johnxue’s AchillesBlog

@belliott20 - I suggest you do these things: 1) type in phrases like, “it does get better”, or “it will get better” into the search box on the achillesblog.com main page. You will find many links to other people’s blogs describing subject, and you will see yes, it does get better but just happens slowly. 2) create your own blog. Obviously you registered and have a log-in name. Now just follow Dennis’s simple instructions - again on the front page. If you create your own blog and describe your experiences you will get tremendous support from this community in the mental and physical recovery from this injury. good luck. -Jon

I don’t really know where to post but any help would be appreciated… i am having a tough time coping with recovery time. I fully ruptured my right Achilles playing soccer. its been three weeks since my surgery date which was 6-4-2014. I am in a hard cast and its green, its nice. I am scared that i won’t be back to as active and athletic as i was before, i love soccer, i don’t want to stop playing. I know it’ll take a while to get back to normal and where i was, I’m just really nervous… any support would really help.

Thank you Norm, for sharing your knowledge and experience! It is most helpful to a newbie like me, especially the PWB tips. Really appreciate it. I will try to stick to the UWO protocol and hopefully can achieve the same good results as you did. Cheers!

If your protocol does mean to say FWB in the 4-8 week period, then it’s virtually identical to UWO in the WB progression. For most patients, “WBAT” either means FWB, or it means FWB a day or 3 later.
In the real world, almost every transition and milestone in ATR Rehab could have As Tolerated tagged onto it, because most of us won’t do anything we can’t tolerate. The UWO Protocol told me to take out all my heel wedges at once, when I hit 6 weeks, but it didn’t feel good to me, so I spread out the transition over a day or 3. “Remove heel wedges As Tolerated” it MIGHT have said, but it didn’t.
The whole PWB transition is a classic case. Some patients make it slowly, while others find themselves going without crutches (FWB) before their protocol calls for it. As tolerated.
One other tip I suggest a lot: When you’re changing your ankle angle toward neutral, do it at bedtime and sleep in the boot, to give your ankle ~8 hours of NWB to get used to the “stretch” before you load it up.

Thank you Norm for your detailed comments! That is really good information to me.

I totally agree with you on “going slower produces worse results” and “go with a proven winner”. I guess that’s the main reason I posted the protocol here so that I can get others’ opinions on it. My preference is the proven bit.ly/UWOProtocol too, so I will try to get as close as I can to it.

As you may notice from my protocol, week 4-8 is TWB (left out “crutches”). So I assume it is actually FWB in ROM boot, PF15’ to free PF, which is kinda like with a boot 2 cm heel lifted in the bit.ly/UMO protocol. (maybe it’s just a typo in my protocol. I will find it out in my next appointment.) So may I ask, Norm, is it after 4 weeks when you stop using crutches? If so, is WBAT [Weight Bearing As Tolerated] actual FWB? I am trying to find out how deviated my protocol is from the bit.ly/UMO protocol. Thanks!

That “Fowler Kennedy Accelerated Protocol – Sports Med clinic” is presumably a reference to the “UWO Study”, finally published in 2010. (The sports-med clinic at U. of Western Ontario is the Fowler Kennedy Clinic.)
But the UWO Study’s protocol — bit.ly/UWOProtocol and summarized in achillesblog.com/cecilia/protocols — is quite a bit more aggressive than yours. In fact, all 3 of the highly successful non-op protocols in Cecilia’s chart are quite a bit more aggressive than yours. As you may have read already, going slowly non-op is worse than just a nuisance and a waste of time, it is also associated with worse results, including higher rerupture rates.
While you’re supposed to be Touch WB from 2 wks to 8, the others get to FWB around 4 weeks in. And while you keep the boot for 12 weeks, the others wean off it at 8.
I would fight for (or just adopt) one of the proven-best protocols.
Your schedule for hinging is earlier than some — 2 of Cecilia’s new studies didn’t even use a hinged boot, just the British one — and your schedule for moving toward “neutral” is more aggressive than UWO, I haven’t compared it to the others. My pre

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