Achilles Tendon Rupture Recovery

Aiming for full recovery!

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General Comments

834 Comments

834 responses so far ↓

  • 1 Go 11 // Feb 24, 2008 at 8:52 am

    Hi Dennis,
    Please send me your email address and I’ll forward you a spreadsheet tracking my ATR progress.
    Go 11

  • 2 dennis // Feb 24, 2008 at 4:19 pm

    Thanks for the spreadsheet. I’ll setup a recovery tracking page on achillesblog.com based on your spreadsheet. It’ll be very useful for me, and hopefully for others too.

  • 3 Go 11 // Feb 26, 2008 at 11:26 am

    Congrats on your website efforts; the result is wonderful and likely to help lots of ATR team-members. By the way I forgot to let you know about a UK based forum that gave me a lot of support while I was recovering:
    http://www.marfell.me.uk/nuke/modules.php?name=Forums
    check it out!

  • 4 Herb // Feb 26, 2008 at 12:18 pm

    Well…I tried out the new shower bag with the velcro strap that I purchased from my ortho, and it works beautifully. For those still using tape to seal the top of the bag, I would highly recommend picking up (cost $20) the shower bag with the velco strap, it only takes seconds to put on.

  • 5 dennis // Feb 26, 2008 at 12:25 pm

    Go 11, thanks for your encouraging words. Thanks for the link as well. I added the Marfell forum to the “Informative Sites” on the main site: http://achillesblog.com
    Please let me know if you have any other suggestions to make this site more useful for recovering ATR’s.

  • 6 dennis // Feb 26, 2008 at 5:51 pm

    Herb, let me know if you have a brand/model number. I’ll see if I can find one being sold online, and I’ll put a link to it from the main site. I’ve been using just a kitchen garbage bag, not even bothering to tape it. The leg is sticking out of the tub so it doesn’t really get wet, but I wouldn’t mind having a more protective shower bag. thanks for the info.

  • 7 johnskier // Feb 26, 2008 at 11:07 pm

    The Sugeon’s office provided a bag - no velcro and it’s rubber so it just closes and seals around your leg. I’ll ask about the brand on Thursday. I just have a plastic chair from the garage in the shower.

    Dennis…think you went to the doctor today. How did it go? Are you in a cast, boot or??

    Today I went to work and one of the guys asked what I did and I told him and I got the usual “cringe” and of course a sorry that happened. I just said “it’s not that bad - you guys have forgotten how tough I am” and strutted away on my crutches. Okay, maybe not a strut…but I wasn’t hanging around for negativity. So there!!

  • 8 Herb // Feb 27, 2008 at 12:24 am

    Dennis, the brand name is called the Shower Seal, manufactured by Mar-Med Co., the phone number is 1-800-369-3434. I don’t know if this company only sells as a whole saler.

  • 9 dennis // Feb 27, 2008 at 12:38 am

    Herb, I couldn’t find it on the internet. I guess I should have asked for one while I was at the doctor’s office.

    But these look interesting too: Seal-Tight Cast Protector

  • 10 dennis // Feb 27, 2008 at 1:13 am

    Johnskier,

    yes, I went to see the doctor today. The incision area is healing nicely, and I am in another cast for 2 more weeks. Partial weight bearing. 20 - 30lbs of weight. Here’s my post: Day 18 - Removing the stitches, new cast

    Wish you all the best on your doctor’s visit on Thursday. Keep us all posted on how it’s healing and what recovery protocol your doctor recommends.

    I saw your list on the 1st visit post op and that’s a great idea.
    I had a little notepad with a list, along with a printout of a study on early weight bearing, with me when I went to the hospital today.

    It’s easy to forget all the questions you want to ask the doctor/PA when you are actually there. I felt like a reporter with a little notepad, taking notes, checking things off on the list.
    However, I’d like to think the doctor/PA will respect you more if you ask intelligent questions and really listen and comprehend what they say.

  • 11 johnskier // Feb 27, 2008 at 9:33 am

    Dennis,

    After I asked that I saw your new post. Nice Pics!! Hope mine looks that good. But I got to tell you Dennis…it ain’t that pretty!!

    My blog is http://achillesblog.com/johnskier/. (think that’s right)

    I’ll add to the list to get the brand of my shower bag.

    After my first visit (pre op) my wife was asking “what about this, what about that”?. Of course I didn’t have a list, didn’t know what questions to ask and was pretty much in a stupor. (That and I’m not very bright!)
    Sutures tomorrow. I’m going to ask if I can keep my “Game Ready” ice machine for another 10 days.

  • 12 dennis // Feb 27, 2008 at 10:56 am

    Yeah, it’s not the prettiest thing, and there are lots of dried blood. I was looking at Big Coop’s wound, and mine does look a bit messier. Hopefully it wasn’t some resident learning how to stitch on my leg. ;)

    Yes, I’ve been reading your blog, and it’s very nice. I’ve made a couple of comments on it. Keep us all posted!

  • 13 dennis // Feb 27, 2008 at 10:58 am

    Btw, nice banner image. It looks like heaven.

  • 14 Tom // Feb 27, 2008 at 10:58 am

    Dennis,
    Thanks for keeping this blog. I ruptured my AT on Jan. 3 and had surgery on Jan. 9. I’m finishing up my 7th week post op. I was in plaster/fiberglass splints and casts for 6 weeks and I’m now in the boot, FWB. I think you made a good decision to stay in a cast for a couple more weeks. I didn’t press my ortho, but I’m glad he didn’t put me into the boot until after week 6. I’m an active person and it was tough being on crutches for 6 weeks, but the cast really forces you to just let everything heal. If I’d gotten the boot earlier I think I would have tried to press things too quickly, as your PA mentioned. The only real negative I see with a more conservative rehab is the atrophy of the calf muscle. My calf looks pretty sad right now. But, since I’m an active person, I shouldn’t have a problem building up that muscle again.

  • 15 dennis // Feb 27, 2008 at 11:27 am

    Tom,

    Thanks for your comments. Glad to hear that you are off of the crutches.

    How did your ATR happen? Was it extremely painful or just felt like a mild sprain? From what I’ve been reading, it’s usually one of two extremes.

    I am in the process of creating a ATR recovery tracker on this site. Go 11 sent me his excel spreadsheet that he used to keep track of his ATR recovery.
    He’s done a great job, and I am looking forward to having something similar to it available for everyone to use here.

    If you like, you can sign-up here to create your own AchillesBlog and keep track of your progress.

    I am looking forward to having my hands free when I walk as well. Yes, I think the partial weight bearing is all I can do for now.

    I am curious about the early weight bearing, but without full support from a doctor, and not enough knowledge about the recovery protocol, I felt that it was best to just leave it alone. It’s unfortunate that I am no longer in school as most medical journals are restricted to academia or to people who’s willing to pay a good chunk of change.

  • 16 Herb // Feb 27, 2008 at 11:43 am

    Yeah, I’ve been reading some other people’s posts , and I can’t believe some people are already in a boot after being in a cast for just 2 weeks. A part of me would love to follow an agressive protocol, but not wanting to risk a re-rupture, I’d better play it safe.

    However, Tom has a valid point about being too conservative, the longer you wait the more your leg will atrophy. Sure you can always build that muscle back up, but why not preserve as much muscle as possible while it’s still there.

    Dennis, thanks for the great pics!

  • 17 johnskier // Feb 27, 2008 at 11:44 am

    I’m all for a bit conservatice and if there is more calf atrophy I’ll deal with it. There is the story of Kelly (on achillesblog.com) who reruptured at week 7 (I think with heel lifts only). That one’s worth the read.

  • 18 Tom // Feb 27, 2008 at 12:57 pm

    I ruptured my AT playing volleyball. I started to lunge forward and then heard the snap. I knew immediately what happened, but I don’t remember being in too much pain. I believe it hurt for a minute or two, but I think the frustration masked most of the pain. I knew it meant that I’d likely be away from competitive sports for up to a year.

    I’m curious as to the surgery everyone had. My surgeon did a less invasive technique in which he made 3 horizontal incisions, about 1″ in length, rather than the 4-6″ longitudinal incision. He uses this method because there is less risk of wound complication and less damage to soft tissue. Furthermore, the scarring isn’t as dramatic. Overall I’ve been pleased with the surgery, but I haven’t heard anyone else go through a similar procedure. This is the only article ( http://tinyurl.com/2ac9rk ) I found that sounded similar.

  • 19 dennis // Feb 27, 2008 at 2:46 pm

    That’s really cool. Yep, you’ll have less scarring, that’s for sure. I think there was a surgery video on youtube that they were doing something similar. When I find the video, I’ll post it on the main site: http://achillesblog.com

  • 20 johnskier // Feb 27, 2008 at 3:16 pm

    Dennis - you can post anything from my comments or blog.

    To me timing is a balance…How do you have the least amount of atrophy, get back as quickly as you can, AND not take on greater than normal risk of rerupture?

