First entry, 34 days post surgery
I have appreciated everyone else’s information so hopefully mine will help some others in the future. I fully ruptured my left AT on June 13 playing in a soccer tournament. It was the second game I had played of the day having had no issues prior. I stepped back and planted my left foot to strike the ball with my right. I literally heard a POP (and an uh-oh crossed my mind), as I fell to the ground. But I really had no pain so was looking for a hole I stepped in and inspected my cleat to see if I ripped it or cracked the sole since I hear a pop. Saw nothing, so I stood back up, it felt weird, put more weight on left leg and fell down again. I looked at my heal and saw a big indentation where my tendon used to be and pretty much knew what happened. I ended up going to a nearby ER since it was a tourney and the first aid people insisted. I would have gone anyway since it had never happened to me before, but if I knew then what I know now, I would just skip it. They had no need to do MRI as it was evident the problem and they put a splint, sent me home with crutches and I made a Monday morning appt with a highly recommended Ortho group in DC. Again, the strangest (but a blessing) thing in all this was I really had little to no pain throughout.
The appointment was fine, pretty quick (confirmed the issue, talked about surgery and recovery, though I didn’t absorb a lot at that time). Scheduled surgery for Tuesday 8:30 AM and was home by noon with a cast. The worst part for the first two weeks was the crutches. I ended up getting a kneewalker after 2 weeks and wished I had done it MUCH sooner. It is extremely useful and allows you to carry items and get around the house without the crutch pain/knots etc.. Don’t hesitate to get one - well worth the rental fee. And the kids have fun on it too.
I really felt good from the get-go and 4 days after surgery I decided to try pilates at home. I take 2-3 classes a week so knew what to do and it went great. So, from then on I was going to the gym and taking classes. Yes, the left leg/cast was heavy but it just added to the workout. There were very few things I could not do, all of them weight bearing and a good instructor can modify what you need. If you have done pilates before, keep it up. No reason not too (My doc said “no restrictions as long as no weight bearing. I took it to heart.
First post-op follow up was 11 days after surgery. When they put this cast on they changed the angle to something less than 90 degrees. I requested and got a Gore-tex cast so that I could swim in it. That was another great decision. So I added swimming to my pilates and really was able to keep up my activity. The drag on the leg was something (took me an additional 10 minutes to swim a mile) but of course no real stress since you are in the water. Again, I was back in the gym five days a week either swimming a mile or swimming 1/2 mile with an hour of Pilates.
Second post-op was July 13, 2009, 25 days after surgery. The weekend before, knowing I was going to be in a boot, I began putting some weight on the leg. This caused me no pain (the angle was a bit weird) and it wasn’t a lot or any great length of time (from bed to bathroom for example). However, when I went in for appt the Doc said “You haven’t been walking on it have you?” Well, a little for the last two days. “Don’t do that (didn’t explain why).” Got fitted with a boot and told two more weeks of crutches. I have been in the boot for 5 days now and again have been putting some weight on it.
I had my first Physical Therapy appt one day into the boot. All Range-of-motion stuff which was stiff but felt good to really start something. I had also gone swimming that morning without boot (of course) and it REALLY felt good to have it move. Swimming freestyle was a gentle flexing of the ankle. No pushing off, but otherwise felt very natural and got much of my speed back without cast. I do think that the swimming for the last week without any restrictions has made a big difference in flexibility, along with my two PT sessions to date.
The second PT session got a ’scar massage’ which didn’t hurt nearly what I expected. It was more like a muscle soreness and tenderness. I have been doing some on my own as well since then, as well as daily repititions of recommended exercises. Pilates adds some of its own flexibility so that seems to be helping as well. Even in one week my flexibility has increased dramatically. The first session he measured Neutral (zero degree) on flexing and %35 on pointing. My good leg was -15% on flexing and 65% on pointing. I am going to ask him to measure again next appt.
My advice is, if you were active before, do everything you can to be active again, even if it is something different. I could be doing weights of course, but then I would have to haul myself up the stairs at the gym, and there is only so much time to dedicate with kids home etc..
The real life-saver in all this has been that our area has grocery delivery service. Don’t know what I would do without it! If you have it, take full advantage. One upside is that the kids now know they have to help more and don’t even say a word when I tell them it is time to put away dishes or take out garbage. Small miracles.
And, lest those of you think I am crazy for not listening to my doctor about weight bearing, I provide the information below. My leg seems to have no problem bearing some weight and again I am careful about it (not too far, too often and careful not to bend my ankle yet, so it is more hobbling than walking). But, from this website and other searches it just seems there is such a wide range of when walking begins, and more importantly, I haven’t been able to get an answer for why NOT walking sooner, once cast is off? So, I will discuss again with Doc in a few days, but am making a bit of my own decisions on this. Would love to hear comments either way on this!
From (http://www.mdmercy.com/footandankle/conditions/achilles_tendon_probs/acute_achl_tendonrupture.html)
There were some treatments used many years ago that relied upon a leg cast. This led to tremendous weakness and atrophy of muscle that was often permanent. Approximately fifteen years ago, with a treatment pioneered by Dr. Myerson, the recovery after surgery for repairing the Achilles tendon changed dramatically, leading to maximum restoration of tendon healing and rapid return of strength. Instead of a cast, a removable boot is worn and instead of using crutches, walking is commenced very rapidly after surgery. Therapy and exercises are begun soon after surgery. This therapy process is critical in the recovery after tendon rupture, and without a carefully monitored program, full recovery is never possible. This treatment has made a huge difference in the recovery process for both recreational and professional athletes.
