kimjax’s AchillesBlog

I agree, its not worth taking any risks. DO ThE Stretching!!!! That is what will keep your tendon from shortening!!! And while you’re at it…do some ROM exercises. Every day! The days I skip I have more pain and swelling the next morning, and that’s a fact. Good luck!

Hi wenda
I can live the pain, it’s good to listen to it so dont want to mask the warnings, I will take your good advice on the stretch which I don’t do daily to be honest.
RRR

Okay, that makes sense! The nerve damage will get better over time and can take months, even years. I massage my foot and calf every day. It speeds up the healing of the nervestoo…maybe because it helps with circulation which is poor in that area. Well,16 weeks are still early for non-op route. I also experienced pain on the push-off.
But I’ll be honest, I took cataflam (it is a anti-inflammatory) for a week or so to help with the pain. But I don’t want to say you should. I did not ask a doctor or therapist. So maybe ask yours. I don’t want you to not feel pain, and then push too hard and do damage. but it helped me get over the initial ouch getting my stride right. But please ask first. I must say I didn’t during my first rupture. This was 2nd time round. It also helped with the swelling and really relieved much of the pain. Glad you have access to good therapists and consultants. Oh and do your stretching exercises daily…twice a day if you can.

Hi wenda
The nerve is tingling burning when I touch or excercise, you can do sural damage through rupture , I’m 16 weeks , those with similar time lines are well ahead of me, it’s on the push off that the problem tendon hurts, I’m still far from touching the wall with my knee, anyhow I’m seeing the top physio Monday and consultant in 4 weeks , lets see what they have to say
RRR

Hi Ripraproar, glad you’re doing okay and especially pt is going well for you. How long ago was your AT rupture? I know that if you go the non-op route it takes longer to get back to your previous level of activity. But there are loads of benefits to the non-op route too. I am not sure what you mean with nerve issues. I know that if you’ve had the surgery, very often there are nerve damage and it takes a while for it to heal. But it does, eventually. But I will say this, tearing your AT is a dramatic injury and there will be lots of scar tissue. I have found that muscles and joints in the ankle which wasn’t even involved in the AT tear, became painfull and stiff. They still are, 20 weeks post op. Especially in the morning. The swelling is also still there, but very slightly and especially after a whole day on my feet. It also gets less painfull every week. As to the limp, take very slow strides, but do it as normal as possible to ‘re-train’ your foot to not walk asif you are in the boot. It is as if the foot ‘forgot’ normal stride and tends to not ;follow through’….it is difficult in the beginning and it might sound really silly..

Hi wenda
Thanks for your rely I’m doing kinda good, but behind my fellow time lines, my calfs look very similar , I appear to have strength, but I have a really annoying nerve issue I can’t shake off, hope I don’t need surgery to put that right, after choosing non op route, I also still have a limp and can’t Suss why, I do have AT pain on push of but I’m ok living thru that pain, so if I can live the pain and strength getting better dont know why I can’t shake limp off. But ts not all bad I’m out of boot doing garden work, gym , pt and have a degree of freedom

Sorry guys, I had a hectic May! To Ripraproar…I hope you’re doing okay with your PT. I had my tendon fixed surgically. I have read on other blogs that PT can sometimes be TOO aggressive. Quite a few re-ruptures happen there. Some Surgeons don’t even make use op PT because of that. But then again, it depends on their professionalism. I live in Africa and we do tend to have problems here if you can’t afford the best of the best. My advice, read the re-hab protocols on the blogs and listen to your body! If it doesn’t feel right…don’t do it! I told the therapist I can’t do a single leg calf raise (12weeks post op) and she said I have to try…and snap, there it went again. I actually told my mom before I went that morning that it will be my last as I don’t feel comfortable with the therapist and what she is doing. I learnt the hard way. Good luck to you!
To Kimjax…thank you SO much for all the info and advice. I’m so glad you are improving all the time. Well, as you see I am not going to PT as I had a bad experience. I am seeing progress on a weekly basis. I am doing my own re-hab and I’ll be back on my roadbike in July. I am ta

Hi Wenda - I’m a year postop this week. My swelling never went down until about 10 mos. postop - and in the last couple of months I’ve been able to fit in old shoes, etc. My ankle bones no longer have a “sea of swelling around them” and everything looks pretty normal. My skin now moves easily around the AT - which seemed to be attached in the early days. The lumps are smoothed out but it still looks like a stack of coins.

