Maida’s AchillesBlog

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I was in a hard cast for 6 weeks. At cast removal time doctor told me the same thing - repair is strong, walk as much as tolerable and start a PT under strict observation of a professional.

I went straight into shoes on the street and bare feet at home. There was a lot of paint to walk initially. Was constantly listening to the pain signals and trying to discern a benign pain level from dangerous pain level.

Base level of benign pain was determined initially by my first tiny steps. It was a good baseline, whatever I did for the next few weeks I tried not to go much above (not that I could, as the pain even for small steps was strong).

Also swelling level is important to monitor.
Ankle and lower foot would swell initially very quickly but as long as it was not additionally painful, there were no numbness and the swelling would go down by next morning - I knew that whatever was done yesterday I could do again.

Hey I am 7 weeks post surgery from frayed achilles and removal or heel spur. I had cast for the first 7 days, then boot then boot for 5 weeks. Doctor says to walk without boot and do as much as I can tolerate, I have been walking a lot, sometimes with a cane, got rid of leg roller (which was very helpful). I am concerned that I am doing doing too much too fast. Anyone with the same experience?

Mary, sounds like we have had the same procedure and are at about the same point. I have just completed 2 weeks with a walking boot, after 6 weeks of plaster, nwb casts. With the boot I can now walk around with crutches. The boot has been much more uncomfortable than tge casts and the pain is greater than it was in weeks 2-6. I am not sure if that is the norm and the result of now putting weight on it. I can wear tge boot for 12-14 hours some days, but have to take it on and off every hour or two other days. This may be related to how much I have been using it. I do have burning on both sides between tge back if the foot and the ankles and the bottom of the heel aches. Luckily no fever or sign of infection. I live 6 hours from the surgeon and won’t see him until May 16. I also received no information about what to d, not do or expect with the boot, hence the Google Search. I will try calling a local physiotherapist or tge surgeon again this week.

I am 6 1/2 weeks post-op for calcaneal spur debridement with Achilles’ tendon detachment/re-attachment with 2 screws. The first 6 weeks were NWB status and at week 6 placed in a walking boot and told that I was FWB 1 hour per day for the next 4 weeks. I cannot bear weight without having a raw, horrific pain in and around my heel. I have only been able to take 5 steps (FWB) last evening after taking 2 pain pills (of course I was using crutches in case I needed them, but the weight was on my feet as I walked). Today during my one hour of allotted FWB status, I was only able to apply about 50-70% of my weight (with the aid of crutches), but I am having substantial pain - raw, aching pain - in and around my heel. I also have been running a low-grade fever for the past 3-4 weeks (averaging about 100 degrees). The orthopedist who performed the surgery says my incision looks good and that there is no visible sign of infection. My general practitioner took blood and urine samples which returned from the lab as normal and negative for infection. Between the level of pain I am having deep in my heel when I bear weight on it and my ongoing low

Hi Donna, I am 2 weeks post surgery and have had just a little numbness/tingly feeling on and off. Was your tendon detached and reattached? mine was not. I would tell the doctors office about the numbness just to be safe. I just got my stitches out today and i have a blister right where a shoe would rub the back of the foot…I come out of the cast in a week and go to a boot.

I am 5 weeks post A.T. debridement. I am now just toe touching the floor in a walking boot and the use of a walker.
Basically its NWB, just 10 lbs of weight on the leg. My surgical site is very tender and my foot is painful and numb.
Feels as if there is a string around different toes at different times pulling the toes. I massage the toes and apply a cold compress to help and am taking a half a oxocodone. My foot has been numb since the surgery especially the bottom of the foot. Any one else have all of this.

originally detached gastrocenimus on 08/26/2012, now after treatments that i call lapsing at best i am scheduled for a left achilles tendon debridement(midsubstance and insertion)& FHL transfer. this is due to a 2 cm by 2,5 cm calcification mid tendon. when i saw the x ray i was amazed to see the gastro with over a dozen small white “stars” that i take to be micro calcifications. if this surgery goes off what is my exposure on using that muscle to rehab?

Rhonda, Im 15 days post op. Ironically my calf is what bugs me most at times too. Im just trying to massage it to relax the muscle.

