mags11’s AchillesBlog

This sounds great! I’m 6 days post op and hoping to take a trip to Greece with lots of walking by week 17. Also hoping to return to golf as soon as possible. Sounds like I have a good chance based on your experience.

Good stuff, must have felt good all over!
I was 17 weeks in when my Whistler ski week came up, and I had a blast, no problems except shopping for thinner socks for the slightly bigger left ankle. (Details on my blog.)

Sounds like you’re doing fine. But health professionals dispense more nice-to-hear BS than drugs or exercise! All surgical patients started out way worse than average, and ended up way better. You can see it in the comments reported here, and it makes sense, too.

Thanks Mags11 - still deciding whether to gingerly PWB at 2 and a half weeks but my foot feels fine if I do put weight on it. Maybe I’ll just go for it, slowly.
I hope you continue to recover weel.

Sounds good and sensible. I’ve got nothing on the pea bump.

Great news! 2 shoes is definitely an accomplishment. Good idea to keep the boot handy for larger crowds. After walking quite a bit I have swelling too, but it’s getting better over time and I’m seeing that my foot doesn’t swell as much anymore so I’m hopeful that too will go away in time. I too take gelatin, but I use Great Lakes powdered gelatin (got through Amazon) and I just add it to my protein shake in the morning. As for the bump on the bottom of your foot, can’t say I have that at all and so can’t be of any help. It may be nothing but if you’re not sure it is probably something to ask your dr about.

I continue to be amazed with your progress! Way to go! And congratulations on the upcoming baby!

Impressive! I haven’t checked my fave protocols, but 2-leg heel raises at 7 weeks MUST be faster than ANY of them, no?

I am not a golfer but that is quite impressive at the 7 week mark. Congratulations! Keep it up.

It is great to read your progress and it sounds like you are doing so well. PT makes such a difference and gives goals that you can work towards. 2 shoes in two weeks- yahoo!

Love reading about your progress. I can’t believe how fast you are moving but obviously it is the right pace for you. Keep it up!

I also found it therapuetic to write about my recovery experience early on. There were also some dark periods when I was a little depressed with my situation and frustrated with the seemingly slow pace of my recovery and blogging about it helped me through. You’re through the worst period now, so stay focused on short-term goals and you’ll be getting back to normal activities in no time. Good luck and good healing! -David

Just something I noticed when I did the weight shifting, I would still force my weight on my good foot. I got over this by lifting my right foot to make sure weight went on my left foot.

I think I will do some of the things you’ve mentioned. Just come out of boot at week twelve but no physio til next week. Wish I’d started bit of bare feet walking sooner , it is so different, as you said. Good luck and keep us posted with how you get on.

Nice! Congrats!

These seemingly small steps are massive to us in the ATR club. Congrats. Good luck with the rest of recovery.

Thanks for your post mags11. in two days will mark my 3rd week post op and although i’m still in a cast its good to know how much progress can be right around the corner. best of luck.

Thanks for the clarification.
I find the two terms confusing myself, which is why I’m glad my doctor told me that I could do unassisted stretching with my foot right now. Now that, I could totally understand correctly!

Thanks Chris for the correction - you are right. Not sure where my head was with that passive and active. With my current tendon injury (bicep) my doc wanted only passive so I get a bit confused. I think it is important to be correct with terms or other people can get confused as well. Cheers.

Mags, yes you are right about stretching while walking. I think you just need a little DF to be able to walk anyway. The point is that having the PT perform stretching execises with the goal to reach max df as soon as possible is probably counter productive. Walking in 2 shoes from week 8ish probably adds just about the right amount of stretch for that period.

And to be honest the tendon seems to stretch out by itself from just walking. This is obviously just my personal observation but I’ve read about similar experiences on this blog. I don’t really push hard on stretching but I do the knee to wall test every day just to make sure I don’t go backwards in rom.

Also, this is about semantics but passive stretching is when you apply external force on the joint and active stretching is when you have the joint move with your own muscles connected to that joint. It’s the passive stetching that you should be really careful with. Active stretching is probably not harmful at all if done with moderation even early on. Again, this is just my own thoughts and after all im just regular Atr guy on this site.

