How it happened
Im a 42 years old male, carrying 14 pounds of padding. I need to do sports or gym otherwise I go nuts. After a barren year in 2007 I was determined to stop the rigamortous that I felt spreading through my body. I would bring myself back to life and get active again.
After a long period of low activity I started playing football again. It felt wonderful and I was totally hooked again. I went to play the following week for my second game. Work tried to get in the way but I was still able to make the field with 20 minutes left. If I tore my clothes off and didnt do any warm-up or stretching I would be able to get in the game. Thats what I did and after only 5 minutes of being in the game my left lower leg was hit by a 20Ib sledgehammer. A guy playing said he was standing over 20 yards away and heard my leg blowout! My Achilles Tendon Rupture (a full tear) was somewhat self inflicted.
It was the first and last time I do any major sport without proper warm-up.
Judging from helpful replies to my blog (thanks to you all), its clear an ATR has happened after warming-up. Im not sure all ATR’s are preventable but as you get older or less active you should ease yourself back into any active sport and give your body time to adapt itself to the coming stress and strain. You can then “crank up the volume” each week.
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265 Responses to “How it happened”
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Hi,
I did a full rupture of my Achiles tendon 8 weeks ago. I’m being treated by the NHS and have the conservative treatment of it. Basically I’m in a cast for 8 weeks and then after that I’m not sure what happens…..but it dosen’t involve surgery. Cast comes of tommorow and it was feeling pretty good but managed to slip of my crutches in tesco and now it’s acheing a bit Hopefully this won’t hinder my recover to much. I’m 30 by the way and mine was also injured in a game of football. Fingers crossed I’ll let you now how it goes.
It’s interesting how there are two approaches to treatment. I opted for surgery and I guess people do. So the achilles tendon is suppose to re-attach itself with the conservative treatment? I’m don’t know much about the conservative treatment. I hope all goes well and keep us updated.
Hi Mat,
I am from the UK too and did my ATR playing football as well.
I’m 25 and tore my Achilles tendon a little over 6 months ago. I was in my third match in a doubles tennis tournament when it tore. I opted to have surgery and everything has gone smoothly thus far. I just began playing tennis again. I am so nervous that I am going to tear it again. Both my tendons have been a little sore. I’m now in nursing school and am going to die if anything happens!
Amy, it’s almost unheard-of to re-rupture an AT that late in the game. I had a very conservative surgeon for my first ATR 8-ish yrs ago — No, they were on DIFFERENT legs! — and he recommended that I wait ’til I could do a bunch of 1-leg heel raises without grunting, before I returned to competitive volleyball. So I did, which took me about 10 months, and everything felt great when I started again. But lots of people push it quite a bit faster than that. Many of them take it easy at first. Don’t be nervous, but do be cautious and sensible!
OTOH, there are no guarantees about your other AT, sorry. (There’s an interesting study about that in the “Studies” page linked from the main page. Look for the word “Contralateral”!)
I don’t know your own experience, but one study I read found that 3/4 of ATR patients did NOT feel sore (on anything else) before their ATs ruptured. So your soreness might well just be. . . soreness — rather than a warning of something dire to come.
Amy, just as a fellow friend..seriously, the risk is really really really really really not worth it. I been there..and I know exactly how the “itch” to run and gun and have fun again. But I personally think 6 months is a bit early to be testing it out. I had to bite my tongue to not run out and play sports again..Summer time, Saturday pickup games, but I am honestly glad i waited the extra 2 months. Just consider it insurance bet. I truly think 1 year is the real deal for total recovery…I feel no tweaks or anything at all, but still..I will never put my achilles at risk ever again, so I don’t play often and so glad winter is here to keep my ass off the court. It’s so strong I am just thankful. Just my own little opinion…take it easy out there..that fear is warranted with just 6 months.
I am so glad I found this blog! I fell backwards off a stool , breaking.g my tibia and fully rupturing my achilles tendon . I had been worried that after six months I still could not do 1_leg heel raises and my calf muscle still looks so small! Now I know to keep up the recuperative exercises and give it time . Cheers from Australia
Hi, i ruptured playing doubles nine weeks ago. I have been in a vaco boot for the past 7 weeks a s see a physio on Monday. I am excited about getting into two shoes again, but nervous and scared at the same time. I opted for no surgery, have any other tennis players optd for the no surgery route? How are you getting on? I am looking forward to driving again…. Whenever that may be!
Healing wishes to you all
Anita
Anita, I used to teach tennis and play competitive squash, but I’ve concentrated on competitive volleyball (court and beach) for the past decade or two. I’ve torn BOTH ATs, and went non-op for the second, and recommend it to everybody — as long as you get to follow a good modern fast protocol, like bit.ly/UWOProtocol (or a bit faster).
And I returned to competitive volleyball at the same level after each ATR (and after the heart-valve replacement a year after the second ATR), too. In my case, that’s a good trick, because I’m 68 and my teammates (and opponents) are 20-43! Neither of my healed ATs are perfect (#1 too short, #2 probably too long), but I don’t worry about them, and they haven’t held me back on the courts or decreased my speed or vertical, AFAICS. (If and when my body makes me quit volleyball, it’s most likely to be my right knee — which may have been knocked out of alignment by my too-short post-op right AT. Details on my blogs.)
And Anita, moving to 2 shoes IS nervous-making, and rightly so. You’re much less protected than in a boot. It’s also a mixed blessing because your walking speed will probably slow WAY down. But it’s an important step towards healed/normal, and it helps wake up and re-train all the little muscles and tendons and ligaments and nerves that give our ankles stability and give us balance.
Hi,
I met with an accident 8 weeks ago and I had an injury to my ankle. It was very deep cut. I was treated with tendon repair surgery. And now I still cant stand on my toe (left leg). I feel lot of pain back there while I try to stand on my toes, cant walk properly.
Chandresh, If your achilles was repaired only 8 weeks ago, I wouldn’t expect you to be able to stand on your toes yet. Many (most?) people on this site are still in a walking boot or cast at 8 weeks and don’t begin trying to do heel raises for several weeks after that. I had surgery 7 weeks ago, and my physical therapist has not yet started me on any kind of ankle-strengthening exercises while out of the boot and weight bearing. It’s a very long recovery and it’s important to be patient and not try to do too much too quickly; if you do you run the risk of re-rupturing the tendon. Even if it wasn’t your achilles that was repaired, tendons receive very poor blood supply and therefore heal very slowly.
Hi -
I am 34, and like normofthenorthon I have ruptured both achilles and had the op first time, then natural heal. I am four months in following the second rupture- and can absolutely recommend a natural heal.
NB - it may be because I presented a lot earlier second time round as I knew the symptoms - I was in hospital the same day, rather than a week after.
Importantly for me, I have tried my best to keep doing exercise even when I can’t work the achilles - (weights, very light cycling, etc.) I’ve been able to get on a treadmill today for the first time, four months in.
I’m a 23 year old female and I tore my achilles when I was 21 playing basketball. I had access to awesome therapy (and still do) since I was involved in varsity athletics. However, it’s my 18 month anniversary, and though I have successfully transistioned back to to varsity sports, my left calf is significantly smaller than my right - 5.2 cm in radius different. I was told my achilles was repaired too long - has anyone heard of having additional repairs after the first surgery? or any tips?
Hi to all fellow ATR sufferers,
First off I hope u all recover from this most debilitating injury.
I ruptured my right Achilles Nov 2013 playing badminton. The usual whooshing sound and kick in the back of the leg. At first thought it was just a sprain so didn’t go to A&E until 3 days later. Confirmed that a full atr had occurred and was scheduled for Percutaneous surgery (Keyhole surgery, rather than the full open surgery), 2 days later. Surgery carried out in the morning and was released later that evening. Next day slipped on my crutches and landed on my operated foot/leg/ The pain that went through me was unbearable for the next 15 minutes. Afraid that I may have re ruptured the tendon I got my dear sister to drive me to a&e and got it checked out. Luckily it was still ok. 4 weeks post op and I fell on the foot again, this time I felt something stretch( rather like a soft chewy sweet you pull apart). In the meantime I had started physio classes so I thought I would wait and tell the physio guys what had happened. They checked it and felt that it seemed ok, so for now I continued with the physio sessions. However as weeks passed I noticed I was limping more than previously. Aside from the physio classes I was going for 2 mile walks every other day and at 18 weeks post op went for a few 12 mile cycle rides. All in all was feeling okay. On a Sunday afternoon which was now week 20 post op I went for a walk, and about 15 minutes into the walk my leg suddenly partially collapsed under me. I didn’t fall to the ground and this time there was no whooshing or snapping sound but I felt like a piece of strand that comes away from a rope. There was pain around my ankle, but not severe, just a dull throbbing. I made it home iced the area. The next day I went to the physio session and told the physio guy to phone my surgeon and ask him to see me.
I was seen the next day and an mri scan taken which confirmed that a partial tear was present in my tendon. The surprising thing was the tear was not at the site that had been sewn but another tear above the repair. I have been put into a vacoped boot with 25 degree plantarflexion. The surgeon will see me in 3 weeks. if the mri shows the new rupture is knitting together naturally he may keep me in the boot and follow the conservative method otherwise it looks like it will be full open surgery as I have already got quite a bit of scar tissue from the previous surgery.
Sorry about the long winded explanation, but one thing is clear from here, and other ppl have mentioned this and it is good sound advice. Please follow the instructions of your surgeon and your physio team. Don’t try to push yourself too much otherwise you will end up re rupturing your tendon. I know from experience how frustrating it is not to be able to do the things you were doing before this happens but believe me it is better to heal rather than to push to heal.
Hi All,
I ruptured my AT March 5,2014 playing tennis (doubles) - after falling on my face in the clay I never put my foot down again. Had open surgery March 7. After surgery I never had any pain, came out of molded post op splint at 2 weeks and straight into walking boot with 3 lifts. At 6 weeks post op I started removing one lift at a time to my comfort (feeling no stretch in the AT) I felt a slight gentle stretch when I removed the second lift but that was it. So at 7 weeks post op (once I was flat in the boot) I started an aggressive physical therapy protocol for athletes (nice to still be considered an athlete that fits the bill for aggressive therapy at 45). I have never felt pain and had great movement and balance from day one of PT. Heel raises, one leg balance, and no weakness with the band exercises. At 10 weeks post op I was out of boot and used it only if I thought I needed - which was a few times for long days on my feet. At 11 weeks I was completely released by my surgeon with no restrictions.
I went on the doubles court for a “watered down for me” clinic a few days later and was very safe as the biggest hold up was mental for me. I plan to ease back into tennis - cautiously - just some baseline hitting and volleying - and continuing PT and doing my exercises daily. My calf muscle is returning slowly but surely and I can do a single heel raise on my injured leg about an inch with just a little soreness in the surrounding areas - not in the AT. The only area that is very sore (and at times painful) is the plantar, but good stretches and icing help that. Also my PT told me that to fight off the plantar fasciitis I should ALWAYS wear shoes. My surgeon did say that no matter what - full recovery to “normalcy” even with an aggressive PT protocol is going to be one year and I can see that.
Sorry for the long story, but I haven’t seen a post anywhere that showed a quick recovery like I seem to be having so I thought I would share.
It sounds great, Page - though pretty typical for both surgical and non-op patients who follow a good modern protocol - like the 3 listed at AchillesBlog.com/Cecilia/protocols.
Most post-op patients have more pain than you experienced, and many patients (w/ or w/o surgery) get out of the boot a couple of weeks quicker. And most OSs don’t trust their patients enough to sound the All Clear at 11 weeks - probably the single peak week for reruptures!
BTW, @longbow555, I think you’ve learned - and taught - the wrong lesson from your sad story. “Watch Your Step!” is probably the most important take-home message that I see. You didn’t rerupture by following a modern aggressive protocol, and you would be a very rare bird if you did!
The best evidence-based protocols still give better results than the semi-random (but usually slower) protocols prescribed by most professionals. But falling onto an ATR foot, with or without surgery, will often do serious harm, even with the best protocols.
The good news is that the pros are catching up to the evidence, though still with huge variations from region to region, hospital to hospital, and MD to MD. (The most “out to lunch” MDs are the most annoyed with the Internet, naturally.)
normofthenorth
You’ve rightly said region to region, hospital to hospital, and MD to MD.
My short time coming here seems to show up an even bigger difference - country to country.
US, huge resources, potential massive sample ATR population, but where are the class-leading rehabs? Canada - way smaller population but UWO showing best practice along with, in the UK, Northern Ireland’s Belfast fantastic results, and Exeter’s highly successful reports. Even New Zealand has figured well in the past.
Page - doing well but take extra care for the next 5 or 6 weeks. You are in the danger zone when you feel confident, have good movement, life is getting better. Well done but don’t overdo it.
Quite right, Gavin. I meant “region” in the broadest sense. BTW, the latest report we got here from NZ was disappointing to me - still pretty ferociously non-op (some would say too ferociously) but with some too-slow rehabs, much slower than the one in the landmark 2007 study from NZ.
I’m surprised that (AFAIK) the single-insurer systems like UK, Ontario (& each other Cdn province), Australia, NZ, haven’t worked harder to incorporate the best evidence into some uniform guidelines - at least for ATR Rehab, where the evidence is clear that many patients get treatment that is neither effective nor cost-effective. Settling on op-vs-non-op guidelines is understandably tricky, but this should be easy. And educating non-op practitioners to approximate the tendon ends in equinus as Wallace does (with remarkable success!) should also be easy, 3 years after Wallace published! All of this may be too hard in the fiercely individualistic USA, but what’s wrong with those other places??
Rather than official guidelines I was more puzzled about the apparent lack of research in the US. If that sounds like picking on the US, ok, what about Japan, Germany, and so on - other rich countries with major universities and big populations?
Guidelines are just that, they are not of course compulsory and we don’t want them to be. What we do want is a leading American uni/teaching hospital to pick up the lead established by certain Canadians and Brits. I know I banging on about the States again but lets face it, it has the biggest purses and speaks loudly.
Healthcare is frighteningly expensive and this is one small way to reduce those costs. No need for the ortho guys to worry about loss of income as ATRs are just one injury and they will still make the $’s.
Hello Everyone, my name is Lisa, just rupture my Achilles Tuesday. I am glad I read this blog, I am not sure exactly if I have a partial Achilles or full, but doc said it might be partial bc I still can do raises . But I will know for sure Monday … But the real question I have is for the women! !!! Can I wear my Heels Again???? After Everything?? Lol I am a True shoe lover, and if not heels Wedges? ??
P.S. Was anyone able to Work???? I am being told I can with limited weight bearing.
Hi. I can’t answer the heels question. I’m sure you will be back in them at some point. I can’t see that it can be a full tear if you can do heel raises. If you have a significant partial tear be careful with heel raises at this early stage! I am 3 weeks post ATR (conservative treatment) and was able to work from home on day 1. Back to work officially today as need to be on my feet quite a bit.
Hi everyone,
I am 55 yrs male and ruptured my AT in January while playing walking football in an attempt to get fit(!). I did not realise what problem was and did not attend hospital until 2 days later when it was not getting any better. Leg was in full leg plaster for 3 weeks with foot pointing down (like a ballerina as the physio took great joy in saying) then 3 weeks in knee length plaster with angle of foot about 30 degrees and same again after 3 weeks with foot flat and weight bearing. After the 9 weeks plaster was removed and consultant said everything was healing fine and there was no need to return to hospital or have any physio and I was to mobilise myself .
It is now approaching 16 weeks and I am walking with a limp but it is gradually improving. I feel exhausted if I walk for any more than about half an hour. I think I have been lucky after reading of the pain lots of people suffer as I have had very little pain, the biggest problem was coping with the plasters and using crutches. Now I am unsure how to continue as I am concerned of the possibility of re-injuring myself. I want to exercise as I am putting on weight from my lack of mobility. I work for myself and it involves lifting and carrying heavy boxes, furniture etc.
I feel that as soon as I bend down to pick something up it will snap again. Any advice would be appreciated.
It sounds like you went non op. I think PT is pretty important- so you may want to look into it. I am 10-1/2 weeks post op and the PT has been very important in letting me know what exercises are safe and what I can and can’t do to avoid any re- injury. They also make you feel more confident as you continue to recover. Wishing you well.
Thanks LindaF . Yes there was no op. By PT do you mean physio?
Consultant said no need for physio but I know when I injured my shoulder a few years ago physio was a huge help in my rehab.
As I have been discharged by hospital I think a visit to my GP will be the next move. Good luck with your recovery.
PT is physical therapy so yes the same thing.
Mick - you should not be walking with a limp and a phyiso can help you get rid of that plus much more. I personally think they do more for your recovery than the doctor who you pay lots of money to see for 5 minutes. The way you have been managed is very old school and although you should return to full function in time it would have been better for you to be in a functional rehab with a physio once you were out of plaster. In saying that 9 weeks in a plaster is a long time and it has been found to increase your chances of re-rupture. I don’t mean to alarm you but there is an increased risk or re-rupture for non-ops treated in this manner so be careful lifting heavy boxes for a bit longer. The danger declines from 12 weeks for most but yours may be a bit longer. More modern protocols have you walking in 4 weeks (in a boot) and back to shoes in 8 weeks but still 5 to 6 months for full duties such as you require. I understand the work you do and how demanding on the tendon it can be. You may not be ready for a full return to work for a while but you need and expert to assess you. Get off to a physio now. Not sure which country you are in but from the language I know it is not the US and feel it may be UK or Aus. UK is mostly NHS physio which is a bit hit and miss so a private physio would be better. Aus is mostly private but regardless you should shop for one who knows how to treat this injury and get you back to work at full strength.
Hi Stuart, thank you for the feedback.
I am in the Uk. When the injury happened I was not given any choice of how it was to be treated (op or non op) and at the time I did not know there was alternatives. Maybe this was because of my age(55). When it came to having the weightbearing cast I had read a little by then and asked about the possibility of a boot but was told that was not the way this consultant approached these injuries.
