cayles’s AchillesBlog

Recovering in Victoria

December 9, 2014 · 4 Comments

Hello, Achilles world.
I ruptured my left Achilles on Nov. 30 when I hopped off my mountain bike and landed on some sloping ground.  Felt the pop, knew it immediately, even though it wasn’t all that painful.  I limped out leaning on my bike, toes pointed down, and after lunch I settled in at the ER.  There, a GP diagnosed me and told me all about his own Achilles odyssey, and his successful return to Iron Man races.  The orthopedist on duty confirmed it, recommended non-surgical treatment, and got me into a temporary cast.  Air cast boot the next day, and then I got a fiberglass splint for sleeping and forearm crutches for less painful locomotion.  Now I’m just over a week into recovery, waiting for my next specialist consultation tomorrow.
I have just read the UWO study everyone here knows about, and I believe I will be on those protocols.  Goddam foot is swelling quite a bit and my calf aches, so sleep is not great, but better than sleeping in the air cast.  Main lesson so far:  if you need crutches and you are rich and/or insured, you MUST get some Sidestix forearm crutches!  So, so much more comfortable than armpit crutches, way better designed and safer than cheaper models, and designed / built in BC.  Maybe they will give me a discount for this plug.
Anyway, I was amazed and relieved to discover such a vibrant ATR community here.  I will post updates whenever it seems relevant.
Cheers,
Chris
Victoria, BC, Canada

Categories: Uncategorized

4 responses so far ↓

  • herewegoagain // Dec 10th 2014 at 9:22 am

    Chris- I had exactly the same experience mountain biking on August 21. I got off my mountain bike suddenly and the ground my foot landed on was steeply sloping, maybe even had a compression. Lots of pain with that shocking pop, so lucky you missing that.
    The non-op method has worked really well for me and it sounds like you are in good hands. The swelling is common, the first couple of weeks is the worst- keeping it elevated and iced and it will settle down.
    Good luck!
    Lisa

  • normofthenorth // Dec 12th 2014 at 3:26 am

    I’m a big fan of UWO (which we actually call “Western” here in Ontario). But I think the added trick introduced by Dr. Wallace in Ireland — customizing each ATR patient’s immobilization angle so the two torn AT ends just meet (or “approximate”, as the experts say) — probably produces even better results than UWO’s “one angle fits all” approach. (They used 2cm of heel wedges for everybody, in non-hinged AirCast boots.)
    If I were designing a rehab protocol today, I think I’d consult the 3 great ones at achillesblog.com/Cecilia/Protocols — UWO, Wallace’s, and Exeter’s and then I’d combine Wallace’s customization with one of the others’ schedule. I’m betting that a large study that did that would marginally improve on Wallace’s wonderful results. And, all 3 protocols are so similar in schedule and in results, that a little mixing and matching still satisfies my need to “go with the evidence”.
    BTW, if you can install the ATR Timeline Widget (instructions on Main Page), it will keep reminding us all of where you are, which leg, what you were doing, and how long it’s been…

  • cayles // Dec 12th 2014 at 10:07 pm

    Thanks, Norm. Hopefully next time I meet my specialist, I will be able to get a word in about tailoring the rehab program. I think I have a good doc, but he’s always in a hurry, and has me on a plan that seems fairly generic. Good, but generic. I may fall behind schedule due to holidays getting in the way of my next appointment. But I suppose a week means little in the grand scheme…

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  • normofthenorth // Dec 13th 2014 at 12:41 am

    UWO’s and Exeter’s non-op patients did very well with a good generic protocol. But non-op patients who followed older slower protocols did much worse than the patients in these three fast studies — like 15-25% re-rupture rates instead of ~3%!! It’s hard to know how much the risk rises with each additional week of immobilation, or NWB, but it probably rises, so I’d fight to stay with a proven protocol. If you’re in the AirCast now, you can follow the basics of these three, even if your OS is away skiing somewhere.
    I haven’t heard about anybody beside Wallace using his “trick”, but I think it’s high time everybody did. Not only did he get great results with the usual ATR patients, he also got great results with ALL the reruptures he saw (a feat previously assumed to be impossible), and with the vast majority of the neglected, mid-diagnosed, and “chronic” ATRs he saw (a feat previously “KNOWN” to be impossible)!!
    That’s a pretty good trick, IMO!

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