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/

1,071 Responses to “ATR’s in UK”

  1. what do you need to know

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

  65. 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. 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. 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. 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. 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. 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. 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. Hey jamie..

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

    FM ( luke from facebook)

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

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

  98. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Thanks for the advice 2ndtimer!!!

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

  132. wow It’s a great blog. I love it.

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

  152. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Thanks for the advice and for the link :)

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

  181. Thanks Janet - still trying to decide…

  182. 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. 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. 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. 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. 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. 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. 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. 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. Blog created

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

    Good Luck and Good Healing!

  206. 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. 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. 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. 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. 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. 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. 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!

  213. The sisters Middleton, Pippa, Kate and the new one we’re reading about, Catherine (!) seem on the way to being the most photographed women in the world since… well, since Princess Diana, a former Royal wife and Prince William’s mother. Let’s hope they fare better with the world’s press than she did - and that the press give them more room to live their lives too.

  214. 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. 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. 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. My partner and I stumbled over here by a different page and thought I should check things out. I like what I see so i am just following you. Look forward to looking at your web page yet again.

  218. 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. 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. 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.

  221. cheap Ravens Jerseys Thanks a ton for the fine writeup. Anyway, how could we communicate? Clay Matthews Jerseys

  222. Brees Jerseys Its like you study my mind! You look to master so significantly about this, like you wrote the e book in it or something. I think that you can do with some pics to generate the message home only a tiny bit, but other than that, this really is superb blog. A superb read. I will certainly be back.. cheap NBA Jerseys

  223. 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 :-(

  224. I loved as much as you’ll receive carried out right here. The sketch is tasteful, your authored material stylish. nonetheless, you command get bought an edginess over that you wish be delivering the following. unwell unquestionably come more formerly again since exactly the same nearly a lot often inside case you shield this hike.

  225. 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. 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. 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. 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. 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. 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. 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

  232. Is it true that well maintained cars in Embassies in Delhi are sold at dirt cheap prices regularly in auctions?

  233. 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. 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 :-(

  235. cosie ugg chocolate womens bailey button

  236. 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. 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. 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. 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. 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. 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!!!

  242. I don’t even know how I ended up here, but I thought this post was great. I do not know who you are but certainly you are going to a famous blogger if you aren’t already ;) Cheers!

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

  264. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Hi Alison

    I’m using a Nike Air on my right foot….works fine for me(day 2 of full weight bearing)

  275. 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. 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. 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. Hi Alison,
    If interested this is the boot ; http://djoglobal.com/products/procare/maxtrax-rom-walker

  279. 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. Hi Plummy,

    I don’t suppose one of my stilletos will do? :-)

  281. Hi Alison

    I don’t know how safe that would be but could be a good look! How high?

  282. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. David,
    btw, I was put in a cast and told to PWB immediately.

  345. 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. 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. 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. Hillie,
    just re read, you’re in Vacoped, was that NHS?

  349. 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. Hillie,
    thanks for your quick response. will be on it ASAP!

  351. Sheena

    If you any problem seeing the accessories on the web page, check out http://www.vacocast.com/storage/pdfs/VACOcast_accessories.pdf

  352. Thanks Hillie!

  353. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. I have an NHS supplied chaneco boot.

  368. 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. 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. 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. 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. 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. 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. 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. I chimed in on my page, where Sheena posted the same Q. (BAD Sheena!)

    I largely agree with Ryan (again! :-) ).

  376. 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. 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. Hi David,
    what’s the tip toe reflex. If I wiggles my toes too much my heel aches?

  379. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Wow that sounds awful! That had better not happen with me!

  394. 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. 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. 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. 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. 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. 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. 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. 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. 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. Sheena,

    Great news on the tendon! Worry over for now.

    Off to watch footy!

  404. 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. 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. 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. 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. So surgery doesn’t bring the tendon together quicker than the natural process?

  409. 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. Just took a huge tumble in the bathroom, 4th big fall, fingers crossed for tomorrow, felt it pull big time!

  411. 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. DavidR your fall…just seen it, were you hopping?