As far as the calf circumference - I worked out (hard) and faithfully 6 days a week and saw no gains until the last couple of months. Honestly, it felt like my lower leg was just a stick between the thigh and foot and the thigh was doing all the work. I JUST started seeing calf muscle really come back about 2 mos. ago, but it is MUCH smaller than the good calf. I’m still making lots of progress, though, so hopefully it will get better. (I’ve only recently seen some calf definition begin. )Unlike most AT recoveries, I’ve got some mechanical “issues” with healing very short and am still only able to manage a gimpy run do to lack of DF - but it gets the job done. I’m full speed on my road bike

Hi wenda
I hear you pt I have a real lump and pain fom my first pt, what happened can I ask, was you op or non op first time

Hi Kimjax! I’ve re-ruptured my AT on the 18th of Jan this year at physio…long story but I’m 14wks post op now and doing well(doing my own physio thank you). I live in South Africa and I honestly think the PT wasn’t done correctly. All I can say is Listen to your Body!
I know that you’ve had a adhesion. how is that doing? I have one and I just want to know if yours is better with the treatment you got? And also if you can tell me if your calf circumference is back to normal? Really hope you are doing well. Regards Wenda

I’ll try it!

Kimjax, your “Just no running due to the lack of DF” has me thinking, as does your “I’m compensating by lifting my heel up to get a kind of DF movement to accommodate the knee.” This idea definitely did NOT come from my podiatrist or any other health pro, but. . . wouldn’t heel wedges in your running shoes let them move through a normal ROM (e.g. for running), even though one of your ankles can’t?

I remember that blogpost! I’ve been protecting my knees through this entire adventure as they weren’t good before it happened! I’m actually having trouble with the one on the good leg now that I’m back to normal activity and workouts.

I’m compensating by lifting my heel up to get a kind of DF movement to accommodate the knee. I’m still gaining DF, oddly enough, and I’ve been really slack on doing any calf raises because of an irritated ankle tendon. The doc told me to lay off until it was better. So I never got back to it. I was surprised to see that I couldn’t get more than an inch off the ground for my calf raise on the AT leg! I need to get back on it. I’ve been lazy about PT now that I’m road biking well again. I guess I just compensate with the upper leg?

I have no limp, pain, or swelling anymore. Just no running due to the lack of DF. Time to stop being lazy…

[Kimjax, I tried to post this yesterday, but I think the site went down for a bit. Here it is from my clipboard-manager(!).]
If you haven’t, please check out my (newest?) blog page, with a title like “Maybe healing short is a bit scary after all”.

In addition to the risks and problems I mention there, I’m now starting to think that the main problem that brought me to the podiatrist — a generally worsening “trick” knee on my right (ATR #1) side — is likely caused, or exacerbated, by that short AT-and-calf. It’s clearly a knee-alignment problem (when the knee “snaps” into position, it’s suddenly either perfect or very close), and many smart people think that tight muscles cause most joint-alignment problems. I might be adding 2+2 and getting 6 (again!), but if not, keep your eye on your right KNEE as well as your right ANKLE!

Haha! Thanks, Andrew! I’m STILL improving - and really quickly all of a sudden. I think all the small parts had to “catch up” after the downtime. I also think I needed more rest. I worked out every day from injury to recently and now I’m taking more rest days. Calf raises are getting better - kind of “out of nowhere.” Still a little stiff in the first 5 min. of the morning, but that’s because I healed so “short,” I think. (could it also be age?!)

I also suddenly noticed my ankle bones sticking out again - no more swelling at all! My achilles is still bigger than the other, but you can’t notice from the front. As a matter of fact, I get absolutely no sympathy from my family anymore. I’m back to being the house slave. I kind of miss all the help and pity, haha.

Hope you’re doing well - I feel so badly for all the new folks. Glad to have it all behind me! Kim

Hi Kim, good to see things are progressing nicely, seems like even after 9 months things still have the chance to improve and they do….

