jcharp0912’s AchillesBlog

Hi, everyone! I’m Manny Perez, and I already asked for my blog site here. I totally ruptured my Achilles tendon on Dec. 7th, walking home from the subway station, as I hopped over a crack in the sidewalk.

I am following an accelerated non surgical rehab program, with a Rebound Air Walker cam boot after two weeks in a cast, bearing weight, and basically taking steps without crutches already. Rehab is expected after Jan 14th. But… I am waking at night with pain in my left -injured- hip that shoots down to the calf muscle. It usually hits in the wee hours, waking me fully. during the day I’m pretty well off with aches in my left hip and little twinges in the foot.
the Dr. said to take as much weight as I can handle, and that the aches are inevitable…. no fun! Any ideas?
I already ordered shoe lifts to even up my legs, and spend most of the day in a wheelchair or laying in the couch. But I hate being inactive.

hey jcharp0912, you still reading these blogs?

You can write short articles (posts) about your personal experience in a weB LOG, a blog. This will help you and future Achilles Tendon Ruptures. On the achillesblog.com home page Dennis writes these instructions:

“To create a new blog, please create a user account first. And then, please send me an e-mail (achillesblog@gmail.com) from the e-mail address that you registered with, and I’ll create a blog for you. Please tell me what your username is, and mention briefly how your injury was caused.”

Good luck

hi. thank u all for the advice. i am currently in a cast, 11 days before the stitches come out,i was 10 months with a rupture and had bad doctors before i got the right man. had to get reconstruction, they took a tendon from my big toe. the fuckin pain im in aint right. was told it would be at least 4 months before i can think about walking again. what do you mean start a blog, sorry im not really computer sav vy

oops, Gavin jumped ahead before I could submit. Follow his advice.

Hi Liam Reilly — I suggest you start a blog — see achillesblog.com/ front page for instructions, and it’s been a while since I set one up but perhaps you can just go to achillesblog.com/wp-signup.php.

Then after 24 hours or less Dennis (site creator / maintainer) who is very responsive will have you set up and you can describe your specific situation and condition.

As far as walk and pain: Yes! walk yes, pain goes away (sort of) yes.

Liam

It would be a good idea to start your own blog here. See the home page for ‘how’ and you’ll then have your online view of your progress and many more here will get a better idea of your situation.

What have your medical guys told you about what happens next? Have you asked questions? Do have a direct line to the clinical physio’s?

A number of scenarios but you should ideally be ‘walking’ in 2 - 3 weeks as you start to put some weight down. This could be with crutches for a short while but try not to let this be for too long.

If you are in a cast when do you get a boot and start some physio-led exercises?

The pain - seems that this varies so much. I was fortunate to have had a fast tracked non-surgical rehab so almost no pain except for a few minutes after the rupture.

Best of luck, now get that blog started, you cannot be too busy!

hi was wonderin if anyone can help me. im 4 days post op how long before i can walk again and will this pain ever go away

Sotisv

To clarify - that 40º range was fine for my last 2 weeks in the boot. Before that it was obviously smaller range.

Something not correct here Sotisv

I’m not familiar with your boot but that doesn’t matter. What does is that that is very big angle for an injured tendon, let alone your ankle.

Out of interest, my Vaco hinged boot had a maximum range from 30º PF to 10º DF (so 40º ROM) and that felt just fine.

Thing being –> hingeing!

Sotisv, you’re describing a 52.5-degree thing being. I hope you really have 7.5 degrees. Both are hinged, not fixed. Understand?

From the Isokinetics web page. Make sure you read the closing words of the paragraph which would confirm my worst suspicions about the figures you quote, especially at your stage of recovery:

Normal ROM of dorsiflexion is said to be 25 degrees while for plantarflexion it is thought to be 45-50 degrees (Miller, 1985) Figures range for both movements to ridiculous values, however, most people agree on one thing. The neutral position is equal to 0 degrees. To give you an idea of the functional ROM during walking there is approximately 10 degrees dorsiflexion to 20 degrees plantarlexion (Mcpoil and Knecht, 1985) whilst during running there is approximately 20 degrees dorsiflexion to 25 degrees plantarflexion (Soutas-Little et al., 1987). On this basis ROM over 45 degrees should really be avoided unless academic interest lies in this area.

yes, the doctor fixed that hinge for the first week -if I read / understand the digits right- at +30 degrees plantarflexion and -22.5 dorsiflexion, I still need the crutches though. How long does it take to ditch the crutches (with the boot on)?

With that ROM boot, you can just use the hinge - at a fixed angle at first - instead of wedges. Your ankle shouldn’t know the difference. I think that’s the same boot I got for ATR #1 and reused from ~week 7 in #2!

thanks for the swift reply normofthenorth! Would I need a (Procare) achilles wedge with such a boot?

sotisv, I don’t love “a pull at the tendon heel when I walk with the boot on.” It suggests you’ve moved to(ward) neutral too suddenly. With luck it will ease quickly. Most of us can’t imagine the transitions that will be comfortabloe in a week or two!

