Posted on September 25th, 2013 by durwood
I had surgery in June 2012 for a rerupture that I tried to heal non-op from an injury that occurred in Feb 2012. My last post was early November 2012. Since then I moved, changed jobs, and life kind of took over and I haven’t kept up with the Achilles Blog community.
My post today is to share my experience with scar infiltration. I was still experiencing a lot of trouble with lack of strength even at the 12-month post-op point. I had fantastic range of motion but for whatever reason I still could not do heel raises although I could jog without it totally killing me.
My doc sent me to see another doc (osteopath) who had done some internship work with acupuncture and other, as he called it, “voodoo” medicine. One of the things she practices is scar infiltration to help promote subcutaneous healing of scar tissue. Her theory was that perhaps the scar tissue adhered to my skin so when my soleus muscle & tendon activated they were essentially dragging all of my skin along for the ride and hence not responding very well.
Not sure if that’s exactly what was going on but it seemed logical to me. Anyway, the treatment has been to get injections of lidocaine and sugar water just below the skin surface to force some spacing between the scar tissue and derma layer. Then she does a quick myofascial release and as the tissues re-heal they hopefully are no longer adhered.
The treatments are every 2 weeks. So far I’ve had 6 and the results have been pretty amazing. I can sort of do heel raises now–far better than before I started treatments. The scar itself looks & feels a ton better. Tissue is less pink/purple and more “normal” colored. The hardened chunks of scar tissue are smaller and/or softer.
She’s done this scar infil treatment on patients like me, women with C-section scars, and other people recovering from surgery who are dealing with issues with scar tissue.
I didn’t remember reading any posts about it when I was actively trolling and contributing to the board so figured I’d write something up and see if anyone else has experienced something similar.
Incidentally, two guys in my new organization each ruptured their Achilles tendons playing in an intramural basketball game–the same game. About 10 mins apart. One is 26 and in great shape and the other in his early 40s. We now have our own support group.
Happy healing to all. Thanks for reading.
3 Comments »
Posted on November 5th, 2012 by durwood
It’s been quite a while since my last post. Things have been progressing for the most part. Sometimes it seems like I’ve come a really long way and sometimes it seems like I’m not making that much progress. I’ve been seeing a phys therapist 1x or 2x per week for the past couple of months but doing the exercises a total of about 4x per week.
I’m still not back to running yet. My single leg lift strength just isn’t there and doesn’t seem to be getting any better. My exercises include walking on my toes; two-legged hops (small hops) where I land on the balls of my feet; and two-footed toe raises (done on a step with heels extended beyond the edge) where I transfer my weight to my bad leg and slowly lower my heels.
My PT said I needed to be able to do single leg toe raises (about 10 reps) and then hop on one leg before he’d clear me for running. My walking gait is doing great…I got out of the boot in mid-August and over the past couple of months my limp as decreased to the point where it’s barely noticeable today. It almost feels like I could start to jog even though I’m not even close to doing the single leg raises yet. I guess the danger is that all the supporting tissues aren’t strong enough yet and I’d risk hurting them if not my Achilles again?
As far as the overall pace of recovery, I realize everybody’s different but I’ve always been a pretty fast healer so I’m surprised and a bit frustrated that is taking so long. Or maybe it’s right on track? My PT said he was very happy with the pace but I dunno…it seems like I’ve plateaued with my progress.
I also had double the rehab time because my injury was in Feb and I tried non-op rehab protocol and then reruptured in May. So maybe the added time off my leg led to even more calf muscle atrophy? Hopefully having double the injury/rehab time doesn’t double the recovery time.
Happy healing to all. Thanks for reading.
3 Comments »
Posted on July 15th, 2012 by durwood
Tomorrow will be 5 weeks from my surgery date. Things are going pretty well. The incision looks great and I’ve been able to get in the pool for a couple weeks now. The exercise is awesome and the kicking has certainly helped with my ROM. Many thanks to Ryanb for the swimming advice!
I do wonder if the tendon is actually healing…tonight I tried giving myself the calf squeeze test and really didn’t get much of anything in my bad leg. Is it too soon to expect that? I have my next follow-up appt in a week and I start PT the day after that. So we’ll see what the ortho Doc says and then my Phys Therapist.
But I know how the tendon felt at this point 3 months ago during my attempt at non-op rehab and how it feels now…and it feels a LOT better/stronger/healthier now. So hopefully the T-test squeeze thing will show some results soon to validate it.
