6 Weeks and 2 Shoes?
I had my 6 week post-surgery check-up yesterday, and my doctor put me into two shoes with a heel lift only in my right shoe (ruptured side). The heel lift has 3 separate lifts stacked to 1/2″ or so I think, and I was instructed to take out one lift each week.
My doctor said I healed very well and that he’s very happy with the progress to date. I was FWB after 4 weeks with a 5 degree plantar flexion / dorsi flexion in the boot, so I’ve been “walking” for 2 weeks. Two shoes is an entirely different ballgame though. I’m very nervous about a re-rupture, so I’m taking it pretty slowly. Walking slowly, one step at a time upstairs to my bedroom, limited stretching of the achilles as I’m walking, etc.
6 weeks into shoes seems pretty fast based on the different blogs I’ve read, but my doctor was pretty confident I was ready. I start PT tomorrow and I’ll be doing 2 sessions / week for 4-6 weeks. Next appointment with my surgeon is at 12 weeks.
Wanted to get the communities take on something - for showering and going from the bed to the bathroom (maybe 25 feet), I’m not using my shoes and just going bare foot. I walk very slowly, but get in and out of the shower without shoes. Is that what others have done as they’ve been moved into shoes? I’m planning on buying “house shoes” so I can move the heel lift into something easier to get on and off.
Overall, I”m very excited to be in 2 shoes, and I’m cautiously optimistic. Thanks for all the comments and guidance. Always helpful to hear how my doctor’s protocols compare to others out there.
Joe
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6 Weeks is early. At 8 weeks, many good protocols do shoes, often with no wedge. For the wedge crowd, I’d assume that wedges in BOTH shoes would give better hip and spine alignment.
Worst risk from shoes at 6 weeks may be that you’ll be over the Watch Your Step nervousness by ~10 weeks, before the rerupture risk is over. Stay nervous!
The alternative is to use the boot some more, hinged all the way toes down, but restricted in the DF direction at a safe angle. I used neutral, but it sounds like you were comfy at 5°DF. Many people WEAN off their boot gradually in any case, either tapering by hours/day or shoes at home and boot in public, etc.
Joe, 6 weeks does sound early for 2-shoes–certainly compared to my protocol, which had me start boot-weaning at 10 weeks. I’d be very careful, especially on stairs. Timing aside, I did not move to 2-shoes until I was neutral in my boot, so no wedges were necessary in shoes and I often have gone/continue to go barefoot at home (in fact, I prefer barefoot indoors). Once I was in the boot-weaning period, I used it only sparingly in public and walked (carefully) mainly without. I certainly wouldn’t want to wear shoes into the shower! Overall, be careful! -David
Joe - I can remember walking from the shower to the bedroom barefoot even before I was in 2 shoes but since you already are then it should be OK. I would resist too much barefoot walking around the house as it will only make you limp due to the lack of flexion. My doc released me at 5 weeks so from there it was up to me and the PT. Officially I went to 2 shoes at week 7 but could easily have done it a week earlier and did at home anyway. I also had a similar wedge in my shoe. The only problem I found was being uneven but that can be fixed by adding the same to the other side. Like Norm said though, you will have to be very careful for a longer time. I took the boot in the car and remember using it on a camping trip for uneven ground at night after a few drinks. Our tent was on top of the car so I also had to climb a ladder to go to bed. I was a bit further along by then, just under 12 weeks, so maybe not as foolhardy as it reads. I also found one crutch helpful for a short time until my confidence grew. It was a visual reminder as well to those around that I was injured and give me some space. You can update your status now as well. Congratulations.
Hello all, this is my first time posting on here, I’m looking for some good insight from all you guys. I ruptured my achilles playing basketball on 5/17 and had surgery on 5/18. Today, I got out of my cast and into a CAM boot. He said it would be 6-8 weeks in the cast but he said it was beautifully. I might add that I am an outlier being that I am only 20 years old. He said i should use crutches another week but I really don’t need to. I tried putting pressure with the boot on and my brain just didn’t respond as its a mixture of nerves and not feeling physically able to do so. Can you guys give me some advice how to navigate swiftly with this boot and any other advice you guys may have. I appreciate it.
Yes this is also my first posting. I ruptured my achilles exactly like gregbaker, and I’m 21. Had my surgery on 29th of May, and had my follow up on June 10th. I was put in a boot june 10th on my follow up also he put in 2 heel lifts (2 inches). My doctor said I could start walking without my crutches with my boot. When I got home, I did some research on recovery and found this site. I read many blogs of recovery saying they started walking after 4-6 week after they got out of their cast and put in the boot.
Its only been 2 weeks for me and I am already allowed to walk in a boot without crutches. Is it because of age? My doctor did say I ruptured my achilles at a young age and said I had healthy achilles tendon. Is it to early to walk? Is it normal? Any one had the same experience? Any help will bring my worry’s down. Thank you.
Greg and Arkose - Age is not as much a factor in healing than most of us would like to think with this injury. There would be some small advantage to you because of collagen production but I doubt it is significant enough. I would suggest your doctor is following a more modern protocol that has focus on early mobilization and weight bearing. My father is in his mid 80’s, went non op and was weight bearing from day 1 after his rupture. Most of the research into these protocols are done on middle aged and older people anyway. The important thing is to do it as tolerated (pain and swelling) and only with the boot on until instructed otherwise. Rest, elevate, ice as required. Were you also told you could commence some gentle movement of the joint with your leg supported? No call for worry at the moment as it seems both of you are on the fast track to recovery. Read much and learn much as this knowledge will help you know what to do as much as what not to do.
