How long is someone at risk of healing long?

Does anyone know how long a person is at risk of healing long?

17 Weeks Post Op

Just checking in as its been a few weeks since I’ve posted anything. Things are progressing slowly on my end. I have been pretty steady on my daily exercises. They consist of the following:
-3X20 double calf raises
-2X10 calf pulses
-3X 1 min one legged balancing on bosun
-3X20 seated calf raises with a dumbell and on a ramp to work my pathetic seated end of range plantar flexion (currently about 2.5-3 cm heel lift).
-25 marching steps

Last week I have started to add eccentrics in but I am trying to slowly phase these in as I find my peroneal tendon really inflames with these. In addition, I have started to walk the dog daily on an gravel trail that has lots of uneven ground.

So far I am getting gains but it is painfully slow. I have done a one legged heel lift…if you can call it that. It is low and not sustained but is much closer than I could do at 8 months post op with the first surgery.

12 Weeks - but who’s counting

Well….12 weeks (second time in) and I am trying to manage expectations but I do think things are better at this point then the first time.  I have been doing incrementally more resistance on my strength training and extensive pool work.  I have been doing single heel lifts in the pool with 1 m of water and walking on the balls of my feet.  I know that some people have walked on the balls of their feet out of water at 13 weeks…pretty sure I won’t be there but I also have not done in a year.

Question for the group here - Any concerns with riding the bike with a little more weight at 12 weeks?  Today I rode the spin bike with 11 on the resistance setting and 75 RPM.  I felt the inside of my calf engaging…which felt good.

Happy healing people


Tendon Elongation

Hi All,

I am 10 weeks post op for tendon shortening surgery.  I have started doing calf raises and other theraband activities for strength.  I had my first full day  out of the boot at 9 weeks and 4 days but wearing a heel wedge in my shoes to avoid any dorsi flexion.  Any concerns with being out this early?

Having gone through this ordeal twice I am obsessed with anything that may cause risk of tendon elongation or rupture.  Not sure if anyone can answer this but I don’t understand what the difference is between doing calf raises and stretching the tendon with dorsi-flexion.  Isn’t putting the tendon under load with calf raises putting the same tensile stress on the tendon as stretching it?  Most protocols allow for strengthening exercises but avoiding dorsi-flexion exercises.


Plantar Flexion Range

Hi All,

I am 9 weeks 4 days post op on shortening surgery.  I have been doing plantar flexion exercises with the grey therabands for about a week now.  I have also started seated calf raises.

I have noticed that my active end of range plantar flexion is not as good as my good leg.  They are the same passively but actively with resistance there are differences.  Does anyone else have this?

5 Weeks - Post shortening surgery

On Wednesday this week I went in for my latest visit with the surgeon.  There is really not much to report as he basically did a wound check on the incision and palpated around the tendon.  Next week (6 weeks post surgery) I will start taking out the first of 3 wedges next week and then remove 1 wedge every week after.  In addition, I can start putting more weight on the injured leg but still need crutches.

I have been reading the recovery protocol of others and I have noticed that my surgeon had me moving my ankle with inversion, eversion and plantar flexion much earlier than some protocols (2 weeks post op).  To clarify this is not with resistance just an active slow movement.  I am a bit nervous though as I still feel my pereonal tendon working when I do a full plantar flexion.  In my previous posts my pereonal tendon was compensating for my elongated achilles….so a bit scared that my problem has not been resolved.

That’s about it for now.


Risk of Re-Rupture at 17 weeks

Hi All,

Looking for thoughts here….I am looking at a family trip to hawaii in December.  At this time I will be 17 weeks post op achilles shortening surgery.

I won’t be 100% by this time but wondering what the risk of re-rupture at this point in the recovery process.  I won’t be doing anything too stressful but do plan to swim, light walking, and general beach activities.

Thoughts on risk?

2 weeks post op and 2 cm shorter.

Just got out of my 2 week post op assessment with the ankle ortho.

I am now thankfully out of the splint and in an aircast with 3 wedges.  He took 2cm out of my tendon with a z pattern technique.  The incision is much longer than the original from the first surgery but the wound is healing nicely and stitches have been removed.  He did tell me that he honestly does not know why I healed long because the original suture was secured cleanly and strongly.  Usually there is mass of thicker than usual scar tissue where the ends of the ruptured tendon have filled in….not in my case.  I am not sure I will ever know why this happened but the only things I can think of are:

1) A fall on the crutches one day after surgery…I remember a small stretching sensation.

