Jen’s Achilles Blog

First, as I am catching up on reading the blog, I was sad to read that Chip and daveleft re-ruptured. I am so sorry you are both going through it again. Hang in there - I am glad you have this blog for support. One thing I am learning about this injury is that there is no black and white. Between the seemingly large variation in treatment protocols, and everyone’s individual response to healing time, ROM, and activity level - it is hard to know when to be more aggressive with activity, and when to back off and allow more healing time.

It’s been a busy, but good few weeks. I went back to work June 16th for the first time, and wore my boot for the three days, as walking in a shoe was still feeling a bit fragile. After work on the last day that week, I went into a shoe full time, and haven’t looked back since. My second week of work I was on my feet for 7 and a half hours straight for 2 days, and was happy to find out that other than the expected swelling, my foot managed it really well. It feels so good to be back at work.

My first physio session was on the 18th, and I have been 3 times since. We are working on stretches, massaging my thick tight scar, doing ultrasound and finishing with ice and electrical stimulation. The best part was that I have learned how to “walk” again. Before physio, I was walking with a huge limp, with my foot turned out to the side, to help me move faster. I learned quickly that if I continued to walk that way, physio was concerned I would throw my hip and back out of line. So now I am walking very slowly, taking smaller steps, with my toe pointed forward, and even use a cane to help me place my heel on the floor first, then follow through with rolling my foot onto my toes. The cane helps me get over the ball of my foot when my leg starts to get tired. (I hope that makes sense). I am still limping a lot, especially if I don’t concentrate on how I am placing my foot. It sounds like I can expect to have a limp for a few more months.

The best news is that I went back to the gym last week, and have done two sessions of riding on the spin bikes. It was weird to see the running track again, and not hop on it and start running, but it was great to be back on the bike. I was happy to realize that I was able to ride with pressure on my foot, and with no pain or pullling in my achilles. It felt great to get my heart rate up and sweat from something other than moving on crutches! Once I got off the bike, I couldn’t believe how great my ankle felt - I had more ROM than ever. The only thing I found uncomfortable is that once I cooled down, I experienced a definite “rebound” tightness in my ankle and achilles. 

For those of you out there that are waiting to get back into two shoes - it will happen! It’s hard to be patient especially when you are on crutches. Now I am finding I need to be patient with my ROM. Even though I am stretching a lot, my achilles/ankle feels very tight. I am still getting a fair amount of swelling as the day goes on, but it is gradually getting less. I am finding the progress to be slow. But it’s OK - because I am walking! I went out to my first really crowded event last night. My 11 year old daughter wanted to go downtown to watch the fireworks for Canada Day. We watched the amazing fireworks, sang “Oh Canada”, and I was so happy to be with her.

Happy 4th of July coming up for everyone in the US!

Hi all,

Is it me, or does just about everyone you meet who hears you have had a ATR say, “Ooh, I’ve heard that takes a long time to heal”, with a look of “that really sucks for you” on their face? I think I have heard that 20 times in the last 6 weeks. I knew I was in trouble when the nurse said it when I was being admitted for surgery. As a fellow nurse, I equate it to telling a patient that “this is going to hurt a little bit”, meaning, “this is actually going to hurt like #@*%!” I’m handling it by putting a big smile on my face, and saying - it gets better every day! Anyone else have any funny responses we can use?

I haven’t posted for awhile, but I have been keeping up with new posts. Last week was a bit of a down week as I was feeling stuck in the PWB/crutch world, but thankfully, this is a new week. I’m sorry to all our new members in that they have joined the “one leg now larger than the other” club, but happy for them in that they have found this site. I met a fellow ATR’r yesterday at the cast clinic - he was 2 weeks post-op, and came in to the clinic with his running jacket on. He runs, plays soccer, and does Tri’s too. I told him about this site, and recommended he log on as there are many people writing in with lots of great advice on how to handle the sudden stop from regular exercise to laying on the couch, to getting back into exercise again!

