! And you are very lucky to still have a working one, and to have gotten it approved for street use!
    I am also non-surgical, still wearing my boot, and doing physical therapy.
    Please keep on posting and telling us your story and advances!
    Manny

  1019. ade515, on February 12th, 2016 at 9:06 am Said:

    A club I hadn’t planned on joining, but there are far worse things that life can thrown at you. Now I can walk around in the boot, and the pain in the sole of my foot has gone - this only lasted the first few days of weight loading, life’s not too bad again.
    Not many Invacars around. mine slipped through the net via the Combe Martin Motorcycle Museum. Not in its original colour, the owner before me, believed all the stuff on the interweb, erroneously stating that they were illegal to use - that is only true if they are government owned.
    So he painted it TNT Orange, and used it as a Bond bug for a bit.
    When I am fully recovered I will treat the Old Girl to a respray in NHS Blue.

  1020. ade515, on February 24th, 2016 at 9:21 am Said:

    Oh yes, given the green light to to be out of the boot inside, and walking without a stick -50-60% weight loading - so my built in strain gauge is calibrated, and I’m semi hobbling around. OOOwa how those muscles know it. But a step in the right direction.
    Seeing the quack on Friday, so am hoping for OK to drive again.
    Invacar still transport Number One.
    14 weeks since the “incident” -how time flies!

  1021. Manny, on February 24th, 2016 at 2:12 pm Said:

    Great news, ade515! walking barefoot is certainly a milestone! and yes, the muscles do complain. :-D
    Keep up the news reports!……. Manny

  1022. ade515, on February 29th, 2016 at 1:01 pm Said:

    Out of Boot - Problem now is finding a comfy pair of shoes, that fit. Crocs seem to work. Ankle a little puffy, and difficult to walk without a limp. But all good really. Work want me to fly to Australia in the next four weeks, at “the back of the bus”. At present the way it feels, the short answer is NO. Work have been good with things but I think this is taking the biscuit.
    We will see nearer the time.
    Given the OK to drive (a big boys car) in a week, which will be nice.
    Although the Invacar is still going to be used -it deserves it.

  1023. Manny, on February 29th, 2016 at 8:08 pm Said:

    ade515, I have two pairs of heeled shoes (the heels protect my tendon since I am walking “toes down”), and an old pair of sneakers with lifts inside as “house slippers”. One of the shoes is an old comfy pair of dress shoes that I added an inch of heels to, and the other is a new pair with 1 inch heels from Zappos. I have extra wide feet, so fitting can be tricky, but Zappos did well for me. Interestingly enough, the old dress shoes have identical heels measured from the outside, but from the inside I feel a difference of about 1/8″… no problem really, since I just put in a cushion in that heel.

    My drs. both speak highly of using shoes with heels, so I’m passing it on to you. And in my opinion, for the long trip, the most important thing is not to forget to do your physical therapy… and to take into consideration that the foot and leg do get tired and swollen, since you and I are still healing!

    Good luck on that road trip! :-D
    Manny

  1024. ade515, on March 1st, 2016 at 9:35 am Said:

    I got told off today by the physio - oooowaa, they don’t like Crocs. Basically sighting what you say about the heal. I now have an old pair of trainers, which have a good heal. Now I am finding that I have to keep my leg more elevated, otherwise the foot gets uncomfortable, I guess there is less room for the swelling. It will be 15 weeks on Thursday since the mishap, I feel that I need to realign my expectations of recovery. Rather than progressive step changes, the changes in what you can do, each time, e.g. weight loading, boot off etc. you go backwards first. No really used to this - I don’t do ill.
    Most frustrating.

  1025. unclefester, on March 8th, 2016 at 5:08 pm Said:

    I am at 5 weeks in VacoPed boot, fitted day after injury, been off crutches since week 4. Seems to help strengthen leg. Doing basic AROM exercises to build up tendon strength. As with others paranoid about re-rupture but getting more confident as time goes on. I take off boot in bed now for bit of normality. Seems this is pretty norm with the Vacoped boot I expect to be in it for 12 weeks but its articulated so the tendon gets exercise from week 4 on… and it gets easier to walk on as its adjusted to allow more movement.

  1026. couchy007, on March 23rd, 2016 at 4:12 am Said:

    Hi all, have just joined this excellent site, thank you to whoever started it! a fab idea. I fully ruptured my Achilles’ tendon just over 3 weeks ago, playing netball - at 46 and in an attempt to get a bit fitter, hah! Pilates after this. Anyway - non-surgical route, cast for first 3 weeks and had got into my routines etc, husband and son helping out. Got a vacoped 2 days ago and have been really struggling with it, turns out it was fitted wrongly so after I read the booklet at home, sorted that out, but it was too tight and my leg is now swollen and a bit bruised. Yikes! I want to persevere with the boot for the long term gains but right now, to be back in a cast would be a delight compared to this. Should the boot feel like it is hanging off my ankle? hospital not fab… As ever with the NHS they are truly lovely people but the minute you are not in danger you drop off the urgent list and that’s it.

    Swelling going down but am having pain for the first time since rupture really, is this how it is with the boot? Thanks everyone!

  1027. Manny, on March 23rd, 2016 at 4:19 pm Said:

    Couchy, I got the boot at 2 weeks, and for me it was wonderful. The pain in the foot is normal, as is the swelling. The swelling will stay with us for the duration of recovery simply because the tendon is healing itself and we are pushing the healing process along. the solution: RICE Rest, Immobilize (the boot does this), Cold (Icing regularly lowers the swelling and pain) and Elevate (the higher the better, though some of us get away with footrests while sitting, and others can sleep with the foot on 2 pillows). Heel pain is another, since the heel swells and hurts in weird ways… I could have sworn at the beginning that my boot had a piece of sharp plastic digging into my heel, but it was just my heel warning me to rest my foot. Funny how we can’t hear the heel’s warnings… LOL

    Read the posts and continue asking questions. We are a wonderful tribe of Achilles Recovery People!
    Happy Healing!…….. Manny

  1028. couchy007, on March 23rd, 2016 at 4:49 pm Said:

    Hey Manny thanks so much for the reassurance, very much appreciated. Having made it through to 46 with no real injuries in life to speak of, this is all a bit of a steep learning curve! Plus I am having to work as much as possible, although I can do it from home for the most part. But good advice, need to learn to listen to my body… will get reading and will ask questions, very relieved to have found this great site.

    Presumably you are taking the front of the boot off to ice… I am not yet confident enough to do that, but am going to have to overcome that one. Thanks!

  1029. Manny, on March 23rd, 2016 at 8:27 pm Said:

    Is “Couchy” the term for retired Agents, 007? LOL and yes, I do love joking. :-)
    OK, now to the serious business of recovery: icing your foot requires taking it out of the boot, which is quite delicate in the first few weeks, though just taking off the top works, too. :-)
    Happy Healing……… Manny

  1030. couchy007, on March 24th, 2016 at 3:52 am Said:

    Ah well if I tell you that Manny, I may have to kill you…. Actually my husband did the James Bond exhibition among others at Beaulieu motor museum, which is where that came from!

    Still finding the boot hard work, day 4 today of having it on. Will persevere over the Easter weekend but so far it has given me 3 bad nights sleep, it’s much harder getting about, and it just doesn’t feel secure like the cast did, everything is harder and hurts more; have not been able to work since having it on and that can’t continue, will soon run out of annual leave! It is getting slightly better, but it needs to get s bit further so I can at least work. I will have the choice of going back into a cast if this doesn’t improve by next Tuesday, that will have been a week with the boot and 4 weeks post ATR. Would welcome thoughts from fellow recoverers who are further up the road than me… Thank you!

