11 weeks and Christmas with Achilles Avulsion Fracture

Since my first visit to physio 2 weeks ago I have been applying the exercises religiouslyand have some movement in the foot, still no pain. Got to be grateful for small mercies. Even managed 1.5 mile walk on crutches. Went to the waterski club and took some skiers out waterskiing, a bit cold but so good to be doing something rather than vegetating.

Yesterday went for physio and then on to see consultant. I felt quite upbeet going to pysio, I had followed their instructions to the letter and had what I considered good movement coming back to the foot. Movement went from 60 degrees to 75 the aim is 100 degrees, so it was a start. The physio said anything less than 90 degrees would leave me with a limp. The physio done her work manipulating the bones and tendons in the foot, I did not realise how stiff the whole foot had become.

Onto the hospital to see the consultant. He quickly brought me back to earth with a bump. First time I saw the consultant 2 weeks after injury they showed concern regarding 2 small fragments of bone that had become displaced. This is now coming back to haunt me, they are not sure if there is enough bone to hold the Achilles in place. The consultant wants me to really stretch the Achilles by pushing against a wall with my hands and at the same time trying to push my heel against the floor and in their words if I push it hard enough and it is not fixing properly this will confirm it as it will again become detached. Well thats reassuring, not. The other problem is if I dont start stretching the Achilles they will need to operate again to lengthen it. And then to cap all of that they sign me off work for another, wait for it, 6 weeks. I thought they were having a laugh.

I am now putting weight on it and trying to walk, really surprising how tender the foot is, I think this is going to be a mind over matter situation. I found it really difficult to put weight on to it and walk, but then I said to myself I can do this, and I did. All the muscle memory has gone, so I need to re-find it. Well it looks like I will have to put myself through the pain barrier and see what happens when I come out the other end.

With Christmas fast approaching I wish you all  a merry Christmas and happy new year free of Achilles problems

Nine weeks and out of plaster

Just over nine weeks gone since my achilles avulsion fracture, where does the time go. If you had asked 9 weeks ago, where I would be in my recovery I would have said full weight baring and on the verge of returning to work. How wrong could I have been.

On my last visit to the fractures clinic they tried to adjust the angle of the foot from fully equine position to somewhere half way between that and level, but with limited success due to tightness of the tendon. On this visit it was hoped to get the foot level and get back into the cast. Well, fat chance of that. It would not move it was like an iron rod in fact I thought the Register was going to break my foot. So they decided they could not put it back into a cast as the foot needed to be level and if they couldn’t get it level it could mean another operation to lengthen the achilles.

Plan B, Physio. Again I had to explain the injury as nobody had delt with it before. Have been given exercises to help make the achilles flexible and after a day there does seem to be a slight improvement but is slight but it is a positve. But still no wieght baring.

Still, it was good to loose the cast, and it was good to get some air to the wound. you can tell where I have been due to the trail of flakey skin which is quite revolting. the suters are still uncomfortable under the skin and are the only thing stopping me having a decent nights sleep

I now feel I am entering stage 2 of the injury. stage 1 was repairing the injury, stage 2 will be getting the foot strong again and stage 3 will be regaining strength and fitness. Stage 4?

7 weeks gone already

I cannot believe 7 weeks have passed so quickly I honestly thought I would be pulling my hair out. One day just drifts into another.

As far as the injury goes not a lot changed still no pain just discomfort from the wound and bolts pressing against the cast. As the muscles waste away and swelling reduces theres more room in the cast and I am able to push my toes fully forward and back, it feels like there is a little bit of movement in the heel and ankle, it does not hurt to move it which I take as a big positive.

Doing some regular exercise got up to 85 press-ups straight off, set a target of 100 by the time I return to work.

Really got to grips with the crutches even able to get up the stairs on them, would not recommend it though, you have to focus and make sure your head is forward so as to avoid losing your balance.

7 weeks is also my next visit to the fracures clinic. Now for some reason I was convinced I would have the sutrers removed. Turned up early, the reasoning is turn up early get seen earlier. On the information board a message telling patients we are one and a half hours behind, how can this be my appointment is 1020 the clinic opens at 0900 how can you be one and a half hours behind-you work it out! They remove the cast and I was plesently surprised to see a lot of the swelling had gone, little bit puffy on the inside ankle and heel and a bit more swollen on the outsite, bruising had gone and the would was clean .

I was sent back to the waiting area, eventually I was called into the consultants room only to be told I need an x-ray. then we have all the plavour again with the x-ray they just are not used to taking pictures of the back of the heel, after several attempts I tell them how it was done before. The x-ray bed was covered with my old flaky skin, it looked like a snakes skin after it slougths or changes its skin. When I return to the waiting area the place is nearly empty I ended up being one of the last to be seen.

The Doc told me the bolts would need to stay in, I was gutted I thought they would be out on this visit, he also said I will not return to work until the new year, thats another seven weeks, fourteen weeks in all.

I was to go back in plaster but with the foot at a different angle so the heel will be closer to the ground, so no longer in the equine position. Nurse had great difficulty adjusting the foot, the achilles was rock solid she had to use all her strength and body wieght. She reduced the angle by half so thats a start, hopefully it will be level after the next visit.

2 Weeks gone

Read more…

Back Home

It was good to get back home,  now I could plan my recovery. I wanted more information about my injury so I left a message on a waterski message board and was pointed in the direction of achilles blog, loads of info and I strongly recommend you check out assuptions blog.