2) Physio that focused too much on dorsiflexion ROM at the outset.  This is a possibility…but he is a pretty experience PT with high end athletes….and has successfully dealt with this injury numerous times before.

3)Possibly too aggressive on my return to PWB during recovery.

The one thing that struck me was the language the surgeon used was “I improved your situation”.  I probed to get him to elaborate what that meant…..without much luck getting any more specific response back. I have heard he is conservative in communicating the outlook to patients so I’ll monitor.  I am oddly comfortable with this because I was not going to improve much with function or strength in my previous condition.  At 9 months I could still not do a single heel raise.   I just hope “improved” means a full return to the sports I used to play.

Rehab is a bit different this go around.  First of all I am supposed to start taking the boot off and doing 100 active plantar flexes a day. Going down as far as I can and then up to the point where I start to feel a stretch.   Second of all…although there is still no weight bearing while walking with crutches but I can stand with the bad leg normally.  This is much more aggressive than before.

That’s it for now…I return in 3 weeks.

Here we go again….

The saga continues….I had shortening surgery on August 30 after a 9 month failed recovery (healed long) from the original injury in December 2015.  At month 8 I still could not do single heel lift on my injured leg which limited functionality for sports. Pre- injury I was a very fit and active person playing hockey, squash, volleyball, mountain biking, running and tennis.  After a valiant attempt at strength training, aggressive PT, PRP (for tendinosis) and even accupuncture I elected to do surgery as the only way forward to get back to normal.   My lack of achilles strength was even causing issues with my peroneal tendons, hips, back and knee so needed to course correct.

As far as I know the surgery went well…but I have actually not talked to the surgeon since the operation. I see him on September 13 for a wound assessment.  At this point not much to report as the initial phase of the recovery protocol is pretty similar to the first time around.  The foot/ankle ortho did explain that later on he will fit me in a cast that allows me to do end of range plantar flexion but a block that only allows me to dorsiflex to a certain ROM.  This will happen during the NWB phase of the recovery.  This is a pretty big departure from the first go around….I will share more in a future milestone update.

For now…I will spend my days lying on my back with an elevated leg….I forgot how frustrating this part is!


The Elongated Tendon Club - Back to the beginning

In my last post I mentioned that my new sports med doctor gave me 3 actions to complete to get me on the path to recovery.  Unfortunately, bullet 2 (referral to an ankle/foot ortho specialist) confirmed my biggest fear…….I have healed long. This explains my inability to gain plantar strength….but according to him my inflamed pereoneal tendon is subluxating because it is over compensating for what my achilles cannot do.

The only way to get back to reasonable functionality is through shortening surgery.  This doctor does them every 2 weeks but they are usually on patients who had undiagnosed achilles tendon ruptures.  We had quite a good discussion on the procedure and the outcomes.  The surgical risks are the same as the usual surgery and the recovery process is almost identical to what I had completed before.  I told him my benchmark is not to walk normal again but rather get back to playing sports and living my previous active lifestyle.  He is confident that I should be able to get back to an active lifestyle but has managed my expectations that I will never be 100% of .  I struggle with this because that is a vague description.

The big question now is why did this happen?  The surgeon could not answer definitively but he did say it is rare to have an outcome like this with a surgery.  He validated that the original surgery was done by a well respected surgeon.  Really the only answer is that the surgeon set the tension on the tendon too loose….or I somehow stretched the tendon early on during the healing process.  In one of my earliest posts I wrote that I was concerned with a fall I had with the crutches where I put my non-weight bearing foot down to brace the fall.  Despite being told by the surgeon that it was still attached I cannot help but think I stretched it here.

This is clearly a tough pill to swallow as I just crossed into Manhattan at 7 months in the proverbial marathon……and now I am heading back to the beginning with surgery likely at the end of August.   In the meantime I will start to prepare myself mentally and take stock of all the lessons learned going through this procedure the first time.

I see there are a few posts from a few years ago that have gone through this and I would really like to find out how they are now.  I am not sure if they still review this blog but if there is a way to get in contact it would be good to check in and get their perspective.