  1031. pozaicer, on March 24th, 2016 at 4:47 am Said:

    couchy007, sorry to hear that it is becoming onerous for you.

    all i can think of is that you may be overdoing something. checklist that came to mind:

    -how often you walk on the boot?
    - - do you walk with or without crutches?
    -how often you elevate?
    -how do you sleep with foot elevated?

    if your answers are ‘a fair amount’ / without crutches / seldom and not very often, then there may be a reason for your discomfort.

    i gone back and re-read your entry and you do seem to be ‘working as much as possible’, i’m assuming you are sitting or lying down for this, but if not you must ensure you take a break every hour or so and elevate/ice as appropriate.

    the boot is a big, and heavy-ish, there’s no way round it. but as you navigate the early days in it you are building up your strength in the upper and lower body, this will eventually compensate.

    i would personally describe the sensation of being in the boot as ‘fitting’, ‘cosy’ and ’safe’. perhaps you can post a couple of photos of your boot (whilst fitted) and we can comment on that?
    the boot has to be snug but it shouldn’t be too tight either.

    in my experience i went back to my workplace after 12 days, once i was in the boot, and ended up putting a ‘library stool’ by my injured leg to keep it raised (still doing so all day long when working) and would take 5-10 minute breaks per hour to lie on the floor and elevate above head level

    my first few weeks in the boot of PWB were uncomfortable, not painful, but this meant that i didn’t really do more than PWB or resting the foot down to aid balance. i didn’t actually go to FWB till week 4-7, and it wasn’t till weeks 6-7 that i started doing so without crutches.

    i suppose that overall i am saying that you have my full empathy, and you are the only one here that can make a decision of what is best for you. nevertheless, going back to a cast has several implications, namely a longer and less functional recovery, so i would strongly advice you to take a step back and reflect on what your options are.

    suerte

  1032. couchy007, on March 24th, 2016 at 1:04 pm Said:

    Suerte, thank you for your thoughts. To answer your questions, I am 3 .5 weeks post ATR, completely NWB and taking that very seriously, the only time this boot comes into contact with anything is when I am resting it on cushions on my calf, in the wheelchair which has a leg raise and when I sit on the loo and its on the floor in front of me. But even then I am supporting the weight of it. I use crutches all the time, or a wheelchair; was not told about elevating by the hospital, just told to do what felt right, and in a cast was far more comfortable but am now since the boot elevating a lot more. In a cast had been sleeping fine with just one pillow under my knee so my leg could roll out bent at the knee, lying on my back. Now in the boot, really struggling to sleep well as the foot part when it rolls to the side is very heavy so feels like it pulls my ankle. Have an extra duvet rolled up down the middle of the bed to support my leg now, hope that will help.

    I haven’t elevated above head level at all, no one has mentioned that at the hospital, will try that. I can work mostly from home at the moment and am shifting my workspace to accommodate the leg being elevated.

    If I can just get this boot fitted properly I think that will help, but to get it to feel safe and snug round the ankle means the circulation on top of my foot ends up being cut off and that hurts. But I’m nervous to take my foot out of it completely, and reshuffle the beads etc, haven’t done that. But that’s where I need to get to; the cast felt safe, this does not yet. But I will get there! when I have worked out how to post photos will do that.

    Thank you!

  1033. pozaicer, on March 24th, 2016 at 5:26 pm Said:

    Couchy007. It is a fine craft getting the boot right. By all means be cautious but do take it off and refit it. Only thing to watch out is bending the foot upwards. The front of boot has to be fitted within the sides of the boot. The middle of the boot strap ought to fit right on top of the arch of the foot and pump air out before fitting. Make sure linning is sitting right at the back of the foot and at the bottom before you start strapping. Once fitted then pump air as needed

    Hopefully you’ll do it soon so you can start enjoying life again. Do use pillows etc as you are, make sure the for is elevated whilst you sleep as having it “down” for bending knee is not allowing the blood flow to reduce and hence the swelling

    Best of luck

  1034. couchy007, on March 24th, 2016 at 6:38 pm Said:

    Eureka!!! found a YouTube video of how the vacoped works and it revealed that the way the hospital showed me to let the air back into the vacuum was wrong - they told me to just move the grey toggle side to side within the green shell, but the video shows you have to actually pull the green shell out and over the grey toggle, and hey presto in goes the air. So the hospital really have fitted this wrongly all round, not just got the straps wrong but this bit too. Ggrrrr…

    Anyway, took the boot off carefully, rearranged the beads and put my leg back in it properly, wrapped it and sucked the air out. It feels much better! safe, comfy, protected. Now I get it about the boot, it isn’t dragging down on my ankle at all now.

    Slightly bothered that the hospital got this wrong… also have been taking ibuprofen for pain relief, alongside Apixaban blood thinner, and my GP advised against this today as the combination apparently increases chance of bleeding more. He asked if the hospital had mentioned this!!! Needless to say they had not…

    Anyway am greatly relieved and thanks everyone for your kind words and advice. Keep smiling…

  1035. Manny, on March 24th, 2016 at 10:28 pm Said:

    Congratulations on properly fitting your boot, Couchy007 without activating the jet pack and other special features… And please do not tell me of your under cover activities, since I do love being alive! LOL

    As for the difficulty working, I found that the low level ache distracted me A LOT, and I couldn’t do any quality thinking or writing. But it does get better.

    The boot will accelerate recovery, and many of us do push the envelope once in the boot, mainly because there are recovery protocols that allow for almost immediate weight bearing once in the boot. Of course we all know we have to follow the Drs instructions, but I know I went full weight 2 weeks before the Dr. “authorized” it. :-)
    Take care, and happy healing!………………. Manny

  1036. couchy007, on March 31st, 2016 at 2:31 pm Said:

    Well exciting news, I have had my first physio appointment today (4 weeks post ATR) and the tendon has knitted back together, hooray! have some nerve damage to my big toe, no sensation or movement due to the boot being incorrectly fitted initially, but that will come back at some point. It is all connected again! Weird sensations on the sole my foot and still feels like it belongs to someone else lol. Am doing exercises and starting to put a teeny bit of weight on it. Woohoo!! a good day.

    Keep going everyone, bit by bit it does get better…
    Couchy x

  1037. Manny, on March 31st, 2016 at 10:20 pm Said:

    congratulations, Couchy! weird sensations are normal, even months later. :-) As for numbness of the toe, I hope it goes away soon.
    Good luck and happy healing! ………. Manny

  1038. walts, on April 8th, 2016 at 1:34 pm Said:

    Good afternoon ATR world, im 3 days into the long ATR road and came across this great website full of positive thinking and great resources. Playing 5-a-side I turned on my right foot and pushed off on my left and bang it went like someone threw a cricket ball at the back of my ankle. Anyway, as per the UK, they said no surgery and have put me in a cast and back in 3 weeks for a boot. I asked about Vacoped but NHS wont supply one, they said its a cheaper boot but does the same job. For now its just a waiting game I guess. Target wise im getting married in just under 4 months…. and while the stag do is likely off, i want to be able to walk freely on my wedding day. Is this a realistic goal? Walts

  1039. xplora, on April 8th, 2016 at 3:39 pm Said:

    Wlats - There is a very good chance you will walk and maybe even dance a little on you wedding day. The NHS has been following the non surgical route for some time and excellent studies conducted in Exeter show results as good as surgery. The important thing for non surgical patients is the early weight bearing and given you will go into a boot soon I would suggest that is the way they are going. Weight bearing usually starts around 3 or 4 weeks and you can be out of the boot in 8 weeks give or take. The re-rupture risk is prominant to 12 weeks and then slides. Re-ruputure rates for non surgical are higher and the time is longer if the early weight bearing protocols are not followed. The important thing is to allow your tendon to knit together in the first 3 weeks and after that it needs to remodel and strengthen. If you search this site for Exeter, Wallace or UWO you will find plenty of information on what you need. You can also drop a line to Normofthenorth who is the resident expert on non surgical protocols.

  1040. couchy007, on April 13th, 2016 at 3:09 pm Said:

    Hey Walts, welcome to this wonderful blog! I am 7 weeks into a full rupture of my Achilles’ tendon. Non-op, NHS in south England. Was hoping to be following a fairly swift protocol; had first 2 weeks in plaster and then into a Vacoped boot since week 3. Told to be still NWB till seen by physio which wasn’t till week 5. Found the boot very difficult, it caused some nerve compression and have lost sensation over big toe and lower part of foot, but this will come back. Felt ready to put some weight on the boot last week (6 wks) but was told not to by consultant, and to work with physio. Second physio session 3 days after first in week 5! very minimal, just given very basic range of motion (ROM) exercises and told I could sleep without the boot and start very gentle PWB. Had first hydrotherapy session today, this is 3rd physio session. Pool physio was surprised I haven’t been given a band to do resistance work, and that the boot has not yet been adjusted, and said my ROM is quite limited… No surprise with hindsight! So I have altered the boot myself this evening and will be cracking on with it at home.

    Fight for what you need, get your team to get you partial weight bearing as soon as you can, reading the excellent advice on here it makes such a difference and the delays in appointments and the caution I have experienced are not helpful. I think I can still catch it back, fingers crossed and advice from fellow ATR folk really welcome.

    You can buy your own vacoped boot if you want to, although the nhs should supply it, if they do in some areas why not in others! Google the company, they are based in Devizes and really helpful. The boot is around £200.

    Those with a vacoped boot, I am using the rocker sole at the moment, when does this change to the flat sole? thanks!

  1041. couchy007, on April 13th, 2016 at 3:13 pm Said:

    By the way Walts, on day 3 I was still reeling from the slow realisation of the seriousness of this injury… if that is you too, don’t despair, it gets better, and without you knowing it, every day you are healing. Especially in the first couple of weeks you’ve got no evidence of your healing and it can be hard to trust it is really happening, but already, your tendon is healing itself. The body knows what it is doing, and it is amazing! Good luck :-)

  1042. pozaicer, on April 14th, 2016 at 5:05 am Said:

    hi folks, NHS Scotland, non op too

    i’ve followed and commented on some of your posts.

    for those who have been pushed back on consultants orders do fight back. there is no reason why you couldn’t do ROM excercises without weight bearing. you can pick up thera-bands on amazon.co.uk for about 8 pounds delivered. i got a yoga ball and the bands for 14 pounds, and these are great for ROM and getting the flexibility up.

