AT Rupture Blues (Week 3 Update)

All began on a pleasant Friday afternoon on 23rd June 2017 whilst playing tennis, I went to spring forward off my left foot when I thought I’d been whacked on the back of my left leg with a stick. Before I knew what had happened I was lying face down on the ground, happened so quick the tennis ball hit me on the back of my head I was told. I immediately suspected what had happened and once I got over the initial shock checked to see if I could feel if my AT was intact - not good, the taught AT  band was no longer there.

I’m an active 58 year old guy living in Ayr, south west Scotland and have suffered my fair share of sports injuries throughout the years (football: broken wrist and ruptured anterior cruciate ligament - Karate: fractured fibula x 2 - Running: Ruptured gastrocnemius/Achilles) so been here before but can honestly say this injury feels the worst one yet given the impact on my lifestyle and likely recovery period.

After it happened went direct to the A&E dept at my local NHS hospital. Left 3 hours later wearing an OSSUR aircast boot having been diagnosed as having suffered a AT rupture after failing the Thomson test and ortho doctor confirming a visible gap in my AT. Was told would be no surgery with conservative approach being the way forward, to keep weight off the foot and to keep elevated and to return to the orthopaedic clinic on Thursday 6th July and that was that.

Woke up on the Saturday morning and started finding out as much as I could about AT rupture and quickly realised this was going to be no quick-fix. I’m now on day 6 post-injury and having spent the whole time sitting with my leg elevated and I’m finding this really tough, as much mentally as physically. Has also put a lot of pressure on to my wife who has now had to pick up a lot of the duties I would normally do, not least to do with my 9 year old grandson who lives with us so it affects everyone in the household. Thankfully came across the blog and see I’m experiencing pretty much what everyone else feels so good to know I’m not alone. Being able to see what’s in front of me is also helpful, assuming no setbacks like re-rupture, have a fair idea of what to expect. Also full of great tips to make the journey easier.

One thing I have noticed is the difference in approaches taken by medics. I’m happy with the non-surgical approach but there appears to be differences as regards approach to early weight-bearing and the various stages of recovery so will be good to compare the approach taken locally with that elsewhere. Really strange but have been amazed at how important food has become, I’m trying not to eat more than normal but feel a real temptation to do so. Coupled with a massive reduction in my energy expenditure see weight gain as a real risk so will need to consciously work on this.

So meantime I’m counting down the days till my appointment next week so I can get a better idea of what’s going on. was supposed to be going to Spain on July 10th for 15 days so still unsure whether or not I should go given I’m likely to be on my feet quite a bit, albeit NWB so will discuss this with doc also. Happy to keep posting if it helps others the way others stories helped me, if even to see different approaches being taken across the UK so I’ll do another update following my hospital appointment next week.

6 Responses to “AT Rupture Blues (Week 3 Update)”

  1. Did mine on April 1 playing tennis - complete rupture. Happened to my left tendon as I pushed off for a serve. I experienced the exact sensations you had. This happened to me in the US. I also opted for the conservative approach - lots of new research supporting this and doctor seemed to think recovery had a good chance to be as good as surgery without the surgical risks. They put me in cast for 2 weeks in equinus position. After that I was fitted with a Vacoped boot - highly recommended for early weight bearing recovery. Had to wear the boot up until end of June even having to sleep with it which took some getting used to. I am now walking indoors without the boot. Hopefully next week I’ll be outside as well without the boot. Strength in the calf muscle is returning gradually. I am not out of the woods by any stretch, but it does seem to have healed. It is a terrible injury for the inconvenience (pain was not too bad after the initial 2 days). I opted not to travel until 8 weeks after the injury. I wish you a healthy recovery and just advise patience and lots of physio. Check out the vacoped - the angle of the boot is gradually lowered over time to put more weight on the foot. This apparently helps stress the area which accelerates healing. Good luck and try not to get too frustrated.

  2. Tennis seem to be a common trait in this thread I completely ruptured mine April 5th playing tennis doubles with my son on my team against his classmate and his father on another team.

    Was backing off to hit the ball when felt like my son hit me with the edge of his racket on the back of my foot. Turned around and my son wasn’t anywhere close to me.

    Went to the doctor next day and he advised a surgery since I am fairly active in sports (46 year old).

    At the time of the injury I had a European vacation scheduled for end of April - decided to cancel as I would not enjoy it very much.

    One thing that made my decision to cancel easier - was that I had purchased a trip insurance beforehand.
    Don’t know what hit me to purchase a trip insurance as I never do - this is the first time I purchased it and it was a blessing to get 100% of the money back.

    Had surgery on April 7th. My doctor had a very conservative protocol of 6 weeks of NWB in the cast. 3 weeks with foot pointing down and 3 weeks with foot in neutral position.

    I did a lot of reading myself and was questioning this approach during 6 long weeks of NWB in the cast, while reading about being allowed to do a WB as early as 3 weeks after surgery in the boot.

    Doctor told me to do all kind of exercises on my injured foot at least 200 lifts each day. Instead I did 200 lifts 4 times per day.