I had some pain but no where near as much as I had expected, I could control it with paracetamol and after a few days didn’t need it. Once the swelling started to go down the cast got quite uncomfortable and it got hard to find a position to get comfortable particularly trying to sleep. I found the best position if on my back was to put my good foot on the cast and that took the pressure off the heel. If I lyed on my side I needed a pilow between my knees. Found great difficulty sleeping. At times the hell would bleed I could detect this as I could feel the dampness of the blood and it would fell sticky, not a lot I could do about that, just hope I don’t get an infection.

I have always been an active person into sports and fitness, in the winter I would be down the gym four days a week working different muscle group every visit, in the summer would waterski up to five times a week and gym a couple times per week. Now to be told to do nothing for perhaps several months was not going to be easy. After a couple of weeks I was taken back  by the muscle wastage particularly on the bad leg, it was really skinny and I mean skinny I have never had my leg look like that, one was normal and the other looked as it could snap. I got on the scales and I had lost nearly half a stone unbelievable, what was the calf muscle going to look like. I needed to start doing something to keep the muscles firing but there is not a lot you can do with your leg when its in plaster. I started a exercise regime I worked the abs with various crunches, press-ups on one leg for the upper body. For the leg.  leg raises on side and back, leg extensions, bringing knee up to chest and then extend and upside down cycling. Any other ideas for this?

It’s amazing the things we take for granted when you are able bodied, crutches really changes things. Y ou cannot just do things as you are used to, you have to plan. Here is a list of things you have to get to grips with.  

  • Getting up and down stairs
  • Going to the loo
  • Showering
  • Making a cuppa
  • Sleeping

Thats to name a few. In the early days getting up the stairs was easy, right hand on the banister left in holding the crutch and then just hop up the stairs one at a time. Once up the top I had to ensure I leaned forward so as I didn’t fall down. going down stairs is easy you just go on your bum. after a couple of days of this I started to get sore left hand knee, obviously so much pressure on the knee due to hopping up the stairs. I was going to have to avoid using the stairs as much. One of things I was warned about is possible injury to the oposite leg or foot due to the extra dependance for the good leg, The problem was however our loo is upstairs but luckily we have a garden that is not over looked, so that was utilised liquids only.

When you go the the loo as a fella you now have two options, first one sit down like a girl or the second one is to balance on one leg and one crutch, make sure you are properly balanced, it is not good at this point to fall side ways.

I was fortunate, before the wife goes to work she brings my breakfast in bed and puts lunch out on a table next to the sofa, lays out the TV channel changers etc. but occasionnaly you fancy a cuppa the great british institution. Well is easy transferring it to another room without spilling it is near damn impossible. so now I have a series of tables and chairs and I just transfere it by moving it from table to table. so you can get by with a bit of planning.

My appointment to have the staples removed was to be in two weeks and that would give me a chance to see the heel, get it xrayed and get a comfortable cast. I hope. . .

Treatment begins day 2

28th September.

Had the night at home, the foot is uncomfortable not a lot of pain on a scale of 1 to 10, I gave it 4. It was really swollen I had to try to sleep with it elavated, not easy but it is something I will need to get use to over the coming months.

Achilles avulsion fracture is where the achilles is torn from the heel bone, when you see the xray you see a small fragment of bone and it looks like it is just floating on its own. What you do not see on the xray is the achilles as it is not bone.

The Surgeon explained the operation. Two suture pins to be inserted through the bone fragment and into the heel, well that sounds striaght forward enough. The leg would be in plaster for up to 10 weeks in the equine position (which means the toes point downwards a bit like a ballerina), and the leg to remain elavated for that time and no weight baring for up to ten weeks.

I had a light breakfast at 0700 hours and was told no food or drink until after the operation I was  absolutly starving. I went down the operating theatre at around 1500 hours, the operation lasted around two hours. When I came round I was offered a cup of tea which I needed so badly and I was offered a sandwich, I was given several to choose from, “I’ll have all of them” and I ate them all. Day two was coming to an end, got no sleep that night. every two hours I had blood pressure, heart rate and temperature checked, then nurse would ask me to wiggle my toes.

One of the amazing things was I had no pain, I put it down to the drugs I was given for the operation.

Zero hour

Welcolme to my Blog, never done one of these before so this is all new. I will start off minutes before the injury ccured September 27th 2009 approx 1300hrs.

I was competting in a waterski competition at South Lake Ski School, England, prior to skiing I had warmed up by riding a spin bike for 5 minutes and done some stretching so I was fully prepared for the exertion’s on my body from a sport that will seek out weaknesses in fitness and strength. I would always recommend warm up before doing any sport.

I cannot remember alot about the accident, I felt the ski leave the water and a sharp pain going through my heel, the next thing I remember was thinking I was upside down in the water trying to get to the surface and taking in water, I was later told I was up the correct way.

I was recovered from the water, when I looked at my heel I could see a gap above my heel of about 3/4 inch it did not look right I just knew it was bad. St Johns checked it out and packed it with ice (always a good idea). by the time the Paramedic turned up it badly swollen. I knew something was broke as I could feel the bone swooshing around.

At the Hospital the Nurse was sure it was an ankle injury, he even told the xray operative it was the ankle. I knew it was the heel. The reaction once they saw the injury was OMG never seen that before. It was an ACHILLES AVULSION FRACTURE. So this is where my recovery begins. I intend to get to full fitness by May so I will be a model patient.

 Hope you like the picture. You can see that appeared as soon as the injury accured. This was 5 minutes after, no swelling yet but the paramedic commented on how the toes were curled over and she said this was caused through trauma.

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