    @Walts i had a very similar experience with regards to the boot, and i simply armed myself with knowledge, went to the consultant and i said i wouldn’t be leaving without a boot. i won

    all of the above said, do bear in mind your personal circumstances and medical history, this determines the prognosis

    suerte

  1043. walts, on April 14th, 2016 at 5:32 pm Said:

    Thanks couchy for the morale boost, I have been pretty upbeat about the journey ahead but there is a lot of self doubt that anything is healing. Experiencing no real pain when foot is elevated but the first couple of minutes after dropping it down there’s a strong throb and ache in my calf which eventually equalises itself. Keep worrying that i could be doing harm by wiggling toes and scratching / rubbing calf in my cast. I have my cast off in 2 weeks and I will fight for the vacoped boot like both you and suerte suggest. How long is it before the pain subsides in the calf or is it just part of the process for the months ahead? Walts

  1044. brenna, on April 14th, 2016 at 6:55 pm Said:

    Hi walts, I found this website and love that we can compare our experiences. I went the surgical route and it has been just over 2 weeks. Like you, I have no idea if my tendon is healing. I had painful calf cramps twice last night. I am trying to massage my calf and not sure if I should be doing that.
    When you say you have pain in your calf is it a tightness feeling that it could cramp at any time.
    I go to see the surgeon in 5 days and can’t wait to hear what’s next and hope he says it’s healing well.

  1045. ckoutny, on April 15th, 2016 at 10:56 am Said:

    For those with calf tenderness early on, I would suggest you talk to your doctor quickly. My calf was extremely tender 2nd week post op. When I went for my 2 week checkup and to get the splint removed, I mentioned this to my ortho. They sent me for an ultrasound and sure enough, DVT clot in my calf. Have been on blood thinner for the past 6 weeks since then. Certainly not trying to scare just sharing my story for information. I was certain I had just strained my calf muscle stretching while sleeping. Clots are nothing to mess around with. Good luck

    Chad

  1046. couchy007, on April 15th, 2016 at 12:45 pm Said:

    Good advice to always check with the medics re possible DVT. Know the symptoms too, and talk to your doctor as Chad says.

    I was non-op, and from pretty early on, certainly by second week, felt a tightening of the calf and was really worried it would cramp. It wasn’t hot, just tight. It never did cramp though despite my fears, and now I am at the stage of getting it all moving again at nearly 8 weeks, think this was just muscle tightness and lack of use. I wiggled my toes loads from the outset, couldn’t rub my calf much as in plaster first 2 weeks but after that I did, gently, no problems. I don’t remember noticing the tightness much after the first fortnight, but maybe I just got used to it.

    I was on blood thinners from the outset for 4 weeks as preventative measure.

    Thanks Pozaicer re the pointers for the theraband, it’s on the way! Keep smiling everyone

  1047. walts, on April 18th, 2016 at 7:26 am Said:

    Hi guys, right a little update that some of you may be able to advise me on. Im 2 weeks in since full ATR, non-operative treatment. In cast for another week then im going into a boot next Tuesday… hopefully the Vacoped but if NHS simply wont then it will be an Aircast.

    Just spoke to Physio department and they have booked my first session for 8 weeks post ATR in early June. I see the specialist for the first time same day. From reading this site that seems quite late and im worried I could have made better progress by then if I had started physio earlier. My question is can I do anything myself in the boot in the meantime as I dont understand why its taking 8 weeks to see specialist and physio again? Surely muscle loss will be less if i can start ROM exercises sooner.

    Walts

  1048. xplora, on April 18th, 2016 at 3:39 pm Said:

    Walts - most people worry about muscle loss but you need not. It comes back in time and will not hamper your recovery. Do not be tempted to gain any dorsi flexion by using a towel or a theraband to pull your foot back. This can hamper your recovery. Dorsi flexion also returns in time and you should follow your physio’s advice with that. What you can do once in the boot is gradually increase the amount of weight you bear until you can walk without crutches. By doing this you will be more ready to put a shoe on after 8 weeks. You can do some Active ROM exercises with your leg out of the boot and fully supported. A recliner chair is good. With the heel of your foot just off the edge you can write the ABC’s. This will help activate the muscles and other soft tissue as well as free up joints which have not worked for a while. Once you can bear weight then you should be able to ride a stationary bike starting with the heel of the boot on the pedal and easy rotations, gradually taking the boot back so more of your foot is engaged and increasing the resistance. Lots of elevation and rest as you do more to reduce the swelling. Do some research before you try anything I have said. Find out how tendons heal and check out Early Weight bearing protocols. I have a tab on my page for some futher reading but there is more on the site. Make sure you understand clearly the difference between Active ROM and Passive ROM. The later is something you should avoid for now but it will come in time. regards Stuart.

  1049. pozaicer, on April 20th, 2016 at 3:45 am Said:

    hi Walts, just want to second Stuart’s wise words. don’t do anything wild whilst in the early stages.

    you will loose muscle, there’s no way around it (i lost 1.75 inches of calf circumference), but it will come back and slowly you will resume life with a brighter and healthier approach (of course unless you don’t want to!)

    suerte

  1050. walts, on April 28th, 2016 at 3:58 pm Said:

    Hi all, 3 weeks in and cast came off today and into a heavy NHS boot! Been a really positive day though, after tentatively learning to get used to the boot PWB with crutches, 4 hours later im FWB with no crutches and getting about fine. No pain (im on 3 wedges still so foot still in equinus position) but with the weight going through my heel im back to some kind of normality. Taking it slow so not to overdo it, but im amazed at how much im able to do so quickly, just needed the confidence to apply weight through the foot.

    As I didnt do surgery im aware that rerupture risk is higher at this stage but hopeful that with the boot as protection, and being able to FWB with no crutches that the tendon with get stronger a little quicker than I was led to believe.

    With all this in mind im very tempted to invest in a Vacoped boot as after such a successful first day in the boot, id like to think it will give me a better walking experience and the gradual adjustments on the Vacoped as opposed to the 3 wedge approach on this monster of a boot will give the tendon an easier ride on the road ahead.

    Any thoughts appreciated on whether im ok FWB so early and on the Vacoped?

    Walts

  1051. winnipegatr, on April 28th, 2016 at 4:35 pm Said:

    Walts, I’m curious to read the responses to your post because I’m nearly the same as you. I am able to FWB while walking (slowly) though I still use one crutch for longer walks. I have no pain and I too have the 3 wedges in. My doc has requested I return to him in 2 weeks (from this past Monday) and he is going to take out 1 wedge. He said if things go well I should be able to walk into him at that appointment.

    That said he suggested not doing any rehab until 12 weeks post injury.

  1052. pozaicer, on April 29th, 2016 at 5:20 am Said:

    hi Walts, i had no problem with the NHS boot (it is of a norwegian make). i had 5 wedges which were removed one a week till flat position.

    as far as my experience goes, you are fine with PWB in the boot as well as FWB.

    how much you do of either is a matter of personal choice, it took me a good few weeks to get comfortable with FWB in the boot, i knew i could put the foot down and apply pressure but psychologically i didn’t want to.

    on average all the protocols suggest that FWB should be avoided until week 4-8, but again this is down to personal recovery times.

    if i recall correctly FWB did cause a bit of discomfort for me early on, so i avoided it till i was ‘ready’, which for me was week 6. my focus was getting the walking motion perfect (whilst still using crutches) and therefore practicing this with PWB.

    the only advice i can clearly give is to ensure every time that the boot is properly strapped before you venture to walk on it! (i missed this a few times and my foot very quickly told me i wasn’t snug enough!)

    suerte

  1053. walts, on May 5th, 2016 at 2:56 am Said:

    Hi, thanks to you all for the excellent advice so far… Really helpful. 1 month in and I’m now into my Vacoped boot, and have boot set at 30-20 degrees, I’m full weight bearing and feeling good. My aim is to adjust 5 degrees a week for the next 4 weeks so I’m at neutral for my 8 week review. I just wondered how you all got on with the tight feeling of the Achilles as you adjust the boot or remove the wedges. I guess it’s a confidence thing but when I switch to 15 degrees I really feel it pull and you have that fear of going back to day 1! Do you just have to trust it will hold firm?! Walts

  1054. pozaicer, on May 5th, 2016 at 11:35 am Said:

    Walts.

    The boot should be snug but shouldn’t hurt. Make sure it’s fitting your ankle properly before strapping tightly.

    I found that with each wedge removal/adjustment in your case, my tendon was tender for up to 24 hours. So on the days I made adjustments I reduced my PWB or my FWB. It is a confidence thing but pain signals caution so it’s best to listen to your body, IMHO. After 24 hours, approx, the sensation would cease and I would continue as before. Also I made sure that the day of or following the adjustment that I didn’t do as much as I normally did to give it time to adjust to the new setting.