I’ve always found strength and motivation in reading your posts and because (in terms of recovery timeline) you were a few weeks in front of me, your blog allowed me to see where I could be in a short number of weeks and it helped me a lot

Here’s to thngs improving even more for you over the coming months and keep sticking it to them young cyclists, plenty of competitive miles left in you!! Of that I am sure

Oh, I remember those days! I’m so glad it’s over and am feeling great sympathy for you right now! Don’t worry about the WB - I was too afraid to try until 5 weeks. I put the biggest sole in the Vaco, and tried to walk - I even put a pic on the blog with my crutches on the floor. Then I picked them right back up for another 2 weeks as my leg hurt so badly that night. In case the doc hasn’t told you, use one crutch at first, and just practice standing as soon as you can get out of that ballerina point. He gave me goals for ratcheting down my angles, and told me that I had to be at 10 degrees or zero by 6 weeks, I believe. It was very painful in the first day or so of reducing my ankle angle - but necessary. I did it about once a week or more often if possible.

I also was constantly worried about re-rupture - and they still joke about it at the PT clinic, haha. I’ll never hear the end of it! You’ll start to make big improvements soon - hang in there. Be sure to do the ankle flexibility exercises at least twice a day - I moved mine constantly. There’s a rehab section on the blog somewhere and it was very helpful to follow

CAST OFF! Umm….now what, lol? Dr. said everything looked great and put me in a boot for 4 weeks, said to start PT soon and could do whatever weight bearing I could tolerate. Yeah-no. My foot is frozen into a lovely pointed position. Impossible to stand even at the highest degree even in the Vacocast. What a cruel joke my dr. played on me by saying that, lol! I will be patient and just do free stretching for now I guess. Any little suggestions till PT starts in a week? My surgery sites are scary and I am afraid they are going to split open along with a re rupture which I know are all normal worries. What a disgusting injury is all I can say! I secretly have enjoyed grossing out my “cool” kids unexpectedly sending a text of my sutures and such. Its the little things to keep this fun right?

Good for you - little goals each day give you a feeling of accomplishment. I remember being so excited when I could empty the dishwasher! Now I’m badgering the kiddos to “keep up” again - it all comes back quickly once you’re able to begin walking fast without fear of re-rupture.

Glad to hear you’re still here spreading good cheer, norm! It’s good to hear that the AT may continue to shrink - it’s a large bump off my heel and looks (and feels) like a stack of quarters. I’d just like to avoid buying more new shoes.

After reading over a few old blog posts, I realized much has changed over the last few months. I no longer have pain in the front of the ankle during stretching, and my ability to stand on tiptoe has “happened” without a lot of trying on my part. Just daily use like going up and down stairs seems to be strengthening all the supporting tendons.

I feel no likelihood of breaking this thing again - it’s stronger than the good one. The skin has finally loosened up around it, and while I have to consciously point toes stepping down the steps sometimes, (I’ve gotten used to the DF position) it’s much more flexible. I think you pick up bad walking habits that have to be discarded as you go along.

I really don’t get much swelling anymore, and can twist, turn, and pivot fine. I probably just need strength for running as I’ve solely concentrated on biking. Keep beating up the youngsters on the

Thank you! I feel encouraged already! Looking forward to next week’s appt. My little goal is to make Chili this weekend for the Redskins Game. I will keep little goals and then they can get bigger as I get stronger!
Kim

Sounds like you’re doing pretty well, all things considered. I’m pleased that the DF is still improving. The thickness of the AT should definitely keep improving for well over a year, maybe 2 years plus, until it’s quite similar to the uninjured one (not that I still have an uninjured one to examine!).

So I wouldn’t throw out all those old shoes, just stash them in the attic somewhere. Mind you, somewhere around 50, a lot of us find our feet start to “spread” a bit, without injuries. . .

And there’s nothing “pitiful” in my book about pushing your body to keep up with your younger pals! I’ve NEVER seen anybody my age at the beach volleyball place where I play, and I hardly ever see anybody within 20 years of my age. And I try hard not to lose many games.