  413. 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. 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. 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. 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. Also is anyone else still wearing the DVT sock on their good leg? I’ve not been told to take it off.

  418. 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. And one thing I forgot to ask, am I still meant to have the leg horizontal at all times now? Thanks.

  420. 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. 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. 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. DavidR,
    what sort of boot did they give you? Do you know the name or brand?

  424. 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. I estimate the angle of my foot is between 10 and 15 degrees.

  426. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Not a soul has mentioned blood thinners to me? Do any non oppers out there take blood thinners?

  444. 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. 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. 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. I’m non-op and was on the blood thinner Xarelto for a month.

  448. 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. 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. 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. 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. 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. DavidR,
    how are you getting on with your Vaco boot? Is it still uncomfortable?

  454. 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. 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. 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. 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. 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. 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. 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. 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. 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. Congrats to England! That should be a great game against Italy this weekend!

  464. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Mikeev

    How did your second opinion go?

  494. 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. 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. Just booked my first physio appointment…next Wednesday, assuming that I get that boot Monday that is! Fingers crossed.

  497. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Hey David,
    great to hear you’re on the mend……..

  514. Rusky,
    no matter whether it’s a fill or partial tear…still a right old pain!

  515. 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. David, did you go with heel raises in your shoes in the end?

  517. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. David - check my latest blog post (http://achillesblog.com/skutr/) on what I did at my last PT session.

    Scott

  547. 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. 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. 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. 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. How do you start a blog? I can’t work it out? Thanks.

  552. 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. 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. I have an account but still can’t work out how to do a blog. What address do I have to email? Thanks!

  555. 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. 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. 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. 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. 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. @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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Hi Hillie,
    Yes I will tell her when I see her….did you take any chances and do stuff you shouldn’t?

  572. 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. Ha ha, that really did make me LOL!

  574. 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. 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. I meant ROSS not rob, apologies!!!!

  577. 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. 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. 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. 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. 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. 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. I of course meant to say London to Paris 2013 in my previous post, I’m not a madman!!!!!!!

  584. David,
    can I ask if you still feel a lot of tightness in your tendon when you walk?

  585. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Thanks Starshep, I’ll take a look.

  596. 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. 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. Thanks Alison, am going out today so will give it a go. Oh to wear matching shoes! :)
    Jaxx

  599. 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. 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. 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. 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. 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. 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. 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. @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. @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. 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. 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. 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. @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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Just to confirm; after reading up on different options, I went the non operation route

    rogerg

  637. 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. 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. 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. Oh and I wasn’t being sexist saying he, it’s definitely a man as I know his name!

  641. 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. 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. 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. 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. 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. 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. 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. 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. @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. 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. @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. 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. 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. Badge,
    Sopranos……ace!

  655. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. DavidR,
    how are you feeling today? Any better?
    xx

  678. 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. 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. 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. 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. 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. 100 days since rupture and still on crutches. Looking forwards now not backwards, here’s hoping September is a great month for all!

  684. 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. 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. 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. 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. 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. 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. 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. 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. 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. David R,
    thanks for the sweet comments! How are you getting along? Do you think your boot would fit me?

  694. 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. 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. Enough is enough with this austerity measures

  697. Wondering if radio silence from Sheena means she had the op today, she may be smiling away on morphene right now!

  698. Hey David,
    just wrote on my own blog! Nahh not a bloody word!

  699. 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. 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. 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. 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. 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. I really like it whenever people come together and share thoughts, great blog, keep writing.

  705. David R,
    where are you and how are you feeling? Long time no hear.
    She.

  706. 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. 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. 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. 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. 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. 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. 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. Sheena,

    How are things?

  714. 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. 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. David R,
    I would love your boot but I think it would be too big.
    Thanks again.

  717. Sheena,
    got my boot hurrah!

  718. 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. 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. 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. 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. 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. Hey badge we have all been there! Trust your instincts. Good old NHS!

  724. 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. 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. 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. 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. 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. 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. 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. 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. 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 is a very good fabrics to make boots and safety shoes. If anyone need shoe materials and footwear materials, welcome to contact us.

  734. 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. 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. @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. 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. 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. 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. 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. 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. 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. 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.