    In theory a properly fitted boot will not allow for the AT to break again, but as Manny says we in theory shouldn’t be here so don’t push it too much!

    Suerte

  1055. xplora, on May 5th, 2016 at 7:28 pm Said:

    Walts - what you are feeling is quite normal. Your tendon is not ready for anything explosive but gentle tension should not be a problem. You could try doing the angle adjustments just before bed and then it will have some time overnight as you sleep to stretch (so to speak). I have read of people here doing this and it seems to work. When I went back into shoes I had some wedges under the heal to help me walk. This was great and once I could walk normally I took one out. There was a bit of adjustment and it felt like I had gone backward but in a couple of days I was back to a good stride, no limp and a fast walk. A week of that and the other wedge came out. Same again. I think you are doing really well.

  1056. vescobg, on May 6th, 2016 at 3:29 am Said:

    Hi Walts, I’m really happy with your progress. I’m in almost the same condition right now. I took my boot 3 days ago and I was able to reduce the angle of my ankle from ~30 degrees to neutral position for just 3 days and now I’m planning to start PWB but I also feel tension in the tendon. I hope we will get better soon :)

  1057. couchy007, on May 8th, 2016 at 6:04 pm Said:

    It’s great to read everyone’s recovery stories, glad to hear everyone is moving forward. I am week 11 post ATR tomorrow, and doing well. Had a bit of a mental hurdle to get over when it came to FWB at week 8-9, was pretty scared it would not take the weight, but all was ok! Was walking in the vacoped but the boot still causing some difficulties and I had much more movement when out of it, so my Physio got me out of the boot and into 2 shoes 2 weeks ago and it feels wonderful! Now haven’t used any walking support for several days, no stick or anything, slight limp but working on that all the time. Hardest bit is the push-off from the ball of the foot when walking, so weak. And heel raises, agh! How long does it take for reasonably normal strength to return, assuming daily exercises and walking etc?
    Thanks all

  1058. tonyukmilllane, on May 15th, 2016 at 3:31 am Said:

    Hi everyone, still working out which uk site to post on. I’m Tony from Farnham, 8 weeks ago i had a full Achilles rupture in my right leg playing tennis. I started at the NHS then into private care (same people) Due to being a business owner and father, i needed to be driving again as soon as possible and get some sort of normal life back. With some own personal research, diet and outside help, i was healed enough for my consultant to let me begin driving again after 6 WEEKS. I’m doing well and getting my walk back. Happy to share my experience and discoveries if anyone is interested….Tony

  1059. couchy007, on May 15th, 2016 at 12:32 pm Said:

    Hi everyone, at 12 weeks tomorrow post ATR I am horribly afraid I have re-ruptured today. I have been out of the boot for nearly 3 weeks, walking without crutches for 2, doing really well, gentle walking every day, almost full flexibility back and about to go into the gym to start strength training. Today I knelt down on my ATR leg, carefully, to plug something in, and used the strength of my good leg and a bit of push in my ATR leg to get up again, and I felt something twang - it hurt a lot - can’t honestly say if I felt it tear or twang and don’t want to be dramatic, but am so afraid I may be back at the beginning! anyone else had this experience? I have looked at the re rupture page but it seems to be all post op, and I was non op. Hoping against hope that I have just twanged the muscles or something rather than have torn anything. Back at hydrotherapy tomorrow so will ask the Physio, but rig now, back to 2 crutches and NWB, ice and a large brandy till I know more. Any thoughts? thank you!

    Hi Tony, glad to hear you are making such a good recovery, and driving again wow! Great stuff.

  1060. juicer47225, on May 15th, 2016 at 12:54 pm Said:

    Hi everyone I’m new to this site and am quite amazed at this site I ruputres both my Achilles and had my left foot done Dec 1 and my right done march 22. Just wondering since I have been back at work. And still in aircast. Was in a wheel chair fornwuite awhile obviously. I am a little bit depressed since I am in massive amounts of apin everyday I can stand for no longer than. 5 min at a time and so beat after a day at work I can’t even spend time with my family. Just wondering how long the pain last and how long if at all anyone has been on pain killers. I do not like the way they feel and to be honest they do not work for the pain thx. Lookong for advice.

  1061. couchy007, on May 16th, 2016 at 2:46 am Said:

    Hi juicer, sorry to hear what a tough time you are having, both at once, crikey! Welcome to this fab site. I am neither qualified not experienced to give you any advice about pain management I am afraid, but know how important even 5 minutes of fun, laughter and enjoyment are to our recovery, to help against feeling down. I hope you get back to those times very soon!

    So after yesterday’s scare, I spent the evening icing and then back into the boot, rocker sole and 2 crutches. This morning I could put some weight on it,not full but 60-40 with crutches, so I walked about carefully with crutches but no boot, and no painkillers, just to see what movement I have got. Now the immediate reaction of that twang have passed, I can still feel the tendon is intact, it still has the dent in where it originally tore, and it is still there and I can press it and no pain. Yay! but - I have done something to it, on the inside of my ankle that is where something twanged, can feel it goes down towards my foot where my arch begins, that is still sore and I do not have as much movement as I did, I have lost the flex movement bringing my foot up much past 90 degrees. So back to a flat footed walk for now, but I am in sensible shoes at least, using one crutch, and being very very slow. Very tender on the inside of the ankle but not on the tendon. Will see what the hospital say later this morning. Fingers crossed!

  1062. couchy007, on May 16th, 2016 at 10:03 am Said:

    Ok an update, seems I have slightly torn some of the fibres of the Achilles’ tendon at the edge, where they connect to the muscle on the inside of the ankle. There is still movement left, right and pointing my toe, what I have lost is any upward movement and the mobility that goes with it. But the tendon is still intact, doing its thing, the Thompson test was ok, I have strength in all directions apart from up. So it’s a rest, ice and elevation week with not much action, give it a few days to settle and get reassessed next Monday to make sure all is well. Probably set me back 3 weeks or so but not right back to the beginning so that is something. So bit subdued but definitely seeing it could have been worse, so finding the positive.

  1063. walts, on May 17th, 2016 at 3:49 pm Said:

    Hello all, today marks the start of week 7 so i thought id post another update for those that have been following. So, I’m now at 30-5 degrees in the Vacoped and due to switch to 30-0 tomorrow (still on rocker sole). Its felt a little tighter on the current setting but after a short while walking seems to loosen up a little. The tendon itself feels ok to touch, but seems to be lumpy at the base of the calf with a small indent below, im assuming this is the rupture point?? The lumpy bits that head up towards the calf… is this normal? Slight aching from time to time with the odd twinge but no real dramas so far. Im also walking without the boot at home bare foot around the house, slowly. Being out of the boot (and off the rocker sole) means its quite a bit tighter at neutral but i dont dare any dorsi flexion yet, just nice to hobble about with nothing but my healing foot! I can climb stairs bare foot carefully as well. Bruising has all gone, swelling isnt too bad at all.

    Moving forwards from here, im still 3 weeks from meeting the specialist and my 1st physio appointment. Ive started the ABC’s with my foot (thats been ok) and toe curls are fine. I just feel ready to try something a bit more… heel lifts sitting down i can feel the shaky feeling to my foot but thats improving. Any advice as to what I can be doing in my current situation? Any recommended exercises to prepare for dreaded heel lifts? Hope everyone else is keeping positive, couchy… reading your latest post just reminds me how vulnerable we all are…. even when we think we are fine, hope your week of rest is doing the job!!

  1064. pozaicer, on May 17th, 2016 at 4:08 pm Said:

    hi walts. great news, well done on such good progress. the only thing i can think off is continuing your non-weight-bearing ROM religiously as often as possible (probably 3-4 times a day is sufficient).

    the lumpy tendon will remain for up to 18 months (so my physio and surgeon said), it takes this long to heal and re-define, and there is the possibility of never getting as defined a tendon as your non-injured leg. i noticed that in my case the ‘lump’ moved from below the calf downwards, week by week, and at the moment is almost at the ankle joint. this apparently is the scarring…. and is normal…

    we are all different and you can only tell how much to push yourself. bear in mind that any accident could potentially set you back or worse.

    i was also non-op and was prevented from going to the pool due to the risk of a fall. if you can SAFELY go to a swimming pool you can simply go in and do your ROM in water, nevertheless i feel that from all the reading i’ve done there is no recommendation to do any weight bearing exercises so early… if you must then neck water depth will keep it almost non-weight bearing…

    you can do static cycling too, with boot on, or as advised by your specialist….

    you are almost over the hilly bit, do not rush and savour every milestone

    keep it up!

    suerte

  1065. couchy007, on May 19th, 2016 at 5:25 pm Said:

    Thanks Walts, am seeing my consultant for a review and may have a scan to see what is going on… it seems to be settling but I have such reduced movement to what I had before, particularly dorsi-flexion. But it will return! And yep the lumpy bit is the rupture point, not sure how long it takes for that to go, I think I read somewhere that it takes 12 months to replace the scar tissue with healthy new tendon tissue, but I don’t know if that is right.
    Stay well!