  • 21 dennis // Feb 27, 2008 at 3:49 pm

    johnskier,
    Yes, I think it depends on the person, nature of the injury, how well the surgery went, etc..

    I don’t think the medical community has quite figured it out yet, and I don’t imagine that they will for quite some time.. ;) Progress is slow, unfortunately. I wish there was a crystal ball answer, but I am afraid it is more like a shot in the dark, sort of.

    In an ideal world, there would be a matrix, where you enter all your personal physical attributes, status of your tendon and out comes your ideal recovery protocol.

  • 22 Philip // Feb 27, 2008 at 5:03 pm

    Well I guess I have just found my new friends. Seems that many of us are within a couple month of each other relative to our initial injuries and surgeries.

    Dennis, Thanks for setting this site up. You and I “popped” our Achilles only two days apart. I fully ruptured mine while playing basketball on Feb 6, just 3 days after my 39th birthday. Nice birthday present! I was playing the second game of the night in my regular Wednesday night league and experienced the Pop and immediate pain as if someone just hit me in the leg with a baseball bat. The pain was very sharp and I fell immediately to the ground. I knew that it was the AT. However, once I dragged myself off the court, I called my first cousin, who is an orthopedic surgeon, he had me feel the tendon and had me lie on my stomach and see if I could point and flex my foot. Amazingly I was able to feel the tendon and point the foot. I was thrilled. He said that I had torn the lower portion of the lateral gastroc muscle. This is the lower portion of the calf muscle that becomes the AT (http://www.arthroscopy.com/sp09009.htm). I was able to walk with a pronounced limp to the car but I was walking. The next three days was more of the same pain in the lower calf but I was walking with a pronounced limp. I finally got in to see my Dr. on Feb 11th (I have already had many knee surgeries). He performed the Thompson Test (http://www.youtube.com/watch?v=AmDi08rlR3I) and quickly determined that I had in fact fully ruptured the Achilles but in a very “rare” location, at the juncture of the Achilles tendon and the Gastroc muscle. My surgery was performed on the 13th.

    So here is where it gets a little screwy, but it is worth mentioning for others when they have the choice of general anesthesia or blocking the pain only in the lower portion of your body and taking mild sedatives. I chose General as I have never had problems in the past. The surgery went very well and my Doc was pleased with his ability to fully pull all the pieces together; however, post op I became hypoxic (meaning I was not getting enough oxygen into my body). They tried for many hours to just let it correct itself while I was in recovery but to no avail. At this point they brought in the EKG and a Cardiac Surgeon as they believed I was having a heart attack. After a while it was determined that that was not the case. So, still hypoxic they tried to check me out of the hospital. My wife asked, “so what happens if his breathing continues to deteriorate.” Their response, “call 911″. That did not go over to well with her. She insisted that they get an answer prior to my leaving. They checked me in and now decided that I had had a pulmonary embolism from a blood clot. Many hours later, 3 chest x-rays, one CT scan, one Pulmonologist, two Cardiologists, a very scared patient and family, no embolism was found and someone in the recovery room finally commented that I had thrown up while coming out of the General anesthesia. Pneumonia caused by asphyxiation. Ahh..haa. I went home the next day with a lot of antibiotics. Two week out, I have no lingering symptoms of the pneumonia. A big scare but a big lesson in always being your own doctor and that General Anesthesia can have its real complications.

    I had my full cast taken off two days ago and replaced with a cast below the knee. I am feeling very good with not too much pain. I am to be NWB till the 31st of March when he will put me in the Boot. I have planned a vacation the week of the 21st with the family (they deserve a break from taking care of me). I am likely to ask the Doc to put me in the boot before that trip even if I am still NWB so that I can take it off to get in the pool with kids. I look forward to discussing the various treatment therapies with you all over the next couple months.

    I wish us all a speedy and productive recovery.

    Philip

  • 23 Tom // Feb 27, 2008 at 5:33 pm

    Philip,
    Thanks for sharing. Sounds like a rather awful experience. Hopefully the pneumonia scare will be the worst part of your recovery and things go smoothly from here. Dennis has set up a great blog which pulls together a lot of information in one site. Looks like I’m about 1 month ahead of you on the road to recovery, so I’d be happy to try and help with any questions you can’t find answers to here.

  • 24 Herb // Feb 27, 2008 at 5:43 pm

    Philip, I blew out my right AT too playing basketball, sorry to hear you had problems coming out of surgery. Now that I’m stuck at home bored out of my mind, I visit this site quite often, so feel free to post any questions you might have. Dennis has done a fantastic job with this site.

  • 25 dennis // Feb 27, 2008 at 6:24 pm

    Philip,
    I’ve posted an excerpt of your experiences on the main site on http://achillesblog.com/avoid-these-hazards

    Thanks for sharing your story, and I am glad to hear that you are now doing great. It looks like your are on a more conservative recovery protocol than what I am on. I guess you are on 5 more weeks of NWB. I am still trying to determine what the best recovery protocol is for me, but I suppose the ideal recovery protocol is mostly dependent on the person, so I don’t know if I should delay getting into a CAM boot also. Keep us all posted on your progress. I am very interested!

    Give the blog a try at: sign up
    It’s been therapeutic for me, and you can share the valuable information you’ve found on your blog in a more organized fashion.

    In addition, I am in the process of creating a ATR recovery tracker on this site. Go 11 sent me his excel spreadsheet that he used to keep track of his ATR recovery.
    He’s done a great job, and I am looking forward to having something similar to it available for everyone to use here.

  • 26 Philip // Feb 28, 2008 at 10:11 pm

    So my doctor gave me bad news today. He will not take off my cast prior to my vacation. He will be going on vacation the week before and won’t let anyone else take off the cast and put me in the boot without him being there. I am really bummed out as I won’t be able to go swimming with my kids. Unless ………

    Does anyone know of some waterproof cast cover that I can take swimming. All the other cast covers seem to be only for bathing? Seems that there should be something like a drysuit with a tight neoprene collar around my thigh.

  • 27 dennis // Feb 28, 2008 at 11:03 pm

    Philip, sorry to hear that you won’t be going into a boot. However, he sounds like he’s really doing a good job, as I didn’t even get to see my doctor in my first follow-up visit. I was only able to see the PA, and there wasn’t much of an examination. More like a cursory glance, in retrospect. ;)

    I did see a couple of water-proof cast covers. Let me see if I can dig up the links..

  • 28 dennis // Feb 28, 2008 at 11:19 pm

    Philip, please checkout:
    Things you might need

  • 29 johnskier // Feb 29, 2008 at 1:16 pm

    Philip - my doc said I could go snorkeling on our spring break trip (5-6 weeks post surgery) if I went out of the boot and they put on a Gore Tex cast for the trip. ( I guess because Gore Tex breathes?). Still would be PWB and we talked about it being tricky getting in and out of the boat. He said I might have to get my butt up on the side of the boat and “plop over” sideways. I asked him jokingly if I would sink and he said no. (in salt water you’re more bouyant). Getting back in the boat could be tricky though. Maybe they could drag me behind the boat back to port (shark bait?) :)

  • 30 Pat // Mar 2, 2008 at 10:48 pm

    I recently ruptured the achilles tendon in my left ankle playing basketball on friday february 8th 2008…isnt that ironic ? I had surgery a week later though (on the 15th)

    Following the surgery, they put me in the usual cast.
    I’m currently 17 days post-op and patiently waiting for my first ortho visit since the surgery, so they can take the stitches out. Right now, i’m not really experiencing any pain. I’ve even gotten back to working out (upper body)

    I know there’s a long process ahead of me, balancing physical recovery with school,but I’m a young active guy (22 years old)…I’ll get through it

    Anyways, I’ll try to visit your blog regularly…the spreadsheet sounds like a great idea

    take care

  • 31 dennis // Mar 2, 2008 at 11:59 pm

    Pat,
    Glad that you were able to find this site. Same rupture date, unbelievable! I wonder if we ruptured our left achilles tendon at exactly the same time as well! ;)

    Check back again as I’ll be announcing a few goodies that I’ve been working on, soon.

    speedy healing!

  • 32 johnskier // Mar 3, 2008 at 11:07 am

    Man - all these hoopsters with ATR’s. I stopped playing in games (still shoot in the driveway) when I was about 40 after I ruptured an ACL. I actually didn’t have surgery on that one as the knee was and still is stable. Odd. Then I rupture the AT skiing!!

    I posted a few pics (including a 12-day picture) at:

    http://achillesblog.com/johnskier/

    I know this gets better so hang in there!!

  • 33 dennis // Mar 3, 2008 at 11:31 am

    johnskier,
    The surgeon did a good job with the sutures. I had those lines across my heel also. I first thought they were messing with me while I was knocked out, but I realized that there was a purpose for them after all. ;)

    How is the iWalkFree? Are you able to walk round easily on it?

