Achilles detached from the heel

I’ve been searching the internet for days researching my injury and have found so little information that I hope what I write will help others in the future.
It began with pain and tenderness around the heel where the tendon attaches on my right foot. This started last fall and after enduring the pain for a month or two I finally went to a Podiatrist. He explained the tenderness and sent me on my way with exercises. He wouldn’t give me a cortisone injection, saying it would weaken the tendon even more. The pain grew worse so I went to an Orthopedic. He x-rayed my foot and gave me an injection. The x-ray did not show anything unusual and the injection was worthless. So I just continued with the exercises and would massage the area every morning after my shower.
Over time the pain increased and moved to higher areas of the tendon. The heel no longer hurt but the area between my foot and calf would burn. Since I drove a great deal I just chalked it up to abuse on my part and didn’t do anything special and kept with my routine.
Then the pain really got bad, to the point where I could not push off or plant my foot. I didn’t want to go back to either the Podiatrist or Orthopedic and being fortunate enough to have a wonderful family physician I called his office and had them issue a prescription for a MRI. I made an appointment to have it done and another to see my physician two days later to review the results. Well, I didn’t make it.
On the 14th of this month my wife and I attended the graduation of our niece from college. While walking back to her dorm room I stepped off/onto the curb in front of her building and suddenly felt an intense burning feeling in my foot, like someone had stabbed me with a hot iron. I stumbled up to a building and propped myself up until the pain subsided. After a minute or two resting against the wall I was able to walk back to my car and drive home, although my foot was very tender.
The next morning I didn’t shower so my morning foot massage did not occur. But the next day as I reached down to massage the tendon area I found a surprise – a big soft area directly above my heel. I could actually feel the gap and the end of the tendon that had torn away. I immediately made an appointment with the Podiatrist (I wasn’t happy with the way I was treated by the Orthopedic) and the next day he gave me the bad news.
The tendon was completely detached from my heel. And because of the nature of the injury the only recourse was surgery. He explained how pins would be screwed into my heel and the tendon stretched and attached. If the tendon did not have enough elasticity he would add some cadaver tendons. I was told the operation would take 3 hours and then spend 2 months in a cast. Well, my wife was too keen on a Podiatrist performing the operation so I arranged to see a different Orthopedic, which happened today.
From everything I’d been able to find on the internet about my injury the consensus was that surgery was the only option. But the doctor toady wanted to put my foot in a cast right away and said the chances were good the tendon would reattach itself to the bone. He said 6 weeks in a cast, then a boot and then PT. This procedure caught me by surprise. I went to him to get the lowdown on surgery and he didn’t want to do it. The Podiatrist had informed me that if scar tissue was present it would be necessary to remove it because the tendons would not attach to the bone with scar tissue present.
There are two reasons why I think there’s scar tissue present. First are my symptoms indicating the tendon may have been gradually tearing away piece by piece and the final ligament snapped that fateful day 2 weeks ago. Another was I had no pain anywhere. Consequently there was no inflammation. Walking was not painful just uncomfortable because I had to “think” while I stepped, making certain I did not push off on my right foot.
When I asked the Orthopedic what would happen if the tendon did not attach, he said he would operate and then I was looking at another cast for 8 weeks. So now I’m at the stage of trying to find another surgeon and get his opinion. I ‘m not going to let the Podiatrist do the operation, just would rather have someone more experienced.
Another hold-up is I’m self-employed. So no sick leave or anything. So I need to get in as much work as possible before the operation to build-up a nest egg. So that’s where I stand now. I will add again after I see the next doctor.

8 Responses to “Achilles detached from the heel”

  1. dogtired: I am so sorry this is happening to you. For the life of me, I can not figure out why so many doctors do this. (Not order an MRI right away) I wonder if it has something to do with the cost of an MRI and they have limits given to them by insurance companies. I have a friend that fits your story to a “T” except for the final complete detachment. I hope his doesn’t completely go like yours did.
    I wonder if your second ortho just doesn’t like to work on Achilles tendons. I have heard that some docs shy away from them because they can be tricky, You could try to find a foot and ankle orthopedic specialist. I did a partial rupture at the heel about 11 years ago and I was casted for 2-3 months. That worked but it was only a partial and I then ruptured in a different place 3 years ago. Hopefully you are at least booted up. Hang in there and I will be curious what happens in your case. I’ll watch for more of your posts.

  2. DT, wow…what an ordeal! I agree with Smish, find an ortho whose specialty is ankle/foot. I had the same kind of tear (detached from the heel). My Ortho didn’t even consider anything but surgery. I am about 7 months out now and doing well… so far. I don’t think you’d want to go through the recovery process for this more than once…if you have a choice!

    Hang in there and stay positive. All the best.

  3. hi,

    One of our Shelties ran past my husband in the backyard on May 23rd. My husband spun around and as soon as he put weight on his right leg, he knew that something was wrong. He iced it, but with his medical history, we decided to deal with this. He called the doctor on call who thought we should wait a couple of days. With his medical history, we thought we should go to the ER. Three hours later, the doctor decided that he had ruptured his Achilles tendon. The ER doctor spoke with the orthopedist and they decided on surgery on Wednesday.

    So he had surgery #14! He was in the first cast for two weeks, had his stitches removed, then in another cast for 4 weeks.