    Each time
    50 - sitting down in the chair lifting just the lower foot
    50 laying down on my back lifting leg up
    50 laying on my stomach and lifting lower foot up
    50 laying on the side an lifting leg up sideways.

    Looking back - my doctor knew what he was doing as each case is individual as it runs out.

    My cast came off May 18th. I spent about 2 hours on the crutches helping my injured foot and discarded them after as I was feeling painful, but bearable to put weight on my foot.

    May 19th I walked 1/2 mile on my own no crutches - just regular sneakers with a 1 1/2 inch heel rise.

    At home I was walking (limping) bare feet, but each step was a lot of pain and they were very small steps.

    Next day I found by recommendation the best Medical injury PT specialist. And started working with him
    He told me ditch a heel rise and walk in a regular sneakers.

    Each day for the next week I walked 0.8 miles 3 times per day morning, lunch and evening.

    When the next weekend came - May 27th - Memorial day weekend in US. We took a small overnight trip to the nearby town. I would have to rest a lot while kids run around, but overall I did 4-5 miles daily during that trip.

    Everyday I would make sure to walk 2-4 miles. I would keep going to PT and listen to him when he told me I could attempt new things.

    End of April European trip that was cancelled was planned again for Mid June.
    When the trip time came. I could walk 3-4 miles without resting with barely noticeable limp.

    Trip went great - I was not a drag (at least I tell myself so :) ) on the rest of our family.

    I lost my limp completely over that trip. And can walk up and down the stairs normally.

    Now I am 12 weeks post surgery and ready to seriously start getting strength back. Before week 11 I was not even attempting a single calf rises as I did one attempt earlier (at week 9) and felt immediate sharp pain in the tendon area that told me not to try it again.

    This time at week 11 tendon was ready physiologically (as there was not as much pain) but not ready physically - no strength.

    One week of strengthening 4-5 times daily let me do a single calf rise 3 times in the row - still not as high as my other leg.
    But that is a starting point. From here its up to me keep exercises going to bring strength back to my injured leg.

    Me and my son set a goal - there is going to be a 5K charity run in October. We’ve participated together last year. The goal is for us to participate again this year and for me to be able to run without stopping.

    Still ways to go to even think about being able to run 5K as I’ve not attempted to run yet. But something to look forward to and keep working towards.

  3. Hello my name is Ty (39 year old/female). I was very active before I injured myself–going to the gym probably 1-2 times a week and/or officiating basketball games. I hurt myself playing basketball/shooting around with my students on the last day of school. Im so stupid and was just wrong out there. 3 days later I had surgery (ATR) on June 20, I am now 3 weeks and 3 days. I had a half cast the first week, then a hard cast for 2 weeks. At the 3 week mark I had the hard cast removed, staples out and the boot put on. I was told I am FWB now and wing myself off the crutches. Its been 3 days since I had the cast off—I am walking with a limp and using 1 crutch. Whenever I am sitting I have to removed the boot. I dont sleep with the boot either.

    I dont have pain and very little to no swelling. I ice every night and do exercises everything I take off he boot.

    From what I hear early WB is good for a quicker recovery. I will have the boot on for another 5 weeks which is when I go back to the surgeon. I start therapy also in 5 weeks.

    I am happy that I am FWB, mentally and physically. I am moving around more independent, happier, and able to clean etc.

  4. Ruptured my R Achillies Tendon in first of July. Ortho. Doc. said due to my activity level surgical repair was the best option. Pain has never really been an issue, i’m going to be 63 y.o. so it because I have a high pain tolerance or do I have some sort of nerve pathology in my foot ? Anyway, soft cast for 2 weeks then to a walking boot, have been fairly aggressive about FWB and keeping up my cardio.( Schwinn AirDyne good for both arms and legs.) And weight training regimen always with the boot in place and only exercises that exclude my injured leg, but will be included as conditions permit. I had good progress and do a lot of walking in my boot ,almost feels like I could leave it behind at times. 2 weeks from now I will be in a shoe and I told my PT all I want is to be back on my snowboard this winter. We’ll see, all in due time !

  5. One thing I forgot to mention, when I received my boot there is about a 2 1/2 in. difference between my heel on the floor and my heel in the boot. I took a resolable shoe to a local cobbler and for $45 he put sole on my shoe that allows me to walk evenly and level. The sole is about 2 1/4 in. thick. The best $ 45 I ever spent. No more back or hip pain from walking unevenly.

  6. The differences in treatments across the uk and us are astounding. Even in the uk. I ruptured my Achilles the first time 4 years ago and then again in July this year. 9 weeks after the second rupture (which was missed by the local hospital dispite a large palpable gap where my tendon should have been) it ruptured for the 3rd time and I have a 4.1cm gap. I am having surgery to have a full reconstruction and fhl graft - my surgeon openly admitted this should have been done after the second surgery!!! I’m having the op on October 5th so in 3 days time. I’m normally very active and would go to the gym daily but have found I have put on weight over the past 3 month due to this which is a nightmare! it’s unlikely I will get full function from my ankle again and I won’t be able to run like I did before but am hopeful I can get back to some gym function. I’m just focusing on being able to walk properly for now! The weight can wait!!

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