I have an appoinment to see my GP next week and will ask about Physio. I want to get back to working but I would rather take a bit longer to get things right first rather than risk having to go through a repeat of the last 4 months again.
Mick - what you are doing now is good. I am not in the UK but know many who are and been through this. The NHS system varies so much and there are some hospitals using modern protocols for non-ops. They do less surgery in the UK on this injury probably due to costs and not your age but you can still have a good outcome without surgery. No need to go into that discussion here. You can read through plenty of blogs and it has all been said before. There is still the option for private physio in the UK and you may not need many visits. Hope it goes well.
Thanks Stuart. I will read up on the bloggs and look to get some physio sessions.
Cheers.
Hi Mick
As Stuart says, protocols across the UK vary a great deal. Some of it may be due to budget pressures but more likely, as in most countries, it seems to be down to OS’s skills and awareness of the modern, more aggressive rehab schedule with early mobility (only 2 weeks max in plaster), bringing in PT early on and continuing into the 4-5 month milestone.
Conscientious practitioners will operate only when it is the right thing to do - and as we now know, it is not as often as once thought. And do try for that NHS physiotherapy - in many parts of the UK they lead on the recovery cycle. I was even able to go to a small hospital near my work so that I could see the physio more often - and for ‘free’ too.
Good luck
Buffy
Thanks Buffy.
Mick.
I had a significant achilles tear in December. Misdiagnosed as a heel spur and given a cortisone shot. It felt better for 2 weeks and then pain returned. Got another opinion and an Xray and Mri confirmed a significant tear. I wore a walking boot for 2 weeks with no improvement. Went to a hard cast for 2 more weeks with some improvement. Dr. recommended I get the PRP (plasma replacement therapy) as a last try before surgery. Dr. put the boot back on for another 3 weeks. PRP worked for me! It is 2 months later and I am walking comfortably for 3 miles, but wary of playing tennis. I have been just hitting with the ball machine but plan to play doubles this weekend. Hopefully, I have given it enough time to heal.
Hi guys, really pleased I found this site! Has put my mind at ease loads as conservative treatment seems to be more common than I thought. I’m a 34 year old male in the Uk and completely snapped my AT 3 weeks ago playing football. Knew straight away and foot has been in a cast pointing down since. My main stress has been dealing with the nhs as can’t afford private….foot was stuck in a cast after a 2 minute consultation and surgery never even discussed. I was told to come back every 3 weeks to get a new cast at a different angle. I was then told next available appointment is 17th sept….7 weeks after my 1st and only contact. After days of battling I’ve got one for next week so 4 weeks after which I can live with, I just have no confidence in the service I’ll get from the nhs.
I know there’s people who would love to swap their injury or illness for ours but it still gets me down none the less - can’t play football possibly ever again, can’t pick up my 5 month old baby and having to sleep on the sofa for the foreseeable!
Anyway thank you to everyone who takes the time to contribute to this blog, it has helped me feel better about the situation and put things into perspective.
Best wishes to everyone in their recovery
Chris
Iam 3 months post opp with some complications while recovering.i never gelt like my progress was textbook. Swelling and pain along the way.2 days ago stepping off my porch i rerupture it again.heard that awful pop.tonite as i write this iam in emence pain,cramping from foot all the way to hamstring.feels like a bomb is going off in the back of my leg from calf down.anyone out there rerupture and what can i expect vs the first go around.iam sure this is gonna be a hard road as it was the first go around.iam on hydrocodene but thats as strong as my doc will prescribed.any encouragement?
Hey guys , what a read ! Ive had a complete ATR just where it joins onto the calf, 4 months in I was feeling pretty worried about why its taking so long I didnt have an op and have been back at work for 3 weeks and my right leg is feeling the stress of it all eg: swollen , knee sore but after reading all your blogs i understand that im pushing it , I work for a drainage company laying pipes , thanks to u all for your comments because now i know to be more careful and stop being a hero …speedy recovery and a strong rehab to you all…
I’m sorry von Mann to hear about your rerupture after all your hard work. Hopefully someone on here will know more.
I’m 7 weeks in non operative with NHS and just thought I’d post on here as I have just my requested re consultancy appointment today after a very non informative consutlant at 4 weeks, inaccurate, no information. I was left feeling very stressed by the last consultant who just told me it’s not moving much, threw out the wedge and tried to run out the door before I got a chance to ask questions. I’ve followed an, I think overly conservative protocol (never to remove boot) but had reassurance today that this was fine when not walking. Just goes to show the difference and willingness to look at your case properly so my advice for anyone who is using NHS consultant to question everything and if you do not get satisfactory answers, keep pushing for better explanations, prognosis etc. Obviously I’m not sure how the next bit will go, but I’m still going to take it slowly and see physio next week for some advice. Good luck all, this injury really is a test of will power, and it’s especially important to know where you’re at and what to expect!
I have a partial high achillies tear…it occurred almost 3 months ago. I did not have surgery….just the boot. I still have a “dent” in my calf muscle. Is this normal.
Amy - this would be a good question for you doctor as it really is necessary for someone to have a look at it. Partial tendon ruptures are a bit of a problem sometimes. Sometimes they heal and other times you end up with a complete rupture at a later date. Probably not what you wanted to hear but no point sugar coating it. Surgery for high ruptures is not usually performed as the tendon tissue in that area is changing to be more like muscle. Too hard to get a good anchor for the sutures. A doctor described it as trying to sew cooked spaggetti. Not sure why there would be a dent in the calf muscle and again without expert examination it would be difficult to suggest any reason.
I go for an MRI Tuesday and see the doctor again on Thrusday. She told me the same about not being able to fix it surgically. I like to work out and I’m anxious to get back to the gym but I terrified by the look of the muscle. I was curious if this “dent” is permanent. Thank you for taking the time to reply.
Amy - please come back and let us know how it goes.
The Dr said the achillies reattached the best that it could. The gap in my muscle is atrophy. I start physical therapy in two weeks.
Amy - hope the PT resolves it.
I snapped my Achilles running around in the street on Halloween night helping police to round up a stray dog. Thought I’d just pulled something…until ice and elevation didn’t help at all. Unfortunately, the A&E Doctor didn’t agree with my suggestion that I’d perhaps torn my Achilles and after a fairly impatient few minutes…chose to squeeze my injured leg (I don’t mean that he did a Thompson test…I mean that he leaned forward and squeezed the epicentre of pain). I’ve been warned before that I don’t present in the way medics anticipate. Sent home whilst in labour ‘cos midwives said I’d be behaving differently if I were really in labour. Drove home and had a baby on the floor…on my own. But I know you guys will each understand that Achilles injury reeeeeally hurts. Anyway, cast on, it’s just a tear. A week later, cast off for another doctor to see. Back slab on this time. Another week ’til it could be scanned by which time, because no one else seemed concerned, I’d started to think I’d gone soft and may indeed have only pulled something. So you can imagine my surprise when the scan-man declared full rupture, quite a mess internally, and at least a four finger gap with no tendon. The next doctor explained the tendon has also come off the muscle…so here I am at home, in a cast, willing my body to chop-chop and grow a tendon. It’s exactly four weeks since the rupture…and I’m surprised at how quickly my toes turn purple and the cast shrinks to an uncomfortable size zero when I’m upright. Did you guys find that? Oh, and…has anyone else been left with a gap that big and made it through without surgery? Thank you to anyone who can help / chat me through a little. As common as the injury is…it’s still not so easy to find other folk in the same boat.
Hi, I’m new here. My Achilles tendon ruptured during my workout session doing box jumps on thanksgiving. I went home to prep the turkey n pop in oven. Showered n realize this is bad and went to urgent care. I’m on crutches for now. The dr don’t know how severe but if it’s partial he doesn’t want it to snap so he put me on crutches and put in referral for Monday for ortho. Of course they are closed for the holiday weekend. Just my luck! Can you move wiggle your toes after your Achilles ruptured ? I hope it is partial. I don’t want to have surgery
Hi, Jamie. My Achilles is fully ruptured and I can wiggle my toes. There’s no need to assume surgery will be your only option. Non surgical, conservative approaches to Achilles rupture are increasingly popular with both patients and clinicians. Outcomes are very similar. As I said, mine’s completely snapped with quite a gap…but I’m not having surgery. Are you in a cast?
Hey Jamie! I’m 4 months from my tear and recovering well having had neither surgery nor any type of immobilization. Played BBall and tennis yesterday, …but very carefully (NOT tearing it up)! Well, if you felt a snap doing box jumps, I would (unfortunately) bet you have a complete rupture, which typically results from quick, explosive movements that overwhelms the tensile strength. Surgery doesn’t have to be rushed into, no doctor would postpone a holiday for it! In fact, the window for surgery extends about 5 weeks after the rupture as per the orthos (what I was told). The gap in my rupture (a small dent about 4-5 inches up) was about 3/4 inch, and now it has filled in and getting strong and tough. Not that you should do what I did with the neglected/natural recovery approach (videos at my youtube channel to describe my thought process and results), there are non-surgical approaches that restore function, have less risk, and allow you more to continue an active lifestyle. In any event, a rupture comes with at least a 6 month recovery span where strength on that side and movement capability is utterly compromised. Conservatively, they say takes a year to recover, and would be rare to regain 100% strength. I don’t believe that. Put in your mind that this is just a abrupt muscular adjustment that will in time have you come back stronger and wiser, a life progression.
Hi Rita and Pete. I saw ortho today and he suggest I do surgery. He didn’t push it but he said I would be limping for life. My calf muscle is pulling on my tendon and pulling it further apart. They put me on splint today and it’s still swollen. I ask about MRI but he said it’s clear that that’s a rupture in my Achilles tendon. I’ve had Achilles tendinitis for almost a year and I’ve done physical therapy but it never fully recovered. Maybe I’m suppose to do surgery. So I decided to do surgery and its scheduled for Thursday morning.
hi,
i was working in a bar on the 6th of November when bottles smashed between my feet, im not sure if what i heard was a bottle exploding or my at separating, but anyway glass ruptured my Achilles quite high up the leg, i knew it was the Achilles because my leg couldn’t take any weight.
i was brought to hospital straight away where i received seven stitches and my leg was put in a cast.
i had surgery the next day and woke up with a downward pointing cast which i had for a week,followed by another cast in more of a flat footed position the next week.
i was given a vacoped boot at 30 degrees last Tuesday and sent on my way, the doctor told me come back in 2 weeks however the only appointment i could get was 4 weeks bringing me to the 22nd of December.
now i am worried that i am not getting the right treatment, i don’t know if i should be changing the angle on the boot, and i haven’t been informed if i can try any sort of foot movement.
I am putting some weight on the toe of the boot for balance on the stairs supported by crutch, but yet again i am in the dark about what i can and cant do .
i am thankful that i received surgery so quickly but would like a bit of closure from the hospital to put my mind at rest.
i hope everyone on here has made a good recovery,and thank you for posting.
Hi Thomas, have you tried PT yet? They may be able to give you some suggestions if you can’t see your doc before the 22nd.
I am 63 yrs old. I ruptured mine 1.2.16 playing pickleball on vacation in Fl.. No pain but felt funny and could not feel achellis bone with my finger. Felt like someone hit me with a baseball bat. Went to local clinic right away said ruptured see ortho. I think it is
a complete rupture but should know for sure in 2 days when I see the Ortho.
decided to come home to GA 1.4.15 and see local Ortho. since it is
a long process and didn’t sound good changing dr. and PT in middle of rehab.
Have a appt. with a highly regarded Orth. dr. this thurs. the 7th of
Jan. From what I read so far sounds like there is a lot of success
with non surgical. My PT said most people opt for surgery but
he has had great success with the ones that do not.
Will ask Ortho. Dr. if I can try PT first and surgery as a last resort.
I am real active so this is a big change. That was the 1st time I played pickleball and sadly the last. will stick to walking, off road cycling, weights and yoga.
Hi, my ATR (full tear) surgery was April 10, 2015. So as of today I am nearing 9 months recovery. I have been working out (1 hr, 3-4 times/week - weights, light running) just fine with a soft cast, without it the area really feels sore. I originally tore it playing doubles volleyball. I am about to sign up for competitive volleyball again. My question is, too soon to go back to 1x/week 3 hr volleyball? I’m nervous - prob just nerves and mental…should I wait longer? My surgeon and PT are really conservative and say I might wait till Apr to my 1 year anniversary. Really?!
Hi Suzy, I’m not in medicine so this is just my uneducated opinion. I don’t want to be a naysayer but biologically the collagen that has been laid down to join the two ends of the tendon takes at least a year to fully convert into tough tendon tissue. So at less than 12 months you must understand that your tendon is not fully strong yet, it’s probably close but it’s not 100%. Additionally, you need to determine how strong your calf is. If it’s as strong as the uninjured leg then I don’t think you have to worry. But if it’s still weaker then your tendon will be taking more strain than usual because your calf is too weak to absorb as much force. This is why your surgeon and PT are being conservative. It worries me that you say that if you exercise without a soft cast then your achilles feels sore. The first two points I mentioned are just for awareness because there are people who can return to competitive sport at 9 months. But the third point should worry you - why is your tendon still sore at 9 months when you exercise? It shouldn’t be. If it is then maybe that indicates there’s still some weakness that needs to be addressed. I’m all for returning to sport as quickly as possible too, it’s almost all I want, but it comes a big second when compared to restarting this achilles rupture process all over again. Most sports you won’t have a problem with - but volleyball played on sand where you could easily jump for a ball as the sand disappears below your heel causing the exact mechanics that lead to a rupture - it scares me to consider this. You know your own body, and if you feel you are ready then you probably are and you will be an exciting success story. Good luck with your decision and all the best!
Sign Beanie…you’re right. Sigh…Thank you for your reply and honesty.
Just to clarify, I’d be playing court volleyball, the beach volleyball would start in May, which would absolutely be 1 year post-op. But point taken about the collagen and the soreness even now. Thanks again Beanie
Arg, sorry Suzy, I feel your heartfelt Sigh! Court volleyball is much better than sand, and it could be good training and preparation for sand later in the year. Please don’t just take what I said, it was just for your information, hopefully other people will respond as well. But the problem is that the recovered people don’t really read the blog anymore, so unless you search the blogs it’s hard to get info on things like returning to sport at 9 months. Think it over and feel it out. I am missing the whole competitive triathlon season, so I do understand how sucky it is and I wouldn’t want to be the one to have stopped you if you are ready!
Hoping I can get some ideas from those on this site. Tore the Achilles over 3 years ago, at first it was treated as a sprain for three months before an MIR revealed the tear….two surgeries, the last a graph, and physical therapy I still limp like a one-legged duck. Climbing stsirs, driving,d walking, all create pain not only in the ankle but now some other areas, behind the knee and the hip. I used to be very active, even at 55, playing inddor and outdoor soccer, raquetball, tennis, jogging, 10k runs etc. I have now turned into amedium sized blimp because I haven’t been able to keep an exercise program for any more than 2-3 weeks before pain shuts it down. Physical Therapy says I have reached max improvement for them but I still am limited. Anyone have suggestions, recommendations, success stories I can try? All conments, suggestions welcome
I’m very sorry you suffered from a misdiagnosis, Michael. And three years later… i really don’t know what can be done, since the pain could also be surgery related, as some in this blog have reported.
Good luck!…….. Manny
Michael, you don’t say how long ago your graph surgery was and were you currently are at in your recovery. From experience I know the extra weight can dramatically limit your overall recovery and pain tolerance level. The heavier you are the more work the tendon has to do and maintain.
Don’t get me wrong, recovery is still possible but the success rate decreases or you can recover to a painless state but not to your previous activity level.
Pain also makes us walk differently which greatly effects the other muscles we use, making them work harder and/or straining them.
There are so many reasons you have not yet recovered. I would suggest you follow up with your doctor. Maybe even a new MRI of the entire tendon to be sure you don’t have any new tears or tendinitis or even a bursitis somewhere causing your pain
Hello ,
I’m 47 I fully ruptured my AT a week ago pushing a pallet there was and still isn’t any pain at all , I went the hospital about 2 hrs later where they put my foot in a cast doing the pointy toe thing . The doctor said it has to stay like this for 6 weeks then I have to go back and have it reset at a different angle for another 3 weeks , after that it’s a shoe with a raised heel which he didn’t say how long that would be for . There seems to be a lot of different ways the doctors treat this and it’s all a little confusing and worrying . All we can do is trust the doctor at the time I suppose , but I am concerned
hi Paul,
where are you based?
in my experience i had appalling treatment to begin with (NHS, Scotland), and sounds like you’ve had an equally ‘mute’ prognosis.
if i was you i would read around in the blog and learn about the operative vs non-op options and then hassle your doctor to give you another appointment so you can actually be able to discuss your treatment plans and the time scales. be armed with knowledge is my best advice.
it’s pretty much impossible to interpret what the doctor ‘planned’ for you without further questioning. immobilisation does work, but now with all the different rehab protocols available it is questionable to go down the passive route without further explanation.
in my case what i truly needed was the CAM boot (that goes under different names and styles, but all do the same thing) as it allows some weight bearing and the flexibility of removing it for washing/getting dressed.
all the best and keep the spirits up! we are here in the same journey
suerte
I am based in the Midlands ( uk ) yes I may go back to the doctors , but on reading a lot more blogs it seems that there are lots of different ways to go with fixing this injury and they all describe all the methods mentioned here so I am a bit more positive, the trouble is once you start looking online you can make you self more worried
Hi Paul, when you are non-op if you follow the protocol you are on now then you have a higher chance of re-rupture (I can’t remember the % but it’s significant). If you follow a more aggressive protocol where you have early weight bearing and mobility then non-op gets the same chance of re-rupture as op (which is something like 3% I think). Additionally 9 weeks of being in a cast with no weight bearing gives you a poorer quality of life and results in a large amount of muscle atrophy. Given that this type of protocol actually has worse results than a boot with early weight bearing and mobility, I would recommend not putting yourself through it. Have a look around for the UWO protocol and the results of the studies. I agree with Carlos and highly recommend that you investigate and then if you agree organise to change your protocol. This injury is tough enough to cope with when you can start walking at 3 weeks. Not walking for 9 weeks! eesh.
