2 weeks, stiches out, boot on
On Thursday, I visited the doctor for my 2 week post op visit and all went well. After two weeks in a soft cast, I was ready for the unveiling of the suture site to see how things looked. I was fearful that I would see an ugly mess, but to my surprise, it was a clean 3 to 4 inch incision from just above my heal and slightly to the inside of where my achilles would come down. The doctor said that it was a clean tear and he didn’t have any trouble stitching the tendon back together in the middle.
Next the stitches were taken out. I was anticipating some pain, but it wasn’t bad and before I knew it, the nurse was telling me that it was all done. Once the stitches were out, the doctor examined things and declared that all looked good. I have some tenderness around the back of my heal, but other than that, there is no pain. My only disappointment was that the doctor told me that I need to wear a boot with no weight bearing for 3 more weeks, followed by 4 weeks, with gradual weight bearing. My first thought was, that I will do all I can to push this timeline. I don’t want to sound stubborn but I will likely try to put weight on the leg in about another week. Just a little bit of weight and gradually add to it. I definitely don’t want to reinjure, but I am a pretty quick healer and I know the doctor’s timeline is intended to be conservative to cover all types of healers. And you know, the last I checked, they do not take you to jail for not exactly following the doctor’s orders.
The doctor also wanted me to wear a soft wrap with a hard splint around my ankle when I sleep. The good news was that I didn’t have to wear the boot. So, I put the wrap on and went to sleep the first night, but woke up to that sore spot on my heal really hurting. Because the splint pushes against the heal, there was a lot of pain there. I immediatly took the wrap off, and the pain subsided. From now on, I will just take the boot off and sleep without anything on my leg. I did that last night, and it was fine.
My boot is mostly soft cloth with a hard bottom and sides around the foot. A wedge was placed in the bottom of the boot to keep my heal up. This boot seems like it has about 10 feet of velcro straps which are wrapped in different places on the boot. When I am at home and sitting, I take the boot off and let the surgical site get some air. The doctor told me to do ankle flexing exercises a few times a day to start stretching the tendon, a little at a time.
Also, now I can take a shower! This is a fantasting thing. Our shower has a seat in it, so I safely get into the shower and then sit down. This is still so much better than those sponge baths of the last 2 weeks.
I went to the gym today and worked out, which was a great thing to do. Although I have tried to do a few things at home to exercise, it was so good to get back to the gym and try to get back in shape, from two weeks away.
I must say, that I was in a little bit of denial for a few days, after this injury occured. The first question, was “why me?” What could I have done to have prevented this? I was in good shape, warmed up and yet it still happened, with no warning at all. After two weeks, I have a long way to go, but I am now taking this injury and recovery as a challenge to get myself back to doing what I could do before. I doubt that I will be back on the tennis court for quite a while. Tennis was always enjoyable, but not my favorite thing to do. I am hoping to get to weight bearing with a boot soon, so I can go out, and practice a few golf chips and putts. I will progress from there. My goal of playing golf in August is still in reach!
May 28th, 2011 at 11:30 pm
We have many bloggers and “posters” here who’ve quietly gone faster than their Doc’s instructions, and others who’ve convinced their Docs that faster is better, based on the evidence. Me, I lean toward the latter, because it also helps the next few dozen patients, who may not be savvy enough to log on here, or read the new studies and their protocols.
One of the most successful new studies (with and without surgery) is right here (full text) at achillesblog.com/files/2008/03/jbjsi01401v1.pdf . There’s a link to their (fast modern) protocol, and I’ve posted the version the authors faxed to my surgeon, too, at bit.ly/UWOProtocol . That schedule has you doing gentle toe-wiggling exercises (though no stretching past the neutral position or 90-degrees) now, and also starting gentle PT now. But it also has you starting PWB, with FWB at only 4 weeks post-whatever (op or non-op).
The only sensible answer to the inevitable “Why me?” question is a combination of (1) being naturally prone to ATR and (2) engaging in engaging in so-called “high risk” activities (like tennis) that generate high tension forces on the AT. The evidence for #1 is that we all are hundreds of times more likely to tear the OTHER AT than the population as a whole.
The study that showed that is linked from the “studies” page that’s listed near the top of the Main Page here — look for a 50-cent word like “transaxial” or “bilateral”. . . They only followed ATR patients for 5-ish years, IIRC, and still found a ~200-fold increase in risk/frequency! That still leaves the vast majority NOT tearing the other side, because the population risk of ATR is so low to start with. But it is something to think about if you do love “high risk” activities — as I, and many of us, do.
The only serious risk from sleeping with a “naked” ATR ankle (unless your wife kicks hard!) is that your calf and AT will tighten up (and your ankle will plantar-flex) overnight, so it’s an uncomfortable (and possibly dangerous) stretch to get back into the boot position. If that’s not a problem, I don’t think there’s a problem, though professional experts may disagree. If it is a problem, you may be able to wrap your leg more loosely, or use the stiff splint on the front instead of the back, etc. This rehab gives us all LOTS of opportunities to be ingenious!
May 29th, 2011 at 1:54 pm
Norm, thanks for the reply. I agree that getting the doctor on board with an aggressive protocol is the best way. My doctor was all for agressive protocols and then he had a person re-rupture when they tripped getting out of the shower a few weeks ago. Now he has gone conservative on me. I really don’t think an accident such as tripping out of a shower should make him change the protocol, but you know how doctors can be, and they are always worried about getting sued for something.
Thanks for the link to the UWO protocol. I am following that, and will also listen to what my body tells me. I have no plans for any hopping, skipping or jumping for a while, but gradual weight bearing sooner, rather than later seems to be working for many people on this site. Again, a lot has to do with what your body tells you too.
My wife, who works in PT says she doesn’t know of anyone who has reinjured when sleeping with a “bare” leg at night, and so far so good, so I will keep with that plan for now. Thx again.