    By the way, while you are at the Admin console on your blog, go to “Users” tab, and you should now see a sub-tab called “Your Achilles Profile”. If you enter info on this profile, the AchillesBlog widget that I am creating will do things like calculating what post-op week you are on, etc.

  • 34 TROY // Mar 5, 2008 at 6:21 pm

    Here you go my friend: Achilles Repair Rehap.pdf

    or you can try this: achilles tendon repair protocol.pdf

  • 35 TROY // Mar 5, 2008 at 6:22 pm

    How often do you guys clean your surgery wounds?
    once a day? twice a day? everyother day?

    did anyone have staples put in? i heard its not that bad getting them out….
    this site is great and helpful thank you

  • 36 dennis // Mar 5, 2008 at 8:09 pm

    Troy,

    Thanks for those links, I’ve posted them on AchillesBlog.com

    I have been in a cast for the past 3 weeks, and I have 1 more week to go until I get in a CAM boot. So I didn’t really get to clean my surgery wounds.. yeah, but I have been cleaning my toes with a wet towel.

    I think the key is to keep it dry so that it doesn’t get infected.
    I had sutures, as you can see from the pictures. ;)

    Glad that you found the site useful. Thanks again and please let me know if you find other informative resources, and I’ll post them here for others to view.

  • 37 Herb // Mar 5, 2008 at 11:40 pm

    Troy, most of us either have a splint or a cast on for the first 6 weeks after post op, therefore the only opportunity we might have in cleaning the incision would be during the ortho office visit. I had sutures and did not have staples to close the incision. However, I am curious to know if it makes a difference in what the scar will look like when the incision is fully healed.

    It sounds like your protocol your ortho has you on is fairly aggressive, and I hope you will keep us informed on your progress in the coming weeks.

  • 38 TROY // Mar 6, 2008 at 8:53 am

    anyone have an infection?
    or a warm/red knee on the same leg they had surgery?

  • 39 johnskier // Mar 6, 2008 at 9:31 am

    Nobody opened the bandage, looked at or touched it for 2 weeks. Then the PA removed the splint and bandage. Nobody touched it then either. The doc put a ’sterile superglue” on it directly from its container. He seemed to take great care not to touch anywhere near the incision with his hands. I asked to clean my leg before the cast was put on and the PA let me wipe it down with rubbing alcohol. No soap. Now a cast for a week and that comes off today. No staples here - just one long suture (you can see it at: achillesblog.com/johnskier/.

    They said to call right away if there was indication of infection (redness, red line) coming up my leg.

    A friend of mine had a hell of a time with infection. Apparently the tendon was irritated by staples and the incision realy never healed that well. 6 months or so later he was in Hawaii in the water and appareintly some bacteria got in there. It “blew up like a grapefruit”. When he got home they took the staples out and the incision healed.

    I think that if you have symptoms of infection get it checked out right away.

  • 40 dennis // Mar 6, 2008 at 10:03 am

    Johnskier: Best of luck with the cast removal today. Do you get a CAM walker now? How’s the iWalkFree working out? Recommend or don’t recommend? My appointment is next Tuesday, and I’ll be getting a CAM walker.

    Troy, it’s not very common to get infection, but it does happen. And of course, it needs to be treated right away.

    Simon Barratt had an infection and had a hell of a time. Here is the link:(warning: contains somewhat-graphic image of the wound) This Sucks

  • 41 TROY // Mar 6, 2008 at 11:08 am

    how often is everyone elevating the leg?

  • 42 dennis // Mar 6, 2008 at 11:14 am

    Troy,

    For the past 3 weeks, pretty much all the time when I am not walking around in crutches. I have a pillow on my desk, and I have my leg propped up on it when I am working.

  • 43 TROY // Mar 6, 2008 at 11:17 am

    SO YOU ARE ELEVATING ABOUT 6 HOURS A DAY?
    DONT YOU WORRY ABOUT BLOOD CLOTS WITH SO MUCH ELEVATION?

  • 44 dennis // Mar 6, 2008 at 11:45 am

    Troy,

    It’s elevated longer than that. I am mostly at my desk working, probably longer than 6 hrs a day. When I am sleeping, I use a pillow to prop up my leg, as best as I can.
    When I am eating, I have it elevated on another chair (not to the level of my heart though)
    When I am sitting on a couch, I have it elevated with a pillow.
    When I am in a car, I have it elevated on the dashboard, even when I am driving. (It’s my left leg).

  • 45 Tom // Mar 6, 2008 at 6:59 pm

    Troy - If the redness/warmth is staying around for longer than a day I would definitely contact your ortho right away. Infections need immediate treatment.

    I did not get staples. My surgery consisted of three small incisions rather than the single long incisions. So, they were able to stitch me back up with disposable sutures. Other than my exposed toes, my leg wasn’t cleaned until I went into the boot, 6 weeks post op.

    The amount you elevate your leg should be related to how much swelling you’re experiencing. My leg was pretty swollen for the first 6 weeks, so I kept my leg elevated as much as possible. This included while sitting at my desk in the office, while watching TV, and while sleeping. However, it generally wasn’t 6 hours straight with my leg in the air. I was getting up and moving around every hour or so, except while sleeping.

  • 46 johnskier // Mar 6, 2008 at 7:41 pm

    I iced and elevated as much as possible especially for the first two weeks. I have very little swelling after almost three weeks. I think it’s worth it. The PA said she doesn’t think I need to ice anymore. That could change if it starts to swell I suppose.

    Dennis - so I’m in an aircast and still NWB for 3 more weeks. So it will be a total of 6 weeks NWB. I can only touch down the foot “for balance”. I can take my foot out of the aircast to take a bath, otherwise they recommend it be on the cast, even at night (you don’t want to fall obviously and rerupture). My PA told me a “horror story” about someone who did not have it on at night, got up to go to the bathroom and fell. Rerupture. No thanks.

    I can move my foot gently but they just want it to heal right now. When I start PT they will get more aggressive to restore range of motion.

    iwalkfree-yes I think it’s a good thing especially with 6 weeks NWB. It takes pressure off of the arms and my wife likes it so I can stand up and do dishes!! I prefer with one crutch rather than none….feels more stable.

    My doc has me on 325 mg aspirin/day to reduce blood clotting risk.

  • 47 dennis // Mar 6, 2008 at 8:42 pm

    johnskier - yeah, I know what you mean about the dishes. Now that I am PWB, I am slowly doing more house chores around the house. I don’t like it one bit, but I have been off the hook for a few weeks. ;)

    How does the aircast feel? I’ll be getting into one or something similar next tuesday. I’ve heard that they are heavier, but still usually preferred over the cast.

    I’ve tested putting a little more weight on my cast, and I’ve sort of limped around the kitchen without the crutches. It feels okay, but I am not pushing it any further than that.

  • 48 Herb // Mar 7, 2008 at 7:14 pm

    Funny…I’ve been washing all the dishes too and I try to help out anywhere I can around the house. I feel really bad for my wife when she has to do everything I used to do for her, and it doesn’t help when she comes home from work while I sit on my ass all day.

  • 49 dennis // Mar 7, 2008 at 8:17 pm

    Herb -
    Yes, I agree. I still can’t do things like clearing snow from the driveway, but I can do most other things, with some difficulty.
    It’ll get easier with FWB

  • 50 johnskier // Mar 7, 2008 at 10:01 pm

    Aircast is heavier and it also rubs on the incision. Neet to figure that out. But I do take it off occasionally and prop up my leg which feels damn good. When I do that I’m really careful. On balance I prefer the aircast.

  • 51 dennis // Mar 8, 2008 at 10:05 am

    Brendan ruptured his achilles on Feb 26th. I think he’s the most recent one of the group.
    Here is the link for his blog:
    Brendan’s blog
    He’s contemplating on going back to work after 1 week, which I think is too early.

  • 52 TROY // Mar 8, 2008 at 10:05 am

    i am 10 days post op……….things seem to be good so far!

    i have a few questions……does anyone get twitches in the leg that was operated on? i got a few while i was sleeping and they woke me up……..does anyone agree that if i reruptured i would be in some serious pain?

  • 53 brendan // Mar 8, 2008 at 10:16 am

    Troy - I got the twitches for the first time last night (5 days post op), I was able to relate it to getting a little cold in the basemen (shivers), but it woke me up for sure. I would think that the stiches holding my tendon together are able withstand those little shakes.

    Dennis - I think I will heed your advice and just work from home next week. My back is starting to hurt from laying around so much, I think the hydrocodoine was masking that….any helpful exercises? Anyone doing crunches or upper body work this eary?

  • 54 dennis // Mar 8, 2008 at 10:57 am

    oops, I fixed the link to brendan’s blog on my previous comment. It’s working now.

