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/
what do you need to know
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.
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
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
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.
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
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
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
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
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
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 !!)
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?
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
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
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
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.