Happy Easter…my first post
I finally decided to get off my butt (figuratively of course) and write some stuff down. I’m a new member of the ATR club and I primarily wanted to share my recovery experience because I was late getting diagnosed and didn’t actually start my rehab/recovery protocol until 3 full weeks after the injury. So I’m a little concerned that the ends of the tendon might have scarred and wonder if that will preclude them from healing properly. I’d be interested in knowing if there are others out there with a similar experience. I opted for no surgery and my docs are familiar with what appears to be the fairly new, progressive rehab protocol–the one based on the Ontario study that is featured and discussed on this website.
My injury happened literally in the final seconds of an indoor soccer game. I passed the ball back to a teammate and BAM! Down goes Frazier! It felt like I’d been kicked in the back of the leg. But the strange thing–and probably the biggest reason why my primary doc didn’t diagnose it right away–was that I was able to walk on it without too much pain. I iced the bejeezus out of the entire lower leg every night for the first week or so and that controlled the swelling for the most part. My ankle wasn’t too bad but my calf blew up like a balloon and that is what got my doc’s attention.
So I went from an ultrasound at 2 weeks to see if there was a blood clot in my calf to an MRI a week later. It was the radiologist looking at the MRI (again, focused on my calf) who asked if I was having trouble getting around because he saw that my Achilles appeared to be nearly all the way ruptured. A subsequent exam by the orthopedic staff determined it was all the way gone with a gap of about 3/4″.
My timeline was: Injury on Tuesday, Feb 21st; first splint on Monday, Mar 12th (NWB); walking boot on Thursday, Mar 15th (by ortho while waiting on decision to go surgery vs. non-surgery) (NWB); new splint on Monday, Mar 19th…that’s when my official “recovery clock” started (NWB). On Monday, Apr 2nd I got the splint off and back in walking boot with partial weight-bearing (25 lbs). My next appt is Apr 18th.
At my appt on the 2nd the doc did the calf-squeeze test and she said she just a tiny bit of movement in my foot so I guess that is decent news…but then she said I’m faaaaaaaar from from being out of the woods. So I’m taking it easy and although the PWB status has made life much easier I’m still extremely careful about what I’m doing. I’m a bit paranoid that I’ll slip with a crutch or lose my balance and jam too much weight on it and screw things up.
Anyway, that’s my story. As I said in the beginning, I’m worried that too much time elapsed before I got diagnosed and that the ends of the tendon won’t grow back properly. The now famous Ontario study disqualified (if I remember correctly) those that were 14 days past their injury date. That makes me think the study results really don’t apply in my case, hence the reason I’m hoping to hear from others that went a month before starting their recovery.
Good luck and happy healing to all on this beautiful Easter Sunday!
Cheers,
Durwood
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Hi Durwood, just wanted to check in with you and share that I too am non-op & I didn’t get to my doctor until about 2 months after my injury and am healing quite well. I had doubts also but once it starts healing it really seems to grow in strength everyday! I don’t want to be remiss especially on Resurrection Sunday/Easter but I’ve prayed a lot and have been prayed for by a lot of friends, family and pastors, I believe in the power of prayer and that the Lord has compassion. Ok, that being said I can tell you from experience that you’re not too late…You also get to avoid the complications that may arise from surgery not to mention the elevated cost! Be cautious but have faith, your body will heal and will amaze you at the week to week gains, sometimes daily gains that you can make. Cheers!
All the best to both of you, but this non-op (and UWO-study) proponent IS worried. Yes, Durwood, the UWO (Ontario, Canada) study was restricted to ATRs within the first 2 weeks post-injury, so you’d both be disqualified. More importantly, the excellent results from this study and a few others may not apply to your cases. You’re breaking new ground, rather than (as I prefer) following a well-worn path with a solid track record.