Had my 6 week follow-up yesterday. Went in with my crutches, PWB, and walked out FWB. I told my Doc I had dropped the crutches the day before for FWB, and tolerated it with no pain, other than some calf muscle cramping in between weight-bearing. He told me I could pull out my last felt wedge, walk around in the boot till Friday, then actually try a shoe this weekend. I was a bit stunned, and very pleasantly surprised! I am to start physio the end of next week (I’ll be almost 8 weeks post-op then). And, I will make it back to work next week. I think I will take my boot though, so if I get tired or sore being up on my feet for the day, I can throw the boot back on. He also told me I can try driving once I am in a shoe. (Yeah!) He said I can swim now, but to be very careful on the slippery deck so I don’t “pop” my tendon again (words from him which sent a large chill down my spine!). I can start to cycle, he said I would probably not be able to put much weight on my right foot at first. 

Things are moving along . . . reflecting on the last 6 weeks, I have found that the time has gone fast. I have a few more days at home before I’m back to work, so I am making sure I enjoy this time. Despite the surgery, and the set-back with my Triathlon training, I have had time to enjoy many moments with good friends, family, and my beagle. For the new club members, hang in - there are positive things to look for in all of this.

Hi fellow ATR’ers,  It’s now week 3 -  I’m in the Aircast/boot, took one felt wedge out yesterday and was surprised to find that my lower leg is more comfortable  in the boot now that my foot is getting closer to 90 degrees. I am trying to put some more weight on my foot, and it’s comfortable so far, I am not experiencing the tugging sensation as much as I was. I am getting pretty tired of the crutches, I find first thing in the morning is the worst - I feel stiff and very slow moving, especially in my right hand and wrist. Once I get moving though, I feel good. I can’t wait to drive again! I wouldn’t blame my husband if he loses his patience soon as my “We need this from the grocery store . . .”, and my “Can you be home by 5pm to take Chris to guitar? Or Em to tutoring/basketball?” . . . is getting old.  Thank you w8Kbrd for posting the pilates link - I had a day of being frustrated about being home bound yesterday (which didn’t help when my husband went to the gym without me) when I realized after that there is no reason for feeling sorry for myself, as I can go too! Exercise always helps, and I will do the pilates at home, keep working on my ABC’s (another great suggestion - thank you everyone), and get to the gym with my husband for whatever I can do. With the bike riding, can I put weight down on my foot to pedal? I imagine that if I use a bike with a toe basket for my good foot, I should be able to push as comfort allows with my recovering leg. Any other suggestions for riding a bike with a boot on?Thanks for the updates everyone - it helps more than words can say. 

I’ve come to the conclusion I have been living in denial. (I actually live in Canada, where due to my restricted ability to leave the house on my own, I have been able to watch out my window as spring is unfolding. Each day more green leaves are appearing, and the grass is getting greener. Today I have seen butterflies, a rabbit, squirrels, Blue Jays, and many chickadees. Not bad for being in the middle of a large city!)

But back to the denial part  . . . I had my 2nd post-op visit 2 days ago, where they removed my fiberglass cast, removed my sutures (stung a bit, but wasn’t too bad), then fit me in an “Aircast”, in which I now appear to have become part Stormtrooper. My ortho Doc told me I can now start to weight bear, with crutches of course. My foot looked great, bruising is still going down, and the swelling was down too. Other than a 4 inch long, thick healing scar, and a hairy dry limp looking lower leg, things looked good. When my Doc squeezed my calf muscle, my toes actually moved again! 2 days later I am now realizing that I didn’t just sprain an ankle - it is slowly starting to sink in that I am in for 4 - 6 months or more of recovery!

I am finding that I am really really bad at laying around. I have spent the last few days taking a really long time to do things like a few loads of laundry, unloading the dishwasher, making breakfast and lunches with my kids, cooking easy suppers, and picking up things being left around the house, placing them in a bag around my neck, then taking them to where they belong. Not much in the scheme of things, as I normally work, exercise, help raise 2 kids, look after the house, and care for a Beagle, a cat, a hamster and 2 goldfish. I realized today that when I lay down after having my foot down for 5 hours, and took my airboot off to look at my foot, that my ankle and foot are now almost as swollen as before my surgery. It probably doesn’t help that I slipped on a bit of water on the floor from when I hopped around to put water in my dog’s dish, and ended up putting my bad foot down harder than I should have, and felt a pull and a deep ache in my calf muscle (oops!). Not trying to do stuff is harder than I thought. And I’ve managed to mentally let go of the fact that I can’t vacuum, wash floors, or carry anything around that won’t fit in the bag around my neck! I guess I thought that once the swelling was down, and that I was told I could start to weight bear, that the healing would keep moving along fairly quickly. Instead I am finding that the swelling is back up, that I can barely put any weight on my foot in my boot, and that it was a lot easier to navigate around with my old small fiberglass cast, than it is with my new larger, bulkier, heavier aircast. (I feel like I am doing a lot of complaining  . . . I shouldn’t, especially since I am lucky enough to have a wonderful supportive family, lots of great friends, and no post-op complications, but it feels good to vent!)