Hi,
I’m 22 years old and I ruptured my Achilles playing squash just over a week ago. I decided on the surgical option and hopefully all going well I will be on my second pot soon and then onto the boot. I’m aware of how difficult the process is however I wanted some advice from people who have been through the experience. Does your tendon ever feel the same again? Can you throw yourself around and push your body to the limits like you used to? I love my sport and I was heartbroken to find out I could be facing up to a year on the sidelines. Injuries are all part of playing sport and I’ve come to accept that very quickly however I’m not sure I could deal with going back to squash and not being able to perform like I used to because. Will it ever be the same or should I just get over it and look for another sport now?
Thanks
George
hi George,
sorry to hear that, i also did mine ‘after’ squash…
in principle the surgery approach should allow you going back to the standard you used to be at, but there is nothing you can do to shortcut the hard work through the rehab process, so focus on that.
beanie is quite an example of health and stamina and she’s halfway there already. keep on reading the blogs and learn from other’s, apply to you within your own physical limitations and you’ll be fine!
suerte
Thanks for all the advice and info here. I ruptured my AT at netball on Sunday. All the classic symptoms - knew immediately what I had done. A&E were great and I came away with a backslab cast and notes to give my GP for referral to fracture clinic at home. GP did ‘urgent’ trauma referral the same day but despite this, I’m only seeing someone next Monday after a barrage of calls to them. This will be day 9. In the meantime I’ve had to cut my plaster at the front as my foot and toes were so compressed, and have had to request stronger painkillers. I thought I was def going for the op option, but thanks to all the info here, not only am I better informed to make a decision, I’m armed with questions for the consultant on his protocols etc. I hope they are ready
As a daily exerciser it’s already sending me nuts being so immobile. Let’s hope the consultant is keen on the early mobilisation and weight bearing protocol! Thanks again.
hi folks , well I’m now 8 weeks in. Last week I had my 1st plaster removed my foot moved and a new cast put back on , the DR told me to then come back in 3 weeks to have it removed again then foot moved then replastered yet again . This is different to what 1st doc said , he said I would be out of plaster after 9 weeks . When I went in to the plaster room the guy there told me to come back in a week and a half , he will then move foot and plaster , then after another week and a half he reckons I will be in a walking boot not plaster . Confused yet ? I am . I was originally told I would be back at work after 12 weeks but now I have no idea as I suspect nor do the NHS .
Thanks for sharing. It’s all down to individual profiles(age, severity of rupture, etc)
You will see around here that the immobilisation is a thing of the past (on average). So it may work to arm yourself with as much reading as you can and challenge your consultant. The CAM boots have excellent prognosis and this will bring you to almost normal mobility quicker
Do push them!
Suerte.
Hi folks , I have been back to the hostpital today and had a 3rd cast put on , this time my foot has been positioned so that I am able to have a boot on and can now walk and put weight on it , with the aid of my crutches . This was only made possible by the guys who fit the plaster casts (orthopaedic technicians) the DR told me I wouldn’t be this far along until another 3 weeks from now . I think the DR knows less about this than the technicians , they also felt the tendon and said it felt good and strong when my foot was flexed back .
Cheers
Hi ,
Just another update , 9 weeks in and I’m now out of plaster and in a walking boot , I am starting Physio next week , my foot is a bit stiff when I raise my toes and I can’t get my foot up all the way at the moment , but all looking good so far . It has been a long time and still away to go but I can now see the light at the end of that tunnel . I have just got to be careful fir a bit while not wearing the boot .
Thanks
Paul
Hi ,
Sorry back again , there’s so much about the risk of the re-rupture rate being higher with certain protocols , but how long after does that risk last , is it days , months or until all muscles have strengthened , I can’t find any info on this risk or how long the risk lasts ?
I specifically asked my OS this question prior to surgery. His comment was the re-rupture rate would always be higher but the risk was particularly higher in the first 12wks. But as you say, there seems to be much conflicting info on this topic and no solid data/studies.
Paul - If I read it right you are with the NHS and going non-op which is their standard. Trouble with the NHS is they do not always comply to the best non-op protocols and you seem to be on a very old one. There have been excellent studies conducted at Exceter hospital but it seems not be be followed for the most. Re-rupture rates are higher with non-op when they do not early weight bear. There are a number or solid data studies which have demonstrated this. Richard Wallace from Ireland, Twaddle from NZ, the Uni of Western Ontario in Canada as well as Exceter in England. Now the risk may be higher the way you are going but it does not mean you will re-rupture. How much longer the risk will be present for you is hard to say but if you think of it as a math equation then you may need to add about 5 weeks to the 12 but even then the risk does not go away after that period. It only reduces but the important thing is to get your tendon strong again through a gradual or incremental strength program. Most re-ruptures are caused by a slip, fall or doing something you shouldn’t. Now you are in a boot you should take advantage of the freedom it offers. You can take it off to do some Active ROM exercises which is simply moving your foot around. This will help loosen things up. Write the alphabet with your foot but make sure you support the leg. Hope your physio goes better than the rest has. I can understand your frustration. It seems common with people dealing the with NHS.
@Paul - just to share notes as i havent had a chance to share, i’m on 9 weeks going into week 10. I have full ROM and was on 2 shoes at week 6. I was PWB as week 2 post op and full weight bearing at week 4. I did not start physio until week 8 intentionally to not get all ahead of myself. I moisturise the tendon area every night to give your skin the best care it needs.
I cold pack the achilles every evening but careful not to burn your calf muscles with the cold pack.
I did every evening the typical leg raisers and the ROM excercises. The alphabet writing exercise i did adhoc.
I haven’t done anything extreme to push myself but work on the minor stretches and exercises frequently.
The main thing is to try and walk slowly without a limp don’t go for speed but technique to get those muscles going.
As of yesterday I took the kids to an apple orchard lifting my 9 year old to pick the higher up fruit. Additionally i did a 2k walk in the park through some forest scrub. The gradients did take its toll on me but albeit I had no choice but to follow the kids. That being said do what you are comfortable with but use pain as a guide.
The most important aspect is to also wear shoes, good shoes to help that walking experience.
Thanks for you replies , I have started doing rom exercise, also lifting my heal of the floor with my toes whilst sat , it’s all a little tight which is to be expected after 9 weeks in a cast , but it does feel already like it’s all starting to loosen up , my ankle is slightly swollen . The boot is great as now I can walk which is a real pick me up , I just hope I get to see a Physio asap so I will know how far to push the exercise , thanks again
Paul
Well I’m now suicdal , I went to my first Physio session today . All was going well , she checked my leg and ankle and said that it looks to be coming on great , then she asked me to balance on my bad leg , then I felt a pop and pain I sat down a felt my tendon and found a gap in it , the Physio examined it and said it was still attached and maybe some of the fibres had broke , she then told me to put boot back on and carry on as I have been , when I got home she phoned me to say she had spoken to her collegues and email my orthopaedic DR who may request a scan to see what damage has been done , I am absolutely gutted I want to cry
paul
my heart just literally shattered reading your update. so sorry to hear it, we are here to hear you out. let us know when you get your scan and the news.
in the meantime stay positive as it is hopefully only a minor drawback, and definitely don’t go through with the suicidal feeling!
suerte
Paul, I’m so sorry. I just had to have 2nd repair on my left Wednesday. With it being sore and tender already, the pain is horrendous! (I had bilateral repairs on March 25th). I have no idea why it ruptured again. I have been trying to be so good.
I really hope and pray yours has not ruptured again. I will be thinking of you.
Glad I found this forum. So sad to see we are all going through this right now.
Julia I too ruptured playing netball 9 days ago. Immediately blamed my GK for treading on me but it seems she was nowhere near me and my lovely achilles just snapped! How are you getting on now?
I’m going down non surgical route with a 2-3cm gap low towards the insertion point. Any words of encouragement from people with similar gap that my collagen will do the job and grow will be appreciated lol!!
Kelly,
Your risk of re-rupture with non-op is much higher. Most studies show 1-3% re-rupture rate with operative, and 10-30% with non-operative. Non-operative early weight-bearing has gotten lots of attention recently, however, and seems to work for many people.
After about a year, outcomes (flexibility, return to regular sport, etc) are generally the same between op and non-op patients. It’s really a trade-off between weighing infection rate vs. re-rupture rate. Which is about 1% infection rate vs. that 10-30% re-rupture rate.
I’ve no plans to return to netball. My sporting days are over - this is the last of a very long list of injuries over the years. About to turn 40 and im done! Consultant agreed non surgical was best route. I’m impatient though and altho only 9 days down im already fed up and willing it to repair at least to a point I can put weight on it. I have another appt next Wednesday at which I am hoping they put me in a boot even if it’s nwb. The day after I did it they out me from the back slab into a fibreglass cast however I suffer from claustrophobia and because there was no escape from it I ended up back in A&E having it cut off due to a severe panic attack. I’m now in a front slab with just bandages round the back so much less claustrophobic. Am guessing with a fibreglass cast the position could be better and more stable but hey ho I shall just hVe to persevere like this even if it does take a bit longer.
Paul - so sorry. You do not know for sure what has happened and that is probably contributing to your feelings. The gap does not sound good if there was no gap before but it may have been a partial rupture of even scar tissue breaking away. Normofthenorth had a similar set back due to a poor physio but still recovered well.
Kelly - What Mibball has said about re-rupture is correct for the last century and the methods used then. It is not correct for those on an early weight bearing protocol or modern protocols and my previous post on this page will lead you to some areas to search. Most of them are located within this forum. I too have trouble with casts and needed to take valium. After a week the doc put me in a boot and things were much better. Weight bearing can start as early as 3 weeks with some protocols. My father did his as well and was weight bearing the entire time going non-op. Personally I would wait the 3 weeks. Much of the old research into re-rupture rates focused on 12 weeks in a cast or non weight bearing and then the person is supposed to be able to walk again. The good collagen comes from the tendon being worked. It is strong and aligned in the direction of force so long periods of non weight bearing does not encourage this collagen to form so common sense will tell you your tendon will be weaker and more prone to re-rupture. It is not something to be rushed but steady incremental progress will see you back on your feet much sooner. Other blogs for you to read are Normofthenorth, Kellygirl and Cecilia. We do not have them around to comment now but you may get a repsonse if you post a question on their page. My page is Xplora and the is a tab for some further reading that may help.
Thanks Stuart, will take a look now. Hope to cut again, your reply has given me an ounce of positivity/hope which is exactly what I need.
chat again even!!
Stuart do you have a link to your page? I can’t seem to find anything. Thanks.
Kelly - Ctrl F (find) and then type Xplora on the main page. It should be the only one there in the left column which lists all the blogs. You can do the same with the other names I gave you.
Sorry to hear your news, Paul. Please keep us posted as to your status. I am thinking about you!
Kelly , I have just gone through non op with the NHS and it’s been a nightmare ,9 weeks on crutches non weight bearing , I would urge you to look at other protocols . If my tendon is damaged again I am going to first find out if my Physio was correct in telling me to try and balance on my bad leg after only 1 week out of plaster and second I am going to ask for op this time with early weight bearing after , I feel that with a combination of bad protocol and possibly bad Physio advice I’m no back to square 1 . I can’t do another 9 weeks in a cast and on crutches we all have to balance this injury with getting on with ours life’s which will not stop because we are injured , the DR say do this for this amount of time and I feel with the NHS that it’s a case of get you in and send you off for a long time and hope you heal .
Thanks again for you words it’s of some comfort to know there are others out who have been here and for those who are still going through it , stay strong
Hi Paul. I’m going to push for a boot on Wednesday which will only be two weeks post rupture so happy to stay nwb for another week after that but from what I’ve read early slight wb and mobilisation is beneficial. Not only physically but also mentally - being nok active with my 3 year old is quite tough as don’t want him to miss out on things
happy and positive thought to everyone, we can push, and will, through these difficult times. celebrate little milestones and enjoy life as much as you can
suerte
Paul, I am so sorry to hear about your snap. Hopefully it’s just scar tissue breaking up, but if there’s a gap, it doesn’t sound good (but it’s possible it could be a partial tear). The non weight bearing for 9 weeks protocol is not good either, like others said. That was not very wise of your therapist to have you stand on a single leg only 1 week after out of a cast NWB. My first exercises with my therapist, I only did it while seated, and I didn’t do any standing exercises until a couple weeks later, and I was already FWB by that time. Keep your chin up, you will get through this. If you have a couple weeks set back, it is just part of the journey. Take care.
Good words pozaicer!
I’ve saved lots of positive quotes pictures on my phone to look at each day when I’m having a wobble. We could all be in a lot worse situations, it won’t be forever
Hi Paul, I think your post was the one we’ll dread having to make. Until I joined this blog site, I never realised there was such variation in treatments and protocols from one practitioner to the next - this is a concern.
I had a really bad experience with physio before my ATR was diagnosed, so following surgery I asked for a senior, tho still not convinced!!
Hopefully, the news will be positive next week.
Louise
hi Kelly, indeed. there is little to do for the first few weeks and it is very important to keep the mind healthy. i’m week 14, now enjoying my foot again (not as advanced as beannie or others in the community but a wee walk and a wee dance are amazing) but very conscious that until it’s close to the 6 month and 12 month milestones this is still early days.
suerte
Hi Kelly,
Sorry to hear about your rupture.
I, too had the the honor of rupturing my achilles tendon around ten days ago.
As you’ve mentioned, this website and everyone’s stories/experiences has been extremely helpful and inspiring. I have decided to pursue recovery through the non surgical method as well. However, I have one question, what position is your foot in your cast? I have read that during the first two weeks of recovery there’s mention of having the foot in plantar flexion (toes flexed down), but nowhere does it mention how much does it have to be flexed down. Does that mean to have it in full equinus position (i.e. fully pointed downwards) or just somewhat plantar flexion? Does it matter? I am about a week in, and currently in 20 degree plantar flexion. I’m worried that this is not “plantar flexed” enough, not allowing the tendons to connect and recover.
Would appreciate any feedback or advice.
Thanks!
Hi Paul, my heart goes out to you. We are all so frightened of hearing that pop again.
Thinking of you and hoping the news next week isn’t as bad as the thoughts going through your mind.
Fingers crossed for you.
Hi Ken
Sorry to hear you’re in the same situation. I too wondered if my foot is pointy enough and I don’t really know how to tell the angle. I do know though that if I put my toes level to the toes on my other foot my heel is off the ground by a good 4 or 5cm so it must be flexed down. I am in the old style cast as had a horrible panic attack when they put the fibreglass cast on me on day 2. It was too claustrophobic for me so they put me back into a front slab. I’m assuming you’re in the synthetic one? If so I don’t think you need worry as your foot will be nice and still and is definitely pointing downwards. X
Hi Kelly,
Thanks for the feedback. I’m actually in a vacocast boot, which acts similarly to a cast, but just not as claustrophobic I would say.
I feel like my heel is more like 2-3cm off the ground. Should have asked him this question the first time around, but I may set up another appointment with the doctor just to double check.
Wishing you a quick and safe recovery!
Ken are you in the UK? Maybe your rupture doesn’t have a big gap hence the lower angle. Did they tell you how far apart the tendon was? They said I have a 2-3cm gap. I’m back to the fracture clinic on Wednesday and really hoping to go into a boot. I take it eventhough you’re in a boot you’re not allowed to put weight on it yet? x
I went back to the orthopaedic clinic today and had an ultra scan , there is a 1 cm tear in the tendon the DR says it’s a rerupture , i have to wait till next Tuesday now to see a specialist to see what the next step is , I asked the DR why I wasn’t given any choice of treatment and he quite bluntly told me that the 1st DR I saw gave me the best treatment he saw fit to give . I am going to the citizens advice to ask if he should have discussed other options within the NHS choice guidelines
Hello me again , I visited the hostpital again today and was seen by an ankle and foot specialist , he assessed me and tells me that because I still have strength in my foot when I pushed against his hand he feels that the tendon isn’t that badly damaged and I should be put back into a walking boot and return to Physio. He says that if after 6 weeks it looks like it’s not progressing then surgery will be needed , but he said he is confidant that it will heal as it is . I did look him up online , he has a lot of letter after his name so he should know what he’s on about
That sounds promising Paul - hope it heals in the next 6 weeks. X
Hi Kelly,
I responded a while back, but it said my post was awaiting moderation, thought it would go through by now, but it’s still under moderation. I swear I didn’t post anything inappropriate. Anyways, below was my msg.
“I’m actually in the States. The Dr didn’t mention how far apart the tendon was. I saw him again today, and he mentioned that “gravitational equinus” (or however your foot hangs when it’s on its own) is enough.
As to whether I can bear weight or not, he actually recommends me bear weight immediately, as tolerated of course, in the boot. He was one of the researchers in the following study that actually shows immediate weight bearing seems to be okay in treating achilles tendon ruptures: fai.sagepub.com/content/24/10/775.abstract. The past week and a half, I’ve been non weight bearing, but going forward, I will try walking around in my boot.
I’ll let you know how it goes. Hope your visit to the clinic will go smoothly and that you’ll be put in a more comfortable boot/cast.”
A little update now that I’m 3 weeks in, with 1 week of full weight bearing (in the vacocast boot), I feel like my achilles is recovering fine. The swelling has gone down significantly (to almost non-existent), however, the few times I’ve taken my foot out of the boot.. aside from the major atrophy I’m seeing in my calf, I also feel a slight hard/large lump at the bottom of my calf. From doing some reading, it sounds like that’s just the scar tissue from the injury.
