My AchillesBlog

I’m on a dilemma now, to bear or not to bear weight???? My OS said 4 weeks NWB and I started at 3 weeks, then I talked to a physio and said I should stay with what the doc said… then research suggests to go with what’s been successful at early weight bearing treatment…

So I stopped, to my dismay, bearing weight yesterday… physio says most likely no damage??? from the 3-4 days PWB at 10/15%…. but now I’m obviously worried and discouraged. I got a suggestion to just stay with what my OS said based on the fact that he has seen me now form my original rupture and knows what is going on with my MRI and such. Also, that it is only 4 more days NWB and since it is a re-rupture should take it easier and be patient (not my virtue).

Hopefully I’m making the right decisions here, I will hopefully be seeing another OS this week for a second opinion. Thank you all for your support and happy healing to all.

Hi there, my last post said 3 weeks, but that is the amount of weeks already passed since re-rupture so I will correct it now. Now entering week 4, I guess I’m a week behind on UWO protocol, hope this doesn’t throw me off, but now on it I’m trying to do as much as I can without over doing it. It’s been really difficult for me to accept the re-rupture and to be doing the same exercises I was doing 4 months ago, and to be honest really depressing. I have to find the mental strength some how to keep going. Needless to say this also brings a lot of fears and insecurities. At least going non-op this time has open a new set of questions and seems like a new process, different care, etc., in my opinion if I had known how less painful and traumatic conservative treatment was, I wouldn’t have hesitated to go this way my first time around, but along come fears with that. At least with surgery you know the tendon is attached surgically and non-op you are letting your body heal and work its magic naturally. So, with that in mind, my main concerns with PWB and ROM this week are:

1) How much walking is recommended once at PWB (protected on VACO and crutches) or is it full time now and walk at any opportunity? Is it safe to sit most of the day?
2) How many degrees increments on Inversion and eversion per day? Or is it as tolerated? How many repetitions a day?
3) When should I start dorsiflexion? My major fear of tearing what is healed.
4) How much exercise (in boot) leg raises, knee extensions, core.

Needless to say I haven’t had significant pain since the day of my re-repture. I’m also feeling rush of blood/fluid coming down my leg when I sit my foot down, I’ve had edema before the re-rupture and now it seems like a balloon filled with water when it swells. I’m following the accelerated protocol UWO on my own and with the help of youtube videos and social media. Unfortunately my OS instructions were very vague “Start ROM exercises and FWB by next appointment” really? No PT until next visit at week 8.

Thank you in advance, not looking for a concrete answer but for any experiences you may have had during this period on your recovery and how would your PT go about at this stage. It’s hard to judge by yourself with out any supervision or help from your doctor. Have a great day and keep up the healing!

I’ve been hesitating on this but I will go with the evidence on early weight bearing and ROM. My foot feels strong and I haven’t had much pain since the re-rupture. I was fortunate to find an awesome youtube channel with exercises that I needed to start with. I strongly recommend it to the new members here. I wish I had them available my first time around https://www.youtube.com/channel/UC9L9i8pVLPqda8fvhx_9LUA

So what’s in store for me today UWO protocol:
• Continue on VACOcast at 30º
• protected partial weight-bearing with crutches
• active plantar and dorsi flexion (may hold on on this for another week), inversion /eversion below neutral-
• Control swelling, elevation (so far I’ve been elevating my leg all year)
• knee/hip exercises as appropriate
• NWB fitness/cardio work
• Hydrotherapy (within motion and weight-bearing limitations) most likely in the tub

So there you have it folks, time to get to action. Wish me luck!

Good news! Here is an update as to what happened at my OS today.

Basically after a physical revision of my tendon, my OS concluded that it seems to be continuity on the tendon, it seems to be together and concluded that surgery is not needed. No explantion as to what could have gone wrong, he couldn’t explain it himself as he had not have any re-rupture in 10 years.

He recommended to stay on the boot Non Weight Bearing for another 10 days, for a total of 28 days (4 weeks) after re-rupture, then I can start Partial Weight Bearing.

