Jasculs’ AchillesBlog

Hi thanks for the post I’m glad that you explained everything the way that you did, I’m 2 days after operation, toes are a little bit swollen and also a little numb ,and i wonder if that is normal , also they put an splinter and now that my foot is swollen I feel some kind of pressure on it , did that happened to you also ?

Sorry you had to spend the Holidays in a cast, Anthony. I was lucky to get my CAM boot (moon boot) on Dec. 23rd, and I certainly understand your impatience. I still have sitting in front of the TV, except for a very few programs….
Good luck with your boot!

Manny

Great wealth of knowledge here. Thanks everyone for posting your experiences. Truly helps with my recovery knowing what others have gone through and I’m not alone.
I tore my Achilles Tendon on 12/15/15 while in TX on a job. At first I thought I rolled my ankle and tweaked the calf muscle but it most definitely was not that. I flew home to NJ 2 days later and I was able to get into surgery on 12/21/15. I’m now 5 weeks post-op.
I had my hard cast removed last week and was put into an adjustable cam boot with a 25 degree setting. I put in some heel lifts and padding around the lower calf as the boot was too loose even when I tightened with the straps. If i strapped the boot too tight though it became very uncomfortable so I suggest finding a good middle ground for your own situation.
My orthopedist does not want me to put any weight on it aside from placing my leg on the ground until I start PT. I am allowed to do minor stretching on the injured leg and moving it feels good to start to try all of this. I think the biggest issue so far is the inactivity, I’m not one to sit around for too long. Seems that the best thing to do though i

I ruptured my achilles in Sept and then 10 weeks into rehab, I re-ruptured it by doing too much too soon. The first time I had surgery and the second they just immobilized for 5 weeks. It’s been much easier the second time around but I definitely learned a lot.
1) Showering- I had a walk in shower with no seat. I used a folding metal chair (the true shower chair felt too shaky) that I lined up with the door. I set up another chair perpendicular to the shower and basically use the two to get in. Once I’m in the shower, I take off my boot and then turn on the shower. When I’m done, my hurt leg is the first to get dried off and the boot goes back on immediately. Then I shimmy to the other chair so I can stand up easier. It sounds silly but it’s the only way I can make it work. Also, the Curad cast covers have been awesome and have never leaked.
2) PT- the first time was very aggressive but the second time was more conservative. I was in a NWB cast and boot for the first 5 weeks. During the 6th week, he had me transition to FWB within a week, keeping my Vacocast at 20 degrees. Then, he had me reduce the angle by 5 degrees

Hey there yes I was in your camp… I had it tough at night. At about 4pm the top portion and leg tightened almost like swelled and felt so tight with cast .. I had some sural nerve issue which is the nerve by the Achilles (affects the outer portion of leg / ankle to baby toe and one next to it) … I got ambien which was a g-dsend .. Don’t get addicted … It helped get sleep .. I wa told at night it is normal just like fever spikes at night so does pain … Hang in there .. I am 10 weeks post op and it feels like light years from where you are .. It will improve .. If you have pain all the time ask your Os

Hi Metonia, I have responded on your blog as well. I bought my own out of my own pocket and I found it to be a worthwhile expense.

Jascul and beanie, was the Vacocast something extra you purchased on your own out of pocket? Or was it covered by insurance? I’m curuios because with my multiple health problems aqua therapy works the best for me and I hate the idea of missing that for over six weeks. I would love to be able to get back in the water asap after I have my surgery in February.

Hi, I’m not sure if this is the proper place to post but thought I’d give it a shot.
I had surgery on 12/29/16 and just received (1/15) my first fiberglass cast. I find the cast very tight at the top of my foot - is this normal? I was very close to going to minor emergency to have the cast removed last night as it was very difficult to sleep. I’m again struggling with the question of going to have it removed then re-casted Monday. Just wondering if anyone else has had the same issue and what your action taken was?

Just wanted to add that I had a hinged ROM walker boot. At the beginning of my third week post surgery until the 8th week the boot was set at 30 degree planterflection to neutral. At eight weeks I came out of the boot and back into two shoes and no wedges.
I was encouraged to walk in boot as soon as pain could tolerate.
So pretty much once I got the technique I was walking unaided in boot.
I questioned the 30 degree and if it had to be altered but he insisted it stays at that until the 8 th week.
He said it encouraged a normal motion and with his suturing technique this is what he recommends. When boot was off I basically did the exercises beanie suggested in her response above until I was given the new sets given by my physio at 8 weeks.
To date I have had no set backs and my progress is on track. We have all experienced different protocols & recovery instructions and we are all doing well, just wanted to let you know I was set at 30 planterflexion and neutral, it worked out just fine for me.