I think I am feeling insecure in this new aircast. The cast clinic staff placed wedges of foam in the heel to keep my toes pointed down. I am supposed to remove one wedge per week for the next 3 weeks, and see my Ortho Doc again in 4 weeks. The plan is to gradually move my foot into a 90 degree angle again. The aircast is great because I can take it off to give my leg some air, and now that I am back on the couch this afternoon with my foot elevated, I can ice it again. Eventually I will take the aircast off in the tub too. For now though, I am finding that if I try to put weight down on my foot, that I either feel a pull at top of my heel where my achilles was re-attached, or a deep ache in my calf. Is this normal? I gather that over the next 4 weeks I will need to stretch my calf muscle and tendon out to be able to get my foot flat again, and that by using the aircast/boot, it will allow me to get this stretch that I need, while providing protection and stability. Did everyone else’s tendon and calf muscle feel really short and tight at first? I won’t start physio for another 4 weeks or so, so is it OK for me to keep pushing my weight bearing to stretch out my tendon and calf? I would think that I can’t re-rupture the tendon by trying to weight bear, but at only 2 and a bit weeks after surgery, I am nervous about that. Should I expect the deep calf ache and pulling sensation through much of my recovery? Is it normal for the swelling to keep going up and down for a long time? And lastly, did everyone try to keep their foot elevated many hours a day 2 weeks post-op? Many of you had gone back to work at this point - did you elevate your foot at your desk during the day?

Thanks so much for your feedback. I have a stack of unopened books and magazines that I guess I should open, then lay back and relax!

Your blog friend,

Jen

Last Tuesday was my first post-op visit (8 days after repair). I went to a cast clinic at one of our local hospitals, where a nurse removed my original plaster cast. I saw my incision for the first time. It is about 4 inches long, and looked better than I had imagined. The swelling in my ankle was down, and the bruising is starting to go away. After a quick wash, my old cast was replaced by a new bright neon green cast (I had a choice of colours :-). My 11 year old and my 15 year old were impressed! This new cast continues to keep my foot and lower leg immobile. I am to go back again in one week to have the new cast removed, and my sutures out. I am not sure if I will get a removable boot of some kind, or another cast again.  I am finding I can be up on my crutches for longer periods of time with my foot down, and I am able to sit at my computer with my foot elevated for much longer periods of time. My new cast is quite tight, which really only bothers me in the late evening. I have found the burning sensation at my incision line is now gone. Even the tingling sensation in my toes from hanging my foot down is getting better. With my new cast on, I am finding I am sleeping better, as I don’t feel like I have to have my foot elevated so high. I am still sleeping with one pillow under my foot, and one between my knees, just to stay comfortable.

All in all, I am getting more energetic, and my leg is feeling better all the time. It feels good to have someone take me out of the house  - although there are lots of runners out there to be jealous of (including my husband :-) He supported me while I trained for my triathlon, so now it’s my turn to support him while he trains for an upcoming race. So far this experience is just motivating me to get back out there and really enjoy whatever physical activity I will be able to do again soon. I’ve decided to buy an indoor trainer for my road bike, so it will be safer and easy for me to get back on a bike when I’m able. Hope everyone else is finding they are improving each day, and for anyone who this has just happened to, I am finding the time is going fairly fast. I’ve been on crutches for almost three weeks now, and it’s going fine. Take care!

Thanks so much for everyone’s comments. I am reading more and more people’s stories, and am amazed how much support there is on this site.