Mags - I concur. I don’t feel at 3 weeks you should be actively stretching the hell out of this. You should only be doing passive stretching (i.e. no external force). If this is how your PT wants to work now then how will it be later. My first PT set my boot wrong and ignored the docs orders. Found another and it was put right but there was a couple of weeks in between. I was NWB at the time and all seems to have healed fine. She was concerned about healing long and had attended a conference recently with some world leading expert talking about that very thing. Your tendon should be knitted with type III collagen by now so as long as you do not continue this all should be OK.

@chrislondon - that is an interesting approach. I’ve heard of the “not past neutral” until 6 to 8 weeks but not out to 12 weeks.

It seems that if one were to go to two shoes before week 12 in that scenario, they would be actively stretching it past neutral (or walking would be almost impossible). I’m not an expert by any stretch, I’m just trying to picture walking with shoes without going past neutral.

I do agree that PTs want to get to normal quickly, that was the vibe I got from mine which is why I’m looking to change.

My OS told both me and my PT to absolutely not to stretch the tendon before week 12 just to make sure it doesn’t heal long. He also said he had never seen a patient whos tendon didn’t end up in correct length despite waiting 12 weeks with passive stretching. I followed this advice and now at week 18 I almost have full DF rom (6 weeks of stretching). At week 12 i could barely get past neutral (knee 13 cm from wall at the knee to wall test, now I’m at -10 cm with toe).

I don’t see any point in rushing the stretching because it would only increase the risk of healing long. It WILL return to full ROM in time if you had a normal repair. If you went non op you will probably have to be even more careful.

My OS also told me that the problem with PT’s is that they want everything to go back to normal as quickly as possible (ROM, strength etc) but few are aware of the risks with healing long.

Yes, Chris. Doing too much of ANYTHING during rehab is a bad thing — that’s why they call it TOO much!!

Quite a few ATR patients, op and non-op, end up Healing (too) Long, and the simplest assumption is that it comes from over-stretching while the tendon is weak and “impressionable” — either stretching intentionally, or slipping and falling and stretching it that way. Healing long is a major cause of dissatisfaction, because it causes weakness and asymmetry. Most of the most successful rehab protocols — UWO is the one I’m most familiar with, bit.ly/UWOProtocol — wait quite a few weeks before allowing their patients to dorsiflex past neutral, and then only “actively” (using your internal leg muscles) for another few weeks.

Pain during ATR rehab is generally a Bad Thing, with only a very few exceptions. A number of post-op patients who had nasty adhesions (adjacent layers of tissue that had grown together with scar tissue) had those broken up with painful deep massage, including Graston technique. A few others got similar relief from slips and falls that scared the @$% out of them (because they thought they’d reruptured). Th

Norm, you mea doing too much dorsi is a bad thing? How else do you get it to go up beside painful stretching.

Chris89, if you end up healing long, your above “I know everyone is different, but the stretching beyond neutral hurt like nobodies business, but the benefit was the next day I had better rom. At this time I can walk on my foot with one crutch, and when I have two I can imitate foot movements better thanks to more dorsiflexion movement.” will be a key bit of evidence in the Root Cause analysys. OTOH, if you heal perfectly, we can make it a Sticky…
Increased ROM (DF) can certainly indicate a longer AT. It can also come from busted adhesions.

Awaiting Moderation - Grrrr!

Here’s another try, less of a URL :

It is sad but true that some PTs do harm by prescribing too much, too soon. Mine gave me a painful 1-month setback after my ATR #1, as I outline on my blog.
And the “Marfell Family Achilles Forum” link on the Main Page here used to point to a very useful ATR section (now vanished) of the Marfell Family Blog, where they surveyed a bunch of ATR folks who had reruptured and asked them what caused it, and listed the results. The most common answer was “slips” or “falls”, but the second most common was “Physio”! (Unfortunately, I can’t find a trace of that useful discussion on Archive.org, and it’s totally vanished from today’s Marfell Family website.)

@Mags — A nice sharp burning with no long lasting pain sounds consistent with scar tissue popping off in my experience, so I wouldn’t be too worried. But good call on finding a new PT if the current one makes you nervous. You want that relationship to be one of trust (and competence), particularly once you start getting into more aggressive rehabilitation.