    When I spoke to the surgeon he said that when he opened up my husband’s leg he could not find the tendon. It had detached from his heel. The doctor had to go looking for it, bring it back down, route it through the tendon sheath and re-attach it to his heel with anchors. The doctor said that in 20 years of this surgery, this was the third time it presented itself like this.

    My husband was in a non-weight bearing cast for two weeks. They removed the stiches and he is in another NWB cast - this time at an angle for another four weeks. They will put him in an achilles cam walker boot after that.

  4. Thank you for creating this blog. I’m 3 weeks into my post-surgery recovery of a detached Achilles and reading your blog was helpful. I also had a tendon shortened on my ankle at the same time so my foot position in healing cannot be the same as a typical Achilles reconstruction. I’m in my second cast (quite fancy in green with a glow in the dark stripe!) which is much lighter than the first and angled differently (90 degrees) which is more comfortable as I have had to rest my heel at times.

    Preparation was key to deal with being in the cast and not being able to drive (my right foot too) while working FT and raising 2 young boys. I didn’t get it all together but thank god for help from family and friends. I could not have done this alone. It’s really hard to manage with crutches when you have to cook dinner, clean up, get kids ready for school, bed, etc. I would highly advocate a walker and I wished I had one (I tried one at the outpatient surgery center and it was so easy to manuever). I completely understand how difficult it is to bathe with the cast on. I still had a plastic bag type cast cover from knee surgery years ago and it worked like a charm for me this time–I don’t have to hassle with duct tape and plastic bags. Ugh, as if being in the cast was enough?

    For me, keeping on the pain killers like clockwork for the next two days post-surgery was also key to keeping the pain in check. I’d set my alarm and wake up at midnight and again at 4am just to take the Percocet.

    I’m expecting to be put in a boot next week but my doc hasn’t mentioned PT so I’m wondering when or if that will occur.

    I now feel a burning sensation in the operated areas and want to believe it’s the tendons healing so I’ll continue to do a bit more web searching on this subject (or talk to the doc) as I haven’t yet found answers to that yet.

    Would love to learn how you are feeling now.

  5. Susan, I don’t know if dogtired is still monitoring this site or not, a year after he last posted here. Some of the rest of us will be glad to give you advice, though, or at least support. Usually the best approach is to (get web-master Dennis to) set up a blog page of your own.

    Your case is unusual (as you indicated) because of the work done to the other tendon. Do you know which one it was? PTT or ATT (if I’ve got the initials right)?

    I’m certainly curious about the symptoms that led to that second part of the surgery.

    Also, if your AT separated right at the heel bone, instead of rupturing above that point, that’s also unusual, though I think I’ve seen a few other blogs here from people with similar experience (including dogtired, of course).

    What’s NOT unusual is that you didn’t start with a full written copy of the rehab protocol your Doc usually follows — including a schedule for the boot and PT. I was one of the few who got one, and it’s a huge luxury to know what’s coming next, instead of waiting weeks (or more!) for a few words of direction during a 10-minute session with “the boss”.

  6. My sympathy to dogtired and thank you for blogging this experience. It is so similar to mine in so many ways; persistent pain for years, visits to M.D, Podiatrist, Orthopedic Surgeon, Physical Therapist, witch doctor, shaman, etc. - each with a different response, none of whom were accurate. No one ordered a MRI and then finally 3/4 of my tendon detached from the heel and tore vertically up the entire length of the tendon leaving it totally frayed. My orhopedic surgeon stitched the tendon together along the vertical, then mechanically attached it to the heel bone and drilled numerous small holes in the bone to cause it to bleed and hopefully stimulate the bodies natural healing process. His prognosis was that I had a 50/50 chance of healing. His last comment to my wife after the surgery was, “they are making some real advancements in artificial tendons…”.
    Not a real confidence booster but a great challenge and motivation for me to do all in my power to help the healing process.
    I did research and added several daily supplements, 6,600 mg collagen type I & III, 2,000 mg colostrum, 200 mg hyaluronic acid, 400 mg chondroitin sulfate and 1,200 mg hydrolyzed collagen type II. I wrap my cast in a heating pad several times per day to increase blood flow.
    I had several sessions with Reiki practitioner and started meditating daily focusing on not only healing but accepting whatever outcome my future would bring.
    I am 60 days post surgery and will remain in a non-weight bearing cast for at least another five weeks at which point I hope to begin physical therapy.

    It was so helpful to find this blog and to know that there are others who have gone through this. I will post again as I progress and hopefully others will find something that will be helpful to them.

    I’m sure many of us who have posted to this site would like to hear how dogtired is doing. Many thanks to him for sharing his experience and I hope he has recovered fully.

  7. CORRECTION;

    I gave incorrect dosage of the supplements in the above post.

    The correct daily supplement intake that I have been taking is as follows;

    6,600 mg collagen type I & II, 1,000 mg colostrum, 100 mg hyaluronic acid, 200 mg chondroitin sulfate and 600 mg hydrolyzed collagen type II.

  8. Hipster….

    I had a similar surgery this past August 14th….Completely ripped my Achilles off my heel. 4 screws to reattach and a 5th screw to use my FHL tendon to further strengthen the Achilles. Yesterday, 11 weeks after surgery, my surgeon told me to stop with the boot and walk in shoes. Damn! It’s really hard to walk, but I’m doing it. Very cautiously though. I think it’s going to be awhile for me to gain confidence in my foot. He told me that I would most likely not run like I used to. I’m 42 and very active. I guess it’s a good thing that I’m mostly a water sport person.

    Good luck in your recovery!

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