Just ruptured your Achilles?
Here’s some helpful information for people who just ruptured their Achilles tendon:
- Should I go to the Emergency Room or instead go see my doctor (or orthopedic surgeon) as soon as possible? Here is a discussion regarding this topic: Emergency Room or no?
- WebMD’s nice overview on ATR surgery and whether it’s right for you.
- Revolutionhealth’s nice article on: Should I have surgery for a ruptured Achilles tendon?
- How much does it cost for the entire Achilles Tendon Rupture medical care? (With or without health insurance) Cost of Health Care
- PreOp Patient Education: Achilles Tendon Repair.
- Interesting article about new advances in Achilles Tendon surgery (Thanks Doc Ross!)
How to determine if you have ruptured Achilles: Thompson’s Test:
PreOp Patient Education Orthopedic: Achilles Tendon Repair: (Part 1)
PreOp Patient Education Orthopedic: Achilles Tendon Repair: (Part 2)
I ruptured my Archilles Tendon on Sat. playing basketball. My Group Health Ortho told me she does not believe in surgery so she casted my leg. She said it would heal the same as surgery. When I have researched online it appears that surgery is the best option. I do lead a very active life and need to return back to work as soon as possible. My concern is that Group Health is forsaking surgery to cut costs.
Do you heal up quicker with surgery or the nonsurgical cast method? My treatment right now is a cast which will be changed every 4 weeks for 12 weeks, then a walking cast for 8 weeks then a boot for 6 weeks. I need to to anything I can to speed up this process.
Vance
I think the tendon generally heals quicker with surgery. A nonsurgical approach is usually followed to avoid some of the possible complications of surgery (sural nerve damage, infection, blood clots). My understanding is that the paitient is generally able to get back to normal activity earlier following surgery. However, I’m sure that your doctor is doing what he or she feels is best for your situation.
Vance
You need to read the research on pros and cons to surgery vs. non surgery.
Did you have a MRI?…that will seal the deal in my opiinion..complete rupture needs to be repaired surgically.
Also I talked with a surgeon and he said if the patient is not very active than non surgical approach is fine but if the individual is young, active and wants to return to running sports than surgery is the way to go.
Sounds like you need a second opinion.
Sooner the better
Doc Ross
Vance-
I am in the hoopster group as well. I opted for the surgery and feel very confident I made the right choice. As Doc said if you want to get back to highly active life you should look hard at surgery. From everything I have read recovery time is similar if not faster…..when fully recovered chance of rerupture is much less with surgery. With no surgery your tendon works its way back together but it heals with mainly scar tissue. With surgery they use very strong sutures and many say after full healing the tendon is as strong if not stronger. While any surgery has its risks so does not having it.
vance -
You’ll find relevant information here:
http://achillesblog.com/atr-rehab-protocols/
Also:
http://achillesblog.com/posts-worth-reading/avoid-these-hazards/
Vance - I believe the incidence of rerupture is much higher for non-surgical patients…something like 20% versus 2-4%. There is some research on that somewhere on this site I believe. I am probably wrong on the numbers but the conclusion is the same.
In terms of total time, brendan’s worksheet indicates the time immobile, in a boot, etc.
Vance,
I received the non-surgical treatment and the treatment for me was 10 weeks in cast ( 4, 4 and 2).
I am currently at the end of the 2nd phase and due to get my final cast fitted on Thursday 24th at which time I will be able to FWB.
As far as I am aware there is no speeding up of the early recovery process, it’s just a sit it out and wait scenario.
Vance..
Just watched the video of my surgery again. There was a 1-11/2 inch space between the two ends of the achilles tendon…and it was by no means a tendon, just a mess of tissue. I cannot see any way that the two ends will migrate together over that space and be anything resembling a tendon.
Wish I could post it..Brendan/Dennis any ideas…its about 20 minutes long.
Doc Ross
Ross - I use a free upload site called Vimeo: http://vimeo.com/ You could try to post it here. My guess is that it needs to be compressed a little though. I’m not a video expert, but if you sent me the DVD in the mail, I could probably figure it out….unless there is anyone else on this site who has a better idea?
Ross - What format is the video in?
