doyouski’s AchillesBlog

Amanda, it’s great that you’re so happy with your recent results — and sorry about the first time! My story is almost identical to yours — tore the right one in 2001, got surgery, eventually tore the left one in 2009, skipped the surgery.

My non-surgical cure was generally much faster and WAY easier (and completely scar-less, of course!), but my longer-term functional results are a bit the other way around — my first (post-op) leg regained full strength faster than my second (non-op) leg has. (At ~11 months, I’m still doing a half-height 1-leg heel raise. No problems doing normal things, but not that, not yet.)

I think there’s a lot of “luck of the draw” natural variability thrown into the pot, so we’ve got to be careful before we take a comparison of two legs — even if they’re both the SAME PERSON’S LEGS!! — and treat them as if it’s a statistically significant control experiment. Everybody’s different, and every leg is different, and stuff happens, with any treatment.

(BTW, I am one of the local leaders of the “skip the surgery Glee Club” here, so I’m NOT just saying this!!)

Hi Manuel,
I completely ruptured my left AT almost 12 months ago I went down the route of no surgery and a full cast for 8 weeks and boy am I glad that I did my AT has repaired, you have to be dedicated to your recovery and have an awesome physio. 15 years ago I completely ruptured my right AT and went down the route of surgery to this day my right leg still gives me problems where the scar is I have the same if not more flexibility with my left AT as what I have with my right AT for me the non surgical repair was better.
Best Luck Amanda

somehow I lost a word at the end and the word is “strengthening.”

You can go into your dashboard and flip the switch that allows people to edit their own posts on your blog. Right now the switch is off.

I tend to agree with Norm that it doesn’t appear you have healed too long. Where he and I diverge is that he’s puzzled you have trouble walking up stairs, and down stairs too I suspect. The general time frame to be completely healed and back to 95-100% is 12 months after the rupture or surgery. You’re only at 5 months and you’re been making up your own therapy as you go, which isn’t always a bad thing, but it is easier to over stress the healing tendon when you’re just winging it. Like most people here you were undoubtedly quite fit before the rupture and it is really hard to know your fitness level is declining. However, I would recommend you lay off all the fitness stuff and only do ROM exercises for a week, basically don’t do anything that puts any stress on the tendon. Your fitness level will decline some, but it won’t be a huge amount and after a week of not doing those things, you may well find your tendon feels a lot better and that you’re walking a bit better. If nothing changes, you haven’t lost much. But, I would highly recommend you seek the advice of a good physical therapist to guide your calf .

Manuel/Doyouski, you can post “replies” to your own blog post. I’d recommend it, so your answers follow our questions in order on the page. (Folks, Manuel has responded to my questions way up above, with an added edit to his original post.)

Basically, I find your symptoms puzzling, and I’m not sure what to recommend! (That’s unusual for me — references on request! ) Your two tests of AT-length with dorsiflexion BOTH suggest that your AT is NOT healed too long. (That’s good news.) But your continued gimp-walking up stairs says that SOMETHING is missing, but maybe only calf strength.

I’m assuming that you did those tests while your leg was NOT very swollen. (Any serious swelling can restrict your ROM quite remarkably.)

I’ll go scratch my head about your leg, and let others pipe up. . .

Manuel, you say you walk without a limp. That would be a miracle if your AT was still disconnected, IMHO. When you walk up stairs, do you do it normally, or do you still put your whole injured-side foot (including the heel) on the step, or do you do that normally now? That’s a tough test of an AT.

If you pass both of those tests, you’ve definitely GOT an AT, though it is probably longer than the other one. The best tests of AT length are simple ones, IMO: How high you can lift your toes, how far from a wall you can plant your foot (flat on the floor) and still push your knee to touch the wall. You haven’t reported those results yet.

Hi Manuel,

I’m unclear about the point of the MRI. What question is it going to answer? If the tendon is still fully ruptured, a simple exam can tell that. In particular, can your push the ball of your foot with at least a fair amount of strength? A simple exam can also answer the healing long question. In particular, if you completely run out of strength at the plantarflexed end of the ankle’s range of motion, because the calf is fully contracted before the ankle is fully plantarflexed, then you have healed too long. If the latter is the case, you can choose between surgery and living with what you have, as Norm described.

One detail I’m not sure about is if your picture changes if you wait longer. My hunch is that you can continue to live with what you have for now, but you are not burning any bridges by not having surgery now, as you can always have surgery later if you change your mind about having a too-long tendon. If you are unsure about surgery, ask your doctor if there is any price to be paid if you delay the decision.

Strictly speaking, Birdie, a calf raise is not an eccentric exercise. Eccentric contract

Hi Manuel
The MRI will determine if you have a full or partial rupture. If its a full rupture you only have I believe one option which is surgery and meanwhile you should be careful with your exercise routine not to damage the tendon further.
If its a partial rupture you may get away with physio and a stringent exercise routine, i.e. Eccentric Exercises ( heel raises etc) but this is itself a long slog with no certainty that it will fully recover.
I have gone thro a similar problem over 12 months
( tear) and eventually fell over and an MRI confirmed a full rupture.
I await surgery as we speak!

Best wishes and Good luck

Birdieboy

Manuel, at this point I doubt you’d get any benefit from immobilization in a boot or cast. Your ankle and AT have kind of stabilized now, they’re not actively creating a lot of new tissue any more. You’ll probably still gain some more strength, but it won’t be as dramatic as where you’ve come from.

“Wrong” and “long” are in the eye of the beholder, which is really you. If you’re content with where you are now, and where you seem to be headed (slowly, on a “plateau”), there’s no law that says you need to have surgery, to try for better or “perfect”. If you’re not content, I think surgery is the only thing that will make a big change. You say you prefer the limitations, over the prospect of surgery. I think that’s exactly the choice, and you’re exactly the person who has to make it.

Good luck — and happiness!

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