  1066. couchy007, on May 29th, 2016 at 3:01 am Said:

    Hi everyone, I would really appreciate some advice if anyone can give it; thanks! Initial ATR 29th Feb, 14 weeks ago. Non-op in UK, all going well till week 12 when, out of the boot and moving about, I tore the tendon again, that was 2 weeks ago today. Saw Physio next day who advised rest, ice, etc till swelling went down, thought it may have torn or may not; and booked to see consultant a week later. Consultant said may be torn, may be scar tissue, not sure, need a scan. I am pretty sure it has torn as the sensation was very similar but less than the initial rupture, I have lost nearly all movement etc etc. If not then great! No sign of when scan will be at 2 weeks post-tear although consultant said if torn, surgery would likely be needed. Advised to go back into the boot when out and about to protect it till the scan tells us more.

    So I am two weeks out from an additional tear of some kind, after a full rupture 14 weeks ago, and I have no date for a scan or anything and am just hobbling about on one crutch. I asked about going private for a scan but was told this was not necessary, very expensive and far away, best to wait. Having waited but heard nothing, I’ve now checked, it would be about £200, quick and very near to me. I am booking one!

    Also looking for a surgeon who does percutaneous repair as my NHS consultant I think is one who opens the whole thing up with a long incision. Reading around this would suggest percutaneous is much better, but I can’t find anyone in the south of England other than London who does this. Is a Mini-repair, where they open up but only a cut of 2.5 cm, better? I would welcome any and all advice, as at the moment I have a mashed up tendon that is going nowhere and needs fixing ASAP. Thanks!

  1067. xplora, on May 29th, 2016 at 3:57 pm Said:

    Paul - the lack of movement does tend to sway the debate about the injury but I would suggest you hold some hope. It is good that you are taking action yourself and lets hope you get a resutl soon. I have read there may be a higher rate of re-rupture with percutaneous repairs but it is less invasive. There are some other methods used as well and without search I think it uses a tool called and Achillion or something like that. I have heard of good results with that. If you opt for the other surgery then ask if your scar can go down the side of your tendon instead of the back. It creates less of a rub on your shoes. I am not sure if there is anywhere in England that is far away from London. My last surgery was in Melbourne (Aus) and that is over 500km away. I guess distance is relative. We drive 2 hours to do a grocery shop. Would the NHS cover you to have this surgery done if you want to choose your surgeon? Keep the foot in the boot at all times and make sure it is pointing down. Hoping this improve for you soon.

  1068. xplora, on May 29th, 2016 at 4:01 pm Said:

    Sorry guys - the last comment was for Couchy007 not Paul.

  1069. leandraweb, on May 29th, 2016 at 4:47 pm Said:

    Nightmare so far!
    Complete rupture of my right achilles tendon at nephews wedding dancing 21/4 after simmons test in north devon district hospital put in back slab half plaster given pain killers and crutches as i live and had to travel back to manchester 4 days later. Told by doctor to get appointment back home. Rang local surgery 25/4 told to go to local A&E tameside hospital because it would take 2 weeks for doctor to get appiintment. Went to A&E 4 hour wait to be told no fracture clinic appointments available. Also asked them to reduce plaster as cutting back of leg and causing bruising/pain. Was asked about family history and was given blood thinners to self inject. Was informed until swelling went down nothing could be done. Btw incompetent nurse tried cutting cast with scissors then after stabbing me admitted she didnt know what she was doing.

    26/4 extreme pain in leg worse after being elevated pain felt worse than when i had ruptured it, so much so i was crying uncontrollably rang 111 who ordered an ambulance 12:40 am was advised that A&E were undersfaffed due to strike and i was not taking enough medication alsotold to ring hospital next day and beg for a fracture clinic appointment, the paramedics convinced me not to go to hospital.

    27/4 pain unbearable when trying to lower leg. Rang hospital and begged them for appointment or it could be 2/3 weeks before specialist saw me, luckily they took pity on me and said i might be sat there for hours but they will fit me in today i was soo relieved. 2:45 pm arrived at fracture clinic. Ortho saw me took off backslab said i needed a doppler scan for dvt asci had explained the pain was horrific. Doppler scan revealed a dvt in my peroneal calf vein. Was very very upset as explained paramedics were called out night before and didnt even check for dvt. Was offered surgical route which i declined and opted for non surgical route. Plaster was put on below knee ( dr wanted above knee but i could not cope with any movement if above knee) sent to ambulatory care, who were fanrastic had blood tests injections and had to return nexr day.

    28/4 returned to ambulatory care unfortuneately via ambulance as awoke 6am screaming in pain and unable to breathe so had to attend A&E where i was told off via a trainee nurse and made to feel awful.
    Was put on rivoraxaban 2x tabs 21 days then 1x 3 months. Was asked why i was put in cast and then taken back to fracture clinic where plaster was cut off and a langer ROM boot agled at 30 degrees was put on. This took 8 hours trying to sort out but ambulatory care were amazing and so too were the fracture clinic. Was informed that north devon hospital should have given me injections due to long journey back to manchester and my family history.

    Those were my initial appointments since then numerous blood tests due to extremely dark urine suggestions of myoglobin in blood, muscle wastage and urinary tract infection all of which have been dealt with disgracefully via my GP when i chose to complain i was treated as though i am depressed, i am not even through all this im positive regarding my injury just annoyed at lack of organisation and trying to find out information.

    Had first check up was told not to take boot off at all, even though fracture room said i could. I did once but to alter sock but felt uneasy. Am following their directions to the letter. Been told approximately 12 weeks until im walking if its healing naturally if not surgery and back to square 1 and another 12 weeks.

    Back for appointment 8/6.

    Currently having heel pain even with elevation and resting but feel its good pain if that makes sense, also having involuntary foot twitches at night again off putting but feel its part of the healing process. Anyone else get burning in heel during elevation?

  1070. ballie, on August 22nd, 2016 at 2:22 pm Said:

    Hi All

    My first visit here. 53 year old male with a complete rupture of my right Achilles playing charity cricket on July 31st. As a keen walker, I opted for surgery and Underwent PARS last Monday. I awoke to find I had been put straight in to a boot with 3 wedges and was told limited FWB. Back to hospital today for wound to be checked ~ all ok but lower leg a little swollen. Told to rest for another week and get my foot up above my heart as much as possible. I need to remove a wedge next week and then repeat every 14 days before my next appointment in 5 weeks.

    Nights are the worst time with my sleep being best described as lousy. Losing your independence is bad enough (no driving for me) but broken sleep is a exhausting. At least I’ve watched more of the Olympics than I normally manage. Any nighttime tips most welcome

  1071. richardmr1, on February 10th, 2017 at 6:22 pm Said:

    Hi - I posted a similar version of this on the main Achilles blog site earlier, then found this page, so apologies if you start reading and this sounds familiar.

    I’m 52 and live near Southampton, and I fully ruptured my right AT playing badminton 12 days ago. I’m pretty active, playing badminton weekly, doing martial arts twice a week & cycling 30 miles every couple of weeks, so this has come as a bit of a shock but I want to get back to doing all those things.

    I guessed what had happened immediately as one of the guys I play with also had ATR about 20 years ago, though as I could still move my foot a little I thought it might just be a partial tear. I went to A&E at Southampton General that evening & got a half leg cast with my foot at about 30 degrees, an appointment with a consultant 8 days later, and advice to hang the leg up & behind when using the crutches. I’m not good at sitting doing nothing so after the first 24 hours I was up & doing what I could around the house on 2 crutches or 1 crutch & a stick, & managed to do a 400 yard circuit to the shops once, though found it pretty tiring. All NWB other than the very slightest touch sometimes needed to maintain balance e.g.when taking a leak!

    After a couple of days the initial swelling seemed to reduce as the cast became a bit loose and started to slip down onto my toes pushing my foot lower, becoming uncomfortable and sometimes causing pain in my heel maybe by pushing the torn ends together too hard?

    I saw the consultant on Day 8, and an ultrasound showed it to be a complete tear in the musculotendinal area with a 3cm gap, which the consultant said wasn’t appropriate for surgery, so I got fitted with an Aircast boot with 3 wedges giving about 20 degrees of flexion. Again I didn’t get much advice on using it with crutches, but it’s a lot easier to get around in than the cast was. As a result I’m not just hanging my leg as I use the crutches; I’m putting my injured foot forward with the crutches and putting a very light load on it so creating a partial walking motion slightly stretching my calf and round the house I sometimes use 1 crutch on the injured side only. It’s also a lot easier to stand without crutches (taking a leak, making breakfast, not at the same time tho!) though most of the weight is on my good leg.

