I have reached the 6 month mark and am thrilled to report I have a happy and smooth ride through my second ATR.
I was unsure about taking a non-surgical recovery initially, but it has been a fantastic experience. I was FWB at 2 weeks and had an early start with PT (4 weeks). Hindsight is a wonderful thing and it is a relief to be looking back over the last 6 months and know that my recovery could not have been any better.
For now I still have a little bit of strength to regain, but I am able to enjoy most things- down hill and skate skiing, yoga, rowing and gym work. I will probably by pass classic skiing this winter and will start a running program in the spring.
For those who are starting out, be patient and stay positive- there is no reason not to come out with a full recovery!
There is finally light at the end of the tunnel. It is not all that close but I am finally feeling like a sense of normal is coming back.
I am 17 weeks post ATR non op and no longer feel walking is totally foreign.
I can do a bunch of feeble single leg heel raises without feeling like my foot is being crushed which in my world is very exciting.
Next challenges to tackle- coming down stairs like a normal person and matching up my calves. My first ATR leg now has less calf muscle. And I thought that one advantage of doubling up the ATR experience would be somewhat matching up my legs!
Wishing everyone a happy Christmas and all the best for 2015!
As well as the whole shebang of strength, mobility and gait pattern that goes AWOL after ATR we lose the ability to balance on one leg. The good news is that it is a very trainable skill!
I have put together my own set of exercises and after a couple of weeks it is all coming back. Hallelujah!
Here are the 6 exercises that sound easy- but aren’t. I perform each on the good leg so that there is a patterning for the affected leg to follow. One minute of balance followed by 10 second rest, if you have a timer app on your phone it makes it super easy. Twice a day if you can squeeze it in.
First level is in supportive shoes, then move to barefoot. The most important thing is that you are balancing on the whole foot- not windmilling ever body part possible and standing on the the outside of your foot. Tap down the foot or hold on as needed.
1. stand on leg and trace semi circles with the raised leg- just above the ground to start and then higher.
2. stand on leg and reach down to a sofa or coffee table keeping the raised leg and back in a straight line- like a single leg dead lift. Work towards not touching back down on the ground.
3. stand on one leg and pass an object over head- start with a yoga block and move up to a weight.
4. stand on one leg and look to left, then up to the sky, then down to the floor- look to the right and then up and down.
5. stand on one leg and toss a ball from hand to hand.
6. stand with the feet in line and heel to toe- affected leg in front first. Close eyes and move head side to side.
Practice up- these could develop into your best party tricks of the holiday season!
I am 13.5 weeks into my recovery on the non-op route and so far things are going well. So far I have managed to judge how successfully I can push each day, and as all of us know the constant rehab is the key to getting back to normal.
Like many who have posted I have had rather unusual medical care. In emerg I was told that surgery was not an option and casted, my first OS appointment was set for the 2 week mark. After reading up on this site I went armed with a modern protocol that I knew would fit with my life and one that I felt comfortable following regardless of the support of my OS. I have added the protocol at the end of the post, it is identical to the CFAS link (now broken!) on Cecilia’s much cited page.
My OS saw me at 2, 6 and 10 weeks- at that point my tendon was well formed and I was released from his care. A little scary and in my opinion far too early but that is they way it is.
PT is something that I have had to source as a private patient. I have chosen a great PT who works with an anti gravity treadmill. What an awesome piece of equipment! I have been using it 3 times a week since week 9 and started single calf raises at 10 weeks- just 20% of my body weight so doable! On top of the treadmill I have a of a ton of exercises to do at home- balance, calf raises,squats, gait etc etc. Combined with the stationery bike and a whole body gym routine the days are full, but it is great to see improvements daily!
Having gone through this twice is a blessing and a curse. Really who would want to even think about repeating the experience? But it is the experience that has made me feel confident and comfortable with strongly advocating my recovery path. For those who are in the early stages- it really does get better and better each day, week and month!
Happy days, I have officially started wearing 2 shoes. After a few sessions on an Alter G I am boot free at home, slow and cautious but it feels fine. I can take small steps limp free, and pain free which feels awesome.
I am not pushing dorsi flexion too much right now, I know that it will come- the rest of my ROM is getting very close to my good leg. I just need to keep building strength and balance which I am not worried about, it will come over time. As far as my tendon goes it is doing well, not too much scar tissue- just has one section which is slightly narrower. With time and PT it will continue to fill out.
So at 10 weeks non-op things are on track for a successful and full recovery.
Happy healing to you all
I am getting to the 8 week mark here, I am surprised how quickly the weeks are passing- I have even had to check back on my calendar a couple of time to be sure I had the right week count!
