6 Weeks Post Op from Achilles Tendon “Debriedment” and bone spur removal

Hello dear comrades!

Oh how I love this site. It got me through my first week in bed with my leg up, the crutches, and now I am walking in a boot….My Doctor is amazing…but conservative (Red Sox Doc etc..) I love him….but he said “no” to the pool or stationary bike. I am going out of my mind. I guess my 10 Boston Marathons have taken their toll. I am to be in the “boot” for 4 more weeks. I am in the pool doing laps¬†without kicking (assume he does not read this), and lifting weights. But I am worried about how much I walk without the crutches and so forth……I never walk without the boot and barely put my foot down in the shower.

Can someone tell me how “debriedment” and repair of a frayed tendon might be different from a rupture? Am I risky or should I be doing more….?

Best to all!

Maida at Mass General

29 Responses to “6 Weeks Post Op from Achilles Tendon “Debriedment” and bone spur removal”

  1. 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)!

  2. 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.

  3. 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 !

  4. 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.

  5. 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.

  6. 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.

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

  8. 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 drilled a tunnel in the heel and threaded the tendon together through that. Nearly seven months later (both recoveries included 2 weeks in a soft cast, 4 weeks in the plaster non-weight baring cast and another 4 weeks in a boot with partial weight baring moving to full weight baring as I could do it.). Anyway, seven months later, doing well, still a bit stiff but range of motion is good and an occasional bit of pain to remind me not to be too stupid!!

    I guess what I learned from all this is that your body will certainly tell you what you can or can not handle. The rest of it is the mind game! Can I do it? Can I do more? Why can’t I do more? Is this pain normal? After knowing what to expect from the first surgery, it was interesting to feel the difference between the two. Recovery time has been almost identical but the pain from the get go, meaning after surgery, was more intense with the second surgery. The body is a fascinating machine!

    Good luck to you. Sorry for being so wordy!

    Pat

  9. 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.

  10. 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?

  11. 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.

  12. 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!

  13. 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….

  14. 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.

  15. 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!

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

  17. 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

  18. 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!!!

  19. 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.

  20. 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.

  21. 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.

  22. 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?

  23. 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.

  24. 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.

  25. 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-grade fever, I am concerned about a bone infection. My orthopedist did debride a significant amount of my calcaneus, and he did use 2 screws in the calcaneus when he re-attached my Achilles’ tendon. I had been down to zero pain pills before my 6-week post-op appointment, and now today I have taken 3 pills due to the pain. I have to admit that my orthopedist has not been very forthcoming with information on the details of what to expect after surgery. The literature they handed to me pre- and post-op has been very bare bones about what to expect. Any insight out there as to whether this might be a bone infection would be appreciated. Has anyone had a similar constellation of symptoms who could offer some advice? Does this sound like a normal course of events after this surgery? Any and all advice is welcome! Thank you.

  26. 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.

  27. 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?

  28. 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.

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