Heel spur removal and Achilles tendon repair with a speed bridge reattachment and one day post op. I am having alot of burning and throbbing in my heel and calf muscle spasms. Is that common and has anyone else experienced this. I am on crutches and zero weight bearing but I find it hard to not put a little weight as leverage. Any tips or tricks. Could us all the advice I can get while I am laid up. Thanks in advance.

I am 2 days out. And my pain is more of the stretch of the tendon in my calf as opposed to pain where my achilles was re-attached. Another 10 days is this soft cast before the hard cast for 6 weeks then boot for another 6. What can iblook forward to when I go to therapy. For the record that hard cast is gonna kill me. Im sooooo not used to having to sit still. I have 3 children and it pretty difficult tondo anything.

I am 11 weeks post op from this exact surgery. I have been in a walking boot for almost four weeks and have been FWB for about 2 of those weeks. The past several days I have been having a burning sensation around my heel and AT area. Does this sound familiar to anyone ? I have always had some sensitivity in the area post op but this pain has just suddenly come up and I’m wondering if anyone else has had this. I do have two screws and. Two anchors in my heel. Thanks!!!

Ken, my first post-op was 12 days after surgery; the second one was at 4 weeks. By the way, I’m in a Vacocast, and set it at neutral this afternoon — the equivalent of having removed all the wedges from a tradtional boot. My ankle feels better at neutral than it did at 5 degrees. I’m not sure why, but I’m not complaining!

Carol

Upstate2519, that’s encouraging. How far out was your first post-op visit?

Ken, as part of my surgery, I had the achilles detached, Haglund’s deformity removed, achilles reattached, and the Flexor hallicus longus tendon transfered. My OS used bioaborbable suture anchors — which I envision as working like dry wall anchors that eventually dissolve. Sounds like we might be on a similar schedule. My surgery was on 7/31; I was told at my first post-op visit that I could remove one wedge every 3-5 days, and could do PWB as tolerated. I’ve been FWB since the 5-week mark. I go back in 10 days and am assuming I’ll get to go to two shoes then.

Once you’re PWB, your options for physical activity improve; ask about riding a stationary bike and tother kinds of cardio. It may not be what you’re used to, but will help slow the deconditioning you’re experiencing now. Good luck!

My surgery involved upper incision to remove tension on the AT, detachment of the AT from the calcaneous, debridement of large calcification deposit from the AT, and finally reattachment of the AT. The use of metal screws cited in some of the earlier posts was never mentioned by my surgeon, and I don’t think were used. The surgeon mentioned recent advances in the procedure for reattach. I’m 7 days post-op, in a cast, and have had VERY little pain, totally managed by Tylenol. I have been good about keeping the foot elevated, so have not encountered any swelling, even when moving around on crutches. Biggest challenge has been just sitting around; I’ve always been physically active. First post-op visit is 13 days after surgery. Initial plan is for me to transition to a CAM boot at the first visit and to gradually start putting weight back on the foot; keeping my fingers crossed that I’m still on track to do that.

i am due to schedule surgery and am scared. Dont know what else to say. Have been in pain for almost a year. My doctor has only done 4 of this surgery….

I had surgery on my Helios tendon on July 30th, 2012. I was released back to work on DEC 28th, I was always having an burning in my foot like a really hot ice pick sticking threw it. The Dr said it would heal in time. I went back to waitressing which i love doing. well the first day I lasted 5 hrs than my foot swelled up and burned so bad I could hardly walk on it, the next day I tried again and I lasted maybe 4 hrs than the same thing but a higher pain level, I went back the 3rd day and had to leave to go to ER the ER DR thinks my body is rejecting the screws that is holding my tendon in place. Went back the day after and I left work on crutches because I could not walk, 2 days later it still hurts really bad and not been back to work yet…CAN ANYONE HELP WITH THIS?

I had the surgery for removal of Haglunds deformity and a huge bone spur on my heel. I am 32 and very active. I am a 5.0 tennis player and basically quit tennis because I didn’t want to be in pain after I played! I urge you to get the surgery if the doctor says you need it. I am about 5 days post op and I feel better! Good luck!

I had my surgery one week ago. Doing well with leg elevated. If I use crutches for bathroom breaks, I get throbbing pain. Will this go away? I get plaster cast off on June 11 and wear airboot after, non weight bearing.