Hi doubletrouble,
I don’t check in much anymore as life has pretty much returned to normal - that is: BUSY with lots of kiddos and orphan advocacy. I feel great sympathy for you - dealing with immobility over the holidays must be difficult! I’ve never heard of a double rupture, but I’m sure some of the veteran posters on this group have seen it. I LOVED my Vaco - and TOLD the doc that I was going to use it. I had terrible aches and pains in my hips and knees with the Frankenstein boots as I’m a small boned person and they were just too heavy. My advice is to remain purposefully positive (use movies, comedies, treat yourself - whatever it takes) and be diligent with your PT. I didn’t realize how much harder some folks worked until about 6 weeks in. The leg lifts and stretches, etc, don’t seem very helpful - but they are! Hip exercises really helped with stability on the injured leg (your muscles atrophy quickly) and balancing exercises are so important for all the small supporting tendons. It seems so long and dreary, but around 8-12 weeks you will see dramatic improvement and things start to move along quickly. So don

Hello,
I am new to this blog. I am female and 4 weeks post op from rupturing my achiles in 2 places. The dr. took my toe tendon to reinforce one rupture at the base of the gastroc muscle. My other rupture is at the heel base where I had a bone spur removed as well. I feel overwhelmed and tired of not being able to walk with 3 kids through the holidays. I bought a Vaco Achiles boot and am anxiously awaiting its arrival. I see my dr next week. I hope he approves the boot and I get out of my cast. Any advise or encouragement is greatly appreciated! Doubletroublerupture

Hi Kim and all:
Just wanted to update you about the pain! I had an ultrasound yesterday and met with the surgeon today. I have alot of scar tissue and inflammation. After discussion, he gave me a shot of cortisone in my ankle. Hoping that it relieves the pain. If it doesn’t, then we will talk about further surgery to remove the scar tissue. He said that the achilles is in tact and healing wonderful. Just the scar tissue giving me some issues. I am sstill in pain tonight and the cortisone, if it is going to help, will start to give some relief in 48 hours or so. Anyway, thanks for all the help. According to my doctor, at this point, 18 weeks, swelling is normal, pain is not! I will keep you posted.

Marltom- I’m so sorry to hear this - but it sounds like you have a positive attitude and you’ll be able to move forward with the PT. I hope this is a short setback and you’ll be on your way to recovery once again.

Saw the Dr. today, week 19 will be spent having my scar reopened. The small sore at the end of the scar still has not healed so he will open it up, clean it out and re-stitch. The good news is he thinks the report from my PT was great. He even told me I can take the small brace off when I am walking on flat surface. This will pass just a small set back.

Kim - thank you so much for replying promptly,. I am looking into hiring a stationary bike & doing v gentle ROM exercises with my ankle as well as massaging and ice. Thank you also for explaining that you went back to crutches until you were ready; some posts online seem to suggest you should push your body to FWB walk as soon as you can, but I feel better knowing that for someone else at least, it was OK to take a (metaphorical) step back even for a few days and return to crutches. And finally - your last words about starting to forget your leg most of the time: well that is brilliant. One day at a time, one day at a time, I will get there too! Thank you again.

Muriel, don’t worry about calf size at this point - it will take a long time to build it back up - mine is still noticeably different at 21 weeks! Unfortunately, there’s not a lot you can do in the early weeks as your AT’s not ready for the load.

I was the same way with pain in the initial PWB stage. In this post, I picked the crutches right back up the next day, because I had severe pain and swelling that evening after my FWB adventure! I waited another week and went to one crutch for a few weeks. Just standing and using the injured leg for balance was good exercise. I remember how frightening it was to put any weight on it at all! I have great sympathy for you!!

Be sure to ride a stationary bike or swim while you heal. Everything starts to atrophy with inactivity, so the more you can do now, the better you’ll feel when you start walking. Even though the ROM exercises and therabands seem worthless, they were really helpful when I did them consistently. I hope you heal quickly - I’m starting to forget about my leg most of the time anymore, and stumbles don’t even faze me or the AT. Far cry from the re-rupture

Hi Kim - so glad I landed on your blog as I seem to be going through the same stages as you did - now 4 weeks post-op, in a CAM boot since yesterday and allowed to bear weight as much as I can tolerate. But I am terrified to do it, as the tendon feels sore after just a few tentative steps, still with both crutches. Ankle movement is also very, very limited. One question for you: did you use any kind of electro-stimulation or ultrasound to help rebuild the calf muscle. Mine is so atrophied I am in shock every time i look at it (and it was so strong before - as a result of 2 weeks of sporty holiday that culminated in ATR)…

Thanks Kim for all the info. I am seeing my doctor to morrow and will talk about pain. I think that the swelling is causing me the limitations. Keep you posted. Thanks again.