Hi jasculs,
I want to comment on one of your points: lack of feeling in the foot (numbness).
This is something that I clearly remember during healing!
My foot was particularly numb at the heel, on the outer edge all the way to my little toe, and on the metatarsals. It was not numb along the big toe or the inner edge. The numbness lasted for several months. If I rubbed the tendon I would get this strange feeling on the toe, as if glass shards were inside and moving.
My doctor said it was a common occurrence due to surgery irritating the Sural nerve and other minor nerves. Eventually the numbness subsided.

Here’s what I did about bathing: While wearing the boot, I put my good foot in the bathtub, and, straddling the tub, went down on that knee. I then removed the boot from the injured foot, and brought the foot into the tub, never placing any weight on it. I then took a shower on my knees.

When I finished, I dried as best I could on my knees, put the injured foot out (carefully), placing the knee on the bathroom floor, and lifted up to sit on the rim of the tub, on the the toilet seat cover, which is very close by. I then got into the boot, and finished drying.

It took a day or two to get the hang of it, but then it worked out really well. Good luck with it.

Like Beanie said. I am a bit concerned about how the PT will get you to neutral in 2 weeks considering you have not had the foot move for 5. Too much passive stretching this early is not helpful. Bearing weight with the boot at that angle will also be awkward so maybe you can get the PT to adjust the boot angle and put a couple of wedges under your heel to increase the angle. This will give you a flatter sole on the boot and take a bit of stress off your knee and hip. If you are part of a study then you should follow directions as this may be important for them to assess outcomes.

Wow! Thank you Beanie for all the details and explanations you gave Jascul, and that also help me!
Jascul, bathing is an issue, but I’ve been bathing for almost two weeks daily now, and have some comments.
A rotating stool is recommended to facilitate moving, but my tub is too small for it to be useful… A high back shower chair is also recommended, but it would not allow me to lean back into the shower and get lots of water down my front.
A hand held shower attachment is very comfortable, but getting one that fits on your bathtub spout might be a problem… so I’ve used plastic cups, loompfas (did I spell that right?) and even a wet sock to clean and rinse my foot. Now, I got a removable, suction cup support handle to put on the shower wall tiles, and it helps with my balance, though it can come loose. With the support I can lean back even more and get the water running down my leg.

While bathing, since I have shower curtains and a tub, I rest my injued leg’s knee on the tub edge, over the curtain, and i am stable as I shower and cleanse the leg. Lifting the uninjured leg is tricky, though… Reminds me of circus acr

Jasculs, congrats on the boot! It is a milestone and things are going to get better and better for you from now on. Your doctor’s protocol sounds a little weird but I don’t think you should be too concerned about it. The most important thing now is to start bearing weight. The higher the angle of the boot the less strain / force on the tendon. So if your doctor wants 30 degrees while you bear weight for the next 2 weeks, then stick to that. But you must bear weight, as much as you can handle, since this will assist the remodeling phase of your recovery. 30 degrees is very steep, I was at 15 degrees at 5 weeks and the Vacocast protocol is already moving to 10 degrees and lower by then. But only your doctor knows what type of suture was used to join your tendon and how much strain / force it can withstand, and only your doctor knows what your tendon looked like during surgery. So if he says 30 degrees for 2 weeks, then do it. Since you can’t see your PT for 6 days, I would recommend starting what’s called “active ROM”. Active means that you move your foot only by using the muscles in your injured leg, you don’t try to use o

Hey beanie, yeah I’m really looking forward to the ability to be more active when I have the Vacocast on. I haven’t done much exercise in the past 5 weeks because I didn’t want to get my cast all smelly and dirty. My gym has a pool and I’m looking forward to getting into that bad boy!

Jascul I also bought my own Vacocast and it was fantastic! I swam with it on and it floats, so although there’s a bit of drag you get a great swim in, and the extra plus is that you’re resting your injured leg in cold water for a while. I also started exercising whatever I could once I got it because I could wash the liner so it didn’t matter if I sweat in it. Enjoy, I’m sure you will, and good luck on the recovery!