    Perhaps as a result I seem to have been getting more swelling in my calf and ankle than when I was in the cast, especially late afternoon and evening, to the extent that it gets uncomfortable and there’s a bulge above the top of the boot and either side of the elastic of my sock when I take the boot off, so I’m therefore going to be taking it easier from now on with more elevation, at least until my first physio session which should be in about 10 days time (Day 22). I have to wait to be contacted about this, so will be interested to hear from others about how quickly you got onto physio and whether you had to chase it up. At this stage I can bend my toes up and down and feel as if I could able to raise my foot slightly with the boot on, but don’t dare try with it off..

    Looking up I seem to have written half a blog already, so I’m planning to start one on the main site, but in the mean time if you read this far any advice or comments if anything seems unusual would be much appreciated. Cheers, Richard

  1072. georgieporgie, on May 21st, 2017 at 6:23 am Said:

    Hi everybody!

    I had an ATR on 7th April, showing off at a works do on a kids assault course. It’s been six weeks now and I’m in a Vacoped boot having gone the non-op route. I think it’s going Ok,

    I can weight bear, stand up evenly without the boot on and toe curl and do some limited ROM exercises. i’m not using my crutches much round the house now, but just use them for being outside.

    I’ve created my own blog - goergeporgie - will be updating that regularly and checking in here too. This is a great place to understand that you are not alone.

  1073. georgieporgie, on May 21st, 2017 at 6:30 am Said:

    richardmr1

    Sounds like you and I are about the same age and going through the same things. I was in a cast for two weeks and then in a Vacoped boot for the last four after going the non-op route

    I was getting a lot of swelling too, and don’t wear socks in my boot anymore and sitting at a desk for hours didn’t help much!

    The tendon feels massive at the back of heel/leg I was wondering if yours felt the same?

  1074. georgieporgie, on June 5th, 2017 at 9:53 am Said:

    So I’m back from the Consultant - thinks I’ve just partially re-ruptured, not fully, as there is some movement from a Thompson test and my foot is not falling completely vertically down to the ground with my leg/knee on a chair.

    So back to 30 degrees for 10 days then could move down to 20 or 15 (he said I could chose depending on how I felt), and then to 10 or zero a week or 10 days after that.

    He said that I didn’t have to sleep in the boot, but I will just to make sure. So a new positive from a bad experience.

    I think I’ve put myself back around 4-5 weeks, but I was healing well before and now I will take absolute care over my tendon.

  1075. gerryf, on June 26th, 2017 at 9:52 am Said:

    I’m a 58 year old guy, very active. I ruptured my left AT on Friday night past playing tennis. Suspected what had happened immediately as couldn’t feel my Achilles, all soft and no tight tendon feel. Went straight to A&E who confirmed rupture using Thomson test, doc could also could see a visible gap in the tendon. I don’t know how badly it’s torn as they didn’t say but got put into a OSSUR boot cast with 5 wedges under my heel.

    I go back to ortho clinic on July 6th so hope to find out more from them. Came across this blog and it’s a tremendous resource but have to say all a bit daunting, a lot of work ahead clearly!

    From what I’ve read here don’t know if I should be putting any weight on the boot yet or total NWB?

    I’m booked to go on holiday to Spain on July 10th so still unsure about going with all the hassle this will entail, flying etc and generally getting around.

  1076. cserpent, on June 27th, 2017 at 3:49 am Said:

    From what I understand with the modern ATR protocol you are NWB for several weeks. For my surgery (bone spur removal) I was NWB for 6 weeks. For me the knee scooter was indespensible since crutches and I did not coordinate well. LOL! You also need to focus on keeping down the swelling which is absolutely key at this part of the recovery. It will be very difficult if you’re in a plane for hours and then going all over the place on crutches since it generally requires sitting or laying with your foot elevated above the heart.

  1077. gerryf, on June 28th, 2017 at 11:38 am Said:

    cserpent, thanks for your comment.

    You more or less conformed what I already suspected and as you can probably guess I’m still at the initial aarrgghh stage. Finding this sitting around doing nothing really tough, hopefully get over this feeling quickly and just accept it and move on. Looking forward to my first appointment at the ortho clinic next Thursday to find out more.

    Will also discuss with the doc whether to go to Spain or not, would be as well sitting in the sun than cool, damp Scotland as at present.

  1078. gerryf, on June 28th, 2017 at 11:39 am Said:

    confirmed lol

  1079. andyfrancis, on July 5th, 2017 at 7:15 am Said:

    Hey all, another UK based ATR here :)

    Did mine on June 17th playing cricket, it seems very rare for it to happen in cricket so I consider myself unlucky, although I did have a little tendonitis down there so perhaps it was inevitable.

    Had the op on 29th, so am now on day 6 post surgery. Wimbledon is helping to alleviate the boredom!

    I’m obsessed with this site now and have read so many of the blogs I’d like to think I have my road map for the next 6 months pretty much sorted. It seems if you devote your self to healing long, forget about coming back quickly, then you’ll be fine.

    For those that cut corners or don’t take their physio seriously, thats when the re-rupture rate creeps up.

    I’m in a case atm but can’t wait for the boot as apparently I’l be able to start very gently on an exercise bike.

    My biggest fear is the amount of muscle I am losing in my leg, my thigh muscle seems to be shrinking before my eyes, endless days of NWB. I’m doing leg raises but not much more than that atm, desperate to keep as much muscle definition in the bad leg as possible. I’ve read many times in this site that the calf muscle especially can take well over a year to come back to it’s natural size and strength!

    Fingers crossed for anyone going through this right now, the boredom is the toughest part I think.

    MY GOALS:
    1. Play golf on my 40th in November.
    2. Go jogging on Christmas day
    3. Ready 100% fit for next cricket season, May 2018.
    4. Run a half marathon a year to the day after injury, June 17th 2018.

    Full blog to follow as I start my journey to be fully fit :)

    Andy

  1080. cserpent, on July 5th, 2017 at 5:05 pm Said:

    LOL! I assume you didn’t really mean “healing long” Andy - you want to heal at just the right length - neither long nor short :) And, yes, your calf muscle will atrophy - you can’t avoid it since you have to give your achilles time to heal. You can do various leg exercises to keep the thighs in shape but the calf will atrophy to some extent - depending on how long you have to be NWB.

  1081. andyfrancis, on July 6th, 2017 at 4:32 am Said:

    By healing long, I mean accepting that the healing process is a long one. So not trying to heal quickly, therefore rushing things and risking re-rupture :)

    If David Haye can get himself back into a boxing ring surely I can get back on to a cricket field!

  1082. georgieporgie, on July 24th, 2017 at 3:31 pm Said:

    So here is my 15 week update.

    So after what may have been a partial retear, I am now back where was, able to walk, but not naturally.

    The inability to walk normally is strange, because few people seem to talk about it in detail, I guess this is because the progress after rupture is full of milestones that can be seen, NWB, PWB and FWB, into two shoes etc.

    For me the challenge now is to move from walking and being afraid of pushing force through the tendon to a position where I can walk reasonably normally.

    My sitting heel lifts are strong- I can do 90-100 lifts with my palm pushing down on top of my knee before my my Soleus gets tired.

    My assisted heel lifts are rubbish - there is no strength there in the Gastro and the only way can do the lifts is in the pool where my weight is supported.

    I am paranoid about pushing off with damaged AT in case it snaps again. My physio has referred me back to the Consultant because she is not sure why my progress is slower, but that is not for a months time. Will investigate private route to get quicker answer.

    Anybody else struggled with walking normally?

  1083. robert49, on July 31st, 2017 at 5:07 am Said:

    Hi Guys: i am 68 yr old male .. was prescribed ciprofloxacin for a suspected urinary infection. was not told that Achilles rupture is well know side effect . Dived into a swimming pool and the rest is history left Achilles rupture. op in Princess Margaret Windsor last Tuesday. 6 weeks after rupture . Silly thing was I was still able to walk and went to phyio. she did the test on my calf and no reaction .. but did not say quick go see specialist . she just continued with acupuncture ultrasound etc. Then I self referred to Surgeon and rupture was diagnosed. Work for myself so heaven knows how I will cope with forced confinement. Active golfer so many trips cancelled . Meant to be supporting wife n Charity cycle across France in September .. can’t see how I can do that either.
    Currently in a cast . moving about with iwalk system which is helpful . Quite a lot of pain when I stop the parcetmol and codeine.

    \Surgeon Took tendon from big toe and grafted it onto broken end and then screwed it into heel.
    Back to see surgeon on 10th August

    Found blog very useful.. no choice but to be really patient but patience is rewarded! Thank god I have a wife who is a nurse.. God knows how a single person copes with this. But it happened to Beckham and he is fine, it happened to Sonny Boy Williamson last year and he was playing for the all blacks this year. .. but when you are 68 and lose a year that is a big part of the remainder of your active life!

