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Mar 12 2016

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cjw1

18 month update (brief) - non surgical achilles rupture

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Hi there all

I am way overdue to provide an update. Apologies.

I am so happy to be able to say its been 18 months (well, its actually been about 17 months) since I ruptured my right Achilles (playing indoor soccer). I went the non-surgical option. And I have to say, I’m glad I did, and I have had no major issues at all.

I am not quite back running (and other exercise) as much as I was before the injury, but this is partly due to me still being very careful and conservative. Walking is fine, I have gone for the odd run (up to 5 km, but usually have a walk break at one or two points during the run). I am riding my pushbike a bit and that’s fine. The running is not 100%, it does feel ‘different’ but not really bad or anything concerning, Its more ‘tight’, as I’m not stretching a lot under the advice of my physio, who I still see occasionally for ongoing advice.

I was almost religious about my rehab, I performed all of my exercises when instructed to by my ohysio early on in the process  and recovery. I did slack off a bit later, and I did pay the price in regard to some loss of progress. But Ive been back on board with my exercises. I basically can do whatever I want again, and function fine. I am still very careful though, and probably being a little too conservative, such as I don’t do any squats at the gym, I am not running much - yet, but I’m cycling a bit more instead. I am able to do three sets of 15 single leg heal raises (admittedly not quite as good as my other leg, but still improving). I’m very happy with this.

The orthopedic specialist (who recommended surgery) said he was happy with how I recovered. The two physios I have seen are also happy with how its recovered. I barely notice much difference between the appearance of the appearance of my Achilles compared to the other uninjured one. My injured one is a bit thicker and flatter, but I cant notice it too much unless really trying.

The period just after the injury was tough, as we all can relate to. My advice is just hang in there. If you are goo with your rehab I’m sure it will all be good. I’m certainly a big fan of non surgical (I had a 2.5 cm gap between the torn tendon ends) but I understand that whatever works for everyone is different.

Good luck to everyone and hang in there!

Cheers.

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Jan 23 2015

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cjw1

Orthotics

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I was wondering about others’ experience and their thoughts regarding orthotics for shoes in relation to part of management post ATR? I have flat feet and different podiatrists have said to me that I need orthotics every time I consulted one for different reasons over the last 20 odd years. I never bothered to get fitted for orthotics and thought I would put it off to the next time I would go and see one again (which would be every five years or so).

The MRI report following my ATR said "The rest of the tendon demonstrates abnormal signal in keeping with
tendinopathy."
The assistant at the imaging centre told me ‘the whole tendon looks stuffed’ after I asked her how it looked and where the tear was, etc.

So I am kind of convinced that my injured achilles (probably both Achilles’) has tendonosis (I think this is where there are many tiny tears in the tendon - possibly from overuse, where I think tendonitis is inflammation of the tendon) due to many years of running with flat feet without orthotics, and that this was a major contributing factor to the injury. I freely admit that I’m possibly way off and there is no scientific method or research I have used for this conclusion, but it makes sense to me (but I will discuss this further with my treating practitioners).  I did a lot of running in the 12 months prior to my atr and did my first half marathon a few months before it snapped. I cant say that I had any symptoms or soreness leading up to the injury.

So I will definitely be getting orthotics after I have healed enough to be able to be fitted for them. Hopefully that will also help with my lower back pain which I have had, and continue to have, my entire life. I have largely managed it with exercise as it is worse if I don’t exercise, but have also seen chiropractors and osteopaths at different times for maintenance.

I’m just curious what others might think about this as a possible contributing factor to the injury occurring (i.e. not having orthotics despite recommendations) and also as part of post injury management (getting orthotics)?

4 responses so far

Jan 13 2015

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cjw1

12 weeks

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Hi all.  Its been great reading everyone’s stories, updates and progress.  I hope everyone has a good recovery.

Its been just short of 12 weeks since my TA Rupture (non-surgical) and it seems to be coming along well.  I got the all clear from the physio last Friday to start driving (finally!) but I am still to use the boot for most of my walking outside and in public.  Its such a relief to be able to walk in two shoes inside and its amazing to be driving again.  It feels like I have just been given my licence for the first time again.

It is definitely feeling stronger and I have been given some new exercises to do at home which include heel raises (from the floor, not a step, no stretching at all yet) using both feet at once and which is difficult not to have my good calf do all the work; and balancing on the injured foot, which is also too difficult for my liking.  But I am slowly getting better at the exercises and I am really happy to be able to advance to more demanding exercises.  I am ecstatic to feel the strength slowly come back.  Walking in two shoes is difficult and feels like going backwards a couple of steps in the process.  But I realise it is still progress.  The physio has told me to concentrate on short strides and to bend the knee (to have a ’soft knee’), which is easier said than done as I am probably more than slightly paranoid about reinjuring my Achilles as I can feel it pulling and stretching a bit.  Overall the physio is very happy with how it is coming along.  I see the physio again in two weeks and the Orthopaedic Surgeon at the end of the month.

