danair’s AchillesBlog

This is the best article I have ever met! Keep up the good work.

I stopped wearing my boot at just under six weeks. It feels good to walk around and ride my bike in tennis shoes. What a incredibly liberating feeling getting the boot off for good. I rode around for a couple of hours today, so I guess I won’t worry about the tendon not being attached.

Brian, thanks for the kind words, and I’m glad my words have helped you.

I think EVERYBODY non-op worries about the tendon not fully attaching!! If we could get MRIs or UltraSounds whenever we wanted to, we’d probably go in weekly if not daily!!! I think even some POST-op patients would join us most of those times. But for the overwhelming majority, the ends grow together, and even do so at roughly their original length. The mechanism is still poorly understood, but that’s true of many medical “cures”. (I’m told that aspirin’s beneficial mechanism is still somewhat mysterious, though that may have changed recently.)

normofthenorth, Thanks for your help. I have been reading your blog since the beginning of my injury and found your information to be very influential. Funny you just wrote about sore soles and heals, that is what I have just been experiencing. I started walking barefoot but now am walking in my Crocs. Crocs are the best. As far as the Thompson test goes, yes I squeezed my own calf. I think my leg was not relaxed. when I squeeze my calf I can feel the tendon move down by my ankle, so I know that it is connected. This was my big early paranoia, That my tendon wasn’t completely attached, that part could be still up by my calf. I think because my doctor said that you can push down on your foot with other sets of muscles other than the calf got me worried in the beginning. Did anyone else non-op have worries about the tendon not fully attaching? On the positive side, I rode my trainer this morning in my crocks set very low resistance. It feels really good to get blood flow into my legs and stretch the tendon a little. Thanks for your help and encouragement.

Soles and heels are almost always hyper-sensitive early in the rehab. Squishy gel-type footbeds or shoes (like Crocs) help a lot, as does rest, elevation, ice, etc. And time!

Brian, there’s a difference between slow and “conservative”, since conservative meens doing what’s safe. The studies seem to show that safer results (e.g., lower re-rupture rates) come with faster protocols, not slower ones — especially without surgery. E.g., check out bit.ly/UWOProtocol for the schedule used in one of the most successful studies.

Did you squeeze your own calf for the Thompson test? For some reason, most of us can’t do that successfully. I don’t know why, maybe it’s related to our not being able to tickle ourselves. . . Get somebody else to squeeze your calf while you like down and relax, face down, with your legs hanging over the edge of whatever you’re on. (And NOT in the boot, either! )

I am also at 5 1/2 weeks. I am a non-op and the doctor is being a little conservative. She didn’t want me WB until about six weeks. I was walking in my cast at 3+ weeks and when I got the boot at 4 weeks I ditched the crutches. Now at 5+ weeks I walk around the house bare foot. I have also ridden my bike outside and in the trainer but only with the boot on. My foot doesn’t have a lot of strength yet but it feels good to feel the balance and move my ankle. I feel I can push down with a fare amount of force on the ball of my foot but when I try the Thompson test nothing seems to happen. I am not sure what is going on there. maybe my ankle is stiff. One more week until my PT apointment, and then another two weeks until I see my doctor again. I hope when I see my doctor I walk in with two shoes on.

hi everyone from Thessaloniki Greece!
I re-raptured my AT during 8wk of post-op while riding my bike and had an emergency stop. Now I am on 5wk post second op. Please be patient since the feeling of re rapture is very depressing…My recovery though is preety much the same as the first ATR.

Neville, I only up non-op because the rupture was so high up. They were already thinking of surgery dates before I had the ultrasound, but not regretting it one but just now. I was all set to tell you that I was getting no swelling until this morning (after a day walking round London yesterday) it is a little swollen around my ankle joint.

My physio had me on a turbo at 5 weeks, but under similar advise to that which Norm has left and with almost no resistance. I cycle in cycling shoes with cleats normally and so whilst you are on the ball of the foot, the foot is held in a good two down position and so the biggest issue was not actually the cycling but the clipping in and out of the pedals. Got round that though by leaving the left shoe in the pedal and then putting my foot in once I was on the bike (velcro fastening shoes help too).

Not actually been out on the road yet bar a very gentle poodle round the block with my son.

Usual precautionary advise though - no two ruptures are the same, so stick with the advice the professionals give you. I think I am the exception rather than the norm, because I seem to be recove

Riding an exercise bike IN a boot (once you’re FWB) is great exercise and “safe as houses”. Riding OUT of a boot puts stress on your AT and calf, which you can largely control by shifting your foot position on the pedal. Stand on the heel, and there’s ~0 stress. Step on the ball or toe, and there’s lots.

Road biking is a bit scarier, but still not too scary in the boot, IMHO. (Once you can “catch” your weight and the bike’s in an emergency stop, you’re probably not at much more risk than when you rode a year ago.)

Trail riding is scarier still, tho’ I’m no expert. One guy here posted some photos of him doing some crazy extreme MTB riding (at Whistler, IIRC) while he was still in a boot! A search might find his posts.

Hi Danair
Reading back over your posts and apart from the fact they are funny it’s also uncanny how many of the posts mirror my own experience. For instance, I was allowed to free myself from the AirCast boot to elevate the leg from time to time, but boy I’m not sure what could have been growing in there. Summer is not a good time to be wearing an AirCast (not that the UK has had a summer!).

I’m at just over 10 weeks and gone through the same protocol. My boot was eventually extracted 10 days ago (very brave physio with clearly no sense of smell) and now I’m at that uncertain 2 shoe stage. It’s interesting that you’ve already been on a turbo-cycle because I intend to buy one this week to start doing some ‘proper’ exercise, although clearly take it easy at the same time. I’ve missed a summer of mountain biking the UK trails and desperate just to get on a bike and turn some pedals. Equally I’m desperate to ensure I mitigate the chance of re-rupture. So I guess the question is, ‘is it too soon to get on the turbo-cycle and do some gentle peddling?’