  1084. marie, on August 17th, 2017 at 10:28 am Said:

    Hello fellow Achilles Bloggers. I’m from the UK and use the NHS. I’ve posted this a couple of times as I’m new to blogging and l’m slowly navigating myself around this site…so please forgive me if you see this same post more than once

  1085. marie, on August 17th, 2017 at 10:32 am Said:

    I ruptured my Achilles’ tendon just over three weeks ago. I was miss diagnosed (no MRI, Ultra Sound or X-ray) at A&E and sent away with pain killers. After visiting my GP ( earliest appointment was ten days), she highly suspected that I’d ruptured my Achilles. I got a letter from her which I took to the hospital and was finally booked in for Ultra Sound and X-Ray the next morning. It was confirmed I had a ruptured Achilles (75% tear with 6cm gap and some fraying of tendon). My foot and calf had been put in plaster for a week and it was taken off yesterday and replaced with an Aircast Walker Boot and 3cm heel rise. I question weather the heel rise is adequate when there is supposedly a 6cm gap! I had originally wanted a non-surgery Achilles recovery when the accident had occurred. However, due to the delay of treatment and what I’ve read on blogs and MedWeb the deadline for this option appears to be one week with 3cm or less tendon gap tear. I enjoyed regularly running between 6 and 12 miles, four to five times a week prior to the accident and would like to get back to doing this. I’m concerned about rerupture or elongated ‘repaired’ tendon that inhibits my ability to walk or run properly. I would be very grateful for people’s views or if they are going through or been through similar hurdles and what they did to overcome them.

    Many thanks in advance.
    Marie

  1086. vicky3177, on October 2nd, 2017 at 11:17 am Said:

    Hi
    I first ruptured my left Achilles 4 years ago. I then ruptured the same one about it was missed by my local hospital in July this year dispite a vaeey large palpable and obvious gap in the back of my ankle. Long story short by the time I eventually saw the specialist it was 5 weeks post rupture and too late to operate. 9 weeks post rupture I slipped slightly in the shower and ruptured it for the 3rd time leaving me with a 4.1cm gap. Thankfully I saw my surgeon within a week and am now having a full reconstruction and fhl graft on 5th October. I have spent the last 3 months in a variety of casts and boots and have no idea what to expect after surgery. I love running and going to the gym but have been told that it is unlikely I will ever have full range again and running will be out of the question. Am dreading waking up in pain - not very good with pain but for now my main focus is being able to walk properly again!

  1087. srhjn, on February 22nd, 2018 at 10:42 am Said:

    hi all
    I ruptured my Achilles two weeks ago, doing box jumps and boxing in the gym. i’m 40 years old with no previous tendon trouble. the hospital has been a bit rubbish to be honest. I had my plaster cast removed yesterday and put in the boot (too old for surgery in Bristol apparently! i’m 40) and I was expecting things to get a bit better. however it really, really hurts more than in the cast. I still can’t put any weight on it. i’m just scared because no one has told me anything at the hospital (the consultant I saw was with me for 3 minutes two weeks ago) and with all the info online, including this great resource, no-one seems to mention the pain. I feel like I’m behind where a lot of others are at two weeks. I have a high pain threshold as well and prior to injury was fit and active. the constant throbbing pain in my heel has really taken me aback and it gets worse at night - is this swelling? I am not in work still and I feel like I am being a bit of a wimp ( I got signed off) and I should just be doing more. but is all thus normal? would appreciate advice as feel very alone and scared despite having lots of support; no one I know has had this injury. thank you.

  1088. chaiwallah, on February 22nd, 2018 at 6:44 pm Said:

    Hi Srhjin,

    I ruptured my achilles just over 3 weeks ago in Kenya, got it stabilised and back to the UK. NHS in Kingston were great with me at emergency care. I flew back to the UK on a Saturday night and went to AE first thing Sunday morning they diagnosed me straight away, put me in a new cast and got me on blood thinners - they were very worried about DVT risk due to the flight home and mistreatment in Kenya.

    The next day I got a call from the Ortho’s, and went in for scans, X-rays and a new cast - I was told that they preferred conservative treatment but I might meet the criteria for surgery as I still do a lot of sports despite being in my 40’s. I left hospital after being told a consultant would call me in a day or two with a treatment plan and surgery might be required but would come down to beds and surgery availability but they may elect to follow a conservative approach,

    The following day, I started to have breathing difficulties, and was rushed to hospital by ambulance as my oxygen levels were low and there was a risk of a DVT or even cardiac issue - Treatment was superb, they eliminated both of those issues and diagnosed just a chest infection - pure relief- was discharged at 3am.

    I was bed bound the Wednesday and no call came from the ortho consultants, by this stage I had also arranged for my travel insurance and personal medical insurance to allow me to go private.

    On the Friday morning, I got a letter from the hospital advising me of an appointment two weeks later, which would have been over 3 weeks post injury (assume that this was for conservative approach, but who knows??).

    I also had my first appointment with a private surgeon that day - who is head of orthopaedics at a neighbouring hospital - within 2 mins of meeting him, he said that I met all of the criteria for surgery and if I wanted to continue surfing and cycling long distances surgery would be best and was booked for 7 days later allowing for the chest infection to clear.

    I had surgery last friday and have mild throbbing and pain in my ankle but am keeping it raised most of the day. The physio told me not to do any exercises that raise my heart rate whilst I have a cast so I have not really done anything this week. Seeing the doctor next friar to move to a boot and hopefully start hydrotherapy / physio or at least have a plan.

    I have been signed off for 2 weeks and told that I will not be driving for 12 weeks - so will be working from home a lot as a cab journey would £20++ each way and the doctor will not allow me to use public transport. I also feel a bit of a wimp as have not been into the office since late january and before my trip to Kenya - but I have done a lot of work from home prior to the operation..

    I would push the hospital for a treatment plan and also ask why you do not qualify for surgery, but to be honest you sound in a very similar position to me (bar the fact I have had surgery).

  1089. peterd, on March 9th, 2018 at 7:15 am Said:

    I am a fairly fit 68 year old, and unwisely decided to try badminton again after a gap of 7 years. A popping sound in the back of the leg, and searing pain had me collapsed on the floor. After briefly passing out and throwing up, the leisure centre decided to call an ambulance. In A&E, I had an ultrasound scan, and was fitted with a cast, then sent home. It appears to be an almost complete rupture, the consultant has recommended non-operative treatment. I was in the cast for 3 weeks (supposed to be 2, but I couldn’t get in because of snow (UK, beginning of March). I now have a walking boot and am still on crutches. I need to remove a wedge every 2 weeks, and will be called back to the fracture clinic in 6 weeks. After that, physio. I’m very worried about the potential for re-rupturing, and the length of rehabilitation required.

  1090. zenzero, on November 3rd, 2018 at 8:31 pm Said:

    Hi. I am 42 year old male and I ruptured my left achilles on 1st October. Was in plaster for 10 days. Then had ultra sound scan and put in vacoped boot at fixed 30 degree angle for 3 weeks.

    On 2nd November (Friday) I saw the consultant again and had the boot adjusted to vary between 30 and 15 degrees.

    The next day I went for a walk with just one crutch. On the way home I tripped on a paving stone. The bottom leading edge of my boot caught on the edge of a slab. The slabs on the pavement are uneven and should be replaced.

    To stop myself falling I put alot of weight through my bad foot. Now my achilles is hurting again similar to how it was when I first ruptured it. I’m not sure how much damage I have done. Perhaps I have only jarred it. But it was only my second day with the variable angle so I may have done something bad :-(

    I’ve adjusted the boot back to a fixed 30 degrees. But don’t know whether to keep it like that or set it to variable. When I was at the fixed angle I had to have clexane injections and would need to get some more if I stay at 30 degrees. Don’t know what to do.

    I suffer from depression and anxiety and am feeling very low. Any advice greatly appreciated.

  1091. cserpent, on November 3rd, 2018 at 10:22 pm Said:

    Call your doctor and get in to see him/her ASAP. They are the only ones who can figure out if any damage was done.

  1092. zenzero, on November 5th, 2018 at 6:59 pm Said:

    Thanks cserpent.

    I saw the consultant and he says I’ve probably just done some minor damage. If it hasn’t improved in a week or so I am to go back for another ultrasound scan.

    In the mean time he recommended that I keep the boot fixed at 30 degrees for a further week or two.