I can start from now some limited Range of Motion exercises and increase flexion as in the boot degree increments.

4 Weeks - In 10 days start PWB - ROM exercises continue.
5 Weeks - In 17 days from today I can reduce the angle of my boot dorsi flexion to 20º (PWB in boot) ROM exercises continue.
6 Weeks - In 24 days to 10º (PWB in boot) - ROM exercises continue.
7 Weeks - In 31 days to 0º and Full Weight Bearing (in boot) - ROM exercises continue.

Next OS Appointment 8/3/2015

I’m happy with this, but I’m not sure about the new protocol, it seems a little aggressive as far as the degree increments and stepping towards FWB. Also I am not sure as to how gradually I can increase my ROM exercises, and/or if I can introduce other ones.

He said no therapy until next visit a month from now, then we would look into strengthening exercises. He also mention that since it is a re-rupture we need to take it slowly to avoid any more setbacks.

So, there you have it, it seems like I’m over the worse and on my way to recovery again. Needless to say I feel much better and like many mentioned (stuart/Richard many thanks), taking one thing at a time. Thank you all for your support and if you’d like to share your protocol or any suggestion I will really appreciate it.

Took the boot for the first time in 2 weeks and it looks strange. I guess there was pressure in those spots and that is the shape my foot took. I was able to wiggle my toes, the bog toe was the hardest but I managed to move it up and down. Hoping everything is ok, I can’t really see my tendon there, hopefully everything will clear by Monday when I go to the doctor. Let me know what you think.

Hoping I can get some advice during 4th of July weekend. I’m sure most people are enjoying a BBQ with friends and family here in the U.S. Happy 4th btw. I’m day 16th now post re-rupture, I started my rehab on an aircast boot from day one of re-rupture June 18th until June 22nd and since then on VACOCast Achilles boot until today at 30º PF. So basically I’ve been on the VACO 12 days today, but more than 2 weeks on a boot.

Obviously, after re-rupturing I’m being extra cautious and focusing 100% on the injury, trying to make it right the second time around but non-op now. Since I’m doing this with no medical advice or support, I’m following the foot steps of fellow ATRs in this blog. So, today will be the first time I take my foot off the boot!!! But before I do, if anybody could share their experience I will truly appreciate it.

I’m following the UWO protocol this time around and suggests:
2-4 WEEKS
-aircast boot with 2 cm heel lift (I’m on VACO)
-protected weight-bearing with crutches (ho much weight?)
-active plantar and dorsi flexion to neutral, inversion /eversion below neutral - (skipping the flexion for now)
-modalities to control swelling (I will start RICE off the boot)
-incision mobilization/modalities as indicated (no idea)
-knee/hip exercises as appropriate
-NWB fitness/cardio work
-Hydrotherapy (within motion and weight-bearing limitations. (bath tub ok?)

I know it is early for me to jump into all of these, but for those who already been thru this phase, could you share some of your experience? What to expect off the boot for the first time? what excercises should I start right off the bat and what to avoid? Anything will be helpful, TBH I’m sweating just to think I will see my foot again and I don’t want to hurt it!! As always, thank you to this great community and keep up the healing.

First of I’d like to say this forum has been great support from the beginning of this dreadful journey. I’ve been having a really hard time getting a grip of myself this time around after my re-rupture, and when it seems like it could get better it has just gotten worse. I’m so sorry to put this on the new comers, but I just need some encouragement at this point. Here I am trying to figure out how I will make it out of this abysmal hole, where I lost most everything and now with the news that I may even loose my job, which means insurance and all of the above when there is no income. I’ve been fighting anxiety and depression for a while now, and I find myself in tears most times, I guess I’m catching up on the crying since I don’t even remember the last time I did. I know this is beyond the ATR but I guess is a consequence of it. I’m now praying to make the right decision between conservative or not coming July 6th on my next OS visit. I’m hoping I still have insurance by then if not I will have no choice but hope that the UWO protocol works for me as I am doing right now. I keep looking at my MRI and keep reading every blog possible to try and find answers comfort, I feel exhausted and overwhelmed with information. I’m really glad for all of you that have recovered from this, I really wish some day I can come back to read this post and see it as part of my life that I overcame as many of you have. I know it gets better because I’ve been there and even tasted a couple weeks of a normal life before re-rupturing it, but as of right now I just feel in that dark hole again.

