Surgery or not, that is the question
Posted on June 18th, 2012 by christinahagerty
back in august 2011 i was returning from a light run and felt super sharp and horrible pain in my achilles area. its been a year of yoga, PT, walking boot for 3 months, cast for 4 weeks… NOTHING has worked. Heel is red, swollen, only wearing clog type shoes, cycling and swimming. Now I am contemplating surgery but its very hard to choose and I feel like it is a huge risk given the 6 month recovery time… So i just wanted some feedback as to weather or not the surgery is worth it. This year has been really difficult, I’m ready to get back to my normal activities!! Is achilles repair surgery worth the 6 moth recovery? Should I be happy with the limited activities I can do now? Thanks!
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Hi Christina,
Were you diagnosed with a full Achilles tendon rupture back in August 2011?
What has the doctor suggested to you? Did you get ultrasound and MRI?
For most of us, the recovery period following Achilles repair surgery is one year. The same for those who follow the non surgical approach. Some people heal faster than others, hope you fall in that group!
Christina,
Based on what you said regarding 4 weeks in a cast, 3 months in a boot and PT it already sounds like you had gone through non-surgical ATR repair. Did you rupture your Achilles tendon or was it something else? Also what do you consider your normal activities to be?
You don’t mention any of the symptoms of a “normal” AT Rupture, other than pain (which many of us didn’t even have much of). What was your diagnosis? If it’s tendinosis or Haglund’s deformity, then there are people here who know way more than I do.
For those of us who ruptured an AT, we suddenly found ourselves facing 6-12 months of impaired strength and mobility, with or without surgery. And we also found ourselves facing a likely near-100% recovery over that same time period, op or non-op. It sounds as if you’re facing a very different choice, and one where your own control, and comfort in your decision, may be as important to your recovery (or your sanity DURING recovery) as the surgery itself.
It also sounds like a supremely personal decision, based on the best information you can gather on YOUR condition and your options. Some of us may be able to help with the information once we understand what your condition is, and what your options are.
I am scheduled to have sugery next week 8/28 for a torn achilles. A virtical tear that appears to be 2+” in length. I have been eading some of the comments on this blog and I’m now afraid. OMG… It will be a year before I’m myself again and can walk and wear shoes? An entire summer and I haven’t played golf yet. My Dr. didn’t make a big deal out of it when he suggested surgery. Said on crutches for 4-6 weeks then the boot for a bit then a shoe without a heel. Guess I better get a better recovery outline from him at pre-op Friday.
Mary, you say you have a vertical AT tear. Does that mean that your AT is still continuous, from the calf muscles to the heel bone — i.e., do you still pass the Thompson test?
If you have a vertical tear, i.e., the tendon has split, and it’s interfering with your mobility, then it’s quite possible that a surgical repair is indicated. But I wouldn’t expect your rehab to be any slower or longer than those who’ve had horizontal AT ruptures repaired (or gone non-op). The best modern rehab protocols — like bit.ly/UWOProtocol — get you walking (Full Weight Bearing = FWB) at FOUR WEEKS into treatment, and wearing shoes at eight weeks. Hardly “a year before I’m myself again and can walk and wear shoes”.
The 12-month “marathon” that’s referred to on the Main Page and elsewhere is a rough rule of thumb for getting back to 100%, or playing your high-risk sports again without thinking about your Achilles. And many of us get to those points several months faster than that, though there are no guarantees with this thing.
Your doctor’s description of his protocol — on crutches for 4-6 weeks then the boot for a bit — sounds a bit slower than the UWO-study’’s highly successful protocol I linked above, but not very much so. UWO patients spend 4 weeks on crutches, most of it IN the boot, then another 4 weeks walking around FWB in the boot. There’s no advantage to casts instead of boots — apart from an absorbent plaster cast or splint for the first couple of weeks post-op, to avoid staining the boot liner with various seeping body fluids.
It’s far from a walk in the park, but not quite as scary as you imply, either.