    This means I have to go back on clexane injections :-( I got a new batch of syringes but I just tried one and I couldn’t pierce the skin. Maybe I’m being a big baby? But I didn’t have this problem with the previous four or five weeks of injections. It is like the needle is blunt or something. The skin was bowing in and the needle was leaving a divot but it still wouldn’t go in :-(

  1093. andymc78, on November 27th, 2018 at 3:13 pm Said:

    This is a very shortened version of my story. Original rupture to AT on May 2nd and 20 weeks later, it goes again doing a one legged heel raise as part of my rehab programme.
    Managed to get an emergency clinic appointment a few days later and sent referred for an emergency ultrasound and MRI. US reported a 2 cm gap but had to wait for MRI results before treatment plan was decided. Next appointment I could get was 3 weeks after the MRI, subsequently cancelled and ended up being a 5 week wait. Decided I could not wait that long and paid to see a private consultant. He could not see the MRI scans but managed to chase down the MRI report. Report stated there was a 0.2 cm gap which is tiny. Advised to keep foot in boot. Returned for my NHS appointment and was told I had a gap of at least 2 cm and required surgery using a graft from my big toe, also said it could be a 4-8 week wait for surgery. Bit of shock when two weeks earlier I was told it was 0.2 cm. Rang up the PALs hotline to query it and added an extra 2 week delay whilst they investigated it. They also removed me from the waiting list whilst they investigated which was nice of them.
    Anyway, I am now booked in to get it sorted privately and have a date of 20th Dec for surgery. It will be roughly 3 months after the re-rupture and if I waited for the NHS, God knows when it would be. Mentally, it has been tough but hopefully I will be sorted soon.

  1094. disappointed, on November 29th, 2018 at 5:47 am Said:

    oh my ….. i feel gutted for you. Your treatment by the nhs sounds dreadful. This sounds like my worst nightmare ….i hate reading about reruptures ….you poor chap. Im only 10 weeks post rupture so i have no advise …. don’t give up ….i just wanted to share some solidarity with you x

  1095. slippywilly, on December 19th, 2018 at 9:48 am Said:

    Hi folks, first time posting on here and have been reading through your comments with interest.

    I’m 30 years old and I ruptured my right achilles tendon approx 3 months ago playing rugby. Was immediately put into a cast for a week and anticoagulated. After this I was reviewed, had an ultrasound scan which confirmed partial rupture and the decision was made for conservative management. Went into a boot at fixed 30 degree plantar flexion. Over the next 3 months I progressed in the boot and was rehabbing well, eventually getting back to full weight bearing with no boot. Things seemed to be going well.

    Last week I had a bit of a freak accident - I sustained an electric shock when changing a light switch in our hallway. I’m sure I didn’t jump away or really move at all, but I immediately felt a pop in the tendon, similar to the last time. I was reviewed in A&E that evening and re-rupture was confirmed. After another ultrasound, surgery was apparently the only option on this occasion. I had my operation yesterday as a day case and am now at home and in a cast for 2 weeks.

    Following the initial rupture, I was given this boot:
    https://www.amazon.com/MaxTrax-Air-Walker-Cast-Boot/dp/B006L8M17U

    However on this occasion my consultant has advised me to purchase my own Vacoped boot as he says these are the best boots for full recovery and are not provided by my local NHS trust. The Vacoped boots are £240 new, so I wanted to post on here to see if anyone was in possession of one and no longer required it? I’m happy to buy one second hand and pay for postage etc. I think I would need a large (UK shoe size 10.5), but possibly might be able to squeeze into a medium?

    Thanks,
    Will

  1096. scarlini, on May 31st, 2019 at 9:23 am Said:

    Hi everyone,

    Just thought I would share my experience this far and pick peoples brains who have suffered with this injury.

    38 yr old and ruptured right achilles playing football on Sat 18th May. Similar story as everyone else in that I jumped to control the ball on my chest and then felt like somebody had hit me with a steel bar across my heel/achilles.

    Went straight to A&E and after a lengthy wait and an x-ray was put into a front cast. Returned 6 days later for cast removal and to be put into a vaco-ped boot. I was able to get about fine on my crutches in the cast with no pain with my leg hanging down but the first few days in the boot were agony. Also had alot of pain in the mornings when hanging my leg off the side of the bed first thing but that seems to have calmed down in the last few days.

    I have the boot at the 30 degree angle and i’m no longer using crutches around the house. Pretty much pain free and pretty much FWB after 2 weeks. Is this normal or advised? I have been reading that FWB early helps but my sheet says NWB for first 2 weeks.

    I have a physio appointment which will be 4.5 weeks after the rupture and also a follow up appointment with the specialist 7 weeks after the rupture. I’m able to get personal physio appointments through private healthcare and wonder at what stage should I do this? Is it the earlier the better?

    I go on holiday in 8 weeks and would ideally like to be driving and out of the boot by then.
    Mentally its been challenging as i’m very active in terms of sports and going the gym but hoping for a speedy recovery.

  1097. jimbo83, on July 30th, 2019 at 3:41 am Said:

    Hope you’re recovering well Scarlini and was able to make your holiday.

    I managed to rupture mine on the 25th June playing tennis felt the dreaded whack to the back of the calf and then fell to the ground with a numb leg before been helped off the court. Made it to A&E a couple of hours later and after a few hours wait was finally seen and diagnosed with a ATR, put in a half cast with toes in ballerina position then handed some crutches, box of blood thinning injections and codeine then sent home.

    Appointment with specialist was 6 days later they took the cast off had another look and feel and went through the two options to recovery - natural or surgery - with a strong recommendation I go for natural. Was then put in a AirStep leg cast boot with 4 wedges.

    I questioned this and requested a scan be done before deciding. It then took another 4 day wait just to get the ultrasound done. I was then seen by the specialist the day after the scan and they confirmed a 12mm gap and I requested surgery given my age (35) and been a very sporty person.

    They squeezed me in 2 days later on a Sunday for surgery and went home that evening with my leg back in a half cast with toes pointed down and some more blood thinning injections. Not too much pain until about 24hrs post surgery when the leg block wore off but that didn’t last long.

    Follow up was 12 days later they took off the cast and cleaned up the wound which looked quite neat and healing ok before putting me back in the AirStep boot with 4 wedges again with instructions to remove one each week and to start putting weight on it as much as I can.

    It’s now just over 3 weeks since surgery and 10 days since I’ve been back in the boot and things are feeling and looking pretty good. Not much too much swelling or pain just stiffness and have progressed to one crutch with a little bit of no crutches around the house.

    Back in 10 days for a checkup and should be down to 2 wedges in the boot by then.

    So far I’ve been pretty happy with the care from the NHS, the 6 day wait for the specialist and 4 days for the scan set me back a bit but pleased they got me in for surgery soon after and looks like they are following the early weight bearing protocol. No mention of any physio yet but will push for that when I see them next week.

    Only other gripe is I never actually got to speak to the consultant to ask what type of surgery I was having and been seen by 2 different specialist so far and the last one gave me all of 2 minutes before leaving me with the nurses to clean up and dress the wound and a sheet of paper with very limited instructions on what to do.

    Thankfully this website has been very informative so many thanks :)

  1098. jimbo83, on September 4th, 2019 at 2:09 am Said:

    Well a further 2 months down the line and coming up to 9 weeks post surgery and I am still waiting for my first NHS physio appointment.

    I have been advised it can take 10 weeks from been referred so only another 5 weeks to wait.

    I have worn out the sole on my aircast boot so decided to take it off myself and been walking around in 2 trainers for the last week or so without much trouble and booked myself into some private physio.

    The days of calling it a national treasure seem to be long gone. National embarrassment seems more appropriate.

  1099. guadalorgio, on January 29th, 2020 at 5:21 pm Said:

    Hi everyone,

    I am a 37 yo man and have ruptured my AT playing football on 18th Jan 2020.
    Understood immediately severity of injury as I went on the ground in excruciating pain, however my teammates probably didn’t and thought it was cramps, so hyperextended my leg thinking it would help - it probably just made it worse, at least the pain at that point was absurd.
    Went to Whittington hospital A&E next day and was given a below the knee plaster cast with feet in very slight plantar flexion. Only exams made were manipulation and xrays. Was given tinzaparin shots and an appointment to new fractures clinic in 9 days.
    Could not wait that long to know what had happened precisely so arranged to see a specialist through work medical insurance. Two days later I’ve seen a specialist who run more manual tests, plus an ultrasound scan upon my insistence. It confirmed a full rupture with 1cm gap, however the two pieces of the tendon would touch when feet in plantar flexion.
    I was then re-applied the same cast with a bandage on top and sent home.
    Two days later the specialist told me I could qualify for conservative given the indications of the scan, so I chose that path rather than surgery as was told results are very similar, but more side effects with surgery.
    The next day I went back to A&E to have a new half cast applied, and this time the foot was in equinus position.
    2 days later I have seen the specialist again and he has applied a hard bandage on the half cast to protect the back of the leg.
    He has then informed me of the process:
    3 more weeks in non weight bearing cast
    Then 3 weeks with wedged boot and partial weight bearing.
    Finally 3 weeks with boot and full weight bearing + physiotherapy (which would last for a few months).

    I’d like to know if anyone of you good people has had a similar treatment and what was their feedback on the recovery.
    I have spoken to some specialists in my home country (Italy) and they all said I should have gone for surgery without even thinking about it.

    Also, I’d like to think I could be back on a football pitch in a year or so, do you guys think it’s risky given I went for non op?
    Thanks in advance!

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