Here are more scans of the MRI, I am no expert but on two of them the gap doesn’t seem to be that much. I still have hope I can avoid a second surgery. What do you think??? Right click to open a larger image.

As I lay here again this time on my own, I realize how trying this injury is. I’m basically relying on all information I can gather, testimonials and support from this blog and goggling for any information I can gather. I even contacted RGH Wallace and responded with his protocol. I am just worrying for what is ahead, if what I’m doing is the right thing to do. It just seems surreal after my ATR being surgically repaired and re-rupture, to think that the tendon will re-attach on its own. I’m trying to stay positive and following directions, which are not too many but rest and elevate.

Here is what I’m doing so far:
1. Elevate the foot as much as possible above the heart. I only put it down when I go to the kitchen to cook, to the bathroom and to open the door and so.
2. Toe curls, I am not sure on how often I should do this, but I try to at least 3 times a day. I just feel afraid to disturb the healing.
3. Boot 24/7 - so far I have managed to stay on the boot most of the time. I have taken it out a couple times when it feels really tight and to air it out, which probably amounts to about 3 times so far. I am scare to death to do any more damage or interrupt the healing.
4. Knee flexing and leg elevation while in the bed, about 3 times a day. I am also not sure if I can do this as no instructions were given to me. But I’ve gather around the block that people has done it early in the first 2 weeks.
5. Non weight bearing, I assume this is the most important of all, and so far so good. Some times I rest my foot while sitting, but I even try not to do that at all, I hope it’s ok from the times I did at the beginning of self treatment.

As far as meds, I’m not taking any meds, swelling is down and I haven’t had major pain but the initial pain right after re-rupture. I had a big ball of swelling arounf the re-rupture site but it has all gone down. I fell more discomfort from the boot than the tendon injury.

My major fear of course is that the tendon is not healing, specially since it re-ruptured after being surgically repaired. I don’t know what to expect at my next appointment since my OS always indicated surgery as the way to go. Stuart here mentioned to be careful at my next appointment so they don’t manhandle the tendon and damage what it has already been healed. But I don’t know how to tell them that. I surely hope so they know.

So, that is about it, I have found that writing in this blog and communicating with other ATR’s via email has also helped me to go thru these really dark days in my life. I wish you all a speedy recovery and happy healing!!!!!!

Hi there. Not much to report. I’m on my VACOCast laying most of the time and elevating my feet. I don’t know if it is Vaco boot or I’m just used to the discomfort of having something on my foot, but it hasn’t bother me that much at all this time around. I also haven’t experienced much pain besides the day of re-rupture. I’ve loaded my refrigerator with vegetables and ready to eat food, got tons of Vitamin C and my multi vitamins. Drinking lots of water and started doing some Indian healing meditation. I’m trying to do as much as I can to rehabilitate this tendon enough for my next appointment and avoid surgery. And even if I opt to surgery I will be healthy enough to recover from it and beyond.

I’ve been having a lot of support here at the blog, I have reached to some really nice folks via email and it really humbles me to see how compassionate ATRs become with this injury. I even got offered an iwalk 2.0 for free.

Back to the achilles, I continue elevating and trying to be still as much as I can, but being on my own, I’ve had to run some errands in a bouncy car and had to get up for water and my meals, etc., but in average out of the 24/7 in boot and being still, I would think I have manged to stay on it a solid 18, I haven’t even been out of the boot that much fearing I will move the foot too much and damage what is healed. I would think that is why most people go to a cast, but again, my PA didn’t even suggested.

So, for those that have done it conservatively in a boot, if you have any suggestions or insight about it please let me know.

Thank you everybody for your kind support, I will continue posting if any event happen, but as of now, it is just the boring phase of elevating and hoping the tendon is doing its healing magic.

Happy healing everybody!