I’ve also begun doing some minor exercises, like plantar flexing the foot and wiggling the toes. It’s surprising how a couple weeks of inactivity can make your feet sore from just wiggling your toes. I also just purchased some bands to begin slowly working that into my exercise regime. Seeing my calf atrophy so much has been so painful, so I want to get back to working it as soon as possible. Anyways, scheduled an appointment with the OS to see progress on recovery next week (which would be the 4 week mark for me).
Hope you and everyone else is recovering safely and smoothly!
Exeter UK
Hi I did my Achilles (partial) playing touch rugby on the 28th of April. Was put into a solid cast at 30 degrees and operated on the morning of the 6th. Delayed so the Ankle Specialist Consultant could do it. Not a full open cut but keyhole. Then put into a cast that isn’t full but is open full shin and soft on and around the foot. Good protection but able to move my foot enough to get some decent blood flow. On the 23rd cast off and boot on. I understand that I will be able to take it off at night and use the band to start moving my Ankle. I’ve read Exeter is ahead abit with there protocol and the surgeon told me they have now done 600 with only 2 re ruptures. Watch this space.
Hi Jess
In my experience which is still ongoing the NHS will only have its budget in its best interest , question everything they tell you as I have found they will always try the method that gets you out of the door asap without a care as to whether it is the best method .
I’ll take note of that. Can’t complain at the moment as got moved onto Mr Hugh’s list for surgery, looked him up and couldn’t fault him. Went in today had the stitches removed and had a look at the cut. Very small and healing well. Chatted to the surgeon for 5 mins as he came up while I was waiting and apologies for not seeing me after. Told me it was a full rupture not a partial as I thought. Said it went well and was a good repair. Even chatted about a touch rugby game against the guys he plays with but he did say in about 9 months. Saw the senior Physio who fitted me with a Vaco ped she championed the boot in Exeter and said they have only had 3 re-ruptures out of 600 + which were due to falling over bathing. She is off to Germany to learn even more about the boots. Walking without crutches 2 hours after getting out of plaster and off to watch the Chiefs win the premiership this Sat
Some of post missing.
Boot off now watching TV and moving my foot a small amount. Calf hasn’t shrunk much at all. It’s crap getting the injury but I hope to post positives. Some guys have had it hard. Cheers Jess.
Good to hear Jess , I wish I could have gone to your hostpital
hi guys
i ruptured my achilles tendon. quick question.
2 specialist saw the results & highly recommend me to go ahead with the conservative treatment option. i ruptured my achilles playing football just running normally.
if i want to return to sports is conservative the way to go or should i seek another option for surgery… they refused to operatate on it they said it will heal naturally.. please help me out im stressing out.
are you in the UK ?reading alot about this it seems the conservative method is ok as long as you are early weight bearing, i was in a cast for nine weeks and a week out of cast i re-ruptured it and i think this was due to a bad method or protocol ,i think it depends on which hostpital you are treated at .mine is NHS worcester who i think are still in the dark ages .so if you can get a protocol that allows early weight bearing .
Jason, the conservative treatment is a good option if it’s done right. You have to make sure your protocol allows for early weight bearing at 3 weeks or so, gentle ROM exercises at 2 weeks or so, and your foot will have to be cast at a certain angle to allow for the tendon ends to meet. If you had an ultrasound, or an MRI and your tendons are close, you might be a good candidate for the conservative method. Please look at the comments below for answers, especially from Stuart, he is the expert here.
Jason - if your tendon ends meet when you point your foot down and you foot is held in that position for around 3 weeks then you should have no problem returning to sports. The body will heal the tendon but the advantage of surgery is they make sure the tendon ends meet and are held together with sutures. An ultrasound can determine the angle the foot should be at so that does away with the peak inside to some degree. Sometimes surgeons will cut a bit of the ruptured tendon away and you end up healing a little short. This will reduce your flexion and can cause other issues up the leg and into the back. The concern with any method is for the patient not to heal long and it seems there is a greater risk of this with non-op treatment but again that is more likely because the tendon ends did not meet up properly and the body fills in the gap with new tissue. So it is your body that heals your tendon regardless of the method your doctor uses but if you go non-op then, as mentioned above, make sure it is an early weight bearing and movement protocol. This promotes strength in the tendon and encourages good collagen to form. It also reduces your risk of re-rupture. This weight bearing starts in a boot or walking cast and should have you back in shoes around 8 weeks and back to normal activities in 6 months or so with a complete heal at 12 months. The healing process does actually go on for up to 2 years but the improvements will be very subtle. So I agree with what has been said already but not sure if the tag ‘expert’ applies. I have just been around here longer than most and have acquired a bit of experience.
thanks so much for this guys..
im from australia by the way, this is the latest.
i am in a moon boot & crutches, i keep my foot elevated almost every chance i get (should i take the moon boot off while i am sleeping?)
below is the diagnosis of my injury,
U/S L ACHILLES
-COMPLETE RUPTURE SEEN
-TEAR
= 10CM UP SOLE OF FOOT
= 3.3CM UP CALCAREAL INSERT
= NO TENDON END SEPARATION
=MINIMAL ADJACENT LEMATOMA SEEN
i dont know if my diagnosis is really good or really bad can you please let me know?
appreciate this heaps guys.
Jason - not sure what a lematoma is but since you don’t have any I would not worry. Could that be hematoma? The calcaneal insert is where the tendon joins your heal bone and you have ruptured in a typical spot. No tendon end separation seems also to be good which means you should join up really well. There are a few from Oz hanging around at the moment. Beanie is one and is a great help. I am in Victoria and yesterday was up in the snow briefly until they decided to close the road. Spend the time reading up on things and if unsure you can ask.
i’m sorry i couldnt understand her writing hahaha
yeah it is hematoma… is that good that i dont have that?
mate you have been a big help i appreciate this big time.
in the mean time im in the moon boot & im going to the hospital on Tuesday for a second visit… once i am finished i will log back on & keep you posted of the outcome.
Thank you.
No hematoma is a good thing. It is a collection of blood and a very general term. Even if you had a bit it would not be of great concern. By the way I forgot to say you should sleep in your boot for as long as you can tolerate it and maybe then some. It is better to keep it on in case you have to get up in the middle of the night and forget but for now your tendon needs it so there is really no choice. How long? Talk to the doc about that but some non-ops have ditched it around 6 weeks. By then your tendon should be strong enough to bear a bit of leg thrashing and getting caught in the sheets. You could get a physio to make you a night splint out of the heat moulded plastic and some velcro straps. It would go in front of your leg and prevent any flexion of the foot but they would probably just tell you to leave the boot on. If you are doing this through Medicare only, especially the physio, then be prepared for them to not have any clue about this injury or how to treat it. Private physio will cost but if you do not have health insurance then there is no option but to pay or suck it up with what the government provides. The other problem with the hospital based physio is continuity. You can get a different one each visit. If you were playing football for a club at the time of the injury then there may be some medical expenses paid by the club (their insurance) as part of your registration fees.
Hi folks ,
It’s now 4 weeks since my re-rupture , I think all is going well but won’t know until I see the specialist again on 21st June , each time I go to the Physio I can move my foot back a little more , I’m told I am only a couple of degrees of neutral now , I’m walking well in the boot and haven’t had any pain ,sometimes the tendon feels a little tender but that’s all . There is still a gap where it popped but it feels more solid around and in the gap than it did 4 weeks ago in hoping that is where the tendon is healing and getting stronger . I was told by one Physio that the gap my never go as the tendon will heal around it , but I was also told the gap will eventually go ( any advice on that ) so until I go back that’s me for now
Thanks for reading
Paul
Paul - Personally I would feel the gap should go in time as new tissue is formed. Some people have a lump instead of a gap. Don’t be too keen about getting the dorsi-flexion back early. Stretching the guts out of it to get that flexion may be pulling the tendon ends apart. Still in the early stages of healing and things are not strong in there as yet. If you pull them apart the body will fill them again but you will heal long and then will need surgery and a start over to fix it.
Hi xplora, I am strictly following the Physio advise , they adjust the boot each week so hopefully it’s not stretching too much too soon
Paul - that fine. Just was concerned you may have been hitting the passive ROM with something like a towel or theraband. Cheers. (xplora)
Hi Stuart
As our previous conversation, i went for a visit to the surgeon today.
He said because there is no tendon end separation i am going to go ahead & proceed with the option “conservative treatment”.
so yeah i’m going to make an appointment with my physio (iv’e got private health) & start my rehabilitation.
The surgeon wants to see me in 4 weeks just to see how everything is progressing but none the less this is great news i guess.
Thanks.
Jason - Yes this is good news. Your physio may want instructions from your doc. Most do and will only work very loosely outside those guidelines. Hope you have someone who will work with you and give you the outcome you desire.
So I most likely partially ruptured my left Achilles tendon about a year and 2 -3 months ago jump roping at my local gym. It hurt a little bit and was sore for a while. I didn’t go to the doctor or anything because I’m a stubborn person and thought I could just walk it off for a few days/weeks and be fine. Sure enough over the past year it has never healed properly ,so I recently went to go get an MRI because it has been killing me after my intramural sports. MRI resulted in a 50% partial rupture in my Achilles. Doctor prescribed me to wear a walking boot for 6-8 weeks to see how it heals. Doctor was very surprised I was even walking at all.
I hope recovery goes well, but I’m nervous I won’t be 100% even after 8 weeks of the boot.
Hi 5 weeks after my op full rupture. Scar has healed well 2.5″ cut with 3 stitches. Had the boot adjusted 2 days ago allowing more movement between 30-15 degrees. For 2 weeks it was fixed at 30 and now moves freely between 30-15 so working the tendon. Sleeping at night without a boot which feels good. Able to rotate my ankle full motion both ways which helps keep it from stiffening up. Bought a stand for my mountain bike and used it for the first time today and cycled for an hour with the boot on getting some good blood flow. Aware of my diet and eating food that helps the body make collegen and heal. Even bought some Solomon’s seal a plant extract that supposed to help tendons and ligaments heal. Also invested in a foot spa which hasn’t arrived yet for some hydro therapy. One of the places I’m very careful is showering as the only re-ruptures Exeter have had is people falling over showering so still use my crutches, stool and never but any direct weight on my foot. Walking is a lot easier now the boot has been adjusted and the sole is a lot thinner. It seems to be going well and I need it to as I’m a Saturation Diver in the oil industry and this is costing me. On the bright side the Welsh prop playing against the All Blacks on Saturday fully ruptured his just over 9 months ago and is back playing international rugby.
Hi all
Glad I found this site. I had found one years back when I tore my ACL and it definitely helped my sanity!! High grade 80% rupture playing soccer 2 weeks ago. Just had surgery yesterday, wiggling my toes and doing leg raises as much as I can just don’t want to disrupt the tendon. Is stat possible?? I also read so somewhere that I should lie more on my stomach with my leg raised?? Is that needed given I’m in a plaster cast??
Sounds like I can only start physio in a month or so which is a drag
Thanks to in advance for any advice
Congrats to everyone on here and as my 6 year old reminded me….”never give up”
Dan
I’m so glad I’ve found this site I’m one week in from my injury which is a full rupture. Initially put in a non weight baring thigh high cast until I went back to A&e and they changed to a under the knee half cast with my toes tipped downwards. This is until I see my consultant who is a physio therapist who specialises in this injury.
I’m not in any pain other than on my hands off my crutches…
Fingers crossed I go into my walking boot next week and my healing process will begin X
Hi Dan
what’s your diagnosis?
this was mine, i’ve also torn my ACL too but i’m all good now from that.
U/S L ACHILLES
-COMPLETE RUPTURE SEEN
-TEAR
= 10CM UP SOLE OF FOOT
= 3.3CM UP CALCAREAL INSERT
= NO TENDON END SEPARATION
=MINIMAL ADJACENT LEMATOMA SEEN
They told me to go ahead with the conservative treatment (no operation) because there is no tendon end seperation which is good. I also did mine playing soccer too, at the moment i’m in a moon boot for 3 weeks now & i start my physio next week. I can feel it getting better but it’s just a time thing they reckon 4-6 months for a full recovery.
Hi folks ,it’s now just over 7 weeks since my partial re-rupture and 18weeks since the full rupture , I saw the dr yesterday and he tells me the tendon is mending well , I am to stay in the boot for another 2 weeks but am now starting muscles building exercises , i am hoping to be back at work in about 6 - 8 weeks , man it has been a long time.
Hi Paul
How’d you get the re-rupture? What happened? I’ve been doing conservative treatment for 1 month now and i can feel it healing, i’ve also ruputured it. Does this way work without the operation to go back into sports?
Hi jono, I re-ruptured mine during Physio , I was 1 week out of cast when the Physio told me to balance on my bad leg which I since learned was a mistake , from what I have heard you will be able to go back into sport I’m sure someone here with more knowledge will be able to answer that are you in a cast and for how long ? It is better if you can get weight bearing early on , my cast was on for 9 weeks which is a bad method . After my re-rupture I saw a different dr who uses the early weight bearing method .
Hey paul
i’ve been in a moon boot for 1 month now… i’m going to see the dr on tuesday to hopefully get the permission to take it off.. i’ve been walking on the boot here n there, i take it off at night when i sleep and in the shower etc. its been ok. ill let u know how everything goes but so far so good.
DIAGNOSIS.
ULTRASOUND LEFT ACHILLES TENDON
FINDINGS: TARGETED STUDY DEMONSTRATES COMPLETE ACHILLES TENDON RUPTURE, POSITIONED 3.3CM ABOVE THE CALCANEAL INSERTION. THE PROXIMAL FIBRES OF SOLEUS AND GASTROCNAEMIUS MUSCLES ARE RELATIVELY REDUNDANT AND PARTIALLY RETRACTED. SMALL HEMATOMA DEMONSTRATED ADJACENT TO THE TENDON TEAR.
I have injured my achilles 1 month ago & after speaking with the surgeon he has suggested in order to return to sports etc i am going ahead with the conservative treatment option. I have been in a moon boot for 1 month now & i am seeing my physio once a week for a massage & small activities. From looking at my diagnosis does it look like it could fully heal? The surgeon said everything is looking good so far & it will be too late to have a operation even if I needed one because my scar tissue is healing really good & it could cause more damge. He said i dont need an operation because there is no tendon end seperation. Please someone who understands this tell me what you think. Thanks Mark.
Mark - What your doctor has said is spot on as you would hope. We are trying to get away from the term conservative for a non-op treatment as modern protocols are less than conservative but for a doctor that just mean no intervention. There is no reason why your tendon will not fully heal just the same as if you had surgery as your tendon ends where touching presumably with your toes pointing down. It is really the boot doing the work of holding your tendon ends together until new tissues form. By now you should be starting to put some weight on it. This is very important for non-op more so than surgical patients as it will reduce the risk of re-rupture considerably. Your tendon by now should also be joined with new tissue but the first collagen (Type III) is weak and soon it will lay more of the good collagen (Type I)down. This is called remodelling and the new tissue aligns with the direction of the force. That is why weight bearing from now is important. It encourages the new tissue to form and align but you are still protected in the boot.
Hi Stuart
Thanks for getting back to me. Good news is that I am currently weight bearing with the moon boot with no real pain, i’m just worried because sport is a big part of my life & I get paid to play etc… I just want to return to the game as soon as possible. I don’t mind waiting i just want to know if I do the rehab properly etc with rehabs that I’ll have a good chance of returning, besides that i’m doing my rehab at the seeing the physio twice a week for a massage & small exercises etc. I hope this heals
Mark- I think you will do fine and get back to sport some time within the next 5 or 6 months. It may take a bit longer for you to get up to your best but life improves quicker than you expect. It is all about an incremental increase and walking is the best therapy of all once you get loose of the boot. Never limp. If you do then you are going too fast or your stride is too long. It is of course hard to walk properly in the boot so you are excused for the moment.
Hi
So it’s now 9 weeks after my partial re-rupture , I am now walking with shoes , it feels strange and I’m trying not to limp , I find taking small steps helps . I’m doing heel lift exercises whilst sat down and I can already feel the strength returning in my lower leg . I still have a bit of tenderness or bruise like feeling in the what the Physio called the tendon sleeve, I wouldn’t say it’s pain just sensitive . My Physio says there is no set time to start driving but to maybe sit in the car and work the pedals and see how it feels ,so all in all positive I thinks .what stage have any others on here started driving ? That’s all for now
Cheers
I was playing tennis yesterday (July 4th, yes) and upon lunging toward the net for the ball, I felt something crack/pop in my lower achilles tendon, pretty much at the insertion point at the heel.
Since I started playing this season, I had non-stop achilles issues in both feet. In my left foot, the problem was at the insertion point (where I injured it) and on the right foot, at the mid-tendon area. The truth is, it was actually mostly the right foot (mid tendon section) that bothered me most during playing. Whereas my left foot mostly hurt after playing, and especially the day after in the morning.
I am 34 and I work in the office in NYC and play tennis once weekly. And other than weightlifting in the gym 2-3 days a week, I don’t get any other exercise on regular basis, especially that involves my AT.
I don’t know whether I severely sprained my AT yesterday, or partially tore it, but it I am walking around with a limp now, my foot wrapped in an Ace bandage. It hurts a lot to stretch it, but no pain contracting it (pointing toes). I don’t think I have a full rupture of my AT, however.
Any advice on what this could be and how to treat it best and how long recovery time is, would be appreciated.
Thanks All!
Igor
I would go and see a dr asap , im no expert but when I fully ruptured mine there was no pain at all , I was told by the specialist that normally if it’s a partial rupture then you feel pain . The sooner you see a DR the sooner they can start treatment .
For my rupture, i didn’t feel any pain. But I DEFINITELY could feel with my hand behind my foot that my achilles area (that it was soft and definitely not like behind my other foot. It felt soft and not hard and defined. I went to the hospital that night. I wouldn’t mess around with it and go to the doctor. Can’t buy another leg.
Hello
I am not have surgery but they have told me I’ll be in plaster for 12 weeks… such a bore, my first 3 are in toes pointing down then every two weeks after move the positions with the wedges and so on.