  • 55 dennis // Mar 8, 2008 at 11:08 am

    Troy -
    Well, I used to have twitches (more like involuntary movements while you sleep I suppose). It used to hurt like hell and woke me up, but it’s not a problem any more. Either I don’t do it because I’ve finally learned to not move my repaired tendon, or it has healed enough to not hurt anymore.

    Brendan - I did have a back problem for a while. I got around the problem by moving around while lying down, and doing stretches. Here’s a link to my post about it. Back Problem

  • 56 TROY // Mar 8, 2008 at 11:37 am

    dennis do you think the surgeons know you are going to have involuntary movements and base there materials and procedures off that?
    so you agree with me that if i reruptured i would know it

  • 57 johnskier // Mar 8, 2008 at 12:02 pm

    Troy - My guess is that you would know it if you reruptured. Are you concerned because you fell or put excessive pressure on it? On the second day I happened to catch myself with my bad foot (which was in a splint) and felt a short, sharp pain and it’s fine. I think it would take quite a bit of pressure on the repaired achilles to take out those sutures AND you would really feel that.

    One night I had a cramp in my calf that hurt like crazy.

    Seems to me involuntary movements would be normal from damage to nerves etc.

    I did go to work 10 days post surgery and it may have been too much. I was exhausted and caught a nasty cold.

    I’ve been on an exercise bike with my bad leg on a stool, plus some leg lifts to keep my quad firing. The doc said I could do upper body weights as long as I was NWB.

  • 58 TROY // Mar 8, 2008 at 12:07 pm

    john i did not fall or anything like that…….just some nasty involuntary movements.

    its been 10 days today since my surgery.
    i start rehab this wednesday, and my staples come out thursday.
    my ortho believes in early rehab to promote quicker healing.

  • 59 dennis // Mar 8, 2008 at 12:31 pm

    Troy,

    I think you would know if there was a re-rupture. My guess is that you are fine if you are in your cast (or cam boot) since it limits your movements, and your tendon isn’t under a lot of tension. If you are really worried though, you should see your doctor immediately. There is something to be said for having a peace of mind.. and it’s your body, your most precious asset.

  • 60 dennis // Mar 8, 2008 at 12:37 pm

    johnskier -
    I had the same problem with cramps, and Philip pointed this out to me: For the cramps
    I’ve been snacking on dried apricots, and I haven’t had any problems since. (Drinking lots of water too.)

  • 61 Herb // Mar 8, 2008 at 5:00 pm

    Troy, the sutures used to repair your AT is very strong, if you had reruptured your achilles tendon you would definitely know it.

    I understand you are going to start rehab after just 2 weeks after surgery? So, does that mean you will be in a walking boot come Wednesday? What I really want to know is how strong is the tendon at this point that would allow for PT this soon. Perhaps I can talk to my ortho on Monday when I am fitted with a cast (I have 4 more weeks of casting). I think its great you are able to be put on such an aggressive protocol, keep us posted.

  • 62 johnskier // Mar 8, 2008 at 7:44 pm

    Yes, let us know…my guess is that it’s range of motion, very light resistance. Be careful.

    They basically only want me to do very light “touches” for “balance” and no PT for 6 weeks.

  • 63 TROY // Mar 8, 2008 at 9:53 pm

    Hi Herb,
    As far as the sutures my ortho told me he used fiber wires.. … so i guess that they are strong have you heard of them?
    Yes I am starting rehab after 2 weeks of surgery, its more range of motion, electric stim, ultra sound, toe movement but no weight bearing till about week 4-6.
    also they took my splint cast off after week 1 and put me into a cam boot with 4 wedges.

  • 64 johnskier // Mar 9, 2008 at 11:24 am

    Troy -

    Mine are Fiberwire too. My surgeon told me that they are made of Kevlar so I’d say pretty strong! I need to ask about electric stim and ultra sound. My surgeon has not mentioned it, and maybe it’s part of PT???

  • 65 TROY // Mar 9, 2008 at 12:20 pm

    electric stim and ultra sound help in the healing muscles process.
    i have read alot of things online and from what i understand the soone you start pt the better the results.

  • 66 TROY // Mar 9, 2008 at 12:36 pm

    so if those fiber wires came apart we would know it right? or wouldnt we?

    i wonder if they could loosen up

  • 67 ross // Mar 9, 2008 at 12:51 pm

    Have been doing alot of checking regarding PT protocols, nutrtion, etc…The tendon has very little blood supply and most of the nutrition for it comes from circulation to the gastroc and soleus mm. Also by moving toes, ankle, etc there is an effect of pushing fluid, O2 into the tendon. Also some interesting research on making sure you move the opposite ankle and calf for reciprocal innervation benefits. As for PT…stim, massage, ultrasound, and cold laser therapy.
    Hope this helps..
    I am scouring my journals, websites for more info.
    If you have any specific questions let me know

    Doc Ross

  • 68 TROY // Mar 9, 2008 at 1:02 pm

    hello ross thats some good info,
    have you found articles too that show the sooner you start pt the better the results

  • 69 johnskier // Mar 9, 2008 at 1:10 pm

    Troy -

    I can’t imagine you NOT knowing but if you think something’s wrong it doesn’t hurt to have it checked out.

    Doc Ross - I understand that the reason the ruptures typically are 4 - 6 cm from the heel is because there is less blood supply there (the weakest link so to speak). So that means that it’s “good” to move your toes to get fluid/02 to that area?

  • 70 Tom // Mar 10, 2008 at 9:35 am

    Troy - I agree with everyone else that you’d probably have a pretty good idea if you reruptured the tendon. I think it would take a lot more than a twitch for a rerupture as the suture material is very strong.

    I spent a good portion of the weekend shuffling around the house without the boot. I’m now at 8.5 weeks post op. and have been in the boot for 2.5 weeks. The AT is still very stiff and I don’t have much strength, but I can definitely see some improvements.

    I was also able to ride on my bike trainer this weekend without the boot. I’ve been riding about 4 times a week for the last 4 weeks, but this was the first time without the boot. It was a bit of a strain to get going, but the tendon loosened up a bit as I went along. It was pretty liberating.

  • 71 TROY // Mar 10, 2008 at 10:13 am

    what is the normal time frame for the tendon to be healed?? 4-6 weeks after surgery?

    hey tom thanks for the info…… you doing any weight bearing yet? walking in the boot?

  • 72 Tom // Mar 10, 2008 at 11:13 am

    Troy - I’ve been FWB and walking freely since I got the boot at 6 weeks post op. I was PWB at 4 weeks while in my last cast. I was able to get around with one crutch just prior to getting the boot, but it was a bit uncomfortable because the cast would jab into my toes.

    I’m not too sure about the normal time frame for healing, but I think it takes up to a year for “full” healing. By “full” recovery I mean that the collegan fibers that make up the tendon have had a chance to completely realign. I believe you achieve a significant amount of healing in the first 8 weeks (maybe around 80%), but then it plateaus until you are able to rebuild strength in your leg. This was the impression I got from reading some info and speaking with my ortho, but I may be wrong. I’m curious what everyone else has learned about the healing process.

  • 73 TROY // Mar 10, 2008 at 11:23 am

    does your boot have the wedges in it?

  • 74 Tom // Mar 10, 2008 at 2:48 pm

    I was given a very low profile wedge with my boot, however, I only used it for about a week. My ortho allowed me the latitude to remove the wedge if I felt comfortable without it. Keep in mind that I went through 6 weeks of splints and casts during which time the angle of my foot was changed every two weeks with my foot in a neutral position the last two weeks. Changing casts and foot angle basically simulates removing the wedges from the walking boot for those who get the boot earlier in the recovery process. Therefore, I didn’t have a big need for the larger wedges when I went into the boot.

  • 75 TROY // Mar 10, 2008 at 2:49 pm

    I found a couple more sites and I hope they help everyone:
    http://www.wheelessonline.com/ortho/achilles_tendon_rupture

    http://www.physioroom.com/research/reviews/200311_review_achilles_tendon.php

    http://proceedings.jbjs.org.uk/cgi/content/abstract/85-B/SUPP_III/244-c

  • 76 TROY // Mar 10, 2008 at 2:55 pm

    one week after surgery they took my splint cast off and put me in a cam walker with three wedges.

    i was looking online today and came across that bledsoe boot and i really like it.

  • 77 dennis // Mar 10, 2008 at 7:52 pm

    Troy -
    Thanks for those links. I’ll put them on the main site. Yes, I saw the Bledsoe boot, and I am hoping that my ortho is using them as well. I’ll find out tomorrow when I get into a boot. I’ll keep you posted.