Moreover, there are “logical” reasons to doubt that non-op can compete with “op” for old or stale ATRs. Basically, it’s the trauma of the injury (and the surgical “reinjury”) that triggers the body’s heroic response, and the immobilization etc. of the rehab protocol just steers or channels that response But if that response has largely passed by the time rehab begins, . . .
All of that said, if it seems to be working, then it probably makes more sense to “stay the course” than to schedule surgery now. We’ve had maybe two bloggers here who seem to have done well with non-op treatment of REruptures (one post-op and one post-non-op), and they were also outside the parameters of all the studies I’ve seen. Healing is an amazing thing, and maybe it will continue to work for both of you. I’ll try to throw in some prayers from hereabout, too.
But if you get some serious indication that your leg is NOT progressing according to schedule, this non-op proponent might well suggest that you find a surgeon who’s willing to operate on a stale ATR. And yes, there are costs and risks and pain, etc., not to mention the burden of starting over again. . .
BTW, Durwood, there are many people here who wonder if they should have warmed up more, or stretched more, and if that might have prevented their ATR. But like me with BOTH of mine and very many others here, your ATR happened late in a long session of activity, which suggests that’s NOT the case. FWIW.
Just wanted to shoot a quick note your way in reply Norm. I was 2 months from my injury to treatment and in that time I worked a physically demanding job as a Pebble Beach Caddie carrying golf bags or running down and around the golf course for 7 miles a day until I just couldn’t take the pain anymore. My leg was still responding to the trauma as I had to deal with some serious inflammation. I don’t know if it was because of the daily grind and trauma I put my leg through during that time but my leg responded immediately upon initiation of treatment. I also don’t know if it being a partial rupture had anything to do with it either & I do attribute my solid healing to pray and so far wise choices…But I can tell you from looking at and feeling my tendon I have healed very well. I only have my injury to judge from but wouldn’t you think since the docs didn’t try to talk Durwood out of the conservative treatment that this a good sign…And really 2 weeks as opposed to 3…I would ask Durwood if he’s seeing the body displaying signs that it’s starting the healing process, is there swelling? Anyways He should see some indication on the 18th if his body is healing, so I hope we hear about that appointment.
Hi Ultra & Norm,
Thanks for your thoughtful responses. My apologies for delayed response…last Tuesday I had to go the ER because I was having chest pain & trouble breathing! Turned out to be pleurisy. Wow. What a painful experience that was. I was confined to my recliner for a few days and couldn’t really muster the energy (or manage the pain threshold) to even get up and go to the bathroom (I know, I know…TMI).
Anyway, my 4-week checkup is tomorrow (that is, 4 weeks from my official treatment start since injury is more like 7 weeks). Still a bit of swelling but all in all it feels good. The defect feels a little better…almost like it used to be a full gap that my finger fit nicely into but now the gap seems to be filling up? I hope it’s a good sign. But my Doc will let me know for sure.
Many thanks for the good vibes and more to come soon.
Durwood
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Interesting stuff, ultrarunning316, thanks. Of course, there’s a big difference between something that CAN work well, or SOMETIMES works well, and something that works well reasonably reliably, or so frequently that it’s worth recommending to your pals. Heck, our grand-dads’ “conservative casting” avoided re-ruptures ~85% of the time, so there were lots of success stories. But that ~15% rerupture rate was maybe 5x higher than UWO got with its modern non-op protocol, and it seems outrageously and unacceptably high in hindsight. (Mind you, our grand-dads’ surgery probably had pretty high complication rates, too!)
Most of us humans like to (over-)generalize from anecdotes that have happened to us or our close associates, and it takes a mental effort to try to value the faceless numbers from careful studies more than the personal anecdotes. For those of you whose ATRs fall outside the bounds of those studies, any treatment approach is a kind of experiment, guided by medical judgment. I’d expect many or most of those experiments to succeed — but it still seems very different from following a well-tested path. Even very popular medical treatments sometimes fail the test of randomized trials, which is why “Evidence-Based Medicine” is still controversial in some circles.