First 2.5 weeks

This injury story is typical. Ruptured my right Achilles tendon on August 6th while playing basketball. While running down court, felt a kick on the back of my leg and found myself falling to the ground. If there was a popping sound, I didn’t hear it, but I knew immediately what had happened and crawled to the bench in shock. Got to urgent care within an hour to confirm my self-diagnosis, saw an orthopedic surgeon the next day and elected for operative treatment. Surgery was on August 11th and I went home with my leg in a gravity-equinus fiberglass cast.

My OS asked me to come in three days later (August 14th) for a followup appointment. He’s an older doctor, and his treatment is a mixture of what has worked for him, and what he’s read in literature. He’s keeping me in this cast for four weeks, but he also told me to get a cast shoe (which fits over the bottom of the cast) and gave me permission to go full weight-bearing. He gave me a goal of walking into the next consultation without crutches.

Now at 18 days post-surgery (and three weeks post-injury), the only significant frustration to achieving this goal is understanding my limitations. Even though the OS said I may bear full weight, it just doesn’t feel right as my leg sinks in the cast, presses into the cast shoe, and blood rushes toward my foot. There’s no pain, just discomfort from swelling (which does cause some loss of sensation). So I’m using crutches and left without any idea of where to go from here. Should I trust that the cast will protect me, set my crutches down, and really try to walk on my healing leg? Or should I gradually work up to it? Where are the real dangers of a re-rupture at this stage?

5 Responses to “First 2.5 weeks”

  1. Really didn’t help that there is no agreement on his to treat this. You’d think that for such a common injury the medical profession would have worked out the good, bad and ugly of treatment. Seemingly not.

    I can’t offer you any advice. For starters I elected no surgery, so or situations diverge from the start. I was told no weight for the 6 weeks I was in cast.

  2. The cast should protect your tendon but there may be some movement now as your leg has reduced in size since it was applied. Weight bearing in casts is a bit harder than in a boot but not impossible. I image you are a bit uneven and that will throw things out. You need to start by placing weight on the your leg while using the crutches for balance and also to take some weight off. Gradually increase the weight as tolerated by pain and swelling. You will also need to rest and elevate more often. The progression to FWB without crutches can take a week or two.

  3. Was it a full rupture? FWB at day 3, much less day 18, is by far the earliest I’ve heard of.

  4. @Stuart — Thanks for the guidance. What you suggested has more or less been my plan but it’s been frustrating not really knowing if I could/should be doing more.

    @oscillot — Yes, full rupture. My OS gave permission based on what he’s read in studies and how he’s handled other patients.

  5. Looking forward to following your recovery, Dave. My surgeon prescribed the opposite (slow) approach, so I’m curious to hear how yours goes. The worst part of going slow was the atrophy and not having use of my hands while crutching / scooting. I wouldn’t be surprised if your recovery goes faster without any negative effects.

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