  • 78 ross // Mar 11, 2008 at 7:51 am

    Troy.
    Sorry to have not addressed your comment. I am still navigating this site and did not see it. As for early rehab and weight bearing protocols it appears that there is no statistically evidence that early PT increases muscle strength and flexibility in the long term however becoming mobile, getting back to work and moving forward to me are defintiley short term goals that are attractive.
    The type of surgery is more indicative of long term succes and decreased chance of re-rupture. Lengthening the musle, grafting, etc shows benefits than a standard open and attach type. Unfortunately finding this site is usually post op, as in my case, so reaching those future ATRs prior to surgery although difficult would make a difference.
    Appreciate your responses and comments

    Ross

  • 79 ross // Mar 11, 2008 at 8:02 am

    Tom,

    You are correct on the healing process. It takes a full 9-12 months for complete healing. During the first 8 weeks your body is responding to the injury by laying down collagen (scar tissue) at the site. Based on research and my 20 years of doctoring that It is very important to get moving and get range of motion exercises started asap. This helps to lay down the matrix of collagen in a parallel configuration that will be stronger and more flexible in the long run. If you just sit around and avoid rehab because of pain than the fibers will be in a more haphazard alginment and be more prone to re-rupture, swelling and long term ache due to micro tears during your lifetime.

    so based on the surgical procedure listen to the MD about getting on your feet asap, doing the exercises and working the muscles.
    Nutrition is also a factor as you want to give your body the fuel and energy needed to heal. So no crap, get a protein shake, good multi and some loving nutrition.
    Let me know if you need anything

    Ross

  • 80 Tom // Mar 11, 2008 at 9:21 am

    Ross - Thanks for sharing your medical experience. I think it is very helpful on a blog like this.

    I’m curious about your thoughts of my rehab - My ortho has not pressed PT, but he does have me exercising at home. I’ve been doing some simple ROM exercises since I’ve been in the boot at week 6 (I’m now finishing up 8 weeks post op) such as ankle circles, flexion-extension, and long duration stretches. I’ve been riding on my bike trainer for the last 4.5 weeks (4 weeks in casts and the boot and the last couple of days without the boot). I’ve been FWB since week 6. Should I be concerned that my ortho hasn’t set me up with a PT yet, or is the work that I’m doing at home similar to what I’d be doing in PT at this point? I will probably be meeting with a PT after my 10 week post op appointment. I realize you’re going through this for the first time as well, but I thought maybe your medical background would be helpful. Your last comment made me a little concerned that I should be doing more now to ensure the collagen fibers align properly.

    Thanks in advance.

  • 81 TROY // Mar 11, 2008 at 10:30 am

    hey everyone how are you all doing? well i hope!

    just wondering if anyone here has started pt yet and if so what did you do your 1st time?

    does anyone elses hands hurt from the crutches….
    my wrist and palms are killing me

  • 82 dennis // Mar 11, 2008 at 2:03 pm

    Dr. Ross - If possible, could you point us to (or put on your page) the papers or case studies that discusses these findings? I know it’s too late for most of us now, but I am curious about better ways in treating ATR. thanks

    The type of surgery is more indicative of long term succes and decreased chance of re-rupture. Lengthening the musle, grafting, etc shows benefits than a standard open and attach type.

  • 83 ross // Mar 11, 2008 at 6:03 pm

    Here are some that I have found. Trying to sut and paste for you to click but like I said not to coputer savvy..

    Post op protocols http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=12006003422

    Here are some on surgery
    Am Journal of Sports Med 2007 35; 245-251
    using platelet rich fibrin matrices during surgery

    http://www.jbjs.org/abstracts/maoa05/maoa_abs103-110.pdf
    this one talks about turn down procedure with the gastroc muscle

    I will post some more but if anyone has a specific question let me know.

    Doc Ross

  • 84 ross // Mar 11, 2008 at 6:05 pm

    ok so no spell check… sorry..
    “cut and paste”
    “computer savvy”
    must be the meds..
    LOL

    Doc Ross

  • 85 johnskier // Mar 11, 2008 at 7:53 pm

    Troy - My wrists don’t hurt as much as my palms. they are sore from supporting my body. I sort of trade off between the iwalk and crutches…

    I think keep your wrists straight as possible …

  • 86 TROY // Mar 12, 2008 at 12:39 pm

    hello everyone!
    just wanted to give everyone some heads up on my 1st day of rehab.
    i am 2 weeks post op.
    they did some light stretching, ankle movement, foot movement and toes excercises.
    Then they put my foot into this boot with these chambers and they hooked it up to this machine and when they turned it on it filled up with ice cold water and then i felt some air moving in there and it i could feel some compression. They had me on that machine for about 15min.

  • 87 ross // Mar 13, 2008 at 5:35 pm

    Hey..
    Trying to look ahead…Has anyone thought about post rehab ankle braces that we will be using to play golf, tennis, basketball, etc..
    Have checked several ortho supply companies but was wondering if there is anyone still on this site that far along???
    Doc Ross

  • 88 dennis // Mar 13, 2008 at 7:29 pm

    ross,
    Actually that’s a good idea. I should start looking into that. I know that my doctor was recommending heel inserts, so I might buy some of those.
    I did a quick search, and there are some options. They also have a night splint. Maybe I’ll wear that around the house instead.

    check here

  • 89 TROY // Mar 13, 2008 at 8:25 pm

    stan i think thats an interesting surgical procedure that your surgeon did by not using fiber wires because fromwhat i have understood is that its a common suture to be used for the repair.

    the absorable ones he used take about a year to dissolve if i am correct……

    has anyone elses surgeon used fiberwires?

  • 90 johnskier // Mar 13, 2008 at 9:13 pm

    Troy - My doc used Fiberwire, which apparently is made of Kevlar. I haven’t asked about the sutures that dissolve. Also, I had a machine like your PT machine (called a Game Ready) for the first 10 days and it was a lifesaver in terms of keeping swelling down. Recommend it whole-heartedly.

    Ross - it’s a good question re braces. After I elected not to reconstruct my ACL ( and still don’t have one) the doctor actually recommended against a brace as I would become reliant on it. He liked me building up my quads, etc. better. Perhaps ask the PT people what they think and what the research indicates??

  • 91 Tom // Mar 14, 2008 at 8:58 am

    Doc Ross - I have been giving some thought about a brace as I take the next step in the recovery process. It is a question I plan to ask my ortho at my 10 week post op appointment next week. However, after thinking more about is, I believe the brace would only help mentally, not physically. I know they make a few braces that are suppose to help with Achilles tendonitis, but I don’t think it would necessarily prevent a rerupture. Like John said, the brace may actually give a false sense of security.

    I have just about completely transferred out of the boot and back into a regular shoe. My ortho wanted me to do this prior to my 10 week appointment. I’ve been wearing a shoe while inside for about the last week, but today I took my first steps outside without the boot. Hooray!! I use a 1/4″ lift in my shoe which helps relieve a little stress on the tendon. A string of 40 degree days has also helped melt away some of the snow and ice, making me feel much more comfortable walking outside.

  • 92 TROY // Mar 14, 2008 at 12:44 pm

    hello dennis how are you?
    i have a few questions for you…..
    you are 6 weeks post op correct?
    you are in a walking boot?
    are you doing any weight bearing yet?

  • 93 dennis // Mar 14, 2008 at 1:26 pm

    Hi Troy,
    To see how far along I am in the recovery, please check my ACHILLES TIMELINE on the upper right side of my page.

    I am in a walking boot, FWB right now.

  • 94 TROY // Mar 15, 2008 at 1:41 pm

    i wonder what the chances of the fiber wires loosening or the repair itself loosening.

    probably pretty low

  • 95 TROY // Mar 15, 2008 at 4:59 pm

    hey dennis how is the boot? you walking ok in it?
    i was curious on what your surgeons technique was on your repair?

  • 96 TROY // Mar 15, 2008 at 5:02 pm

    i had my second therapy appointment yesterday
    its very weird to be doing therapy so early after surgery.
    when the therapist was lightly stretching my tendon and i mean lightly, it was real tight but i told him i was worried about him pulling the repair apart but he said that it would take alot of force to do that.

    the more i read online, it doesnt really matter what technique is used it seems like the earlier you start rehab the better things are down the road.

  • 97 dennis // Mar 16, 2008 at 7:25 pm

    Troy,

    I’ve posted my Operative Report: My Operative Report

  • 98 TROY // Mar 17, 2008 at 1:00 pm

    Thanks for the report Dennis.

    Does your boot have any wedges in it or no?

  • 99 dennis // Mar 17, 2008 at 1:43 pm

    Troy:
    I just have a heel lift, but I don’t think I even need that. The doctor suggested using it only if it made walking more comfortable. I might take it out since it’s actually a bit uncomfortable with it.

    Nancy:
    I don’t think it’s EWB, but it’s fairly aggressive as you can see from my rebab protocol.

  • 100 TROY // Mar 18, 2008 at 3:04 pm

    Hey Brendan and Johnskier,
    I understand where you guys are coming from with your good leg hurting.
    I think its probably natural for it to be sore based on the fact its doing all the work right now.
    I asked my therapist about what I could do because mine has been hurting like crazy, he said to do heat wraps a few times a day 15min each time, then ice,
    massage the calf,tendon,ankle and foot. He told me to get a good boot with a big heal on it and when I walk on crutches to let the heal strike down 1st.
    Dont walk flat footed he said either.

