Achilles injury to two weeks post surgery

Hello All, my name is John and I am 33 years old.  I ruptured my left Achilles’ tendon on July 5, 2013.  It happened when I was playing two on two basketball. It was certainly nothing high speed, in fact I wasn’t moving at all when it happened.  I was passed the ball and I was standing All by myself.  I took a shot and heard a very distinct t pop.  Immediately following the pop, I hopped off the court and was very concerned what happened.  I had never been injured before so when I heard the pop, I thought I had broke something.  However there was no pain upon touching the area.  When I Attempted to put weight on the leg, I pain emanated from my heel area and I immediately knew it was an achilles injury.  I was hoping that it was just a strain as the pain wasn’t overwhelming. I could walk putting most of the pressure on my heel.  However, doing research during the following day, it seemed that my injury was a telltale rupture.

I went to the emergency room on Sunday July 7,  little under 48 hrs after injury.  They did the Thompson test and immediately knew it was a rupture, no MRI required.  They fitted me with a splint and I went to the orthopedic surgeon the next day.  I opted for surgery, as the re rupture percentage is much less than natural healing, and the odds tend to, but not always point to performance level can get back up to pre injury level.  I got fitted with a hard cast and my surgery was scheduled for July 17, 12 days post injury.  At no time from injury to surgery, did I take a pain medication.  There was no pain as I completely rested and was off the leg, on crutches the entire time.

The day of surgery was here.  Cast cut off, leg was lightly bruised and pathetically skinny, IV was inserted And must for this surgery…PAIN BLOCK was given.  According to dr surgery was less than 45 minutes.  Splint was on and i went home.  Pain block lasted 22 hrs for me, varies for everyone.  The pain came on once the pain block wore off.  It was never completely overwhelming for me but it wasn’t a piece of cake.  Hydrocodone helped.  I didn’t move out of bed besides bathroom breaks for the first three days with my leg elevated the entire time.  I only took Pain meds the following day and haven’t taken one since.

back to orthopedic surgeon a week after surgery.  They cut the splint off and wound looked perfect.  Cast went back on.  Then one more week of cast which takes me to today.  Cast was just taken off, stitches out and I am now in walking boot with heel wedges.  It is very difficult to walk without crutches.  NOT due to pain as your foot is at such an angle that there is no pressure on achilles.  It is a balance issue.  It feels like a baseball is underneath my foot in the boot.  So I am putting pressure on boot with assistance of crutches.

so next step is PT in 15 days.  Every 4-5 days i will remove a heel wedge until I am flat in the boot.  I will keep this updated how the boot feels once some wedges come out.  Please feel free to comment or ask questions.  I look forward to keeping up with this blog.

7 Responses to “Achilles injury to two weeks post surgery”

  1. 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

  2. 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

  3. 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….

  4. 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.

  5. 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.

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

  7. 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 haven’t yet tried to walk without crutches. I’ve just watched the how to walk with boot youtube and I’m going to tighten the straps right up and give it a go.

    My boot was so uncomfortable for the first week more so the tighter I did the straps. Then I had a brainwave. Just a few yards away were my ski boots with insoles customised to my feet! It feels so much more comfortable and more secure. The insoles result in pointing my toes down a bit more, but only 1/30~ 0.03 radians~30th of 60degrees so 2degrees I’m fine with that. I can’t believe that for all that week and all those weeks in 2008 I didn’t use the insole!

    I have been doing quite a lot of walking with crutches, but I’d love to be able to have free hands. I also tried pressing on my bathroom scales planning to increase weight through bad foot by 5 Kg/day, But then read on blog about importance of only putting weight through heel- I was pressing on scales with ball of boot-good job I didn’t keep going to 40, 60, 100 Kg!!

    I don’t know how unusual I am not to have tried walking in boot without crutches before 4 weeks.

    Thanks to all out their; this is so useful (I’m new to this whole blogging thing).

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