Thanks for your reply normofthenorth and sorry I didn’t make it clear in my post, I did have surgery (right achilles tendon), today the doc took off the cast (finally!) after 8 weeks in it and luckily a couple of days ago my DonJoy MaxTrax ROM Walker (no air) which I had ordered a month ago arrived. The doc put it on and I’ve had it on only for a day. He said I should walk with crutches for another week and then ditch them. The right calf muscle is not what it used to be of course and I acn feel a pull at the tendon heel kwhen I walk with the boot on. Is this normal? For the time being walking without crutches seems out of the question.

sotisv, especially if you skipped the surgery, going as slow as your Doctor plans is harmful, and you should not do it. Slow non-op treatment - like 8 weeks in a cast! - has much higher rerupture rates than going as fast as bit.ly/UWOProtocol.
For best results you should spend 2 or max 3 weeks NWB (boot or cast) then another week or 2 before you’re walking FWB, no crutches, in the boot, 4 weeks after you started. Going slower is hard mentally too, but it’s also bad medical practice, very old-fashioned. Lots of evidence by now.
The choice of boot is usually much less important than the choice of protocol. I prefer hinged boots to fixed ones, though theyre usually heavier and more expensive. The Vaco boot - they run are on this site - is very popular here, though pricey.

I managed to tear my achilles tendon and I need to buy a CAM walker boot but have no idea which one. I’m 4 weeks post-op, leg in a cast from knee down.The doc will take off the cast in 4 weeks. Any suggestions as to what and especially what not to choose?

I am 41 days after surgery, and I just started to walk around my apartment without my boot. I see my doc next week to get the order to ditch the boot.

I feel strong, and my scars have healed perfectly. Not much pain after transitioning from the cast to the boot. I was actually able to partially bear weight about 3 weeks after surgery and fully bear weight 4 weeks after surgery.

It’s good to hear some people are having great recoveries.

After you ditched the boot, did you feel uneasy about walking around? Sometimes around my apt, I feel like if i’m not careful I could fall or do something to tweak it. So I am a bit worried about walking with sneakers without any “protection”.

Yay! And Don’t Stop!
Install the ATR Timeline Widget if you can, to answer our FAQs.

Hi jcharp0912, I ruptured my right achilles tendon about the same time as you- Mon 8th July 2013. I took a quick jump back to hit a slow bowl to my body SNAP looked round sure that the bat in my hand or the ball that I could see had hit the back of my heel! Took a few strides and realised it was achilles tendon AGAIN!! and immediately hopped to a stop.

I had some trouble convincing people around me and the first aiders that I’d ruptured my tendon-why wasn’t I screaming in agony? But had leg iced and elevated within 2 minutes of injury and lying in NHS bed talking through proceedure and risks and signing consent forms with consultant less than 4 hours after injury. Had surgery 9am following morning. NHS is GREAT!!

Not so great with previous left ATR in 2008. Then it was almost two weeks until op and slow protocol afterwards, everyone seemed sure that slower had to be better. Even my employer, although then the college was a building site and they might have had one eye on their liability since the injury occurred playing Netball at work as part of a lesson.

I have been PWB in ROM boot/walker boot since 25th July, but ha

Very cool - It took me a while to learn to trust my boot and drive that shin forward, but once I got it down it was a piece of cake. Another thing that helped me and was well worth the money was an EVENUP shoe heightener for the other side. Took the extra strain on my good leg/hip. Just something to consider. Enjoy the freedom of walking and carrying stuff.

Sure is. Thank u so much.

Sounds like you figured it out! I posted the link to ryan’s video in the comments of your last post. Good luck on the rest of your recovery. Isn’t mobility great ?

Kelly, can u post a link for Ryan’s video on how to walk in boot. Thank u

Just read Hillie’s post and Exeter data: the 3 reruptures were from the combined operative and non-op cases, over 200 in total. That 1.2% rate is so impresive.

Hillie has given you great advice. Take a look at ryanb’s video on how to walk in a boot. (It seems like it’s a no brainer but I found that I was walking incorrectly.) You use the rocker sole to roll forward and have to push your leg against the front of the secured boot. Good luck with the recovery.

Yes, we’ve seen figures like that before - scary!

The first 4 years (2008 - 2012) of the new physiotherapy rehabilitation programme at the Royal Devon and Exeter Hospital in the UK (search on Google) showed a 1.2% re-rupture rate for non-op (3 cases out of 200+) while 2% of surgical cases suffered complications. Other practitioners follow similar protocols but they don’t seem widespread yet.

Progressively intensive physiotherapy starting by the 3rd week, and early weight bearing mobility are the key elements of faster rehab. You can also look up the UWO studies on the Achillesblog homepage.

You ask about the boot - mine was a VACOped boot from Oped, so no wedges. I was weaning off the crutches after week 3 and suffered little pain throughout. Some calf and ankle swelling, alleviated by icing and raising that leg. You will need to balance the hips or your good side will suffer be creative with your shoe or buy an even-up add-on sole.

You say you hope to have more kids - don’t worry, an ATR won’t stop that….

Surgery 4% vs 14-18% for non. It wasn’t all that different. However in most cases you can start PT with the surgery route a few weeks before non. So I’m young with a young daughter and hope to have more kids, so I went with the higher percentages at a full recovery and performing At the level I was at. We will see.

One question for u….when u first got into boot with wedges did u feel the same As I do….not feeling pain when I put pressure, feeling more of a balance issue and not pain and therefore need crutches…

Thanks

Hi

In the next week or two you should find that you can begin weight bearing and quickly lose the crutches. On an accelerated protocol, ideally seeing physio regularly, by week 8 or 9, you’ll be in two shoes, all being well. Some do even better, but earlier is riskier, and who wants to re-rupture?

Out of interest (I went non-op a year ago) what were the figures that the surgeon quoted for operative treatment v non-op?

H