8 weeks!

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!

6 Responses so far »

  1. 1

    normofthenorth said,

    October 15, 2014 @ 1:23 pm

    Your “their protocol” means Vaco’s protocol? The step backwards - from hinging 30° plantarflex at 8 weeks to only 10° 8-10 - seems strange to me. I do understand that you’re introducing dorsiflex hinging (10° past neutral), which is “a stretch”, but I don’t see how restricting the PF hinging helps that.
    In my rehabs (both?), using a non-Vaco hinged boot, I tried introducing some DF hinging past neutral, and I didn’t like it at all, so I didn’t keep it. My Doc was following the UWO Protocol (fixed, non-hinged boot), so I was on my own with the hinging. I never restricted the PF much once I started hinging, at 7 weeks (ATR #2, much later with surgery for ATR #1).

  2. 2

    herewegoagain said,

    October 15, 2014 @ 3:55 pm

    Norm, sorry “their protocol” was not the most accurate phrase! I was given a copy of a review that was published in 2013 (out of London I think) which was based on a protocol identical to the one posted under #5 as CFAS on Cecilia’s page (that link is now broken BTW). Not having full access to studies is frustrating, I think this may be similar to Exeter…
    I think it is reasonable to say that the protocol may be in part tailored to showcase the features of that particular boot. I am going to try the limited range of hinging, but am open to full PF if it means better walking. Thanks as always for your help!

  3. 3

    stevenk said,

    October 24, 2014 @ 6:14 pm

    Hi herewegoagain.
    I’m nearly 4 weeks into non-op recovery and glad to see that you’re doing well. Since you’re several weeks ahead of me, I was wondering if I can run a couple of questions by you.

    (1) When you passed the Thompson test at 6 weeks, how did your bad achilles look visibly? Did you still have somewhat of a void that had not yet completely filled out? Or did it look like there was sufficient scar tissue developed in that area?

    (2) I also purchased a Vacocast Pro Achilles but found it to be rather uncomfortable and haven’t put it to use just yet. I’m still using my run of the mill boot with a 15 degree wedge but started walking without crutches a few days ago. My main issue with the Vacocast were the soles. I wish there was something in between the wedge and flat soles.
    I was wondering if you had a similiar issue and when you were able to transition to the flat sole on the Vacocast?

    Thanks very much for your help in advance.


  4. 4

    herewegoagain said,

    October 29, 2014 @ 11:44 pm

    Steve, sorry I have been away and missed your questions.
    At 4 weeks I only had a very soft feeling tendon, even now the swelling makes it hard to see an obvious/clear outline of the tendon itself. If I was you I wouldn’t worry too much about the possibility of a gap, just keep working to your protocol and be patient (easier said than done I know!!).
    I agree that it would be great if there was more choice in soles for the Vacocast. I stayed with the rocker sole until I was hinged at neutral and wore a higher heel shoe on the good side, without the shoe it is way too hard to walk comfortably. Maybe try an Even up, the hinging is great once you have it figured out so good luck.
    I am hoping to start life back in two shoes tomorrow, will let you know how the tendon is progressing after my app with my OS.
    All the best, Lisa

  5. 5

    stevenk said,

    October 30, 2014 @ 12:55 pm

    Hi Lisa.
    Thanks very much for the advice.
    Yesterday, I met someone who rutpured both his achilles tendons at different times and went through non-op recovery on both. His ruptures were 10+ years ago so the recovery protocol was very different than what we’re doing (i.e. total 8 weeks in a hard cast with gradual change 30-20-10 degree plantar flex position casts with NWB). But he ensured me that non-op recovery works fine. He also felt that in hindsight early functional rehab would’ve helped him recover faster. It was just nice to see someone who’s gone through this on both legs fully recovered with no long term consequences.

    Congratulations on getting into 2 shoes!!!


  6. 6

    herewegoagain said,

    October 31, 2014 @ 1:42 pm

    It is always great to hear confirmation that non-op works out just fine! The early functional rehab definitely makes a huge difference. There is nothing overly complicated or difficult involved but it helps so much mentally and physically- All the best!

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