Not such a noble injury as sport related, unless you include slug sliding a new sport (pretty gross)
I hope that these are just estimations for the time, as I am already fed up after a week, mine keeps swelling making my plaster tight, although I did clean the fridge out.. and hoover the floor on my hands and knees. And I have no clue why I am so tired all the time.
I did not feel pain after the initial boom, and do not feel it now, unless I do to much. And felt nothing when the doctor tried manipulating my leg foot, etc. I am 51 and a designer and find crushes a royal pain the bottom, but I guess I will have to get used to them it’s only been a week.
Hope you all recover and are on recovery
Moonie
Hi moonlake , if you read my other posts and the posts of others they will tell you that the protocol you are on is not a good one , there is a high risk of re-rupture with having your foot in a cast for 12 weeks , I had mine in a cast for 9 weeks and a week out off cast I re-ruptured it in Physio , the best method is early weight bearing , go onto www and have a look , are you in uk ? If so I found my hostpital did the best method for there budget not for the best result . Good luck
Hi this is my second ruptured achilles …now I will have 2 weak legs…After 5 years I went back to football and if felt brilliant. ..i blame new boots this time as I felt a pain on b the back of my leg 5 mins before the horrible snap sound …Before this I had been wearing runners with good heal support ….The last time I was re casted every 2 weeks and did a total of 5 weeks in a cast sent home with no boot …..It never got back to 100 per cent as I’d feel it weak if I had to skip or go on my tip toe….I’m hoping it’s as fast this time I’ve one day done in a cast and already feel like killing someone lol. ..I’m just not able to rest….feel like I’ve ruined my kids hols and disappointed my coworkers. .
Hi guys,
I am only two weeks in after a full ATR, playing pickup basketball on the weekends. Decided that this summer I was going to get my body feeling better by jogging and basketball, problem is I’m not 26 anymore, LOL (36). Second week of playing basketball consecutively and felt the dreaded “pop”. No pain at all actually, just couldn’t walk while pushing off of my right foot and lots of swelling and tenderness. Lucky for me, I work for a physicians office and went to the sports medicine ortho the next day. Was put in a soft cast with foot pointing downward. Opted to go non surgical. Went to the doctors appt following week, and they said apparently my healing is ahead of schedule, so they gave me a walking boot, still with crutches. So two weeks in and the swelling has gone down pretty considerably, but the strength is not there and the tenderness and swelling seem to be moving upwards towards the calf. Is this normal? Thanks and wishing everyone a speedy and safe recovery. Try not to get down!!!! We don’t know why things happen in life always, but they do. Control what you can control. Your joy and happiness!!!!
Chris
2 and a half weeks ago I was playing baseball, rounding 3rd base and felt as though I got hit with a 90 mph fastball in the back of my leg. I went to the ER that night and ER doc said ATR. Saw ortho the next day and he said the rupture was high up near the calf and that I would be fine in 6-8 weeks with the first 3-4 in a 30 degree camwalker boot. I went back to see him 1 week later and my Thompson squeeze was still positive but he said I will be fine. Went for a 2nd opinion today with a more renowned sports doctor and he said my MRI and clinical exams don’t match up. MRI looks like a partial but the clinical exam shows a clear defect and no firing of the calf upon flexion. He said I should have surgery immediately. Now I have 2 very different opinions. I have been weight bearing from day 1 in the boot and have not slept with the boot on ever. Worried that if it is a full rupture the protocol the first doc had me on May have killed my chance at a conservative approach. Contemplating a 33rd opinion now given the contrast in the other 2.
Michael - very few doctors will operate on high ruptures as the tendon is changing to muscle. One said it was like trying to sew soggy spaghetti. Your initial treatment would be fine but you should not be taking your boot off at all for a little while at least (3 weeks min). That is more likely to cause issues later. Weight bearing early is beneficial to recovery without surgery but usually after a couple of weeks. I doubt what you have done would have any long term detrimental effect. It will however take a bit longer than 6 or 8 weeks to recover. A partial rupture may heal enough for you do do most things but partials have a way of becoming a full rupture. Could be that people start explosive activities too soon.
Hi guys
I’m 9 weeks into my conservative non operational rehabilation. I’m full weight bearing & doing calf raise exercises.. I walk ok with a slight limp. Just wondering is this good process so far? I am a football player & my physio said the way i am going it will come to a complete heal so i can resume training again after 6-9 months at a competitive level. Just wondering from everyone’s experience is this good so far or should i be doing more?
Hi Everyone,
Such a brilliant forum, its incredible to read everyone’s stories and recovery regime. I thought I would start my own story from the point of my first physio which starts on Monday (24-7-16) but before I do some quick facts and observations on what has happened to me:
I live in the UK and am 48 years old
Full left achilles rupture
Non-operative treatment given although surgery was *discussed
I am 10 weeks in a ‘moonboot’ - 24/7
Full weightbearing from week 2
Foot at pointed angle with 6 wedges, removed weekly after 3rd week
2 weeks foot flat in boot before physio
Physio about to start on Monday
*as mentioned surgery was ‘discussed’ but more in a way to advise against it - than for it, it seems (certainly in the UK) and after extensive research by Exeter Hospital that expert opinion sits firmly
in a non-operative route but importantly with the caveat that this means EARLY weightbearing to assist in with the natural process of the tendon repairing.
As I sit here now I can comfortably bring my foot on tip-toes whilst sitting down and can push quite hard on my toes but wouldn’t dare for a moment attempt to stand on my left tiptoes unaided. I am 6 feet five and weigh 18 stone, this tendon needs to be strong
My left tendon area is noticeably ’skinnier’ and you can still see there has been trauma, but as mentioned I can exert some pressure on my toes and things seem to be going the right way (I hope)
So, I will report back after physio on Monday and every physio session thereafter on what I hope will be a helpful ‘blog’ on recovery (or not) from the treatment of non-operative route and timescales you can expect from this injury.
We are all different - but have one thing in common sadly!
This forum has been invaluable to me over the past few weeks and I hope my future posts in someway help others.
Good luck!
John - you are only at 9 weeks so do not expect too much just yet. Another month should see you getting more aggressive. You are doing fine so stick with the program and be mindful of the re-rupture risk. This will slide after 12 weeks but what you are doing now is moving toward a stronger tendon.
Duncan - best thing to do is set up your own page to keep the information easier to find. It would be good also to have a page to refer to when telling people the benefits of a non-op protocol. We have a few more here at the moment and it is good to see. Exeter did some very good work but sadly it is not followed by all hospitals in the UK. I am surprised you are still in a boot at 10 weeks if you are following the Exeter protocol but 114kg (if my conversion is correct) may have an influence on that. It is also interesting that you injured tendon is thinner than the other. Usually they are thicker. It may still be laying collagen down so keep an eye on that and chat with your doctor or physio.
Hi Stuart,
My height and weight was mentioned and my consultant said from the outset “big trees take longer to grow” and therefore should expect a slightly longer recovery time. I admired his tact.
When I say ‘thinner’ the area of the achilles is ‘flatter’ and more noticeable than my right leg, so thinking about it you could be right, probably thicker in width but appears skinnier side on, and yes, I think collagen is still being formed. There is obvious connection though, and my consultant says I have “active dorsi flexion and plantar flexion” whatever that means?
I will take the advice of my physio on Monday, to be honest I can walk almost normally in the boot and I’m already nervous about my new life without it and avoiding the dreaded ‘pop’ again.
Interestingly a friend of mine ruptured his a week after me, he lives 50 miles away and they operated ‘because they do’ in his area. As people have eluded to here it is SO confusing that different treatments are offered for the same injury, the arguments will know doubt rumble on regarding the best course of action but certainly I feel patients (us) should have the facts spelt out in more detail at the time of the initial consultation, it would stop the worry by simply understanding the treatment, we all have a long time to think about it!
I will look at starting a blog.
Thanks for all your input, Stuart!
Duncan - Active plantar (pointing down) and dorsi (pointing up) of your foot means you can do it with your own muscles and do not need aid such as a theraband or someone else pushing your foot. Passive movement is when it is done with an aid or external force.
Hi all, on 22.06.2016 which was a Wednesday, I was playing football with a group of mate, at the beginning of the game i felt that my right leg ankle area was not comfortable enough as I had some bandage on it, at one stage of the I even tried to loose my liaise, any way 20 minutes into the game a colleague passed the ball to me and I tried to take a quick touch to go forward I heard a loud pop at the back of my right leg and felt like someone shot at my leg as I couldn’t put any Wight on it went down to the ground! The lads were saying its a cramp just give it a rest a bit you should be ok and I said no this is a serious injury! Even the goalie says he heard the sound as I was playing at back on 5 aside. An hour later went to A&E and confirmed a ful ATR. The leg rapped in the cast an hour later in angle 30dgree, a nurse gave information to get in touch with fracture clinch the next day and I might be lucky to be seen and to put my leg into boot, lucky it all worked out and I’m in the boot from the second day for 8 weeks, in Angel of 30 degree for the first 4 weeks and then change the angle for another 2 weeks also in foot flat in the last 2. I also got told I even can put weight on it, the worst things is that I was going away on the 1st of July a week later but got a letter from the doc that I should be ok to fly with family and friends which wasn’t a good things to be honest as you need rest and elevation as much as possible on your first few weeks and also drink lots of fluids in case of DVT, I should have gone back to hospital every 2 weeks so that the wash my leg knee down and put a clean pad on it, family done that for me in Spain as I was there, after 4 weeks went back to hospital for a leg wash and changed the angle of the boot as I have more flexibility and fell an ache in the calf muscle and that’s normal as doc said, and I also asked if there is a sign of healing and she said yes and told me to feel my Achilles where is attached and was felt a lot better from what I heard, I also I asked to as when can I drive she said normally 2 weeks after the boot off, I will be going to see PT after the boot come off and will follow his instructions of exercise to get fully recovered and hopefully be able to get back into the sport I love. At the end thanks guys for your blog as the were very helpful full as I read all of the story, I wish everyone a good luck in there recovery and hopefully everyone gets back to normal walking life and make sure avoiding the horrible injuries again. Any questions I’m happy to get back to you all.
Am 76 years with a full rupture caused, I think by 2nd Cort. Shot now in boot for 4 wks. Surgery to follow I think. I am retired but will I recover?
Hi Ron, how did yours happened? Also how long will be in boot for after surgery? You differently will recover but everyone’s injury are different and the healing process are different too, elevate and rest it for as much as u can. Hopefully you will recover along with everyone else who has the injury
9 weeks and 5 days
That is how long it’s been since I ruptured my achilles. I’ve been doing heaps of calf raises with my rehabilation. I was told to go with the non operative conservative option for my recovery. When i do lift my foot up you can see like a little lump where i ruptured it, is that normal? (there is pain but it feels like its getting better). Do you think i’m travelling well or am i too infront of behind in my rehab? I’m just following the protocols set by the physio. Thanks, Wayne.
Hi all, hurt my Achilles on 19 July while playing football. Heard the classical pop and immediately knew what was wrong as both younger brothers had same injury. They both had surgery and are 100% OK. Doc says mine doesn’t need surgery and that freaks me out. Younger brother did the squeeze test on my calf and told me it’s torn. Doc said he will reassess in 7 days time. Not sure what to do now
Suleiman - Sorry about your rupture. Did your doctor put you in a cast or in a boot with your toes pointing down? If he/she did not you might want to get a second opinion. If you have a partial rupture, the conservative treatment will probably be ordered, but you would need to be placed in something that has your toes pointing down. That’s the most important thing in the initial stage of healing. What was the diagnosis your doc gave you?
Wayne, I think you are doing really well to be able to do heaps of calf raises , how did you do your rupture and how long was you in the cas or boots? You are in the right direction as I did mine 5 weeks ago and went A&E last week for a foot wash and change pad as I’m in the boot for 8 weeks and the doc said she can feel the attached tendon and and I looked at it and felt it and it’s like a lump and that’s sign of recovery, she says that will get back to normal after the physiotherapist exercise program. Hope everyone gets back to normal with their Achilles injury
Hi superman, I did my Achilles playing football on 22/6/2016 I also heard the classical pop and felt like someone tacked me or got shot at the back of my leg, anyway went A&E same day after a calf squeeze test I got told that I got full ATR !! Was really disappointed as I have never seen that injury or had, they put me in the cast toes pointing down the following day I managed to make an appointment to put my leg in the VACO BOOT and the doc discussed the surgery or non surgery she said the are both giving the same result and plus none surgical are better because it heals neutrally and you don’t have the risk of infection having surgical. Where about you from if you don’t mind? And keep us posted on how it going, good luck with recovery . Thanks Bilal
Sorry I meant Suleiman
Bilal I’m in the same exact situation as you playing football.. I’m out of the boot now just doing my rehabilitation. My surgeon told me non operative is the way to go.. I just want to play football again you reckon I’ll be ok???
I’ve just had a full rupture - late on Monday night and full NHS treatment immediately with boot fitted yesterday by mid-day. The tendon area not that painful - aching at heel/calf area as to be expected according to what I have read and been told - but the main problem is the acute pain I am getting across the top of my foot. Has anyone else had this. I didn’t sleep a wink last night. I can tolerate pain pretty well but this was agony. Today it went away for a bit but back again. Anyone else had this? Is the boot too tight? Please tell me it goes away!
Anne - I had pain on the bone on top of my foot whenever I tightened the strap too tightly. My boot has 2 straps on the foot. It’s the second one from the toes (the one on top of my foot) that creates the pain when too tight. I don’t know what boot you have, but can you loosen parts of it?
Wayne,
Did you check out Brady Browne on youtube? He is a Canadian football player who went non-operative route and he is doing great. I am 7 weeks post rupture today and am non-operative as well. I was really active before the injury and am planning to going back to all my sports after as well. The key with non-op is early weight bearing and early range of motion protocol. I am now full weight bearing in a boot and coming out of the boot in 2.5 weeks. Btw, you can still work out from the beginning without putting weight on the injured foot and with no stretching the injured calf to keep in shape.
Wayne, I think you are in a good position from what hear from you, I’m sure you will be able to get back to playing football, but you have to be patient and follow the PT exercise and don’t try to do to much to quick, 2 in third people are normally getting back to normal and do their activities, so keep up the rehabilitation and you should be fine. Where about you from and what age group are you, the younger you are the better chance to get back to activates. I hope everyone gets over that horrible injury and get well soon. Let us know how the rehab is going ? as I will be out in the boot in three weeks time then PT.
Hi Ann, sorry to hear that you done your ATR , I had the same treatment like you was in the boot second day, yeah I had the same problem couldn’t sleep at night as I had pain on top of my foot (the bridge) what boot are you in? Over the night I loosen the strips all four as I’m in VACO BOOT , after two weeks went back A&E to have a foot wash and change the pad and seen that I had a bruise on my bridge foot the cleaned it and put plaster on for me, before that happened to you try and ring them to tell that your feet isn’t comfortable, where you from Ann ? Also is your toes pointing down and how long will you be in boot for? Good luck with recovery
I’m from Melbourne(Australia) & I’m 28 years old. What about your self?
I did it at training just running and it went, i heard the pop.
I’ll be seeing my physio tonight i think he wants me to start on the bike slowly, everything is going well it just frustrates me that when i do my calf raise i can see a little lump & I’m not too sure if it’s healing or not. I can stand on both toes when i do this WHICH is really good because i could never do that at the start but i still mentally/physically can’t stand on 1 foot(the injured) without any support.
I am from England, Leicester city the champion lol and I’m 34 I di mine 20 minutes into the game making a sudden sharp move forward, the lump is normal it’s the sign of healing and tendon attached, and you are doing well if you can do calf raises, obviously it’s a bit too early for an injured leg to but full weight baring on but it well gradually gets better each day I’m sure just be patient with it. Where exactly your lump are, how many inches from the heal bone? Also after you wer out of boot did you still use crutches if so for how long? Good luck
Nah bro when i was out of the boot that’s it no more crutches.. full weight baring. it’s 3.3cm away.. .what bout you bro?
My lump is about 7-8 cm from heel bones and I should imagine that where that is ruptered, what exercises do you do and how long for you are going to see PT?
I’m going to stick with the physio the whole way dude, till 4-6 months, i see him every fortnight, he gives me a massage & exercises. I just do calf raises at the moment & then i behind lower like i’m doing a squat & i do calf raises again. I also sit down put 5KG or 10KG on my leg & just lift it up. All easy stuff mate, soon i will be doing pools/exercise bike. i do the bike sometimes now but i will smash it once he gives me the go ahead.
That’s the way Wayne, stick with the PT plan and hopefully you will get back to normal, I miss driving as mine is right leg and I can’t do much, was yours left or right? Is the lump still there or disappearing slowly?
It’s still there but slowly going.. I’m feeling much better.. it’s on the left. The only thing i’m scared about is this… IF you have a OPERATION then you are 100% back in 6months to normal.. IF you dont have a operation (i dont know if you even come back normal & even if you do it takes 6-9 months) am i looking into this correct or am i wrong? i just hope my non operative option works out and i can play sports again.
agnesatron 27 Jul 2016 at 7:37 pm 165
Wayne,
Did you check out Brady Browne on youtube? He is a Canadian football player who went non-operative route and he is doing great. I am 7 weeks post rupture today and am non-operative as well. I was really active before the injury and am planning to going back to all my sports after as well. The key with non-op is early weight bearing and early range of motion protocol. I am now full weight bearing in a boot and coming out of the boot in 2.5 weeks. Btw, you can still work out from the beginning without putting weight on the injured foot and with no stretching the injured calf to keep in shape.
(JUST SAW THIS NOW… SORRY, THANKS DUDE!!) APPRECIATE IT.
Evan Brown also has a great batch of videos, following a whole year of recovery. He was my guide. Very good information.
I was wondering if anybody that has healed enough to call yourself healed do you still have a dent in your heel, or is that an indicator of still some split in the tendon.