One more thing: The PT told me that part of the problem is that the bands at the front/sides of my ankle are tight from atrophy and disuse. When I stretch, I often feel pain in the ankle rather than stretch in the AT. The PT will hold the front of my ankle back to allow me more stretch on the lunge. He says this will improve as the area gets more use and loosens up. Apparently, the upper front bone doesn’t stay where it should be and causes obstruction.

Marg - have you talked to your doc about the pain? I have pain when I overdo fast walking - but it’s not terrible - just reminds me that things are still stretching/healing. I have no pain in every day walking, biking, etc. I also have trouble with DF - but it improves little by little. There are some days where it seems to go backward - usually when I haven’t done exercise to loosen it up. I am doing a LOT of stretching, twice a day, after warming my leg through exercising or heat. I still have trouble with the wall lunge as well, but hoping the increased walking will continue to loosen it up. My swelling really resolved about the 20 week point. I’m only about an inch off the floor on my single calf raises, but really max them out in the pool. That really helps my calf as straight leg raises use different muscles than seated. HTH!

I am 18+ weeks and am having real problems with swelling, pain and df. I can go up on toes, point toes, but lunging towards wall is minimal. Any suggestions on getting the df working.

Hi, I am 67 18 weeks post op and i feel good. I have my brace off, and real shoes on. I still have a small wound at the end of my scar that just will not heal. Causes by a stitch not healing. My df is fair but my therapist is very happy with my progres. I can finally see the light at the end of the tunnel. Yea!

Great - that’s something to aim for! My PT keeps telling me to try a single and I get about an inch off the floor. I keep asking if it will re-rupture to try this and he says, “NO!” (I’ve been asking this about everything since week 4 and it’s now a running joke with them all) He seems to think that my AT is very thick and strong now. I just worry a little since it’s so inflexible.

Hi Kim

I’ve actually been doing the cross trrainer and a cardio wave machine, so perhaps not true stepping, sorry. As with the rowing machine, if I don’t have quite enough ROM with the bad side, I lift/adapt slightly. If anything hurts though, I dont do it! I haven’t attempted any single calf raises yet, my physio has said not to but I look forward to trying!

Kim

At 27 weeks I’m further on than you and at 18 weeks as you are now, I couldn’t do a single heel lift on that side at all. I think that it was about 20-21 weeks, since when the recovery was quite quick, albeit with plenty of exercises.

Feel better now… thanks hillie & kimjax.

hilie - you can do a single heel raise already? I can only get about an inch off the floor - but am getting stronger every week. I do fine with single heel raises in the pool - but the calf just isn’t strong enough yet to do it dry.

Dave S

Don’t worry. I’m 50+, full rupture, non-op, and was walking very well quite early in my rehab. I saw a physio every 2 weeks when I had my boot adjusted and was in 2 shoes by week 9.

However, the biggest gains in strength and flexibility were after 15-16 weeks when I upped the exercise regime with the help, first of all from another NHS physio, then a sports physio who I will see for another couple of weeks.

Heel raise on ATR foot is now the same as on the other side. Just don’t start slacking!

Hala - are you using a stair stepper? Do you go up on your toes or just lift the foot flat?

mcdarling - DF is dorsiflexion: how far you can move your foot towards your shin. I can do a ballerina point (plantarflexion or PF) but am very limited in the DF area. (see previous pics) My doc had to cut off quite a bit of tendon because it was shredded from my “blowout,” and it’s healing short. It was very painful to make each new flatter degree adjustment when I was in my boot early on. But I’m also hindered by tissue adhesion from the healing after surgery, so as that breaks up, I get more flexibility. I saw your post about jumping with the teens - hilarious. (except for the rupture )

daves - I’m an oldie, too (49)! It’s all coming back slowly but surely. My PT said I’d continue to improve - just the doc was gloom and doom. I got out on my road bike today and felt great! When the AT is warmed up, I walk almost normally. It just gets tight after sitting for extended periods.

Am I to understand that there is some sort of conventional wisdom which says whatever length your tendon is at 12 weeks is where it stays?? I don’t think mine will likely be stretched to normal length by that time. What a scary thought. But it sounds like some people are still making progress well after 12 weeks. Hope that applies to older guys too.

Very good update! Pictures are good too! Can you define DF? No idea what that is. Thanks! Continue with your great progress. Blessings!