If it’s on a vhs tape, then it needs to be digitized. So that’s a little tricky and the process can get a bit involved. There are places where they digitize it for you. Probably some places where they develop film, etc.. (maybe some places online where you can send your tape.)
If you have a DVD of the surgery, then it’s a bit easier. There’s software out there that can do it. I think VideoReDo Plus is one of them.
You Tube?
Doc Ross -
If you are on a Mac and your video is on a DVD, you can use HandBrake to get it into digital format. Then you might need to compress it (I think You Tube’s size limit is around 1 gig). You can send it to me if you want, I’ve got all the software - I’m a web designer. I’m curious to see it!
Thank you for all the great info. I have been working with Group Health for a week now to get authorizaton for a 2nd opinion.
Vance - GET THE SURGERY! I had a doctor recommend the same ot me, but he was old and I think at the end of the day just wasnt comfortable with hte procedure. Your rehab will be much shorter. Also, you’ll notice that all major athletes ge tthe surgery…there is a reas on why. good luck!
I just ruptured my achilles tendon 3 weeks ago at a gym and I opted with a sport orthopedic surgeon to go non-operative. I am a 40yr very active person myself. I don’t jog or run much but I like working out at the gym (till now of course). I’m in a airboot cast now with a heel lift. I am really bored keeping my leg up watching tv,reading, gameboy, computer, etc. I want to go back to work but I’m out for the summer. I feel so helpless can’t carry anything on crutches unless w/backpack any ideas to cover this thing up so I could swim in a pool?
april - You might want to check out this section for the cast protectors for swimming: http://achillesblog.com/things-you-might-need/cast-covers-for-swimming/
I ruptured mine two days ago playing ball with the kids. I researched it and went to the ER for verification. The doc admited that he didn’t have a ton of experience with this type of injury but after a Thompson test and an ultrasound, verified my self-diagnosis of an ATR. He then made a call and I’m scheduled for Sugery Thursday (ATR +5days). After reading some of the great posts here, I’ve decided to get a second opion re surgery. A generic diagnosis and surgery call by a doc with no real experience with this injury just doesn’t work for me! I’m sure he is a great doctor but I need to be sure for myself here.
Keith, Did you ever see and orthopedist, or just the ER doc? The ER doc may have called the ortho doc and scheduled your surgery, but the ER doc won’t be doing the surgery. I would want to meed the guy cutting me before I had surgery.
Jim, I called another emerg to see if they had an ortho on call. Spent most of Canada Day waiting but yes, I did get to speak with a specialist. he gave me some good feeback and I opted for the non-surgical approach. I left with an aircast to hold me over for a few days and I got my leg cast on yesterday. needless to say, I cancelled the schedule surgery that the first emerg booked for me.
I can’t beleive that I actually miss the aircast! I see the ortho again July 14
Anyone here had a Partially ruptured achilles? Doc said it is only a partial rupture where the tendon meets the calf muscle…..No sugery….just rest and an boot cast for 3-4 weeks. He isn’t even talking about Physical Therapy yet and I am very active. I don’t want to heal so tight that I can’t get back to my sports and running soon.
I’ve just ruptured my achilles while rugby training, no contact, just snapped.
Ortho has recommended me non-surgical, 6 weeks in a cast, being changed every 2 weeks to raise my toes.
Can I go back to being as active as before (rugby, squash, jogging etc, or do I have to resign myself to the rugby retirement home at 32 years old?
I have come back to work as I have a desk job after 6 days.
Jonathan,
I personally see no reason in returning to your sport, but like us all it is down to what you put in at the PT on the return trail.
The recovery time for non surgical and surgical is similar i.e. 12 months.
I am currently 5 months 2 weeks after non-surgery, 10 weeks in plaster, and still to start running again, although cycling is not an issue.
Log on for a blog and shre your progress/story with us all.
Johnk
Cheers johnk,
I will try and sort out a blog, although gutted that I won’t be running for 6 months at least.
Ah well, nowt I can do about it now.