I was in a cast for the first 2 weeks and then moved into a Vacocast. Since then I have been following their protocol-
- week 2-4, 30 degree fixed
- week 4-6, 30-15 degree hinged
- week 6-8, 30-0 degree hinged
The next phase is +10 to -10 degree in the boot for another 2 weeks and then transitioning to 2 shoes at week 10. A little slower than the other protocols but it suits me just fine as I have a week away during that time. I also feel that following the protocol from beginning to end makes sense.
I have to say that I don’t feel there is much restricting my day to day life during this recovery, I do feel more tired but that is probably a combination of healing and not having the best sleep. I started ROM exercises at week 2, PT at week 4 and have been riding a spin bike most days for the last month. I can do a normal upper body and core workout at the gym and with yoga and foam rolling feel like I am keeping any side effects to the rest of my body at bay.
At 6 weeks I passed the Thompson test which was not a great surprise, it was obvious that there was now a tendon where it should be!
Now I am getting closer to moving out of my boot I have the same feeling that comes when all of a sudden you realize that Christmas is just around the corner. Excited, but totally aware of all the work that needs to be done. I will be using an Alter G treadmill, the pool, more acupuncture and of course lots of PT to get me through the next phase.
I actually can’t remember lots of the details about my last ATR, I do remember lots of pain, swelling and discomfort, and that I went from 8 weeks in a few different casts straight into 2 shoes. No transition, just straight out of the door and into an incredibly busy life. I guess if that was possible this time around will be just fine!
I can’t say enough about how glad I am that I took the non-op route, and that I found this site.
Hope everyones recovery is going well!
Five weeks plus and recovery is going really well- that makes me happy!
Having been down the ATR road many years back with a surgical repair I was reasonably concerned at first that the non-op route was valid. So far I am thrilled. Pain is minimal as well as the comparative impact on my day to day life, and there is lots to be said for both of these.
Being able to shed the boot means I can gently move my foot and work through PT exercises. I can massage my leg and work on swelling before it sticks which is a huge advantage- now my poor old foot is no longer acting like a zombie.
Most importantly my tendon is remodelling. It is a work in progress down there but the fact that the body is able to do this all on its own- no knife, drugs, stitches or scars is truly amazing.
So, right now I am quietly confident and happy!
The slowest two weeks have to be those following rupture, NWB, crutches, fighting the blues make for a total pain.
What a change a boot makes. My Vacocast arrived at the very last minute and just in time for my 2 week OS appointment today. It was the first time the staff at my local hospital had seen this boot, my doctor thought it looked like a great improvement over the typical boot. The nurse turned his nose up at it big time.
He refused to believe it would be possible to swim in it- if I did I would get heel rot! Its too bad that new ideas challenge some “professionals”. It is also too bad that the nurse couldn’t be bothered to read any of the the instructions and set the boot at 20 degrees instead of 30. No harm done, I refitted and adjusted the straps etc easily.
My doctor seems very relaxed and is happy to let me follow the Exeter protocol. Not sure if this is the protocol he uses, maybe is as it didn’t seem to raise any eyebrows. I am so glad that I am not battling old school rehab that’s for sure.
For now I am happily testing the water, slowly PWB. So far seems like it is very doable, but will build over the coming week. ROM feels bizarre but having the boot off is such a treat!
I have started to think about the connection between antibiotics and ATR. I was given tetracyline as a toddler, it stained and left a ridge on my forming teeth. I can’t help but wonder if there is any research the effects of drugs such as these on young tendons……
Hope your days are happy and healing is a work in progress!
There is no doubt that ATR recovery is a huge test of patience.
Life with your feet up is not all it is cracked up to be. I am a very active person and it is so hard to not be frustrated by the crutches and inability to do simple tasks. Taking it one day at a time!
I have been doing lots of research on recovery, my last rupture was pre-Google. How things have changed.
My foot is currently cast at 27 degrees. I wasn’t given any other info at the time other than the casting would be changed progressively and a boot used at some point. Is 27 degrees too close to neutral?
I also am still getting some swelling- will keep the chunky old leg elevated as much as I can so that this hopefully passes soon.
A quick step off my mountain bike and I heard that unmistakable sound from my left ankle. Unfortunately I heard it more than 15 years earlier on the other leg so knew exactly where I was heading.
My last rupture was surgically repaired and I have had a great recovery, it was a long road though. I was so worried when the non-surgical route was my only option this time. Was it going to be inferior, strong enough and would the recovery be full? I was given very little advice in the emerg department which didn’t add much in the way of faith.
Thanks to all the info on this site I am now totally confident. I am in a cast and will be seeing my OS in a couple of weeks armed with a Vacocast. Fingers crossed he will be on board with the UWO protocol!
So- I am 4 days in, staying positive and resting up. I am able to move my toes easily- it this normal?
I must say that skipping the trip to surgery is a huge plus. It took me weeks to get over the op last time and the fear of infection was huge. By the time the final cast came off I had no hope of moving my ankle much which added lots to an already extensive rehab.