Stuart - Thanks for replaying. Yes the doctor told me I could move my foot up and down slightly to neutral when I’m on the bed or sitting, without the boot. When my doctor said I could walk without my crutches, did he mean I can put my full weight while walking? Of course no weight without the boot on.
Arkose - I take from what you have said that your doctor has told you to take all your weight (FWB) on the foot as you walk but in reality many of us progress from partial WB to full using the crutches to take some of the load. No crutches equals FWB. This transition does not have to take long and depends really how much it hurts. The more you do the less it hurts which doesn’t mean go out and do more until it doesn’t hurt. As tolerated is the word we use. Some people can tolerate more than others so it may be quicker for them to FWB. Overdoing it and pushing through bad pain doesn’t necessarily make you heal quicker either.
Hi!
Gosh, I’m at 11 weeks and still not fully weaned from the boot. I’ve had a really hard time wearing shoes due to the swelling I still have. Also, I have an anchor in my heel that rubs a shoe uncomfortably. I limp pretty badly when I do wear two shoes. I don’t think I could even do FWB in the boot at six weeks….I mean, I tried, but couldn’t really manage till 8 weeks. Anyway, take it easy. It’s not a race. But I’m glad you’re doing well.
Hi Stuart
Where did you get the idea that research into these protocols is done on middle aged and older people?
From my reasonably well informed viewpoint it would seem that your statement is completely wrong, with the data typically being collated from all atr patients over a set period of time.
Perhaps you could follow up with your reference points?
Apologies, should have written ‘mostly done on middle aged…’.
Stuart / Akrose - My first blog post has my overall timing, but I’ll provide a quick summary here.
Ruptured Achilles April 19
Surgery April 30
- non-removable cast until June 7 (Week 1)
- Removeable cast June 7 - June 14 (Week 2)
- Walking Boot at Week 2 - but no weight bearing
- PWB (partial) week 3-4. About 50%, with crutches
- FWB (full) week 4 - 6 post surgery. I weaned off of crutches pretty quickly. Just felt comfortable putting weight on it and had no issues with swelling or pain
- Put into shoes at week 6 with a heel lift. I’m walking cautiously, but not using crutches at all.
Overall, I’m being cautious but also following a more active protocol that I believe follows this U of Wi report. http://www.uwhealth.org/files/uwhealth/docs/sportsmed/SM-27399_AchillesTendonProtocol.pdf
I feel really good, but I’m walking slowly (takes me much longer to get around than when I was in the boot). Overall, I’m happy with my progress, but as Norm and others can attest, you’re not out of the “risk of rerupture” phase for awhile, so it always makes sense to be cautious and understand what your body is able/willing to do.
Joe
Joe - I probably follow some what of your protocal since I’m not ready to put weight on my leg because it doesn’t feel right when I do. I’m guessing I will put into shoes in 6 weeks too, because that’s when my next follow up.
Joe - Forgot to mention, did you do any physiotherapy when you got your boot? My doctor told me I didn’t need it.
ATRbuff - there are 2 links on may page to studies on early weight bearing and both show a mean age in the 40’s. Google this web site for another achillestendon.com/achilles-tendon-rupture/ or go to achillestendon.com. I am not sure how many references you require. Of course when they carry out research they use patients who fit the requirements or guidelines. Age may not be one of those but as this injury mostly occurs in middle age and older people (search ‘mean age achilles tendon rupture’) then it follows that most the participants in the research will be in that portion of the bell curve. There is also reseach showing age does not affect tendon healing. Hope this is helpful. regards Stuart.
Stu
“A mean age in the 40s” - doesn’t really mean middle age or older does it? Can’t it equally mean middle age or younger? Maybe it is on your page somewhere together with upper and lower quartiles, median and all the rest of the statistical hokum (i know, I know, it is valuable research data) but as I’m just off out to go climbing I don’t really have the time.
Have a great recovery
ATRbuff - Not sure what we are debating here or why. Is it that I am completely wrong or is it that age is relevant with regard to early weight bearing and mobilization. Accepting the fact the studies had a range of age then it included older people and mostly middle aged. Tell me how I should word it to satisfy you???
No debate Stu. I just thought that your post needed a little clarification. Certainly no need to get cross, and not the ‘house style’ for Achillesblog. By the way, I’m not being biased towards the younger quartile either - I’m over 60 myself and went non-surgical after a 100% rupture. Progressive OS.
Now, my mountain calls - a hard day ahead, and no cell reception anywhere near there.
Have a nice day or night or whatever…
ATRbuff - certainly not cross, just a little confused. Don’t mind being told I am wrong either just like some substance as to why. Happy to leave it at that.
Hi Joe, Great to hear that you are moving into 2 shoes. I moved from boot to shoes at just over 6 weeks and didn’t have a boot weaning period. I was, of course, very careful and slow but did well in my recovery, this was over a yr ago and you can find my blog on here somewhere. I did carry on sitting in the shower on the stool I brought, but like you walked barefoot across the bedroom only. I wore trainers indoors initially with both heel lifts in, this was all as advised by the orthopods ( I was non op).
Good luck with the healing
Micah