Thanks
Lara
Wayne - operative or non-op and it will still take a year or more to be 100%. 6 months is OK to get back to normal activities either way but at a reduced level. You are being managed well and should have every chance of a full recovery and as mentioned the early weight bearing is important. Not so much of the early stretching and eccentric exercises.
With op or non-op route, it will generally take a year plus to get back to your “regular” self, i.e. you mostly forget about the injury completely. I am 6, almost 7 months in post-op, by all means doing really well and am quickly regaining jumping and running ability, but still have a long ways to go with building strength and stamina. Stuart is correct.
Even with access to the best PT and equipment, professional athletes can take a year or longer. Many of them never return to pre-injury levels of competitiveness. Whether that’s a mental constraint/fear or physical limitation, or both, I’m not entirely sure. Although the fact that this happens to most athletes after the age of 30 might suggest it’s just a matter of the body slowing down in general, alongside diminishing ability, not the cause of it.
Thanks guys… I’m 2 months in.. Still a long way to go but I’ll be patient!!!!! Goodluck all
Hi Lara ,I am 12 weeks after my partial re-rupture I still have a slight dent where the rupture was , the Physio tells me that it will eventually will go ,
Hi Lara ,I am 12 weeks after my partial re-rupture I still have a slight dent where the rupture was , the Physio tells me that it will eventually will go , m
Hi guys, I’m in 6 weeks right leg full Achilles ruptured none surgery in my last 2 week in the boot and I’m already walking without crutches and full weight bearing , guys I got a lump below my calf muscle is that where the rupture is? Any ideas please? Good luck with your own recovery all
Thanks Paul, that does make me feel better. I was worried it meant it was not reattaching. My next appointment in the 20th which will be 10 weeks ish. And hopefully I will get out of this darn boot.
Well it’s 14 weeks since my re-rupture and I’m going back to work today , my calf muscle is getting stronger everyday with the excersices I’m doing all in all looking gooood .
Hi all, 7 weeks since that horrible injury now, I’m out of the boot on the 18 of August and I can’t wait, I feel like the tendon mended nicely as I’m full weight bearing on the boot from week 6, but I got a lumb below calf muscle as it gone skinny I wonder if anyone had that ? Also be nice to hear how you guys felt after coming out of boot, any advice on how to look after it, also dose anyone had Achilles support on after coming out of boot? Any advice or information would be appreciated. Wishing everybody a good recovery
Hi bilal10
I’m 14 weeks since injury I was out of boot 5 weeks ago and yes I also have a slight dent where the injury was , I’ve been told it may never go , my advice is take it slow do the exercises gradually , when I started doing mine I had loads of pain in my foot which I was told was the muscles reforming . My calf muscle on injured leg is still thinner than my good leg but can see improvement everyday , I’m back at work but taking think real steady . Just go slow at first that’s when I think the real danger is , all the best
Hi Paul, thanks for the advise, I’m out of boot on Thursday and can’t wait, got memory foam trainers ready to walk in shoes again and I feel positive about it, did you use crutches after you were out boot if so for how long? Good luck with your recovery
Hi bilal,yes I used crutches for about 5 days after coming out of the boot , just to get used to walking again , it’s scary without them st first especially when walking on uneven pavements but the more you do the stretching exercises the easier it becomes .dont forget that your knee won’t be able to bend very far forward over you toes so when walking up hill it can put strain on the tendon , just take it carefull and concentrate on where you place your foot when walking ,
Good luck
Hi Paul, thanks again for getting back to me and advise on how to look after it, did put any Achilles support on after coming out? And are you anywhere close getting to walk normal and do you drive? Wish you all the best on your own recovery
Hi bilal, no I didn’t wear any Achilles support ,It took a couple of weeks to walk near normal , I found I had a lot of pain in my foot where I was told all the muscles were reforming , I’m walking normal now although when I get tired I have a slight limp , I started driving about 2 weeks after boot came off which was 10 weeks from injury ,again I was told by Physio there is no set protocol as to when you should drive , you should feel you leg and foot are strong enough to do an emergency stop. Keep doing excersise stage Physio gives you and you will feel an improvement in the strength . Try sitting in the car and keep trying the brake pedal and see how it feels , you don’t want to come this far and damage the tendon again by having to brake hard . Good luck
Paul
Hi All
I fully ruptured my Achilles after a tackle in a 5aside football match early June. I initially drove to A&E due to the severity of the pain where I was misdiagnosed after about two minutes and no scans. I continued to work and drive for another 3-4 weeks until I saw a physio privately through work for a second opinion as I knew it was ruptured. I had the operation at 5 weeks post rupture.
The 22nd of August is just 5 1/2 weeks post op but the plan is for the cast to be removed and then to wear a boot which seems quite soon but I suppose each case is very individual as everyone’s rehab seems quite different.
At 39 I think football is finished for me, even though I’m very positive I don’t think I would take the risk and I don’t think work would appreciate it a second time!
Good luck everyone.
Regarding driving - You should obtain a clearance from your doctor if the leg is needed for vehicle operation. This will ensure you are covered for insurance firstly and secondly any more serious prosecution should you be involved in a collision. Modern vehicles do not require a great deal of leg effort to stop quickly but your brain may find it hard to realise that in an emergency. That is when ABS takes over if your car has it otherwise you lock up. My doc said once I was back in shoes I could drive but even then I left extra space from the vehicle in front and drove slower.
I have secretly become a left foot driver. I drive slow with lots of distance, and practiced on a quiet street. I do look really cool as I sit slightly twisted in my seat. But hey we gotta get out sometimes. Good luck all
Hi Paul, and thanks for advise once again, reading all your blogs and it was hard to take as you have been on a long journey, especially the re-rupture! Glad you are doing well and recovered well, learned a lot from you and I have to be careful not to try and stand on my tip toes on my first physio therapy. By the way was yours left or right leg? Take a good care Paul and thanks. Bilal
Hi Lara, how did you become a left driver.? Are we talking auto gear or manual? Good luck with your own recovery
Hi bilal10 mine is right leg
Many right foot ATR’s have used their left foot to control the pedals in an auto. The risk is entirely up to you but few consider the risk before doing so. If you are involved in a collision and you seriously hurt someone then the negligence can amount to criminal negligence which means you could do some time. Your insurance company will wipe you so you will have to pay the damages for the rest of your life. Now you may feel this is unlikely to happen to you because you are extra careful but personally I do not see the risk worth the chance I may injure someone else.
Hello all , I’m 16 week from injury and I’m back at work , I’m wondering at what point I can start lifting and carring heavy objects , my job involves fitting heavy to screens onto walls but at the moment I’m not doing any of the lifting .
Thanks
I’m came out of the boot today and feeling so happy, I can walk without crutches slowly with a slight limp, as my tendon is tight and need to massage it after I had my leg in the soaking warmish water for ten minutes, I wonder if anyone has that and gone through that process and how it feels now? How are the guys done there’s playing football, as im thinking if I can play agin or not? Hope everyone gets well
Hi bilal10, yes it’s a good feeling being able to walk again but be carefull walking without the crutches , it’s ok on flat surfaces but you don’t want to be stepping on anything uneven until your muscles can lift your foot over it , you don’t want to be bending you foot up too much until the tendon gets back it’s elasticity, that’s a Gradual thing .
Hi Paul, yeah I need to be really careful for the next two weeks at least, I got few exricies to do until I go to see PT and got told I should be able to drive after 2 weeks, also I’m glad that you are doing well , thanks for your concern and advise Paul.
Keep in touch on how you doing. Thanks bilal
Hi all, any ideas how long does it take for the tendon and calf muscle to start getting lose as mine still feels tight and I’m out of the boot just over 2 weeks. Any information and answer would be appreciated. Hope you all are doing well with your own recovery
Hi All:
I’m afraid to read this blog since I only ruptured my tendon a week ago. The specialist I saw 2 days after an emergency room visit told me to go get an ultrasound and come back to see him in 2 weeks at which point surgery would be scheduled only if its a full rupture. (He indicated that surgery is not done very often now adays unless its a full rupture because recoveries are more or less similiar.) The annoying thing is it will be over 2 weeks before I even find out if I have a full rupture and require surgery. If that’s the case I am just hobbling around on crutches for 3 weeks with no start to the healing process. Does this experience sound familiar?
Sorry to hear that Holdfast, did the specialist do a Thompson test on your calf? That will normally tell a kind rupter you have, or if you haven’t got pain in the tendon that is a full ATR and if there is a pain then it’s a PTR. Hope things go well for you and wish a quick recovery
Hi bilal 10
I’m 10 weeks now out off boot and 4 weeks back at work ‘ my tendon does still feel stiff but is getting more flexible all the time ,if I put my big toe against a flat wall I can now touch my knee against the wall , it has taken about 5 week to get to this stage , the more stretching exercise I do the more pain pops up in different parts of my leg and foot , bear in mind I hadn’t used my foot since February , I saw my specialist today and he told me it could take 18 months to get full range back ,
Hi holdfast
It seems a bit strange that you specialist is waiting 2 weeks until you go back I would have thought they should get you in asap so they can start recovery program ,
I ruptured my Achilles 9 weeks ago in the gym running. I live in the U.K. and I am being treated by the NHS. I’ve spent 9 weeks in casts. I’ve got three weeks left to go. This for me has been the none surgical route; as they change the position of my foot each month, and stretch the tendon. I’m anticipating having the boot next once the cast is removed. My progress has been hampered by aggressive swelling in the first week(had the cast removed for one week), and my ankle is still very swollen and hard at 9 weeks. I’m having to inject Claxane every day to stop blood clot, as a blood test indicated raised levels and potential for clotting. I don’t think I’ve had the best treatment with the NHS , I haven’t had a scan of the tendon and don’t anticipate walking in a shoe for sometime yet. I probably should have been weight baring a while ago, but I was told not to after my last examination. I wish I’d insisted on surgery now, seems like I’m in for the long hall due to the complications with the ankle and my tendon not healing as quickly as expected.
Hi Sheridan
I too I’m in uk and treated by NHS , I found that the NHS treats people the cheapest way not the best way , I was on the same protocol as you which if you read past post you will see it’s not a good protocol , when I came out of cast at nine weeks my Physio gave me bad advice and I rerupture day tendon , with the protocol your on there is a high risk of rerupture ,
Sheridan - Paul is quite correct about your protocol but not all NHS treatment for this injury is bad. All depends on the hospital you go to. There are many nightmare NHS stories here but also some very good ones. Early weight bearing is important for non-op patients, more so than surgical as it will reduce the risk of re-rupture. Studies in Exceter hospital have shown this (as well as many others in Canada, Ireland, New Zealand). 12 weeks in a cast and then a walking boot is very old school but it does not mean you will re-rupture. As Paul said, he got some bad advice from the physio which led to his re-rupture. Tendons repair mostly with collagen but the first collagen laid down is weak and disorganised (Type III). Through a program of incremental loading your tendon begins to lay down the better collagen (type I) which aligns itself in the direction of the force and is strong. This starts around 6 weeks. Since there is no force then there is no alignment and most likely less of the good collagen. Most people can start bearing weight around 4 weeks. Some start earlier and others a little later so when you start bearing weight you should think of yourself at that point. The re-rupture risk for them will start to slide after 12 weeks but for you it will be more like 20. Old school thinking was to lock your tendon up for 12 weeks with the mistaken view the re-rupture risk would be over by then. This has been scientifically proven to be very wrong. Once you are able to walk then walking is what you should do and be guided by swelling and pain. Do not limp. If you do then shorten your stride and go slower. Adding a couple of wedges to your shoes will take some pressure off the tendon and help you walk. This is all for when you go to shoes. You will also have to remember the rest of your leg has been locked up for some time and there will be joints around your ankle which will be very tight. You may also find some problems in your knees and hips. I am not saying you will not recover well but you will need to be more careful and do not compare your time with others on faster protocols, thinking you will be able to do the same.
Hi all 11 week in none srgical route, 8 weeks in the boot from the second day the rupter happens, early weight bearing from the second day in the boot, and I’m walking, driving and start coming down the stairs as normally do, the only things I can’t do bend my knee out towards tiptoes. Hope veryone get better. For you guys who are out off boot, put your injured leg in the bucket of hot water for 10 mins then massage it after that do your exricese as it will be helpful for the tendon to stretch and improve.
Hi my name is Demetrius, did a small run in karate to finish the session off and pop my leg just collapsed under me. I managed walk off have a shower limping back to the car I knew it was not right so I decided to go to A&E in Wrexham North Wales. They knew straight away I had a MRI to confirm the injury and it was confirmed a partial tear. They have put my leg in a cast at the moment below my knee with my toes pointing out. I got a appointment on 22of Sep to see what next. What do you think I should suggest with the Doctor or should I follow the Doctors next step , I have read a lot online and peoples fir rent outcomes. I lead very physical life before the injury, gym work,Karate and running. What do you suggest.
Many Thanks
Demetrius
Stuart and co, might find it easier to find the UK research under Exeter, not Exceter. Hope this helps.
Hi All
Just found this site 30 mins ago and wanted to say a massive thanks for all the contribution you all make and of course the encouragement you provide to everyone. I did my achilles a week ago today, NHS told me it was torn so in plaster with foot angled down. Finding I get cramp in my calf quite regularly particularly when on crutches for any time. Having an MRI tomorrow and making some choices I guess op or no op?
Hi Grant, sorry to hear that you done your Achille, I did mine 4 months ago playing football and I chose a noon sergical route. After 9 weeks seen physio and he said that my rupter was a parcial one as if I had a complet rupter I would have to have done the surgery for it.
Find out from your MRI scan if it not a complet rupter and hopefully not, take a noon sergical route as it will be healed same as sergical and plus you don’t have to worry about an infliction as you might get if you do go through sergical route.
How did you do it and was it painfull?
Hi Bilal
Thanks for responding and the great advice, I guess the MRI will
answer many questions for me. My main problem is suffering from cramp in my calf, this is particularly bad if I am standing for any time.
Will let you know what I find out today, good luck to you too Grant
July 2nd I completely tore my achillies playing football. Had surgery on July 5th??? Had cast on for 2.5 weeks. Then went in the doctor to take off the stitches, to put on a new cast for another 2.5 weeks. During my last week of my second cast, I took off the cast myself and started walking with an obvious limp. Went in and Doctor on August 19th and told me that I seem to not need the boot. Said that I would be able to jog in two weeks, which would in September 9th!!!
I returned to work on September 12th and that was my therapy (lots of walking and heavy lifting). My limp was GONE returning to work. I figured I was recovery REALLY fast. Walking on my in my cast since the 3rd week of surgery, skipping the boot, and walking with no limp.
Then I gathered a youth team under 18 to coach to play football. I jogged a couple of times for 5-10 seconds during the practices to test out my leg! It felt great. Really great.
Fast forward to October 9th! Keeping in mind that the doctor cleared me to run on September 9th, it’s been exactly a month now… I coached my team and I wanted to demonstrate them tips in football. So as I tried to demonstrate, I heard that same ol pop from when I tore it the first time. I knew right then I reeupture my achillies. Touched the back of my leg and I saw and felt an obvious gap. I couldn’t help but feel a lot of stupidity, angry, upset, and all these other mix feelings! Dreaded enough that I cried to bed, knowing that I have to go through the process again and fearing of depression from thinking how I can pay for the bill.
Went in to the doctors and confirmed I tore my achillies. Had an MRI, showing a 2 inch tear. Doctor suggested to do another surgery because it was such a huge gap, but I honestly didn’t want to deal with it again. Especially when I don’t have insurance. So I took the non surgical and now I’m in a cast. And willing to take the risk and I feel confident that I can recover from watching others recover from their injury taking the conservative route. The reason I took the conservative route was because after a week from the rerupture, I didn’t have to zombie walk anymore, I could “press the gas” and flex my calf. I know the doctor knows more than me, but I think I can recover just as fast as when I had surgery. Im just hoping so that the results will be true.
For sure this time I’m staying away from sports and any kind of danger to my feet for a whole year! The athletic side of me and the heart of a champion side of me said that I could do it. The sport of football in my community was dying and I couldn’t help but see it crumble. And because I loved the sport so much. I wanted to introduce it to other kids that I think they would find it crucial their life; in terms of relating football to their life.
But to all of you guys, be optimistic and be brave! But be safe at all times. At the time before the rerupture of my achillies, I thought it was a sane thing to do, to test out my legs, but it left me with a lot of regrets. But we live with that and we learn to persevere around it. All I’ve got to say is, STAY OFF THAT LEG! More than 6 months. Make sure you’re mentally and physically ready. Take it easy and be safe! And most importantly, be patient.
It is October 20th. & I have a long way until I get the cast off (November 29th). Will update so others can get info!
Hi everyone, I’m 5 months in after rupturing my Achilles. Like most of you I got mixed messages on which treatment to go for, it’s a minefield with so many arguing the case for and against and initially which ever path you choose (if you have a choice) you will then see forums full of keyboard doctors telling you how brilliant or bad their recovery was and therefore the path they chose was obviously the right - or wrong way to go. I was given the choice, surgical or non, and had the various stats and figures and re-rupture rates thrown at me. It’s so confusing and worrying and in a nutshell I made a choice that 5 months later for me was the right one (so far) I am walking well with a very slight limp and now leading almost the life I led before but I am very protective and don’t run, skip or jump yet. What is agreed is this is a year to recover fully and 4-7 months in is prime re-rupture territory so caution is your friend. Coincidentally and importantly perhaps if you’re reading this and looking for guidance - my work colleague ruptured his a week after me and we went different routes, I am walking far better than him, have had far less pain and generally am in a better place. He regularly tells me he can’t believe how well I’m doing in comparison to him and regrets his decision. My Achilles feels thick and strong but my calf has a long way to go to recover to it’s former strength but again, mine seems to be stronger than my colleagues which brings me to my casing point that we are both similar age but different builds but he was far more active than me, but my leg has to this point won the race to recovery. I’m 48, 6 feet 5 and weigh 18 stone, he’s 42 6 feet 0 and weighs 12 stone.