Jon
Hi guys
I was dancing at a friends birthday party when it felt like someone had jumped on the back of my ankle. I felp a pop and my leg just collapsed. The pain was intense. I hobbled to accident and emergency (uk) and they told me I had “probably” torn the soleus muscle and was sent home with nothing not even painkillers. I couldnt sleep for the pain. I went to my doctor two days later and she didnt examine it as she had the doctors report from the hospital, told me to elevate and rest and gave me painkillers. Now 4 weeks on the pain and swelling isnt getting any easier. I can feel a gap in the tendon just above the heel, I can flex my foot upwards with difficulty and pain. I am worried now that it may be too late for treatment and the damage will be permanent. Any advice you could give me would be grately appreciated,
Hi Karen,
you must have a test for an ATR as soon as possible. I would go to hospital and get it done now. Phone the NHS Direct helpline now (0845-4647 they diagnosed my ATR and sent me to hospital).
It sounds like you have had some poor treatment.
A normall achilles is well defined so the fact you can feel a gap (I assume no gap on the other?) doesnt sound good. Get an ATR inspection ASAP and let us know how it goes.
Elevate your leg and put cold packs on it (ice bag/frozen peas wrapped in a tea towel can work well) and rest it. Im sorry you are having such a rough time and hope it goes well. Its never too late, so get on the phone now. Good luck!
I don’t understand the non-surgical approach. How does a complete rupture heal? I had a complete rupture on APril 17th playing basketball. I am 26 years old.
I had the surgery on April 24th, and had a splint on and no weight bearing for 6 weeks after surgery. I moved to a walking boot with partial weight bearing, with or without crutches. Whatever I was comfortable with. I started PT during this time also. My range of motion was pretty good, so I primarily worked on strengthening my leg.
Now a full 3 months out, on July 24th, I am walking with no pain or swelling. I am in a regular shoe. I am on target. THe doctor said it was a 4 month process.
SO now its up to me to get my leg back into shape. I
I also monitored NBA player Elton Brand. He ruptured his completely in August 2007. He was back to practice with his team 5 months later in late January 2008.
He was cleared to play in real games in April of 2008. A total of 8 months between the injury and his return.
I just don’t see how this would heal on its own without surgery. If there is a huge gap, it is not going to magically jump back together. If it does I would think it would easily rupture again!
Darek,
I can shed some light on the nonsurgical approach. Around every tendon there is a sheath, a covering that encloses the tendon, that helps to bind the tendon. With ATRs the sheath is usually intact and lets the tendon heal within the confines of it. This apporach leads to a scar tissue formation that is haphazard in alignment, think big knot, that can lead to other problems in the future….bursitis, tendonitis. It is important with non-surgical treatment to adhere to a strick PT protocol and to continue with it for a year. I had my surgery videotaped and you can see the sheath being cut prior to repair. There was a gap of 2 inches, too long for me to allow a non-surgical approach.
Let me know if you have any questions.
Doc Ross
Week 9 - Non-surgurical
Hello, again everyone. This site is great with so many suggestions. I am now at the point in my recovery that I am starting to take off my boot twice a day stretching and walking good foot first for about 5-8 min. each time with crutches. I’m not quit able to roll my ATR foot into walking form yet, tendon too weak feeling and shakey. So half step for now as per physio directions. Swelling down alot over the weeks. Still have to put foot up alot but normal I`ve been told. Getting around more sure helps with feeling caged. I sure would love to hear any other non-surgical recoveries.
I have a huge question. I go for an MRI on Friday to find out how bad my tendon is. They think it is fully ruptured. My question though is can I move my foot or toes with it being fully ruptured? I don’t understand anything about this and I have researched it so much. All I know is my heal burns sooo bad and my calf throbs and I’m in a cast until my MRI. When I injured it I heard and felt it snap.
Angel,
I had a complete rupture as big as it gets said the Surgeon and I walked around for a few weeks before I had the operation. I was not and still cannot lift up onto my toes but was always able to flex the foot left, right and up and down. I have had terrible problems with heel pain right through until just recently you may have to learn to live with it. It was worse at night and did keep me awake.
Need any more information, create your own blog, you will find there is always someone on this site who is able to help and support you through the long process of healing.
Good luck
Annie
Annie,
Thank you so much for that info. That is what I was afraid of. Oh well it has been done and no reason not to still smile and get over it and learn to live with what comes. Good luck with yours and thank you again.