    I hope this helps you guys. Also I had my 3rd therapy session and let me tell you it hurts like hell when they stretch that tendon. I couldnt possibly imagine how it would feel if I had to wait 10 weeks before I started therapy.

    Does anyone worry about blood clots in there surgical leg?? I wonder if after a few weeks if we have to worry about it anymore………..anyone know??

  • 101 brendan // Mar 18, 2008 at 9:16 pm

    Troy -

    I tried ice and massage last night with my good ankle and that seemed to help a bit today. I have to invest in a heating pad too…Doc Ross mentioned heat, movement, ice, and massage for ROM stuff as well…so that will be a must have.

    My discomfort in my good ankle seems to be a combo of across the top of my foot just in front of the ankle…a sort of crampy like feel…almost like when you are just getting back from a sprained ankle. There is also some heat generation going on in that area….I kind of wonder if there are some nerves crossing paths and some of the feelings that are happening in my recovering ankle/AT are being felt in my good ankle?

    The flat feet thing is a good point, I do notice that mine is better when I’m wearing shoes as opposed to barefoot (I have flat feet).

    I’m not worried about blood clots…just don’t have the time to worry about that one!

  • 102 johnskier // Mar 18, 2008 at 9:43 pm

    Troy…Thanks for the suggestions. It’s better today and perhaps I’m a tad paranoid? :)

    I was told of 325 mg of aspirin iniitally to reduce risk of clotting but haven;t done that since maybe a week after surgery.

    Oh man….I’m trying to work gently on ROM now…you’re scaring me!!. I start PT at about 6 weeks.

  • 103 TROY // Mar 19, 2008 at 9:27 pm

    Hey Dennis hows the boot?
    I am 22 days post op and they started me on partial weight bearing……………but how……….I am not knowing how much weight…..how did you deal with it when you went to pwb.

    thanks for the advice…

  • 104 dennis // Mar 19, 2008 at 10:27 pm

    Troy,

    The boot has been fine. I am able to walk on it when I have to walk to get groceries, etc.

    You should ask your doctor what he means exactly by PWB, but my doctor said to start off with 20 - 30 lbs weight. That pretty much means no walking, so basically being able to stand on it. To get a feel for what 20 - 30 lbs is like, I basically got a bathroom scale out and stood on it with the cast leg until it hit the 20 lbs mark.

    Glad that you are getting closer to the point of being able to walk.

    So what has your physical therapy sessions been like? I think it was a good idea to start early.

  • 105 TROY // Mar 20, 2008 at 9:20 am

    Dennis thanks for the info.
    I talked to the doctor, he would like me to put about 25% of my body weight on the surgical leg while walking and of course whenever I am standing he would like weight on that as well. I have been doing that and so far so good!!!!

    Physical therapy has been pretty good so far.
    My therapist is really great. He is gentle, conservative to a point and he talks to me about everything that is going on with the protocol.
    I go to therapy for an 1.5hr , 2 days a week.
    When I get there they start me out on heat wraps for 15min, then i get a ankle, foot,heel and toe massage, then i get a light stretch of the achilles. Then he works on the ankle movement and stretching it.
    After that I put both feet on this rocker board and I rock the feet/ankles back & forth for 5min. Then put the repaired foot/ankle into a game ready machine for 15min and then I go home.

  • 106 TROY // Mar 20, 2008 at 2:56 pm

    Does anyone know when we dont have to worry about infections anymore?
    I am 3 1/2 weeks post op………..

  • 107 Jim // Mar 20, 2008 at 4:26 pm

    Troy–I’d say at 3.5 weeks your chances of infection are very very low. By now the body has built a nice barrier to the outside. You are usually allowed to get a laceration wet once the sutures are removed (I’m an ER nurse by night). You will probably feel the scar tissue for some time though.

    Jim

  • 108 Jim // Mar 20, 2008 at 4:30 pm

    Question–I have started to bear weight on the bad leg. My new worry is that my ankle joint is probably the most painful part. It feel loose or sprained. I feel like I want to “pop” it but I’m in a cast so that is not possible. It’s like when I feel the need to crack my knuckles. Any thoughts? I have not had any ankle joint pain up to this point.

    Dennis–Is this the best place to post questions and comments, or should I be doing it somewhere else.

  • 109 dennis // Mar 20, 2008 at 4:55 pm

    Jim - you can post questions anywhere as a comment, and it’ll appear either on the main page, or mine on the right sidebar. I have setup a forum, but it is not used at all. It looks like there will be a newer version of the forum released soon anyways, so I’ll wait until I can upgrade it to make any customizations.

    Software for this site will be upgraded too after wordpress 2.5 is released and they update the wordpress mu as well.

    As for the ankle, my guess is it’s probably because it’s swollen. (I am not a doctor by the way, so you should ask your physician if it becomes painful or too uncomfortable..) Maybe there are others here who have experienced the same sensation..

  • 110 TROY // Mar 21, 2008 at 10:32 am

    Hello Jim thanks for the info,
    I have read articles online about deep infections but I didnt know when that would occur.

    One would assume that it would be in the first couple of weeks.

    Is it normal to feel soreness/pain and what not after 3.5 weeks of surgery.

  • 111 Troy // Apr 3, 2008 at 7:57 pm

    Hello! Hope everyone is doing well.
    Been reading up on everyones comments.
    Here is a great tip:
    My surgeon recommened Amerigel and let me tell you that is some great stuff. You can get it at your local pharmacy or visit here–http://www.amerigel.com/wounddressing.asp
    I promise you wont be dissappointed.
    I am 5.5 weeks post op and my calf has been sore and have had some pain in the ankle/tendon area and was wondering if that was normal or if anyone has experienced this. I am rehabbing 2 days a week and 80% weight bearing.

  • 112 Tom // Apr 4, 2008 at 11:18 am

    Troy - I think some minor pain/discomfort is to be expected. You are starting to stimulate muscle and nerve endings that have been resting for awhile as well as restretching the tendon. It’s probably a good idea to mention the pain to your therapist. They may change up your rehab slightly. Also, see if ice and elevation reduce the pain. If the pain persists and becomes unbearable, then you’ll want to speak with your surgeon.

  • 113 Troy // Apr 5, 2008 at 9:33 am

    I AM SUPRISED THAT PEOPLE AREN’T WEIGHT BEARING EARLIER. FROM WHAT I HAVE HEARD READ I UNDERSTAND THE EARLIER THE WIEGHT BEARING THE BETTER THE HEALING PROCESS.
    YOU CANT HURT THE AT BECAUSE ITS VERY PROTECTED IN THE BOOT.
    I THINK GOING 5 WEEKS OR MORE WITHOUT BEARING IS NOT GOOD.

  • 114 brendan // Apr 5, 2008 at 10:30 am

    Troy - while I think you may be right that there is a lot of research that indicates that bearing weight earlier may have positive indications, the reality of the treatment protocol that is still widely accepted in the states is 4-6 weeks immobile with 6-8 weeks until weightbearing. Our 30 or so ATR’s on this site are averaging 4 weeks immobile, 4 weeks PWB, and 5 weeks FWB. That said, our sample size is probably not statistically relevant. I do however disagree with your comment that going 5 weeks or more without bearing weight is not good. I haven’t seen any studies that talk about the long term consequences of waiting to bear weight…I just think all of the earlier mobility and WB studies are being done in an effort to speed up the recovery process and get people back to their normal daily activities, but I haven’t seen any long term benefits associated with EWB and/or Early Mobility.

  • 115 dennis // Apr 5, 2008 at 11:38 am

    I’d like to fill in the missing info on the achillesblog-injury-rehab-tracker spreadsheet.
    Brendan, thanks for taking care of this. btw, I am 33 yrs old. I don’t mind being 32 though. ;)

    (Of course it’s all voluntary.) please respond if you want your complete information on the spreadsheet. :D

    Chad - which foot? Age? Activity?
    Philip - which foot? Age?
    Patrick - which foot?
    Alexandra - which foot? Age? Activity?
    Herb - which foot? Age? Date of injury?
    James - which foot? age?
    Troy - which foot? Age? Activity? Date of injury?
    Stan - which foot? Age? Activity? Date of injury?
    Rob Hopkins - which foot?
    Doc Ross - Which foot?
    Bri - your age?
    Nancy - your age?
    Anne - your age? date of injury?
    Chip- your age?
    Mike - which leg? date of injury?
    Mike R - age? activity? date of injury?
    Jason - which leg? age?