Only minor complaint is the heel lift in my boot. My original ortho staff gave me a different boot then the one I have now (brand name is Bledsoe). The lifts in my old boot were just rubber pads that were 1-cm thick each. But this one has a plastic wedge that is velcroed to the bottom. My foot tilts on the wedge so the foam pads that were glued & velcroed on top of the wedge slide to the right. Anyway, I’m constantly adjusting those stupid pads and when they slide off my heel is on top of the plastic wedge with no padding and it’s quite painful.
Does anybody else have a Bledsoe boot or one with a similar velcro wedge system? Any tips on how to keep those pads from sliding over?
Good luck to all in our recoveries. Some struggle more than others but it’s still a struggle for us all!
16 Comments »
Posted on June 24th, 2012 by durwood
Quick update: Surgery to fix my rerupture was Monday, June 11th. I had originally attempted the UWO non-op protocol but I didn’t start rehab until about a month after the injury because it took 3 weeks to get it diagnosed. At week 10 it reruptured (I was in 2 shoes and walking to my 2nd PT appt).
Rehab is moving along quickly and going well. I was NWB in a splint for 1 week and had the splint removed on Tuesday the 19th. The doctor said I could transition to WBAT. It took me about 2-3 days of PWB with crutches, then down to 1 crutch for about a day, and as of yesterday I dropped both crutches. I’m still pretty careful about watching my step but overall it feels fantastic.
Incision was healing nicely at my checkup but I keep it elevated & iced quite a bit if I’m just sitting around.
The wedge heel lift thing in my boot is pretty big–I haven’t measured it but it looks like it’s 3 or 4 cm. I’m in that for a month and then I imagine it’ll be lowered over time. Should be cleared for the pool in a couple of days but that’s more for comfort than PT because I’m not cleared to fully kick/flex my ankle. But some one-legged swimming will help me get back into shape because unfortunately I have packed a few pounds on since my original injury in February!
Good luck to everybody–especially those that are dealing with reruptures because Lord knows it’s hard enough to get through this experience once.
5 Comments »
Posted on June 11th, 2012 by durwood
Thanks to all for the kind words of support over the past couple of days. Surgery today was a success. Well, I guess I should define success as there was nothing out of the ordinary, no complications during the procedure, and the surgeon didn’t see anything that wasn’t already anticipated. No fhl tendon transfer, no graft, etc.
The operation took 90 minutes and I was back home in my lazyboy by 1.00.
Nerve blocker is still in effect so my entire lower leg is entirely numb. But I have plenty of pain meds for when that wears off.
I was actually pretty nervous which seemed kind of silly because compared to “real” surgeries (like open heart, c-section, etc.) this seemed pretty trivial. But I’d never been been under a general anesthetic before so I was curious and a bit anxious about that.
Anyway, round 2 of healing has begun!
5 Comments »
Posted on June 8th, 2012 by durwood
It’s been pretty eventful since my rerupture episode on May 30th. I had a referral to see a foot & ankle specialist this week on Wednesday and surgery is scheduled for Monday morning. As anxious as I was and have been about having surgery, I think I reached the conclusion that it’s my best option at this point. I just couldn’t fathom the prospect of trying non-op rehab again and getting 12-15 weeks down the road (again) and having it rerupture (again)! So surgery here we come.
The surgeon seemed pretty sure it would be a straightforward procedure and that he doesn’t think it’ll be anything more than cleaning up the scar tissue and doing a conventional repair. But…isn’t what they all say? Obviously he won’t know until he gets it opened up and sees just how bad it is (or isn’t). I can only imagine waking up from anesthesia on Monday with stitches on my foot as well as a sign that he had to do an fhl transfer! But hopefully that’s not the case.
I was able to borrow one of those ice water-pump-cooler-things to wrap my ankle and keep the swelling down (and stitches from popping out). The protocol they’ll have me follow–assuming no complications–is 1 week in a splint NWB and starting in week 2 I switch to PWB in a boot. The beginning of the week will be less weight and by the end of the week I should be at WBAT. Interesting. It’s more aggressive than my previous protocol–which specified the same timelines and milestones for both surgical & non-op rehabs.
We’ll see how it goes. Fingers are crossed!
Good luck and happy healing to everybody in our happy but unfortunate community!
9 Comments »
Posted on June 1st, 2012 by durwood
I saw the orthopedics today (a different PA as my usual one was not there) and they confirmed that I did fully re-rupture my Achilles on Wednesday. So I guess it’s back to square 1 with the non-op rehab protocol although I’m not 100% convinced that will work. My other PA basically said we should give the non-op method a go and if it didn’t work we could always have it surgically repaired later.
Well, now that we’re at that point the PA today said that surgery at this point would be extremely complicated because of the amount of elapsed time from injury (Feb 21st) and that it could require a graft or extensive cleaning up of the scar tissue.
