Week 6 - More Information
Reading other blogs about their procedures I thought I’d clarify my protocol a bit.
If you didn’t read from the beginning, I’m now in a boot at the end of 6 weeks in 2 week interval fiberglass casts. My boot is the Ossur Equalizer Walker model W0600 which extends up over the top of my calf muscle. It’s not fancy like the Vaco boot but when I questioned him on why they did not use the Vaco boot he said that is primarily used when you use the boot in lieu of casting since the foot angle can be adjusted as you progress. Makes sense to me. My boot online runs about $52 versus the $290 Vaco. If I was going more aggressive then I’d likely choose the Vaco.
So the day I received my boot my ortho doc cleared me to walk and cycle as long as I wear the boot. I was also allowed to swim without the boot of course. No running or jogging at all. He also said I should do some ROM movements when sitting around but no other exercises like toe lifts or stretching. After he examines me in 6 weeks he’ll start me off in PT. But again, I have almost full ROM already and he thinks since I did not have the surgery that I may not need as much PT. My Achilles is still tender to the touch and slightly tight when I bring my toes towards me but I have nearly the same range as my good foot.
I’m not pushing things now. I’m happy with taking it easy in the boot. While I’m a believer in early motion and weight bearing I still think you have to be patient and give your body the time to heal. And again the danger is stumbling forward without the support of the boot which will likely result in a re-rupture. Incidentally, 3 days after receiving the boot I did just that in the garage! I actually stumbled and caught my weight on the boot foot. I can safely report that the boot performed wonderfully and I didn’t even feel stress on the tendon! Knock on wood though because this has made me a humble being.
Going forward, I wear the boot for 4 weeks FWB (skipped PWB) then start using 2 shoes. He recommended I use a gel insert under my heel for support. I go back for a follow up with my ortho doctor in 6 weeks at which time he will start me on PT (he didn’t want to start PT until after the 3 month mark). No sports activities until after 6 months. I can live with that!
Oh, and I’ve dropped down to normal doses of vitamin C and only drink the protein supplement once a day now.
August 28th, 2011 at 12:07 pm
I sat here this morning and ready through all your posts. I have to say that the one thing that sticks out is your calm, confident common sense approach. The gel insert in the boot has helped others from memory as from now on you will be more mobile. Well done to now.
August 28th, 2011 at 3:06 pm
Kickstand,
Glad to hear that at week 6, your healing is progressing. I too took the non-surgical approach to my ATR and I am now in week 9. Still in the cam boot but doing physical therapy. At about week 6, I too had the tenderness and the tightness when I tried to move my foot. The doctor stated, that was the tendon, muscles and nerves healing and that through ROM exercise, it would “loosen” over time. I won’t move to shoes until around week 12 mainly because, I am not trying to rush my recovery and I am perfectly fine with this decision. Just wanted to give you and the readers a ray of hope to say that as long as you take the time to heal properly, the risk of re-injury is much less. Best of luck to everyone during their recovery.
MrKnox30
August 28th, 2011 at 4:16 pm
A gel insert was a life saver for reducing heal pain for me as my boot seemed to have some tiny notch in the bottom that really aggravated at times. Also seemed to relieve some of the same pain at night at times.
Good luck with the healing kickstand!
August 29th, 2011 at 2:56 am
I agree with Stuart, you blog boasts confidence and I’m thinking more positive about my own recovery now, I thought I wouldn’t be PWB or FWB for 10-12 weeks.
Out of interest did you have any more scans during the cast changes to check that the tendon was repairing nicely?
August 29th, 2011 at 7:02 am
Thanks Stuart. If nothing else, I’ve learned that patience is the key to recovery. 1 day at a time!
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August 29th, 2011 at 7:06 am
Thanks MrKnox30 for the rays. Send some out to the people on the east coast while you’re at it. They need it too!
I was out Sunday walking around a basketball tournament for my daughter. I noticed that I was starting to walk a bit more normal if you can call it that. I wasn’t walking with the boot sideways like I did the first few days before I began trusting it. I thought I would wake up today in pain but surprisingly it felt fine. I’ll still take it easy but it was encouraging. Glad to see you’re moving along well on the non-surgical route!
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August 29th, 2011 at 7:09 am
Thanks bcurr. My boot had a similar bump under the heal but I discovered it was just a kink in the insert. After I straightened it out I haven’t had any problems.
Just to clarify, I’m not using a gel insert now with my boot. The ortho doc recommended I use them once I start back with 2 shoes. My heel is a bit sensitive and tender in the boot but most likely from not using it so much and because I’m putting most of my weight on it and not the full foot. In time I think it will dissipate.
Good luck with your recovery!
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August 29th, 2011 at 7:19 am
Good catch pringles! Aside from the initial x-ray the day after my ATR, the ortho doc did a ultrasound at the 2 week mark when I was given my second cast. I got to see it (and the x-ray) and could clearly see the rupture on both. Fortunately for me I did not walk on it before they initially immobilized it at the ER so the ends of my Achilles had not retracted too far. From what I could see the gap was between 1/2″ to 1″ but because it kind of curled back it was hard to tell how far apart the ends were. And, of course, the images were not so clear for a lay persons eyes to read.
All I can offer is what I’ve read here and on other sites. Patience is key but you also have to be disciplined and not try to jump start your Achilles. The new tissue needs to be brought up to speed and strengthened. My immediate goal is to reach the 3 month mark, which is where my doctor wants me to start PT.
Incidentally when I walk with longer strides over the top of my boot (not sideways) I feel a tug on my tendon so I try to use a medium stride. I’m 6′-4″ so I’m used to taking long steps. Being the last walking is new to me but fine in the “long run.”
Good success with your recovery!!!
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