Today is day 4 since being “fixed”- managed to get in the tub today, with my foot up on the edge. I am learning to do things slowly and carefully. The crutches work really well. I am finding that the advice of “keep your foot elevated” is very important. I can tolerate some time with my foot down early in the day, but by late afternoon, even putting my foot down to get to the bathroom and back causes lots of throbbing, and my toes to turn purple. It seems like some people experienced minimal swelling, and others felt more like me. I am also finding that in the evening I have periods of time where my incision line burns and stings. I am hoping that by next week, the swelling and the burning sensation will settle down.

 I am wondering if anyone else has a job where they are up on their feet all day? Once I am in a FWB cast, will I be able to walk around easily? I am a nurse in a busy Dr’s office. I work pretty much 7.5 hours straight, 3-4 days per week. Am I crazy to think I can go back to this in 6-8 weeks?

Have a good sleep everyone, even if your leg is elevated on 3 pillows

Hi everyone,

I never thought I would start a blog. I never thought I would have the time to maintain a blog. I never thought I would rupture my achilles tendon. I do NOW have the time to create a rather large lengthy blog! How things can change with a backwards step taken to return a tennis ball across the court. Yes, I now too understand the acronym “ATR”.

I have to start by saying how impressed I am with this site. It’s the first time since I injured myself that I am starting to feel less alone, and less useless. I am really looking forward to reading about everyone’s days, and to having an outlet to share mine.

I recently turned 40, and as a suprise, my best friend signed us up for a Sprint Triathlon race in California on April 20th. Having only been a runner before, I decided to take on the challenge, and joined a Triathlon Club here in Calgary, Canada. I have been training since January, and have been feeling more physically fit than I have in over 20 years. We flew to Palm Springs last week, and competed in the Triathlon 11 days ago. It was so much fun. There were 4 of us girls, and we had a wonderful time. Three days later, the four of us were playing tennis, when I ran backwards to return the ball. I felt my running shoe stick to the court, while my leg continued to move backwards. I felt the snap, immediatley went down on my butt, then felt pain. I knew instantly what had happened, and I was scared to let go of my calf, as I had visions of my calf muscle bunched up by the back of my knee! When I finally let go, it no longer hurt, but there was an obvious indent, and I could not feel my calf muscle move when I pointed my foot downwards. My friends grabbed our rental van, and we started asking around for an emergency clinic. I couldn’t believe I could have this happen, when I had been working hard to get into shape.

We decided to go to an Emergency Medical Clinic. I wanted to know for sure what had happened so I could decide if I needed to fly back to Canada 4 days early. I was seen by a Doctor, who told me it was a “ruptured plantaris muscle”. I specifically asked him if he thought it could be my achilles, as there was an obvious indent at the back of my heel, and I was unable to palpate the actual tendon. He assurred me that it wasn’t my achilles, because I could still point my toes down to the ground, and bring my foot back up a few inches. I left with an x-ray and crutches, and we continued on with our holiday. We even managed to go dancing for a bit one night, with me using my crutches for balance.

I flew home  4 days later, and my foot and ankle were swelling and bruising more than ever. I was able to put weight on my heel, but no pressure on my toes. On Sunday, I decided that I’d better get it looked at. After consulting with a friend who had an ATR, I decided to go to Emergency. Within an hour I was diagnosed with a complete tear of my achilles. They started an IV, and took me to day surgery, where I waited 12 hours, then had surgery. We are so lucky here in Canada. I stayed for 2 nights as the surgeon wanted me to have 4 doses of IV antibiotics, then I arrived home 2 days ago.

I go  back next week to see the surgeon, and have my plaster cast removed, and a new cast of some kind put on. I have been told 6 weeks in a cast, but I am not sure when I will be able to weight bear, nor when I can go back to work in the busy Doctors office I work in (on my feet all day). Reality is starting to set in - it looks like I have a few months of recovery ahead of me, and I am worried about my husband and kids. As it’s my right foot, I can’t drive. My husband has been wonderful, as I am pretty much stuck with my foot above my heart as much as possible. Hopefully the swelling will be down soon, and I will be able to tolerate more time with my foot down.

• In the scheme of things, I know I am still pretty lucky. I have a sports injury that should mostly recover. I know someday I will be able to swim, bike and run again. Many women my age are fighting breast cancer. Things could be way worse. In the meantime, I will read lots of books, write on this blog - and maybe dream up a new career for the future.  Sorry for being so long winded - if anyone actually manages to read all of this - thanks for listening (I mean reading!)