Feb 21 2012
I met with the Orthopedic surgeon on Wednesday 15/Feb/2012.
Having done some preliminary research, I thought I was set on surgery. It seemed to me that if you wanted to return to full strength and have less chance of a re-rupture, surgery was the choice.
To my surprise, the doctor advised against surgery. He was a fan of a study published in the Journal of Bone and Joint Surgery (JBJS) that showed the non-surgical route being just as effective, and without the complications of surgery. The problem with past studies was that the conservative methodology was just that, it was too conservative; it required immobilization for about 6 weeks before even beginning rehab. This study used a much more "aggressive" rehabilitation approach.
(I would later find the link to the article here: Operative versus Nonoperative Treatment of Acute Achilles Tendon Ruptures )
In the end he mentioned it was my choice, but I listened to him. There were some other factors as well, main one being that I did not want to miss work for any longer than I would have to.
I was strapped into an AirCast Boot fitted with heel wedges (to provide a 20 degree plantar flexion), given crutches, and advised to go non-weight bearing (NWB) for 2 weeks before seeing him again.
Though with my arrogance, impatient nature, and very (overly) optimistic view I haven’t been NWB but that’s a blog post for another time.
* On a Side Note *
I just wanted to add that I was actually misdiagnosed when I went to a walk in clinic the day after my injury. I expressed my concern that I was afraid I had an ATR, so the doctor gave me a couple tests to see if I could exert pressure against her hand with my foot. She said I had simply strained the tendon and to rest up for 2 weeks and then come back and see her.
I was relieved, but I still had a lingering in my gut that it was worse than she said it was. I went and got a second opinion the next day, and was told immediately to go to the ER after the doctor performed the Thompson Test. It was then that I got scheduled to meet with the Orthopedic surgeon.
I have all the respect for doctors in the world; many of my close friends are pursuing that path. It is rigorous, demanding, and most often at times an under-appreciated profession. Doctors make mistakes, I understand that. But if you are unsure, I do advise to get a second opinion.