dkirkpatrick’s AchillesBlog

Fantastic, sounds like your are doing all the correct things and making great progress, keep it up!

Shoes,

I am not sure. He seemed aggressive at first because he casted me at 90 degrees. I have been walking the last 4 days with my boot with no problems. My next appointment isn’t until the 8 weeks post op. We’ll see what he says at that point. I’m going to ask him a lot more questions at that point. This whole situation is giving me a huge lesson in patience! I’m going to keep walking and work on my ROM exercises for two more weeks. Then I’m going to insisit on PT immediately.

Is your doctor so cautious because you were operated on?

I ask because although I had a complete rupture, I didn’t have surgery and went into a boot after 2 weeks in a cast, and was in shoes after 2 months. Or do some medics just have different ideas?

The anti-spam word here is ‘patience’ - I hope you have plenty.

Hey Greg,

I was in a splint for 2 weeks, hard cast for another 2 weeks. I am currently week 6 and have been in a boot for 2 weeks. I just started walking in the boot the last 3 or 4 days on a limited basis. Doc says he wants me in the boot for a total of 6–8 weeks. 10-12 weeks after the surgery. I have been doing my ROM exercises at 2-3 times a day and have very little swelling. I have excellent range of motion, almost the same as my good foot. I have an appointment on Aug 25th and will be prescribed PT at that point.

I had Surgery on July 10, 2014. I was in the “Jones” splint for 3 weeks, and I am in a hard fiberglass cast now. I go back tomorrow (August 12th) to hopefully have my stitches removed and get my walking boot. How long will I have the walking boot? I am hearing 4 weeks…then into a special sneaker for 4 weeks..then I do PT.

ATR2014,

We’re you bootless on the bike? How many weeks post op before you started the bike?

Thank you for the feed back. I have been walking around the house in the boot this evening after I read it. I’m pretty comfortable doing it. I had no pain or discomfort. I was nervous doing it at first, but relaxed after a few steps. I walked up the stairs without hurting anything. I think I’m going to keep testing it. I am doing some dorsiflexion exercises and some circles today. It feels pretty good. I now realize how weak it really is.

I was in a cast for four weeks (including the splint that I had for one week after surgery) and was told to do just toe touches for the first week and then PWB the second week and FWB starting at 6 weeks with a goal to go two shoes at 8 weeks.

For me, it was all mental - I was afraid to put any weight on my foot but slowly did it after the second day in the boot and was FWB immediately when I realized there wasn’t any pain or discomfort. I was told by my PT to do what I wanted as long as I wasn’t in any pain or discomfort but don’t do too much too soon. I went back to the gym yesterday for the first time and just rode the stationary bike for 20 minutes and worked on upper body exercises as well as my abs. Total time spent at the gym was about 90 minutes and I felt great! My heart rate was up and I was sweaty! Went again today and had another great work out!

Hey man the earlier weight bearing the better, so attack is discomfort is a sign you are not ready, but it seems like you are and the wound looks nice. My surgeon told me initially i’d be 4 weeks cast 4 weeks boot then walking, but last time I saw him, he admitted that I should spend 3 weeks in the boot or less, so our bodies sometime go above and beyond and heal quick, so I suggest you do what gives you the best recovery, but do not push it.

I see the picture fine when I paste in the address — though it’s not a live clickable link for some reason.

The most successful protocols — like the three at achillesblog.com/cecilia/protocols — all have you FWB by now. But going against your own surgeon’s advice, or suggesting that somebody else should, is always scary.
It’s natural and tempting to assume that his advice is specifically tailored to you, your leg, your surgical repair, etc., etc. And it occasionally must be true, I guess. But I think the overwhelming majority of that kind of protocol advice is 100% specific to your OS and 0% specific to you or your leg.

Heel wedges or hinged boot angled down are not a barrier to early boot walking, as you can see from all the best protocols. E.g., UWO hits PWB at 2 weeks in and FWB at 4, all still in full PF/equinus, 2cm of heel wedges. Wedges don’t come out til 6 weeks post-whatever, so I had two weeks of walking fast in my boot - NOT hobbling!! - before I got to neutral. It takes a few minutes more work to even up your two legs if you’re in equinus, but that’s about the only downside.
Post-op patients might have a problem getting to neutral as quickly and easily as non-op, because some (many? most??) OSs trim enough off the torn AT ends to make the system shorter than before. (Mine did that quite intentionally, he told me.)

I see them fine.

I was the same at 2 weeks - no miracle I am afraid, have to agree, a lot down to amount of separation in the tendon and how well the scar has healed (No one has a quick healing tendon, due to the lack of blood supply) To be honest it won’t get us to the final destination any quicker but what it does do is allow us to hobble around a bit sooner on two feet without crutches - which is good I can’t deny that!!!!

http://AchillesBlog.com/dkirkpatrick/2014/07/15/2-weeks-post-op/image/

Congrats!

I think I’m just real lucky. I have always been a quick healer when I get cuts. As far as getting to 90 degrees, the OS said I was lucky that there was not much separation between the ruptures end and he was going to try to get it close to 90 right after the surgery. He was able to initially cast it real close. I only had to pull my foot up about 1 cm to get it there. Then he casted at 90. We’ll see what happens next. I’ll try to post a pic of the wound and the cast. I still have a long road ahead!

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Wow 90 degrees at 2 weeks and stitches removed. I have to admit I am a little jealous since it took 3 weeks for removal of my stitches and I am having a tough time going to 90 degrees for the cast they put me at 45 and told me to do physical therapy to increase that. How are you doing this miracle recovery.

I like that idea!! I may try it out.

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I found the pillow under the mattress more uncomfortable for me, but it is a great suggestion. I used a long body pillow under my leg. It was enough to elevate and since it ran down my whole leg and not just the lower half it was easier on me.

Yes it is!! Elevated above the heard is the best thing to do during your healing process. And really helps if you have a walk in shower instead of a tub.