I have been performing the Thompson test on myself while kneeling on a chair and I am getting some good movement from it.  I still elevate and ice it when I am at home.  I am very happy with how things are going but I am very mindful not to do anything too stupid nor will I rush things.  Wishing everyone a safe and good recovery.

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Nov 29 2014

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cjw1

Slowly but surely - 5 weeks post TA rupture, non-surgical

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Hi there all

I’m grateful for finding this page.  Its been such a great support and so valuable in so many ways.  I hope everyone is healing well.

I ruptured my right Achilles tendon approximately 5 weeks ago, on 22 October 2014, while playing indoor soccer.  I am probably in a better frame of mind now to set up my blog (apart form the fact that I am so IT challenged and couldn’t work how to do it anyway).  I think I would have been worried about how negative and down I may have sounded if I posted earlier.

I am a 41 yo male, living in Australia and have always been physically active.  I enjoy my running, gym and cycling.  I run once or twice a week and do the odd fun run.  I cycle to work occasionally and I go to the gym a few times per week and I completed my first half marathon in July this year.  I definitely have set myself a goal of doing more of these in the future.

I decided to go the non-operative route, which was against my Orthopaedic Surgeon’s recommendations.  I had an MRI which showed the rupture was in the mid Achilles (the hospital initially conducted an ultrasound and said the tear was higher up, but I later sought a second opinion).  The MRI report said there was a gap of at least 2.5cm between the torn tendon ends.  I advised my surgeon that I did not want surgery as I am not a fan of surgery, and don’t want any surgery unless I really need it.  He respected my decision and said it should heal ok taking the conservative approach and referred me to a physio and both seem to be recommending a fairly fast, aggressive rehab protocol.  I did feel better and relieved that my decision had been made and was now on the - very slow - road to recovery.

I have been in an Aircast boot since the start of week 2 (when I saw the second Ortho), I was in a front cast prior to this.  I started physio after 3 weeks with some gentle mobility exercises performed 2 - 4 times per day, as well as ‘desensitisation’ twice a day.  I had my second physio appointment a week after the first one and I progressed to using a thera-band to provide some light resistance exercises in addition to the other exercises.  I have my next physio appointment next week and I will be very interested in what he says as I feel like I have made some good progress.  I’m doing so much better with the thera-band and able to flex down against and through it while pulling resistance back.  I’m down to two wedges in the boot (started with four and am removing one every 10 days).  I get a bit of pain here and there and have had difficulty sleeping with the boot on.  Hopefully I can start sleeping without it soon.

I have been trying to be as philosophical as possible with this injury and have been trying to use it as an opportunity to do some positive things that I would not normally get the time for and just having the time to think about anything and everything has been good.  I have been re-evaluating so many things in my life.  I have returned to work last week on part time hours.  Thankfully I have a lot of paid sick leave I have built up to use.  I do believe things happen for a reason and this has made me slow down a lot which isn’t a bad thing.  And I will never take my mobility, health and independence for granted ever again, once I am healed.  I day dream and visualise about walking and being able to drive again, and it always brings a smile to my face.  I have been told by my doctor and physio that I will have the boot on until January and that I cannot drive until I don’t need the boot.  And I have a manual car so I couldn’t drive anyway if I wanted to try.  I live alone, and my apartment does not have a lift and I am on the top floor (of only two floors) and have one flight of stairs.  Thankfully this has been fine so far as I have gone well with the crutches.  I have been partially weight bearing in the boot since after about 2 weeks and am now not using the crutches except for longer trips outside and at work, etc, mainly to keep people away and to make the walking on both feet faster.

This has been so challenging physically and possibly even more so mentally.  I wish everyone a safe, speedy and full recovery and thanks again for all of the information.

Cheers.

4 responses so far

Nov 07 2014

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cjw1

Hello world!

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Welcome to AchillesBlog.com.

This is your first post. Edit or delete it, then start blogging!

Following link will take you to your blog’s “command center” where you can write your posts:
http://AchillesBlog.com/cjw1/wp-admin/

Be sure to fill out your city, Achilles rupture date, surgery date, etc.. (if you know it) here:
Fill out my Achilles Profile Here

When you do, you can keep track of your recovery progress and see your information on the Marathon Tracker.

Here’s more info: using Achilles Timeline Widget

Please change this post’s title to something more descriptive. Just leaving it as “Hello World” leads people to believe that you haven’t updated your first post!

If you have any questions, don’t be afraid to ask! :)

Dennis

One response so far