I was once told a good surgeon doesn’t operate or open the skin if it can possibly be helped. Coincidentally a good surgeon told me he could operate the next day. I took his advice and went for it..
….By going the conservative route!
That’s where I’m at, good luck with yours, it’s a long road but you will recover and follow your recovery regime to the letter, don’t be tempted to remove the boot too early or take it off when you shouldn’t.
My last tip is to weight bear on the leg as much as possible when booted, advice from 10 years ago is outdated and now thought inaccurate.
I’ll come back when I’m a year in. Love and best wishes to all of you.
Duncan - much of what you say is quite valid. People need to make a choice very early and they mostly rely on the information provided by the attending doctors. This choice can also be based on very old (as you have pointed out) practises which the doctors never changes. I have seen this so often here and in my many years of reading and writing on this site I can equate easily why some recover quickly and others struggle, given of course they provide accurate information. This site has helped many to the result they had sort when they were headed in the wrong direction but it is still a blog full of unqualified people and all advice should be measured. It is important people have confidence in the process and it matters little to me if they choose surgery or not. Your treatment method is a little criptic but I am assuming you went the non-surgical route and it is working well for you. I am sure you colleague will be in a similar place to you in 6 months time but without knowing his process or yours I cannot form any opinion as to which was better. It really doesn’t matter anyway for it is what is best for you that counts. The body will heal the tendon just fine without the need for surgery. Surgery usually produces better early results for most people but we are only talking a couple of weeks on modern protocols. The prime re-rupture period however is not 4 to 7 months. Although people do re-rupture in this period it is less common if modern protocols of early weight bearing and movement are followed. The prime period is up to 12 weeks and from then it slides unless treatment involved extensive periods of NWB and lengthy casting. That will push the danger period to 7 months easily. It is common to hear from people who are serial casted for 12 weeks and then thrown out of the doctor’s office in 2 shoes and forgotten with little advice offered. For a non-op patient it is most important for the tendon ends to touch when the foot is plantar flexed otherwise the tendon will heal long and strength will be an issue for life (or until surgery fixes it). Sometimes the tendon retracts too far and this cannot be achieved so surgery is the best option. What I can say is that after 12 months, if you have not re-ruptured, then you can go back to doing everything you did before with the same vigour although it will take longer for the tendon to remodel and gain full strength in the injured leg. This essentially means that you can generally follow the protocol set by your doctor, whatever it is, and in most cases your outcome will be largely the same in the end. Some will achieve goals earlier because they are following a more modern approach and this can be very important for those who need to get back to work or have other priorities in their busy lives. I wish I had found this site before I went to the hospital as it would have changed everything for me. I was given the usual out-dated information and scared into surgery but this site did change my recovery protocol to a large degree. Using it and then researching the information thoroughly (independent of this site) I found most helpful and at 5 months I was able to start building my house with a strong and reliable tendon. I had no fear of re-rupture and was able to walk up ladders carrying huge weights at times. There is good and bad advice available everywhere and it is difficult for many to sort through it. Some of this bad advice comes from the medical profession and trained experts. I read of one on this site just yesterday and if the advice given by the doctor was accurate I would suggest legal action. If I were to rupture my other AT then I would be telling the doctors how I would be treated if I bothered to drive the 2 or more hours to the hospital which would only to be to get the necessary scans. I am sure I would get the same text book speel. I am most happy your recovery meets your expectations and certainly hope your colleague has a successful recovery as well. Thanks for contributing to this site and will look forward to your update.
Hi there, great posts on here. Ruptured my ATon October 23rd. Was playing football and heard that noise people will be aware of, even the guy standing 25 metres awY said he heard the noise! I was debating what to do as never had any injury like it before, luckily the pitch we played on was 5 minutes from the hospital so I decided to swing by A and E. They saw me and put it in a cast and said to come back to the fracture clinic a week to the day. Arrived back on the day of the clinic and went in to speak with the consultant. Fully expecting an examination or scan to see the damage, all I was advised was that I will move round to the plaster room and get an air cast boot with wedges inside. This would be my treatment for the next couple of months and taking a wedge out every other week. So I went along with this advice despite reading about the operation etc and was quite keen to do that. Anyway I had a physio appt a week or 10 days later and immediately thought it was a bad session. The physio informed me that I would be running by January, from what I’ve read this would leave me way ahead of professional athletes recovering with the best treatment! I walked out vowing never to go back. Luckily Mrs B has private medical through work so I’ve got an appointment booked with a specialist next week.
I felt good up until now with my boot and being able to walk without crutches (as per advice from physio). I took my boot off for some air and went up the stairs to see Mrs B who was ill in bed. Without boot I shall add, got half way up the stairs……SNAP/BANG/CLAP whatever noise you would describe it as….ahhhhhhh noooooo, why did I do that!!!! Straight back in my boot as tight as I can and now awaiting my specialist appointment. Don’t think trip to A and E is needed as I have my boot back on, has anyone else done this silly thing also?
Great posts on here and very informative.
Hi all,
Some great posts in here. Helpful to read other people’s experiences. I have my own that I’d like to share also, apologies that it is a long one…
FYI I’m now 31, male - relatively fit. 5ft 6 - 11 stone, cycle a lot and play football but don’t use the gym enough - something I’ll be changing soon. My injuries have always been to do with football and yes it might just be simple for me to give up with the sport.. but I keep finding myself going back to it.. I clearly need to get in a good shape before I play this game or not play to the same vigour..
All injuries from playing football (a sport I’ve done since I was 8 on concrete, grass and all sorts - a lot of wear and tear perhaps..)
Summer 2005 (20yrs old) - left knee operation to remove damaged cartilage - 6 weeks in a leg cast
Summer 2009 (24yrs old) - tore right knee cartilage (no operation - just rested, recovered fully and never had a problem again
Autumn 2011 (26yrs old) - tore my left knee cartilage (no operation - just rested and recovered)
Summer 2014 (28yrs old) - partial rupture of the right achilles? - 11 weeks in a leg cast.
28/11/2016 (31yrs old) - left achilles injury (full diagnosis in process)
Achilles history:
In the Summer of 2014 I was playing football (5 aside) on typical 3G fake grass (Goals Soccer Centre - South London, UK). I was 28 (going on 29) and was in ok shape but not my peak after a few knee injuries since hitting my 20s. During one game I rushed back from work and played immediately. I was late to the game and didn’t have time to warm up properly. I managed to play for 10 minutes before half time and then during the second half (each half is 20mins) I was running backwards when suddenly I felt the achilles pop in my right leg. I thought some local chav had launched some cricket balls at the back of my ankle but obviously reality soon hit and no one was close to me nor had any unauthorised person run into the pitch area to attack me with hard cricket balls. So.. I knew I had done something seriously bad. I went to A&E that evening and had it assessed. Was told it was a full rupture by the nurse before being sent to see a doctor who subsequently told me that it was a partial rupture and he explained that “if it were full you wouldn’t have the up and down mobility that you’re able to demonstrate to me”. He then told me that it didnt matter whether it was partial or full though as the same treatment would be required. I was given no option of an op, and was put in a cast for an initial two weeks with my feet pointing downwards. I would then have the cast replaced several times. All in all I was in a cast of some kind for 11 weeks!! (I was told should be 8-9 at the beginning - I think they made a mistake..) Finally in September, the day I moved into my newly bought flat, I had the cast removed and was put into a pressurised boot and had appointments with a physio. Over the next month I slowly got myself walking free of the boot and although one month later I went out clubbing and came home in agony (soreness and a limp) which I considered a bit of a setback, I still seemed to improve afterwards and put that down to doing too much (ie stnading and dancing on my legs for too long and so soon).
6 monhts later, (9months after the initial injury) I felt like I was back to my normal self. Cycling to work, walking perfectly and running after the occasional bus. But no football just yet.
It was almost a year before I started playing football (May 2015), and even then only as a five a side goalkeeper. I joined a team and have played in goal with a few cautious cameo appearances on pitch ever since. The amount I’ve played on pitch has steadily increased since May 2015 to now (November 2016).
My right achilles seems fine.. however… in the last 2-4 months I’ve begun to get a lot more confident and been playing on pitch regularly. Now 31 with a desk job in Central London I dont cycle to work (not often anyway), and do little other exercise other than play football once or twice a week. I’ve felt really good but last night I had a reality check.. this time my left achilles!
It was freezing and I naively didn’t do a proper warm up. I played in goal during the first half and came out for my usual second half cameo on pitch. I played like I used to, running around, twisting and turning like I was 20 again. Sadly I did one turn too many, twisted, took a shot and when I landed on my feet I felt that awful pop again and new right away it was my achilles, this time the left one.
I went to A&E last night and been put in a temporary cast, had an x ray (which I think is pointless) and told that the fracture clinic will call me within 3 days to organise a consultation and a possible scan. I was also told that I will be put into a boot and not a cast, which sounds promising compared to my last treatment (although I cannot really fault my treatment first time round).
Would anyone have any advise in regards to using the boot and what types of questions I should be asking during the consultation to ensure I get the most appropriate treatment? I know I’ve been here before but after reading this forum and other websites I’m now more confused haha. At first I wanted the operation but now thinking that the conservative method may bring less complications although I don’t want to be in a cast for 11 weeks like last time!!
Hi Kevin, sorry to hear that you injured your Achilles, I did mine on June the 22 this year, same thing to you was playing football 20 minutes into the game got the ball and made A sudden sharp move and pop at the back my right leg thought someone tacked me from Behind, or someone shot at the back of my leg, like you I had so many injuries in my career but I straight way knew this is the worst one, anyway went to A&E and diagnosed a full ATR. Put in the cast but managed to go in the boot the following day and was in the boot for 8 weeks 24/7, after coming out the boot on 18th of August got booked with a PT , as I saw him today as it was my 5th session he gave me some positive news that I’ll be be able to go back on play football in February. By the way I took a none operative route.
I believe it is the right treatment the sooner you put in the boot it is better than as you can put some weight on it and you can move around without crutches, elevate your foot as much as possible and don’t do too much too soon remember.
Hope you get the right treatment and back on the field sooner then you think.
Good luck on to your
Thanks Bilal.
Pleasing to hear about your experience and hope all goes well at this stage of your recovery process. It’s really frustrating that our bodies just can’t cope with those sharp turns at times. Makes me wonder if my body is cut out for football or whether I have too much wear and tear over the years that maybe I should give it a rest, seeing as this is my second rupture of the achilles.. one in each leg… My nurse said I’ll be put in a boot, have my appointment on Monday ( a week after the incident.. so slow!) I went the non op first time round and reckon I’ll go for the same this time unless advised otherwise. Hope I get that weight bearing boot .. how does it work? Crutches are such a nuissance! Hate them! So restrictive.
Plan to join a gym in the new year (once I’m out of cast/boot) and really work hard in the gym on all elements of my body and posture before I even think about returning to the game.
Also.. I know rest is key, but does anyone have some good exercises to do whilst in the cast/boot during those tough recovery weeks where your body deteriorates. I want to try and be in the best shape possible when I get out.
Thanks again.
Kevin
Hi Kevin
Hope it all goes well with your own recovery too, well here in Leicester A&E they provide you a Vacocast/ Achilles boot which I believe is the best especially for early weight bearing as you can check it out on google.
Yeah I’m agree with you to get into the gym and work on all the body elements, remember we are not 18 or 20 year old anymore so we need to work harder to stay fit and injury less, all l was doing during my leg in the boot was working on my upper body at home.
Anyway how did your previous Achilles rupter mended and did you get back to the same level of playing football and normal again? That’s my concern, mine just gone passed 5 months and still feel a long way to get back to where I was.
Good luck
Hi everyone, I pop my head in now and then and read other people’s recovery with interest. It’s obvious from not only this forum, but others as well, that conservative treatment seems to be strongly favoured now.
To compare notes, I’m 7 months in from a full ATR, treated conservatively. I can now function at 80% but still walk with a very sight limp, like I have a pebble in my shoe. It should be noted I’m a big fella, 6 feet 6ish and weigh 19 stone, my injured left leg still has a lot of calf muscle to regain. I have been to a few concerts in the last few weeks and am confident to do the basics, stand for hours and walk a fair distance. If you’re young and fit you may find your further along the recovery path than I, but I’m a 49 year old man who has been non active for a decade, but I would still urge caution.
My advice is know your body, know your limits, and don’t fall in to the trap I’ve read others have lived to regret. The people who know tell you it’s a year to recover, but life hits some normality after about 4-5 months. Normality means walking, driving and generally going about your life without crutches and a boot. It feels good.
Psychologically this is a testing injury. I have read horror stories of those who kicked that football too soon or hit that tennis or squash ball too early, and put themselves back months. Caution is your friend, and as always I wish you all well. Have a merry Xmas, we will all have a better one in 2017.
For those of you going through a non-operative route, just to let you know that from my personal perspective it was the best choice I ever made. I am active martial artist who fully ruptured my right achilles three years ago at the age of 41. The NHS did not want to operate on me, but their rehabilitation or lack of would have been disasterous and I am sure I would be limping to this day. Private options included surgery but having contacted Mark Glazebrook in Canada I paid my own physio to put me through an early weight bearing accelerated rehab programme. I was back running and training lightly by 6 months, after 12 months the only difference i noted was early fatigue in my right calf and slight deteoration in push off power, at 24 months I saw no difference other than when skipping on one foot! In short, if you have access to the protocol and some guidance from a physio go the non surgical route…..if you dont then consider surgery as NHS lack of rehab will condemn you to failure.
Incidentally, the accelerated rehab does mean pushing the limit of what your achilles will allow. I was told by Mark’s physio (who he also put me in contact with!) that as long as the movements are gradually loaded then there should be no pain…..stick to the type of exercises in the protocol which does not include for example kicking a ball….do as much dynamic work in a pool as possible moving to shallower waters as your achilles gets stronger…good luck
Hi I have been told recently I have damaged my achilles tendon..i have been told to do exercises and have been given a boot to supposedly wear at night in bed but it is very uncomfortable so I wear it when I’m sat on an evening..Ive seen a podiatrist who seems unsure of what is wrong with my foot Ana has now transferred me to another doctor..My foot is excruciating and I have a very bad limp when I can manage to walk…does this sound like a tear or rupture to anyone and if so am I causing more damage with the exercises…..
This sounds like a tear rather than a rupture , until you see another doc I would stop doing the exercises as you could be doing more damage , where are you based , I would suggest asking for an X-ray . I’m not an expert but the fact you are in pain isn’t right and you may need to have your foot placed in the toe pointing down position for a week or two before you carry on exercising,
Take care
Paul
Lynn - there is really not enough information to give any answer but even then you need confirmation by a medical expert. Sounds like you are in the US to me. A tendon will rupture not tear. Muscles will tear. Just terminology for the same sort of thing. An X-ray will show nothing if it is soft tissue. Ultrasound or MRI are the only diagnostic tools for these injuries. It does however sound serious enough for you to stop the exercises until the problem is confirmed. If it is only a muscle tear then you will be fine in a few weeks and exercise is important. If the AT has ruptured or even partially ruptured then different treatment is required. I the pain is in your foot then something else may be wrong.
Hi again,
Update on my case. I had a second kind of rupture after my first and paid to go private, well through the wife’s work. MRI scan provided information to say there was to much damage to the tendon to treat conservatively so operation was required 2 days later. This was completed, my first ever operation and placed back in a cast for two weeks over Christmas. 28th had my cast off and wound inspected and told all was healing well. Placed back into weight bearing boot and walking on it without need of crutches. All seems to be going well so far, but very very tight on moving the ankle joint about. Hoping stretching will eventually free it up and having some physio in the coming weeks. Scar is getting better by the day and I just wanted to say that my consultant/surgeon has been fantastic and very knowledgable. I would highly recommend him if any one has any issues. Out of interest I wondered if any one from Essex, U.K. Was on here and reading? Happy new year all, rob.
I am a 64 yr old woman. I ruptured the Achilles tendon when I fell over the cat scratching post in the dark. Booted at first.then a soft cast and boot. Finally surgery, boot, hard cast and now boot. This all started in mid October ‘16…finally walking with a boot…no more knee walker! I just want to wear 2 shoes again and drive! No mention of pt yet… surgeon’s approach is cautious due my age and other health issues. It just feels so good to walk again… boot or no boot!
Hi ATR people, after just over 6 months I have started to play footy again on Wednesday just gone, started in goal and 10 minutes of filed play towards the end, felt nervous but luckily it was ok, I’m going to play badminton now but of course with caution, has anyone started to go back to thier activities yet? Good luck to you allowing
Hello,
Thanks for all the useful commentary on this thread. I had an ATR last Wednesday evening playing 5 a sides. Like so many others I thought at the time I had been tackled from behind but no one near me. It seems that I just turned too quickly. I am male 37 and pretty fit. I go to Crossfit 3/4 times a week and regularly do 10 km runs most weekends. I have never experienced any tendon pain. I think the only trigger could have been that I only started playing 5 asides again after about a 15 year break as one of work colleagues plays and they were a man short. The funny thing is that this happened after week 3 being back playing 5 asides. I went to A&E the same night and they did the Thomson test and confirmed ATR. I was completely gutted when they started to tell me recovery times etc and what I could not do. They put me in a boot straightaway and I seen the consultant 2 days later. I spent the next 2 days researching ATR. When I seen the consultant he said in my situation surgery was a better option if I wanted to get back to fitness at the same level and that rates of re rupture are lower. I had surgery on Monday this week (5 days after it happened) and I have been placed in a cast. I did wonder why they opted for open surgery as opposed to PARS which seems less invasive but I had read some studies to say that outcomes were pretty much the same. The cast is not a full one as I think they allow for swelling and I have an appointment to see the surgeon again on Monday next week and another appointment with the Consultant on Friday next week. When I first seen the consultant before the op he said that I would be mountain climbing after 3 months, which based on what I have read seems a little optimistic! I had to spend one night in hospital as I had the surgery late on Monday afternoon and they wanted me to see the physio before I left. The pain after surgery has not been too bad. Most pain has been around the wound / calf. It is 2 days now after the op and I have already reduced the amount of pain medication that I need. One of my crutches slipped a bit on my wooden flooring earlier today which caused a bit of pain as my injured leg did stretch a bit but fine now. It is so debilitating having a cast and crutches and really interferes with day to day life. I am hoping to return to work after 2 weeks. I have moved to a desk on the ground floor to avoid having to manage the stairs. I am hoping to be at least partial weight bearing or minus the crutches after 6 weeks. Here’s hoping.