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I am contemplating the above surgery and I am concerned that I won’t be able to play tennis at the 5.0 level again. Any thoughts? Have you all been able to get back to your normal level of activites after surgery and rehab?

Cast came off 10/4/10 but the screws holes where they reattached the tendon and realigned the heel have been infected and very slow to heal. I am in PT but really feel my progress has been held back to all the inflamation. Is the inflamation normal because I’m walking on it and has little to do with the infection? I never did get to wear a boot because the back of my heel was so inflamed I basically went from cast to shoes.

Maida,

Had reconstructive surgery in September of ‘08 on my right tendon. Debridement/removal of the cacified mass then lengthening of the tendon and reattachment of the tendon with screws. Twenty five months later it’s better than new!

Exactly one year to the day after the surgery, went back to the doc as my left heel was hurting. Doc looked at me as I walked by him on the way to the examination room, smiled and said “back for the left one huh?” He told me during follow-ups from the first surgery that he would see me in a year or two for the other Achilles tendon. Boy did he nail that one! April 20th of this year had the same surgery done to reconstruct the left Achilles tendon! This time with an additional twist as a week prior to surgery I went to see him for pre-op and showed him a bony lump on the upper/inside of my foot. One MRI later doc determined a similar situation going on with the anterior tibialis tendon where it attaches in the foot. So…surgery to correct that, plus lengthening of the achilles, debridement of both, removal of calcified mass on both tendons and reattachment, this time no screws, he dr

Yes it did-and after the Debridement no one is going to dig on me anymore so they better figure out something else

Screws? Why do you have screws? Did the tendon detach from the calcaneus? If you have a persistent infection where the screws are, your body is likely rejecting them. Mine didn’t like the internal suture material.

I has this done 8/5/10 and was in a cast until 10/4/10. Wanted me in a boot for a few weeks and I tried but it irritated me to the point of getting blistered so I chucked that and moved on to shoes. I too have an infection at the point they inserted the screws and after Debridement 10/13 it still isn’t healing well. Started PT same day the cast came off but just this week I’m really starting to exercise it.

Rosemary,
Tell us more about your infection. Is there drainage from the incision? What is the infection? Are you saying you have been FWB since the surgery? Or have you been getting around by some other means, like a wheelchair? Heel pain is very common with this and generally goes away in just a few days.

hi- i am 5 weeks out and had the exact same surgery as you. my doctor says that stationary bike exersize is good now, and that i can finally get a pedicure. i have the boot for another 4 weeks. i never use crutches. my biggest trouble has been an infection that started above the insision.i am on an antibiotic for it, however the recovery for it is very slow and has gotten in the way of healing. my question for you is do you have throbbing heal pain? do you find it more painfull to stand now than in the beginning of recovery? i am a florist and this is really getting in the way of my work !

From Wikipedia; “Debridement is the medical removal of a patient’s dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue.” Debridement is most often done to remove dead tissue. When I had a persistent draining hole at my original ATR surgical site I had debridement done once a week to remove dead tissue caused by the infection. A rupture is when the tendon either completely or partially breaks and repairing a frayed tendon is just that.

No clue here, Maida, sorry. Good questions, though! I think it’s “debridement”, though.

ATRs are one of the slower rehabs around, though, so it boggles the mind that yours might have to be much slower! A sailing friend recently got a replacement (artificial) ankle, and I think his rehab protocol was roughly as fast as mine (which was faster than average here)!

When I had my first ATR done surgically, I think I moaned and stayed mostly in bed for about a week. (I skipped the surgery for my second one!) The desire for less elaborate elevation continues much longer for most of us — footstools, maybe a leg up on a chair or table. . . There’s no prize for being “the best here”, just do what your leg needs you to do!

Boots work better than casts. Check out the link to “ATR Rehab Protocols, Publications, Studies” on the front page here for the evidence. One modern protocol that worked well with and without surgery is reproduced on my blog at bit.ly/UWOProtocol . If your surgeon wants you to be on crutches or in casts longer than that protocol, ask him or her hard questions — like “Why in God’s name?!?!?” The science generally says that quicker rehab produces FEWER re-ruptures, but many docs act as if it’s the other way ’round. A lot of what they learned in Med School has been disproven in randomized trials, poor things!