I will report back regularly!
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I’m so glad I read your post. I injured my AT playing softball and I am currently 4 days post op. I had terrible pain the day after surgery, but not so bad since. I’m glad that you mentioned remaining active. I am very active and had been working out at home everyday–with weights, treadmill, pilates, etc, and I am anxious to continue, Doc wants me to keep the leg elevated all week until my 1st post op appointment on the 28th,
I too did not really absorb what the doctor was telling me about rehab. He said something about 8 weeks, but I don’t know if that means 8 weeks in the boot, non weight bearing, or 8 weeks and I will be able to wear 2 shoes. I also noticed on this site that there are big differences in the amount of time between surgery and weight bearing. Some doctors say to begin right away and others seem to be more conservative.
How did you get to the gym? Were you able to drive? That’s what is making me really crazy–not being able to drive, even though it’s my left AT that’s injured. Did you have a plaster cast in the beginning? I thought that was what I was getting but I ended up with a boot. It’s very heavy –like a big frankenstein shoe, but I intend on using it as a leg weight for workouts, as soon as doc says it’s ok.
For now, I’m just sitting here with my leg elevated–doctors orders. Good luck with your recovery and thanks for the advice.
Jane
Hi Jane! Sorry to hear about it. It is a total bummer but in the grand scheme of things that is really all it is. We will get back to it. Do take it easy the first week for sure. Sometimes we need to be forced to slow down and that’s OK. I was very surprised when I got the casts off (first one after 2 weeks then 2 weeks more after second) and I still had swelling in both cases. When you have the boot you can (check with doc) sleep without it so it was much easier to prop up on a pillow and in the morning looked very normal. But after activity and walking around stilled swelled up. I continued to ice it some too.
You should totally be able to drive since it is your left, as was mine. I drove 5 days after surgery just to go out and see a movie since I was stir crazy. No issues with driving. The more dangerous part is using the crutches. I fell 3 times, once enough to give me some good bruising on my arms and legs. Tried not to put weight on bad leg and managed to avoid it for the most part but during the falls there was some pressure. Never really afraid I had damaged it more, but it was painful. And depressing. I had a pretty good attitude throughout (which helps a lot!) but after a bad fall I just cried. Had enough.
So, my best advice is renting the kneewalker or rollabout. That really relieved a lot of body stress, makes you less dependent on others and is fun!
I am walking around barefoot (in the house) and am being careful. My heel does hurt a bit from the added stress of compensating on not pushing off on AT. I went to post-op last Thursday since I was going on vacation. Even though I wasn’t supposed to be walking without crutches he knew I was and said “as long as you are careful…” He said 4 more weeks of boot. It’s purpose is to ‘protect yourself’. I found that to be true when I stopped at a reststop and turned around to dry my hands. I did not see the doorstop and stepped right on it. Had I not been in the boot it would have majorly stressed my achilles and at best hurt a lot and at worst done some real damage. So, I wear the boot to go out for sure. Have to be careful on stairs inside too. Again, if you don’t pay attention and step wrong then it will hurt!
Yes, there does seem to be a huge range of rehab. Ask the doc lots of questions and do what you feel is right with your body as long as you take it slowly. Progress was pretty quick once PT was started for range of motion, but it will be a long road until I can push up on my toes to any real degree.
Keep up the rest for a while, try some of the old exercises next week and keep a good attitude!
Good luck!
Thanks, for all the advice. I jsut went to my second post op appoitment and staples were removed. Doc made it a point to tell me 4 times that it is imperative tht I do not put weight on my foot. I didn’t ask him if I could—he must have seen it in my eyes! Still doing nothing but sitting around because I am getting some wierd sensations in the side of my foot(it is numb to touch), kind of like pin pricks, and it feels better when elevated and with ice. Haven’t driven yet, mostly due to the fact that I have a lot of swelling when my foot is down. Apparently the tendon was shredded and the doc had to go “fishing” for it in my calf.
I’m getting around pretty well on the crutches. No issues yet except for really dry skin on my hands. My only problem is the boot–it weighs a TON, and I can’t walk that far while holding it up because it puts too much pressure on my knee, just dangling in the air. I did make it to the beach last weekend where I scored two wheelchairs–one specifically for the beach and another for the boardwalk. I was very happy just to get out of the house.
I’m learning to be a patient patient. It’s difficult, as I know you know. But when this is over I intend on being in the best shape of my life.
Thanks for the advice and well wishes. Good luck with your recovery.
Jane
While you may have missed the opatmil time where your body would respond best to treatment it is never too late to go to physical therapy. I would ask for a referral from your doctor that did the surgery. If they will not give you one you can go to your primary care doc and ask for one or you may have direct access in your state meaning you can go to a Physical Therapist without needing a referral from a doctor.
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Eat 5 times a dayStart with baeakfrst. The more you eat for baeakfrst, the less food you will want to eat at night. Please, don’t skip this meal as you’ll end up devouring everything in sight for the rest of the day. You don’t need to gobble up 5 large meals, just 3 meals of a sensible size and 2 delicious yet low calorie snacks. Eat sensibly so your body doesn’t crave for food. If you treat your body right it won’t demand for more attention!
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