    Thanks evry1! :mrgreen:

  • 116 dennis // Apr 5, 2008 at 11:47 am

    Also please reply either here or get more info on Brendan’s page if you want to be included! ;)
    http://achillesblog.com/brendan/achillesblog-user-datainformation/

  • 117 Tom // Apr 5, 2008 at 1:14 pm

    I completely agree with Brendan’s comment regarding early weightbearing. Their may be some advantages like less calf atrophy and an earlier return to doing some of the simple daily activities that are difficult to do while on crutches. But, I don’t believe there is any data that shows that a longer period of NWB is bad for recovery. Remember that this is an injury that has dozens of different recovery protocols and the studies I’ve read seem to show that the 1 year results of all protocols are very similar. Some non-surgical routes include over 8 weeks of immobilization and NWB and the long term results are the same.

    I don’t think anyone should feel discouraged if their doctor uses a more conservative protocol. I’ve found it interesting that almost every journal article I’ve read begins by saying “there is no consensus on the best way to treat an Achilles rupture.” Doctor’s have not perfected the optimal treatment, and maybe never will. 10 years from now ATR victims may be doing something completely different.

  • 118 Jim // Apr 5, 2008 at 1:45 pm

    I should add, being in the medical field, there are fads just like any other field. Things I learned when I started were then replaced by other protocols, and then full circle to what we used to do. It’s kind of a cycle it seems. I was reading an article the other day that said surgery was not looked on favorably until the mid 80’s (I’m sure you can find an article that disagrees). I think the age of the doctor has a lot to do with their learning too. My doc is quite young, so maybe he has a different view of things than a doc who has been working for 40 years.

  • 119 Troy // Apr 6, 2008 at 1:55 pm

    Dennis,
    I am 30 years old
    Injured my left AT
    Playing indoor football which I have been playing for 12 years.
    I play defensive end so the pushing off is what got me.

  • 120 Troy // Apr 6, 2008 at 1:56 pm

    ANYONE HAVE ANY PROBLEMS WITH A BLOOD CLOT.

  • 121 Chad // Apr 6, 2008 at 3:57 pm

    Hi Dennis,

    I’m a little older than you, 34.
    Right foot, and it is my dominate foot.
    I did it playing volleyball. But, when I had previously over the last few years hurt my left leg frequently (which is your primary jumping foot if you are right handed). I realized I was jumping off of my back foot more and more when I would play and my lft would be hurt.. I guess now, they will be even again.

    Revised protocol:

    2 weeks splint
    8 weeks air cast with weight bearing at week 5.
    Walking after 8 weeks in boot with a regular shoe.

  • 122 Bonnie // Jan 10, 2009 at 5:22 pm

    My 19 year old needs surgery to repair a ruptured achilles tendon - left ankle. He is an athlete in very good condition. My question: General anesthsia, spinal anesthsia or local? Positives and negatives to each. PLEASE email me your opinion and why. Thanks.

  • 123 Smish // Jan 12, 2009 at 9:49 am

    Dennis: I tried to register this weekend and had some problems. I never got a confirmation e-mail back. When I went in and tried to register again it said that my name and e-mail account was already reserved. How can I fix this? Sorry.

  • 124 dennis // Jan 12, 2009 at 2:42 pm

    smish - hmm, I could be that the confirmation e-mail landed in your spam folder. Did you check there? Otherwise, I can create it for you by hand. please let me know.

  • 125 smish // Jan 12, 2009 at 5:14 pm

    Dennis: You were correct, it had gone to a spam folder and I didn’t even think to check there. I think I am updated now. Thanks.

  • 126 dennis // Dec 31, 2009 at 8:45 pm

    From now on, I will approve every AchillesBlog registration. This way, the site will be free from splogs (spam blogs).
    If you want to create a blog and share your recovery story, please sign-up a username first. Then, from the e-mail address that you registered from, please e-mail: achillesblog@gmail.com

    Please briefly describe how you were injured and what your user name is. I will then create the blog for you.

    I check my e-mail frequently, so there shouldn’t be much of a delay.
    Happy new year!

  • 127 mshap // Dec 31, 2009 at 9:07 pm

    Dennis,

    I would like to wish you happy and healty New Year. I dont think I can put enouph value on what you have been doing for all of us. God Bless you! I believe that whatever you do for others will come back to you and some. Once again, thank you very much!!!
    Marina

  • 128 dennis // Dec 31, 2009 at 9:32 pm

    Marina - Thanks and have a happy new year to you too! Glad that you’ve found the site helpful, and I wish you speedy recovery. I am out in SLC visiting family, and I am going to see if I can head up to Alta. My diet has been deficient in vitamin P this past year.. (vitamin Powder), and I hope to get some tomorrow. :)

  • 129 GerryR // Dec 31, 2009 at 11:09 pm

    Dennis,
    I really appreciate this site. It has been very informative and has provided some mental relief while sitting with my leg elevated.

    I like your approach to dealing with the spammers, it was getting pretty bad there while you were away. There may still be a couple, like the first two “Recently Updated Posts.”

    Alta is my favorite ski area, simply the best. I’m envious.

    Gerry

  • 130 dennis // Jan 1, 2010 at 1:05 am

    gerryr - no problem. normofthenorth actually is the first person to e-mail me to request creation of a blog. I wasn’t really sure if nelsonrichardson1975 was a spammer or not, but since he hasn’t posted anything, I’ve just marked it as a splog.. Glad that you’ve found the site to be informative. Thanks for your comments, and I wish you a happy new year!

  • 131 gerryr // Jan 2, 2010 at 12:08 am

    How do I reset my full recovery target date? I remember setting a target date when I first joined up here but can’t find where to change it. That’ll teach me to be optimistic.

  • 132 dennis // Jan 2, 2010 at 2:31 am

    gerryr - From the blog’s management console, go to Appearance -> Widgets.
    From there, you should see “ATR NYC Marathon: It’s a Marathon” under “Current Widgets”. From there, you can click “edit” and change your goal date. Then be sure to click: “Done”. Please let me know if you have any other questions.

  • 133 gerryr // Jan 2, 2010 at 11:38 pm

    Thanks, Dennis.

  • 134 Juan // Jan 11, 2010 at 3:55 am

    I suffered an achilles tendon rupture and I am attempting to sign up but I having problems. Can anybody help?

  • 135 dennis // Jan 11, 2010 at 11:59 pm

    juan - I’ve replied to your e-mail. Please let me know if you have any questions.

  • 136 btsilver // Mar 15, 2010 at 11:40 am

    How do you create a blog on this site?

  • 137 soccermom // Mar 17, 2011 at 12:00 am

    Hello,
    I am new to this site and not quite sure how to start a blog. I ruptured my achilles on Feb. 24th, had surgery March 8th and am getting stitches out on March 23rd. I have some questions people may be able to help with:
    I have a vacation planned for March 30th, will I be able to fly?
    I stopped taking my meds, but am scared of getting staples removed. Should I take meds on that day to prepare?
    Is it worth it to spend the money on a Roll-about?

  • 138 GerryR // Mar 17, 2011 at 12:30 am

    The third paragraph on the main page, http:\\achillesblog.com , states exactly what you need to do to start your own blog.

    You should be able to fly but it will not be very comfortable. Did you have stitches or staples? It doesn’t hurt to have stitches removed but I can’t comment on staples because I have never had them. If you are really nervous about getting them removed take a pain pill about 45 minutes before the appointment so it has time to work. Good luck.

  • 139 southafrican // Mar 17, 2011 at 2:30 am

    I had staples removed,it was not sore at all.They use a tool that bends the staple without pain. GOOD LUCK

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  • 141 Carl // May 10, 2011 at 2:24 pm

    Anyone still having issues 1 year out? Was treated for 6 months for inflamed burser sacks (including cortizeone injections) with limited results. After 6 months at 58, I tore achilles 2/12/10 (bowling)–surgery 2/22 and cast..walking boot until June. Got back to activities by July… One year check-up…Dr. said he ‘wasn’t as encouraged as he once was” and that short of fusing the ankle…that’s about all he could do. Note I didn”t say anything in post-surgery recoop time doing ANY PT. Wasn’t ordered. Now seeing PT who’s working me to build up tissue around the region but still seeing swelling in area above heel. Anyone go through anything similar and can offer ideas/pitfalls to look out for in trying to get past this??

  • 142 np13 // Oct 4, 2011 at 4:28 pm

    hi dennis, i’m trying to start a blog but just keep getting taken back to a screen that tells me that i am logged in and don’t need to log back in.. not sure where to go from there…

  • 143 np13 // Oct 4, 2011 at 4:29 pm

    oh, ok.. i just saw that i need to email. will do that.

  • 144 garyo // Jan 14, 2012 at 2:48 pm

    I would love to hear other input about success or failure with archilles surgery related to getting back and playing active sports.

    I am currently on the fence as to having this surgery or not. I did not have a rupture but I have a big knot of degenerative mess on the back of my heel and a bone spur caused by tight tendons. My surgeon did a gastroc surgery on one calf in hopes of calming the situation, which did not work for me, although I am more flexible now. Still too much pain, soreness and swelling when trying to play sports.