Does you leg swell up after doing the cycling? My ankle swells when I

All good words Danair. I bought a turbo trainer and set up my old hard tail mountain bike. It has been excellent but still not as good as the real thing. It is a bit noisy but my rear tyre is chunky. I was interested in what your physio said about clips and I have had similar discussions with others about it. Yesterday was the first time I took my other bike out for a free ride. A bit nervous but fortunately everything went well. I didn’t clip in as I wanted to concentrate on stopping and getting my foot down. I thought putting my good foot down first would be the right thing to do but quickly found it was the other way round. Just like on crutches, bad down first and heel not toes. I am off to physio today with lots of questions. Regarding your boot and walking, I didn’t do it but heard someone else put an arch support from a running shoe inside and it seemed to help. The advice came from their physio and seemed quite logical. Can’t remember who it was but they may read this and offer a comment.

Buenas Noches! I would just like to offer my thanks for the super information contained in this post. I will be coming back to your site for more cool info in the near future.

Awesome Danair! After one week, my doc said I could put some weight on it and do my “ABC” exercises. I thought this was quick but I am all about moving. Anyway over the past few days, I have hobbled around minus the crutches (to my wife’s displeasure) but I have felt pretty good. I get the stitches out tomorrow, so I will ask if I can do this for real. Thanks Danair..

At times like these it can be hard to remember how bad we felt, how depressed we were and how we thought it would never go away. A post like this is always helpful to those in the earlier stages when everything seems so dark.

Buenos Dias I would just like to offer my thanks for the super information you have here on this post. I will be coming back to your site for more awesome info in the near future.

Best wishes to you both. There is light at the end of the tunnel and I’m Dancin’ in it!

How different you sound from your last post. Do you feel you have turned a corner? I saw my osteo last week for the same reason. I also found getting out of the house was like getting out of jail. So glad you can drive once you get the car swapped. I only started a few weeks ago and until then was driven everywhere by my partner. She hates driving in traffic. Now there’s a lesson in patience. Driving also gives you a sense of independence. I think we all initially want to make things happen as soon as possible and the frustration can be overwhelming. A good mental attitude (as many others have said) is a key element in the healing process. Good to hear you are mending well.

Hang in there Danair. I understand what it feels like to see everyone being active. You are not alone. I was also training for the Philly Half Marathon at the time of my injury. I have had a hard time with the sitting. I’m 8 days post op and will be going back to work on 7/5. My doc seems pretty aggressive as he already has me doing gentle exercises at home, which make me feel like i’m doing something.

I’ve really tried to see this as a mental game and my attitude is everything. I can be positive and grateful or I can be negative. I’ve have a choice how I handle this situation. I’m pulling for you buddy!

oops. That’s what i get when i just skim a post.

Keep us updated after your specialist visit. I’m curious to see how long it takes you to get to PWB non-op.

Cheers

Officially or unofficially?

Didn’t have surgery as the rupture is right at the top of the tendon, so I am on a ‘wait it out’ program. The gap between the ends was pretty small (about 2 mm) so I am hoping I will be PWB when I see the specialist next week. But I am having a little experiment now and again as well…

Do you know when you’ll be PWB yet? As soon as that starts happening, you’ll feel a lot better. Since, you’re 17 days post op, I imagine it will be happening in the near future. Hang in there bud.

sorry should add I use my arms for a bit of support (physio instructions) when doing the single leg heel raises. Still pretty scary mind you.

good recovery all.

“single leg heel raises at 10 weeks” is too scary for me!

Great post! so funny. I think the primary key to recovery, aside from patience is a good disposition and lots of humor. You’ve got all that. Cheers on those pesky runners and cyclists who taunt as they whiz by! I guess the most appropriate response is, “Soon, someday, soon!”

I too am a Bastketball victim, torn mine in the same place, 6 weeks in a cast and now 4 weeks in an air cast (3 or 4 more to go) But it all feels good, no surgery, just started single leg heel raises at 10 weeks and walking with no crutch in the cast.

There is light at the end!

Good luck with all your healing, hang in there and enjoy the lego.

m

http://meandmyachilles.wordpress.com/

Good luck with your recovery.

I can 100% confirm item no. 6

Love the attitude and the writing style, danair! I think you lucked out by skipping the surgery, personally, though you should try to follow one of the protocols that’s been demonstrated to produce excellent non-inferior-to-surgery results, like bit.ly/UWOProtocol . In that protocol, you’ll be starting PWB, exercise, and PT in a few days, and FWB (”as tolerated”) two weeks later.

I found sock-changing scary at first, because the NORMAL way to put a sock on involves a lot of heavy-duty toe-pointing (aka “calf pulling at the AT”). Eventually I got so I could do it without excessive worrying.

Many people (including health professionals) seem to conclude that ATs are NOT completely ruptured if the patient can dorsiflex normally while seated. Wrong! There’s at least one other set of muscle-and-tendon (maybe with “longus” in its name??) that can do that job just fine, as long as you’re not standing on the foot at the time. The Thompson (calf-squeeze) test is the Gold Standard — as is the lifestyle observation that stairs must be climbed with the entire foot placed on the next step, and the weight transferred to the heel of the inju

Funny what you said about the chairs. I did that too Every room has a chair for me. My family gets sick of the one in the kitchen, but for weeks I sat right there to eat. Can’t carry anything with crutches!! Now that I’m stronger and in a boot, I figured out how to hold something in my hand and swing the crutch under my arm on it’s own. I have a chair in the bathroom so I can rest my knee and dry my hair. You do what you gotta do

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