Big step backwards today…

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.

Durwood

14 Responses to “Big step backwards today…”

  1. Durwood,
    Sorry to hear that. I went non op too and I asked my orthopedic surgeon about what would happen if I re-ruptured. He said we’d just recast and start the process all over again. Maybe that’s all you’ll need too along with a more extended recovery protocol.

  2. Durwood, Was your AT a complete rupture the first time around? Do not understand completely how a non-op (If complete rupture) heals itself. Is it scar tissue that mends the AT? Hang in there. I opted for surgery and surgery was a tendon graft jacket. June 5th is my 8 month mark. My surgeon gave me options and surgery ws my choice.

  3. Durwood,
    Bad luck mate, I had a very similar experience, nine weeks in a cast and then three weeks later had a re-rupture while walking. Despite being out of action again, I found the re-rupture to be a bit of a blessing in disguise.
    The surgery experience and rehab since has been very positive. Firstly having had all the scar tissue from the initial rupture and several years of tendinitis removed (surgeon described the tendon as a “dogs breakfast”), immediately my ankle was moving a lot freer. Additional to this, the recovery from surgery has been quicker than with conservative treatment and I have had much better support from specialists and physio’s.
    My surgery consisted of a clean out of scar tissue and simple stitching of the tendon.

  4. Awfully sorry to hear that. I’m the head of the non-op Glee Club here, but your non-op plan after the long delay always made me very nervous. Ironically, it might actually work better now, with a fresh tear. But most Docs and patients do choose surgery for re-ruptures (including the UWO study authors).

    Good luck, you’re due for some!

    Doryt, I’m not sure anybody totally understands why or how non-op now (w/ modern rehab protocols like UWO) works virtually as well as surgery on fresh primary complete ATRs, but the evidence says that it does seem to. That’s true of many drugs and other med treatments, too, btw.

  5. That’s really grim news…. I’m so sorry. Keep your chin up.

  6. That’s really bad news, I’m sorry to hear that.
    It also serves as a really good warning! I was beginning to feel a little invincible with my achilles getting better and me pushing it harder by the day…
    I’m also non-op / conservative with the old fashioned long immobilization treatment - which means I’m also in the high risk group for a re-rupture. I think I’ll take things a little easier for a while now.

    Good luck, I hope you make a fast recovery back to where you were.

  7. Oh No! I’m so sorry that happened!! I’m at 12 weeks non-op and re-rupture is my biggest fear. My physical therapist is trying to get me to stretch my tendon during PT, but it makes me nervous out of fear of re-rupture.

  8. Thanks Starshep, we’ll see what happens. It feels different than the first time around…there’s a lot more pain & less range of motion so maybe it only partially tore? I am meeting with my ortho in a couple of hours so we’ll see what they say. Thanks for the kind words & support!

    Durwood

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  9. Thanks Kirk! Glad to hear there might be a silver lining to this process if I do indeed need surgery now. Dogs breakfast…hilarious. We lived in England for a few years so I’m very familiar with that term. Reminds me of another term that popped into my head after my achilles popped, “Bollocks!”

    More to come. I’m meeting with orthopedic this morning. We’ll see what happens. Thanks for sharing your experience. It really does help to know I’m not the only one with this kind of setback.
    Durwood

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  10. Norm, as always, thanks for the educated/experienced point of view. It helps neophytes like me make sense of what might come. I’ll be interested to hear what the orthos say this morning but based on what I think my body is telling me…I am screwed! I think I can feel not one but two defects in the tendon. One is immediately above the ankle area where the tendon starts and the other is in the same spot it originally ruptured–about an inch above the other spot. The whole back part of the tendon leading up to my calf is extremely sore and I have just about zero range of motion. Any amount of pressure on the leg results in shooting pain. So that makes me think it’s only partially torn because the first time around I was able to get around pretty good and not be in much pain at all.

    I can’t imagine how it could heal this time around without surgery. Seems like this probably happened because 3+ weeks elapsed and if all that scar tissue was the primary reason why the healed tendon snapped then surely all that scar tissue will continue to be an issue? I guess I’ll let the experts handle it from here! I am comforted by the fact that the surgeon is a big supporter of the UWO protocol so I’ll believe him if he says he thinks it’ll heal up again without surgery.

    More to come! Thanks for the support. I sure do appreciate it.

    Durwood

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  11. Thanks Mrboro. The mental aspect is the hardest part. But reading the posts & replies to my posts does provide a good deal of inspiration. Thank you very much for the kind words!

    Durwood

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  12. Stalledminidriver, Thanks for sharing. I have to tell you, I was fairly nervous but also excited as I passed each milestone (two shoes, starting cardio as part of my PT regime, etc.). I did have to back off a bit just before Memorial Day weekend because it was a bit sorer than usual but by Tuesday it was back to feeling about right and I did 30 minutes on the exercise bike that day. Wednesday when I woke up I was VERY excited because my leg felt great…and then BAM!

    My physical therapist said he didn’t think I did anything wrong. I followed the stretching & strengthening regimen he’d given me and trusted that it was the right thing to do. Did some of the stretching & bike riding lead to the re-rupture? I suppose it’s possible. But I can’t second guess the protocol. Maybe my particular injury history with the length of time that elapsed between injury & diagnosis should have led me to take it slower during PT? I don’t know. But my PT’s guidance was to listen to my body and if the stretching & exercises didn’t “feel right” to simply back off. I was pretty good about doing that so I really don’t think I overdid it and caused this to happen because I was careless.

    Keep up with your routine. Trust in your docs. Keep building up the strength because I think the lack of activity is just as bad as overdoing it! Good luck in your recovery.

    Durwood

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  13. Cindy, I know exactly what you’re talking about. Every time I stretched or did flexing/strengthening exercises I wondered if it would just snap. Just ease into it and if you feel something out of the ordinary you’ll know to back off. I firmly believe activity is very important so you can’t let the fear of re-rupture keep you from working it out! Go easy, go slow…but keep going! Good luck to you and I’ll keep my fingers crossed for you and your recovery.

    Durwood

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  14. Cindy:
    You need to trust your therapist. If you don’t put the proper strain/stress on your tendon while it is repairing, it might not attain the level of strength it needs. Stressing and straining it in the proper manner forces it to become stronger. Of course putting too much stress and strain on it also bad. That is where the guidance of a good therapist comes in.

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