Ryan, I had the op done and had a cast on for 2 weeks, then back into my boot straight away fully weight bearing on it and it and life has become easier again. Scar is healing extremely well which I’m happy about. Where are you from? My pain afterwards was minimal, no different to when I originally done it, and like you slipped slightly and overstretched.
Hi RobB,
I live just outside Manchester. Seen the consultant today and I am back in the boot with wedges. There are 2 wedges and he said take one out after 2 weeks. No pain at all now but did feel more stretched when put my foot in the boot today after having been in cast for 2 weeks. He says I should be out the boot altogether at my next appointment in 4 weeks although he said I may still need crutches for a bit. He said to me that I could do everything I would normally so long as I have the boot on but that I don’t need to sleep with it on. I am pretty pleased with the treatment I have had so far.
How long since you had your op?
Ryan,
Had operation on the 14th December. Started with 3 wedges as the complex issue that occurred originally with mine. Down to 1 on Wednesday and then 2 weeks with that one!
Hi all:
I fully ruptured my Achilles 22 weeks ago (3cm gap) and have followed the non-operative approach. Things were going very well except that I have always had quite a bulge of scar tissue at the tendon rupture piont. Walking is pretty much normal up and down stairs until today. I was carrying a stack of books going downstairs and didn’t notice anything particular until I sat down. Then I felt something was wrong like a general weakness in the muscle and a bit more mushiness in the tendon. Of course I am expecting the worst. I can still walk but it feels very weak. I’m going to call my doc tomorrow if it doesn feel better. Fingers crossed.
Hi all
32 weeks post injury none operative, PT gave me a green light to go back and play footy felt excited, as I played 6 aside on Wednesday was on the filed for 30 minutes until I felt the leg is getting tired for the rest of the match was in goal and managed to stay safe.
Has anyone made it come back that early?
Best of luck with your own recovery people.
Hello All
Thought I would post an update on my progress. Had cast on for 2 weeks and then was in boot for next 4. Was fully weight bearing from day one of wearing the boot. It made life so much easier than being in the cast. I slept in the boot for one week and then slept without it for the remainder of the time. I did lots of ankle circles and used a band to flex my foot. Went to see the consultant on Friday which was just short of 6 weeks from my surgery date. He got me to walk out of the boot which I did. He said I made good progress and that I could be discharged. Now back in normal footwear and walking without crutches. Just need to build strength back up over next 6 weeks but his advice was return to full normal activities at 12 week point. I went out for a walk yesterday since having the boot off. Was limping quite a bit but no pain. Ankle area was swollen but was less so after nights sleep. Consultant recommends swimming for rehab so I am going to take that advice and try swimming as much as possible for next 6 weeks.
Ryanjww - My time and experience threw a couple of red flags with what you have said and I would urge some caution. From memory I believe you are in the UK and NHS consultants can be a bit hit and miss with their advice. You have done very well and I only offer this advice to ensure your progress is not set back. I am not sure what ‘full normal activities’ for you is but if that involves any sports then in my opinion 12 weeks is way too soon. I would suggest 5 to 6 months at best. Some doctors do not feel physiotherapy is necessary but to send you out to swim as your only rehab is not really going to help your healing tendon. Swimming is good exercise but it does not do much for your achilles tendon because of the angle of the foot and very little load on the tendon. Your AT is there to help you walk and run and it will be looking for load to align the collagen type I which is now being laid down by your body. You are now in the remodelling phase of tendon healing and walking would be much better for you. As your tendon and calf gain strength you can incorporate hills, uneven surface and stairs. You should be able to get some physio through NHS but sometimes they are not good either. I rarely comment against doctors but in this case I find exception. Please do not take my word alone. Do some reading here and maybe get a second opinion.
I am 7 days into recovery after an op to stitch a horizontal ATR with an additional tear vertically. Old man playing squash! I will go into my boot next week. I have been using an iWalk rather than crutches. Has anyone used one, are there any problems keeping your leg in the bent position? second question, I am a keen swimmer and want to include pool work into my rehab but my doc is less keen. Did anyone get into the pool early on? BTW, good to read about the mental challenge that others describe, the pain was bad but the sudden, unplanned change to a very active lifestyle has been really tough to cope with.
Russell - most who have had a knee scooter swear by them but some have fallen off and done some damage. Crutches can be just as dangerous, especially on wet tiles. No problem bending the leg onto them. It is very comfortable. Swimming early after an operation can lead to an infection so it is not encouraged until the wound has healed properly. There is some work in the pool which can be done but swimming on its own does not offer a very good rehab. I doubt it would hurt so do it if you enjoy it. You can get busy fairly quick. Walking can start after 3 weeks usually but you can also do some upper body gym work and stationary cycling using your heel on the injured side. People handle the sedentary change differently and usually the first couple of weeks are the worst.
Russell- I’ve been switching between crutches and the iwalk over the last 4 weeks since surgery. I feel better with crutches outdoors but the iwalk is more convenient indoors when I usually need my hands to carry things. Just make sure you are fully secure in the iwalk or else any sudden jarring movement tugs at the incision site. But this may have been all in my head - incision looks to be healing ok.
I ruptured my AT a week ago. I want to go non operative.
My doc just issued me a boot, but didn’t have any wedges? I asked for some but they just had one.
I’m early weight bearing with crutches. Very little pain. Can easily move my toes and I’m icing and mitigating swelling 3x a day.
He never issued me an MRI saying that would only be necessary if we were going to operate.
My physio is concerned not having an MRI and she wasn’t even aware complete ruptured AT could heal without surgery?
Should I be concerned about my boot and lack of wedges pointing my foot down?
Should I find a new pt who understands AT more?
Lastly, should I get the MRI
odheel, is your boot set in neutral, or in the angle with your toes pointing down? If you are in neutral and you want to go non-op, you have to start pointing your toes down as soon as possible. The connective tissue between the ruptured tendon ends creates very quickly. Being in neutral, you are stretching the distance between the ends and more of it will create, thus giving you large risk of healing long. The longer the tendon, the weaker you leg will be upon healing.
If you can also, do find a PT that knows non-op approach well, as initial weeks for op and non-op patents are different. The stretching approach is also different for op and non-op. Later stages of rehab are the same, but the initial stages differ some.
As far as MRI, many doctors will do ultrasound only to confirm how big of a gap you have.
odheel, i did a pretty exhaustive review of the peer-reviewed literature on this and the only objective observation is that re-rupture rate for non-op is higher (ca. 10%) than op (ca. 3%). having said that , the studies were not controlled for activity so maybe the op group were more conservative. However, for what it is worth, unless you are in Uganda or Bangladesh, I’d take a chance on a surgeon! Infection is likely to be low and the procedure is relatively straightforward.
Odheal - Agnes is quite correct and you should deal with this quickly. Russell’s information may be based on older studies as the newer peer reviewed studies using early weight bearing for non-op produce similar re-rupture rates to surgery. There is considerable information on this site about modern non-op protocols. Agnes is a fine example of them.
Hi all, let me please please please consult with you guys. I really need your help..!
I ruptured by Achilles tendon playing b-ball. I went to A&E immediately and was told that it was complete rupture.
I had plaster cast (pointing down) on about 2 weeks. On day 14, was able to see a doctor. We both agreed that I am obliged to take a non-surgical treatment because I had missed golden hours for taking a surgery. As a result, I have been in a walking boot, with half weight bearing allowed.
On day 28, I got ultrasound. I was not able to see the doctor on the same day though… So I asked the ultrasound engineer whether my Achilles tendon was getting better. I was told that it was completely torn and each torn part doesn’t move together when I tried to move up and down my injured foot.
This made me really disappointed. What I heard and read on google is that the first month of injury shows the speediest recovery. It means that I should have seen an obvious improvement by the ultrasound test. Unfortunately, it was not the case for me and I am really worried.
For those who got a non-surgical treatment, do you think is it a normal healing process? am I just over-worried?
Thanks for your time!
Park - time for you to see your doctor. You have not missed any surgical opportunity but I suspect you are in the UK and the NHS does not like to operate if it can be avoided. Your tendon should be joined by 3 weeks. Your initial treatment was appropriate so it may have ruptured again somehow. Not a great deal anyone here can do for you. I would suggest you keep you leg in the boot and if it is adjustable then it should be pointing down. If not then you should have wedges in the boot to give the angle and you will need around 30 degrees to be safe.
Stuart - thanks so much for your note. Yes, I am in the UK and the NHS seems to prefer a non-operative approach. The boot has been pointing down, with 3 wedges in it… I agree with you… it may have re-ruptured… However, there is no evidence because I took the ultrasound just a few days ago, which means there’s nothing to compare and confirm my Achilles improvement.
Park, as part of the protocol I followed surgery was only considered if the patient was to be ‘insistent’ or if there had been a delay in getting treatment…. By this i would infer that surgery is not completely out of the question at this stage for you. I was non surgical and if I remember correctly they did not do the Thompson test again on my Achilles until week 6 when they saw continuity. But I don’t know if it was there earlier. I would have thought the boot you have been in until now is placed in pointed toes too? Could you feel the gap in your tendon when you initially did it? I certainly could and I am fairly certain it was filled in by week 4/5. If you are really concerned you should try to see the doc again and thrash out your concerns. Good luck and I hope you are heeling better than you think.
Hi Gang.
My name is Tim and I live in the US. 8 weeks ago this coming Friday, I had surgery on my AT. I am 55 and very active. My injury happened about two years or so ago and I lived with it not knowing it was a tear. iMy AT would swell sometimes after hiking in Utah or when working hard in the yard. Went to the DR with my girlfriend for a foot problem she was having and I walked out with a surgery appt.
I was not given another option.
I had the surgery where the scarred material was removed and sewn back together. The Surgeon also took a tendon from my big toe and spliced in for added strength. He also removed a small bone spur on the right side of my heel. Two weeks in a ballerina hard cast then stitches removed and second hard cast for 3 more weeks with less of a point to the toe. I am now in a “soft” air cast for the last 3 weeks.
Although the Dr. strongly advised me not to put weight on it even in the soft cast, I have even walked on it in the cast on a few occasions in the past two weeks (weeks 7 and
without pain. Just a weird sensation on the heel area. it feels like I have a pad under my heel and the nerves are tingling.
My question is…Am I hurting my AT by doing this? I just couldn’t stand being immobile of 2mths.
Please forgive my poor typing and thank you in advance for any feedback. My best to you all.
Hi I’m from NZ and 4 weeks in after rupturing my achilles at netball practice. I went to A&E the night it happened and after failing the thompson test was put in a cast with my toes pointing down. I was supposed to see the specialist a week later but wasn’t able to get in till 3 weeks later, my first visit I was told that I would remain in the cast for a further week then I would have the cast removed and I would get a boot. I got the boot 2 days ago which after being pain free for a month was excruciating. The wedge in my boot was very low and there was no way my foot was going to bend, which also contributed to my boot not fitting properly, everytime I lifted my leg the boot would slip down. I asked about a higher wedge which I as told no and if it got too bad put a sock in the boot to let my heel touch something. I was not happy when I left the surgery and ended up going back for them to sort the ill fitting boot and the pain out . It was packed with padding and that was all they would do. I haven’t had a scan, was told they do not do surgery as it poses more problems. I was told to force my foot down to touch the wedge within the next 2 days and he wanted me to be full weight bearing in a week and he’ll see me again in a months time. I never had pain when I ruptured it and was looking forward to having my cast removed, now I have constant pain and dread moving around. I’m from a small area and there arent that many specialists or I would have changed doctors. I was extremely positive before, now I’m dreading every step.
Tim - you do get tingling in your heel when you start walking. Not sure what a soft cast is. I started weight bearing at 6 weeks in a CAM boot. It provides support so you don’t flex past neutral, your ankle is supported and can’t flex. You can check out my blog for pics. When I asked my doc why the CAM boot he said that after 6 weeks of NWB not only are your muscles atrophied but you lose bone density so stress fractures are possible
Day 4 of being out of the cast and in the boot…still struggling to get my foot to bend so I’m on the wedge but it’s getting there. The pain comes and goes but I’m now back into the positive frame of mind. Still can’t put weight on my foot but I try every day, might get better when my foot has support from the wedge. All and all things are looking up.
Hope you get your foot bending to the wedge soon Rose! You should setup your own blog page too! Good luck!
Rose,
Hello from across the ditch. Weight bearing at this stage is very important for you particularly as you are non-op but it needs to be done as tolerated and use pain as your guide. Every adjustment brings discomfort and some pain but that should subside within a few days. Try to put a small amount of weight on it often and then increase the weight as you are able. It can be done without crutches as well if you hold on to the kitchen bench. Once you can accept the weight stationary then you can try it using crutches and moving.
I’m 2 months in now, weight bearing is going well with the exception of when my leg starts to swell which at this stage is when I’m up for longer than half an hour. I take one crutch with me most times as my leg tends to give way when I least expect it and I have fallen twice because of this, nothing serious though. Just a question, I’m getting spasms under my foot they are quite intense and can wake me up at night, has anyone else experienced this? I’m sure it must be part of the healing and will ask my specialist when I see them but am just curious.
I also had some intense spasms/movement in my sleep in the first week after surgery. It seemed to subside after stopping the pain meds. But I was scared it would cause another rupture. The good news was that my dr didn’t seem concerned.
It is now 5 months on from my surgery and I would say that I am about 85% recovered. For the last month I have been doing lots of 10k runs without any pain and my walking is back to normal with no limp at all. I am training back at crossfit 5 times a week too and have not experienced any issues. I have noticed that my skipping is not as good as it was and I have not attempted any box jumps yet. I have been able to do full single calf raises on my injured foot in the last 2-3 weeks. I have also noticed that there is pretty much no swelling at all now after exercise or being on my feet all day. I would definitely recommend trying to keep mobile whilst in the air boot and doing as much strength exercises as you can on your injured foot in the early stages such as using a strength band, ankle circles and stretches. I just built up my runs starting at 1k and then gradually increased each run over the weeks. When it first happens it seems like getting back to normal is such a long way in the future but you will get there. Make use of the wealth of information on the net and find tips and techniques for recovery that suit you. I am definitely glad that I chose the surgical route and it seems that I am lucky that my local hospital was more than willing to offer the surgery to me. Good luck with your recovery all.
Hi. I’m a 43 yr old female living in Essex and I ruptured my achilles on 5th May 2017 while dancing at a Ceilidh. I went to GP on the Monday who diagnosed the rupture and sent me to A and E where it was confirmed and I was put in plaster. I had an appointment 9 days later at the fracture clinic when the consultant diagnosed it again and referred me for an urgent scan. I was told by the radiology department that I had to wait at least 4 weeks for this but luckily the consultant intervened and it was brought forward to 6th June. I went back on Friday 9th to see the consultant and he has recommended surgery because the gap between the tendons in 1.8 cms and he feels anything over 1cm needs surgery to repair. Fortunately he has a cancellation so I am scheduled to have the op next Monday 19th June (fingers crossed).I’ll then have another 6-7 weeks in plaster then 3-4 in a boot. It has been very frustrating especially as we are in the middle of an extension. Not being able to drive is difficult with two children aged 5 and 7 who go to school several miles away. Fortunately friends have been brilliant. I bought a second hand StrideOn Knee Scooter which was recommended by the man who has done the plasters for me. It has been a godsend as I can get around the house, cook and do other jobs. I’ve been able to go to town for shopping (around a mile away) and take the kids to the park. I’d highly recommend it as I would be going mad without it. You can hire them but it would have cost me more for the number weeks I’ll need it for. I will probably sell it afterwards. It’s great fun to whizz around on (as long as the surface is smooth - lots of pavements here are very bumpy and the dropped kerbs are not very helpful) and my fitbit thinks I’ve been on a bike so I feel like I’m keeping up my fitness a tiny bit and also it’s so good to get outdoors. I love swimming and I’m finding it tough not being able to do that. Good luck to everyone with recovery.
Hi can any of ye help me please. I fully ruptured my achillies tendon 10 weeks ago now it took two weeks to get someone to read an ultra sound to confirm it before I could have operation. I’m now 8 weeks (non weight bearing) in cast, I had the cast changed every two weeks to bring it back to neutral position. Once I get this cast off my doctor informs me I’m going into a walking boot “for a short period of time) when I asked how long he told me another 6-8 weeks. After reading all of the stories on here it doesn’t make sense. Everyone seems to be out of cast/walking boot by 8/9 weeks on this. can anyone tell me why they think this might be. ? My dr isn’t the best for answering q’s and honestly makes you feel stupid at times. My own gp has advised me to go for a second opinion but all this is extra expense.
Hi. My 17 year old son tore his achilles (almost a full tear, high up) 2 weeks ago. His orthopedist put him in a hard cast for 12 days and he is now in a boot. He will not have surgery. He tore during his high school basketball game on a Friday night and the ER doc put him in a fiberglass cast right away (Sat am). We saw the orthopedist on Monday and are now 15 days post injury. I have been reading on this blog that people recommend weight bearing and rom PT soon after the injury but I haven’t read at what time post injury this activity should occur. Can anyone please advise? We go back to see the orthopedist in 3 days. Thanks.