So I’m a bit lost right now. If all that is true about things that would complicate surgery, then it seems to me that all of those same factors would also complicate another attempt at non-op rehab. Plus, I know that’s already failed once…what was it that Einstein said was the definition of insanity? Trying the same thing over & over and expecting different results, right?
Right now I’m back in the boot (not a splint) with a heel lift and NWB (hellllllloooooo crutches!) for a few weeks and they also put in a referral for me to see a foot/ankle specialist surgeon to discuss surgical options.
I just want the damn thing to heal so I can resume an active lifestyle. I have little confidence (right now, anyway) that another chance at the non-op route will work…and the PA today made it seem like surgery would be a difficult choice too. Neither path sounds very appealing right now.
I know Norm has said maybe the fresh tear will provide a conducive environment for it to heal properly. I hope that’s the case. Maybe that makes it different than the original injury since 3+ weeks passed before I started the protocol. But what happens with all that scar tissue? The entire lower part of my leg is hard as a rock. How in the world will this thing heal with all that scarring?
19 Comments »
Posted on May 30th, 2012 by durwood
I just passed the 10 week point and had been in two shoes for the past 2 weeks. Things had been going great! I started physical therapy and had been cleared to start cardio which was really exciting because I managed to pack on a few extra pounds over these last couple of months.
I actually had a good session on the stationary bike yesterday and was curious how my Achilles would respond today. Well, it felt fantastic when I woke up this morning. Swelling was way down and my limp was much less pronounced than it had been. I was feeling pretty good about things with summer break coming up and a lot of activities planned with the family. It was looking more & more like I wouldn’t be missing any of it or restricted in any way.
So….I was walking to my physical therapy appointment today and as I entered the building I heard/felt a POP in my lower leg. I had someone get a wheelchair and I made it to see the PT and he is pretty sure my Achilles is gone again. He did a Thompson test (calf squeeze) and wasn’t getting anything. We can also feel a pretty pronounced gap along the tendon and the whole back of my leg leading up to the calf is extremely sore.
I’m meeting with the orthopedic on Friday but this is not looking good. I knew that re-rupture was one of the risks with the non-op approach especially given the fact that 3 weeks elapsed between injury & diagnosis. So I’m guessing surgery will be required now and I’ll be back to square 1 with the rehab. Mentally that’s the hardest part of this situation. It sucks. But I made it through it once before and I’ll just have to suck it up and do it again.
14 Comments »
Posted on May 17th, 2012 by durwood
I’ve had some pretty good news with my recovery over this past week or so. 10 days ago I had my first physical therapy session and he was very happy with my range of motion and overall appearance of my ankle area.
Yesterday was with my ortho for the 8 week appt and she was VERY excited by what she saw. She was actually surprised it has come so far in such a relatively short time given my initial conditions (3 weeks between rupture and start of non-op rehab protocol).
So I’m now in two shoes for the first time in a long and rode a stationary bike today. Felt good to break a sweat and start chipping away at the 10 lbs I’ve put on in these past 3 months. It’s funny seeing my right shoe and how much whiter it is than my left.
Still no idea how much longer it’ll be until I can jog but suspect it’ll still be a few months. But for now it feels great to be able to walk, wear shoes, and do exercises that I can tell are strenghtening my Achilles with each passing day.
Good luck and happy healing to all.
7 Comments »
Posted on April 29th, 2012 by durwood
Today’s post is a question about scar tissue. I am almost 6 weeks along in my rehab (non-op protocol) and am fully weight bearing in a walking boot with the 2 cm heel lift. My 4-week checkup was good and the Docs said it was going well. They could tell the tendon was reconnected and that there was a significant amount of scar tissue–which they said was a good thing.
What concerns me is that when I do my foot flexing exercises I really can’t detect much movement in my calf muscle–especially when compared to my normal leg. Granted, I’m still pretty early in my recovery but it seems to me if the tendon is connected then it should elicit some sort of response in my calf when I flex it, right?
I’m not flexing it much–just taking the foot from its toe-pointed-down position back up to neutral.
Also, I notice just above the “defect area” (which is filling in but I can still feel a slight depression which I assume is where the tendon still needs to grow back together) there is a really hard mass. It feels hard as a rock all the time. I’m guessing this is the scar tissue? And is that the reason why I’m not detecting much movement in my calf when I flex my ankle? It seems like that hard mass would block the kind of response I’m expecting to see in my calf.
Is this normal? Will this get better with time? Will I be able to improve this when I begin physical therapy?
Thanks for the support!
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