As for healing long, one thing to be potentially be wary of: when I was planning my own recovery protocol I did a lot of research on here and observed that people who incorporated early swimming self-reported healing long with a higher incidence than those who didn’t use the pool.

I have no hard stats to back this up, and it’s possible that it could entirely be explained by something else (e.g. swimmers are more aggressive rehabbers and/or more inclined to notice and report something that feels off, etc.), but it was enough to make me think twice about it. I can’t really offer an explanation as to why, either, but If you try kicking with your non-injured leg I think you’ll see there’s a lot of pointing and flexing of the calf going on, and it’s entirely possible that the

Well, I didn’t start pt till about week 4 and 3 days when I had the boot, but from what I know as long as the achilles tendon is healed a little aggressive stretching will not hurt I know everyone is different, but the stretching beyond neutral hurt like nobodies business, but the benefit was the next day I had better rom. At this time I can walk on my foot with one crutch, and when I have two I can imitate foot movements better thanks to more dorsiflexion movement. But you know your body best.

Wow amazing!!!

A full length squishy-gel footbed should help, no harm, provided it doesn’t change your ankle angle (I.e. keep the heel wedge) or your 2-foot balance (add one to your other shoe too?). Many of us had this problem in 2 shoes. I wore Crocs. Easier than carpeting the house with gel!

Yeah it is definitely the bottom. I don’t feel much if anything through my through my Achilles or calf muscle. I’m pretty sure it is from the transition from nwb to pwb to fwb (about a week for that) as that is when it popped up.

The heel wedge I have in looks rather uncomfortable and not squishy… I’ll have to check on a different insole.

Mags, can you confirm that the part of your heel that gets sore is the bottom, and not the back? The former pain is almost universal when we return from NWB immobilization, and usually resolves on its own or with the help of squishy insoles, etc.; the latter one calls for backing off and going slower, IMO.

Hi markk, I ditched the crutches and have been fwb in a boot since day 14. My calf hasn’t been sore, but my heel gets tired/sore after a little while.

I’ve been walking a mile or two in my boot and have been doing the exercise bike for about 20 minutes (with a target of 70 rpm), so that is probably why my heel gets sore.

It was tough mentally to go from pwb to fwb. But my doc wanted me off them so I just did it…i think I needed to hear that from him to get over the edge.

Hi mags. I am just a bit behind you time wise it think. Three weeks post op and in a boot. I am on crutches but no way I can put weight on my foot. Swollen and very sore in my upper calf. Are you walking now?

Best scar pic yet!

Thanks for the info all! And David, if I don’t have any proof I’ll be happy with that!

Wow! I am impressed both with your progress and your quick healing! I think you are one for the record books! You are very lucky. That scar already looks way better than mine was at that same time. Kelocote was recommended to me to use to help with the scar. I only started using it now and I’m at 6 weeks so I can’t tell you how well it’s working, but I know others that used it on their surgical scars with great success.
Keep up the great healing!

Mags11,if you’re not careful, you’re not going to have any proof that you ever had an ATR–that post-op incision looks like it’s healing better than any I’ve ever seen! Personally, I’ve already decided, out of necessity, that I will wear my ATR scar like a badge of honor! -David

That looks great for just two weeks after surgery! My foot surgeon recommended Lubriderm lotion. At about 4 weeks, you can start massaging vitamin E drops onto the incision. Good luck!

I went op and had my stiches removed at day 6.

I’m on both feet down now - ditched the crutches last night as my doc recommended. I bought the even up for my good foot and am working on getting a better gait.

Feels great to be off my crutches.

Wow! That’s fast. Did you get your stitches out already? Or did you go non-op? Are you walking with both feet down and crutches?

Keep it up! I think the stationary bike really helped me. Good luck and keep it up

Mags - my PT gave me the ProCare Ankle Brace. Seemed to work pretty well. Hope you can make your Bandon trip!

Yeah good to know about Bandon. I’ve only walked it and didn’t realize they have doctor exemptions for carts. I’ll have to check on that.

My doc, who has played it, says I would be pretty tired at the end of the day, even if we only did one round.

Do you recall what brace you used at week 11?