    I am wondering if other active sports people have undergone this surgery in order to just play their sport? I am not talking professional sports, 59 years old and I just want to be able to be on the tennis court every week.
    Gary

  • 145 Dee // Feb 25, 2012 at 1:12 am

    Ive found others stories and the resources you’ve linked to hugely helpful in seeing what’s ahead and adjusting my expectations.
    A couple of things I’ve found helpful - I had heaps of swelling and found putting a flight stocking on under the boot each morning has made a big difference. Also I have been swimming since 2.5 weeks (no kicking just trailing legs and extreme care getting in and out - boot at poolside and son hovering) and that has also helped with swelling and also my cardio and mental fitness - its gorgeous to be doing something!

  • 146 joya // Feb 20, 2013 at 4:53 am

    Hi Garyo, I had surgery on full rupture just over thee weeks ago. Still early days but I am now PWB and in an air-cast.

    I opted for surgery because I didn’t want the worry of another rupture in the future. I had started running and playing netball so didn’t want the potential hanging over me. My surgeon also said that without surgery you can lose about 10% push off power in your leg.

    I’m 35 and pretty active. Never going to run a marathon but don’t want to go through this again.

  • 147 Glen // Oct 9, 2013 at 2:58 am

    Hello all,

    I had a complete rupture of my left achilles tendon in August of 2008. I can report today I’m doing great. Able to run treadmill with no pain what so ever. At times it may seem like it’s taking forever to heal, but it gets better I assure you. Good luck to all.

  • 148 CliveC // Oct 9, 2013 at 1:58 pm

    You are not saying that it takes 5 years to get a meaningful recovery? I was banking on 12 months max. Please Glen, clarify.

    NB the anti-spam word when I wrote this was ‘courage’!!

  • 149 jj5875 // Nov 14, 2013 at 4:44 pm

    Hello, This is my first time ever leaving a comment on a blog.
    I had a complete rupture of my right Achilles tendon in November of 2002. I was literally pain-free and doing just about anything I wanted till about 6-8 months ago where the back of my heel started to irritate me. According to the foot dr., I developed a Haglund’s deformity in the same foot and he is recommending surgery. I have quite a bit of scar tissue in this foot and I am very nervous about even opening this up again. I am older now, 43, and am not sure if surgery is really the answer. Does anybody know of another person who has had this happen to them? Any other recommendations?

  • 150 Glen // Feb 10, 2014 at 11:14 pm

    Clive, no! It’s been a little over 5 years since I ruptured my achilles. What I meant was it’s all good today. Full recovery is from 6 to 9 months.

  • 151 peterg // Jul 13, 2014 at 9:20 pm

    hi could anyone give me a little advise please? I am a crossfit athlete and ruptuerd my Achilles 6 days a go, the specialist said not to have surgery but wants to get me into a boot in a couple of weeks. reading about this injury I want the op! what is the strongest way to recover from this as I want to compete again ASAP

  • 152 vegasjoey // Jul 13, 2014 at 10:45 pm

    I did a lot of reading and I think surgery is the route to avoid re-rupturing the tendon, especially for an athlete like you. I chose the surgery route for that very reason. Obviously the recovery time is pretty long. Did you see an orthopedist?

  • 153 peterg // Jul 14, 2014 at 12:16 am

    Hi vegasjoey, thanks for your reply! Yes she is and I’m told one of the best in the country (New Zealand) I think I’m going to push for surgery when I see her in 3 days!

  • 154 filosofo // Jul 16, 2014 at 2:37 pm

    @ joya:
    It seems that your surgeon was giving you information relating to the comparison made between surgery and the old and superceded slow non-surgical option. The new early-weight bearing early-mobility advanced protocols (used mainly in Canada, Sweden, partly in New Zealand and Germany) have no higher rate of rerupture than does surgery, and no greater drop in strength and performance.

  • 155 filosofo // Jul 16, 2014 at 2:55 pm

    @peterg:

    Greetings. A point of interest: if your specialist and orthopedist are the same person, and she is one of the best in the country, why would it be questionable to believe her view about not taking the surgical option? Anyone who really takes to reading most broadly and looking for the latest understanding on the matter will find that non-operative is just as good and successful as the operative option for younger active people doing athletic sports ON THE CONDITION THAT ONE OF THE MODERN EARLY MOBILITY PROTOCOLS is followed.

    (My own experience: I was treated operatively by a highly accredited Achilles expert who works on professional footballers in Germany, and I experienced rerupture after five months. The rerupture was then treated non-operatively. After the same period, recovery has been better and faster and after seven months: no second rerupture)

  • 156 atrbuff // Jul 16, 2014 at 3:43 pm

    To the list of countries that you quote, maybe you should add the UK, where 2 of the 3 modern fast protocols were developed and subsequently published.

  • 157 atrbuff // Jul 16, 2014 at 3:43 pm

    Sorry, I know there are more. Should have said the 3 mentioned here the most.

  • 158 Sarajane // Jul 30, 2015 at 10:52 am

    Anyone else feeling sad or depressed after surgery? I am halfway through my five weeks non-weight bearing and I get sad thinking about the things I cannot do. I did not injure my Achilles it has been coming on for a few years. I have a knee scooter which is a life-saver!

  • 159 donna // Jul 30, 2015 at 12:14 pm

    Hey Sarajane….I don’t think our feelings are a problem, they arise naturally as a result of this difficult time, however, I can say from personal experience that what can become a problem is our focus on them. What really helped me (9 months post op now) was to not deny my feelings but not to indulge them either. I found focusing on what I could do each day really beneficial in not sinking into depression, anger, sadness or any of what we call the negative emotions…and also on giving attention to gratitude…even if I could only find one small thing that I could do to give attention to or only one small thing to be thankful for it really helped. I love how you focus at the end of your comment on how the scooter is a life-saver! Exactly…do more of that.

    The days I focused on what I couldn’t do were long painful days…I saw it was all in my mind. I was telling a negative story. I decided to tell a more positive story by being grateful and giving all my energy to the small daily accomplishments or goals I set for my recovery. Again don’t dismiss the facts of this injury or deny the depression but don’t give them a story either.

    As I posted to someone earlier…”change the way you look at things and the things you look at change.” W. Dyer

    All my best to you.

  • 160 Sarajane // Jul 30, 2015 at 8:47 pm

    Donna - thank you so much for your positive words. I will remember that next time I start to cry and get upset. We head to the beach for vacation on Saturday. There will probably be no beach for me - but at least I can sit and look at the water!

  • 161 oscillot // Jul 31, 2015 at 2:41 am

    Hell yeah, I’m depressed! Try to make lemonade out of the sour lemons life has handed you. Sitting at the beach sounds pretty sweet, actually.

  • 162 Sarajane // Jul 31, 2015 at 8:14 am

    Well - I won’t actually be on the beach - can’t get there in my scooter and won’t dare try it on crutches (54 yo and not that coordinated)! At least I will get out of the house for a week.

    I notice that the number of weeks someone is in a nwb cast varies. I will be five weeks. That seems long.

    Oscillot - I hope at least the weather is good wherever you are.

  • 163 oscillot // Aug 1, 2015 at 7:41 am

    For me, it was 2 weeks in the cast, and four more NWB in a boot, but it depends on how your wound heals and what your doc is comfortable with. It’s worth asking him/her if you can get into a boot sooner than later, and I strongly recommend springing for the Vaco cast, especially if you have access to a pool.

  • 164 marie // Aug 17, 2017 at 10:13 am

    Hello fellow Achilles Bloggers. I ruptured my Achilles’ tendon just over three weeks ago. I was miss diagnosed (no MRI, Ultra Sound or X-ray) at A&E and sent away with pain killers. After visiting my GP ( earliest appointment was ten days), she highly suspected that I’d ruptured my Achilles. I got a letter from her which I took to the hospital and was finally booked in for Ultra Sound and X-Ray the next morning. It was confirmed I had a ruptured Achilles (75% tear with 6cm gap and some fraying of tendon). My foot and calf had been put in plaster for a week and it was taken off yesterday and replaced with an Aircast Walker Boot and 3cm heel rise. I question weather the heel rise is adequate when there is supposedly a 6cm gap! I had originally wanted a non-surgery Achilles recovery when the accident had occurred. However, due to the delay of treatment and what I’ve read on blogs and MedWeb the deadline for this option appears to be one week with 3cm or less tendon gap tear. I enjoyed regularly running between 6 and 12 miles, four to five times a week prior to the accident and would like to get back to doing this. I’m concerned about rerupture or elongated ‘repaired’ tendon that inhibits my ability to walk or run properly. I would be very grateful for people’s views or if they are going through or been through similar hurdles and what they did to overcome them.

    Many thanks in advance.
    Marie

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