Newbie with a re-rupture!

Hi everybody, thanks Dennis for a great website on this subject, it’s been a massive help to me with advice and positive comments after my initial rupture.. And as I’ll explain I’ve just had a re-rupture, so I thought it’s high time I tried to give something back if I can to anybody going through this hideous injury!!

My short story is I’m UK (London) based and I had a first rupture on July 12th 2010 playing tennis. I was given the option of surgery or the conservative route and opted for the surgery, reasoning that I’m very active - into climbing/mountaineering, running, trekking, weights etc. This seemed to be going fine ( I was into shoes) until I stepped onto a kerb I didn’t see in a dark underground car park on the 06th nov 2010! This blew the Achilles again with a lot of pain and splitting the op scar tissue at the bottom with bleeding..  initially I convinced myself that the pain was just skin adhesion giving way. But I had it confirmed a few days later when I saw the consultant and she sent me for an ultrasound immediately (pretty good for the NHS!) When it was confirmed and I knew I was back to square one after 4 months I hit rock bottom!! Then bounced a bit after thinking it actually can be worse!!

I am now writing this having just got out of hospital having had my second surgery 2 days ago. This time the consultant has grafted a tendon from my big toe onto the achilles to strengthen the job (I think it’s the same procedure as beckham had) so I’m happy with this if it’s good enough for him!!

I’ve got the full plastercast on for two weeks and back on crutches non weightbearing again. Initially I had a lot more pain after the surgery but now it seems to be pretty numb?

One thing that did go through my mind from my first recovery is that I was still limping badly after 4 months and the flexibility and strength seemed to be taking a long time to get back. Now I don’t know if this was caused by skin adhesions which the physio was mentioning, or if the initial surgery was a problem?? It just seemed to be taking longer than a lot of others on this site.. But that won’t matter now anyway!

Just want to say try and stay positive through this, it definately is a mental aswell as physical trial, I’ve been through some dark times with it but just have to think it WILL get better and I WILL run again!!

Any comments welcome, and I’d appreciate any advice or comments on power/vibration plates with recovery?? I’ve heard its a new treatment and will be asking the physio about it but was wandering if anybody had tried it?

Thanks, Mark  :)

17 Responses to “Newbie with a re-rupture!”

  1. Good luck, Mark. You seem to be winning the mental game, which is half the battle!

    Check Doug53’s blog for some info on vibration. He used it as part of his blisteringly fast self-administered “bad patient” post-op rehab, which he describes in clear detail.

    The Canadian and UK systems aren’t identical, but when I opted for ATR surgery in late 2001 (first leg of two!), I also was allowed to “jump the queue”, ahead of a bunch of knee and hip replacements that weren’t considered as time-sensitive as an ATR repair. (This second time, I skipped the op, so nobody’s joint replacement had to be delayed! :-) )

    If you can talk your Docs into a boot instead of casts, and a modern fast protocol with early (gentle) exercise and PT, you may find that the mental game AND the physical game both go better.

  2. Your post sent a shiver up my spine, I can’t think of anything worse than getting so far and then rerupturing. Tricky things - kerbs,that’s how I did my AT. I hope that the consultant discussed your treatment and rehab programme, if not I think you’ll need To go to your next appointment armed with a list of questions plus examples of the treatment protocols found on this site.
    Good luck and I hope you keep your positive attitude.

  3. Mark did you have your toe tendon grafted into your achilles ,not seprate acting tendon.
    did they remove your toe tendon ,or only part of it ?

  4. Hi normofthenorth, thanks I’ll have a look at Doug53’s blog for info on the power plate stuff, I’ve been taking it pretty easy today (3 days after op) got the leg up and have just started taking a herbal supplement - Arnica for help with the swelling and healing and high strength omega 3 capsules. I’m not usually into any of this sort of stuff but my thinking this second time is surely it can’t do any harm, and there’s every evidence it will help so i’ll try it…

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  5. Hi southafrican, the surgeon has used the FHL big toe tendon, forgive me if I’m a bit light on the details at the minute but I didn’t get that much chance to chat to him about it beforehand, and the last few days have gone in a bit of a blur!!
    From what I gathered he’s folded the FHL tendon back on itself to then graft onto the achilles, so I’m thinking he must have only made one cut on it and kept one side attached?? He definately didn’t mention taking the whole toe tendon off.. Also he was going to use the same incision as the first operation, but I can’t check anything scar wise at the mo due to the cast covering everything. Hope that helps, and I’ll let you know more as soon as I find out!

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  6. Thanks teresa, good idea with the list, I’ll take that on my next visit in a fortnight. Where abouts in the world are you??
    I’ve noticed that here in the UK, the system seems to be really lacking in any discussion time spent with the surgeon/consultant. They just seem to be too busy, I think there’s a real danger if you’re not a pro-active patient asking the right things at the right time, you can get left behind with treatment sometimes.
    The first time the ATR happened I pretty much had to work it out for myself after the op, when I had my cast removed and got my aircast. This was as the consultant told me what to do in ten minutes at the same time he was taking out the stitches, and nothing was written on notes.. It was pretty much take out one of these wedges every fortnight and I’ll see you in 2 months!!
    Yes kerbs are a new hazard to me now, I look at them differently, how about you?!

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  7. i agree with teresa, reading your post gave me a wake up call.
    so sorry that happened to you but as you say if its good enough for beckham …..

    is it safe to presume that had your tendon not been repaired 4months earlier that this step on the kerb would have resulted in nothing ?
    makes you think.

    good luck and take care

  8. Hi Phil,
    Sorry its taken me a while to reply! Yes you’re right my tendon must have still been in the healing process when the re-rup happened, if it was normal and healthy the kerb would have resulted in nothing.. I just really wanted to tell everybody going through this to be extra extra careful when venturing out initially in shoes. Try and keep 110% concentration on where you are putting your feet every single step. I thought I had been but I must have let it slip for a few seconds, and it was quite dark!

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  9. I’m now 2 weeks 2 days after my re rup surgery. Apologies to everybody who’s put posts on here. I replied to all of them but I’ve just worked out I needed to approve them to publish them!! Hopefully all sorted out now?

    I had an appointment yesterday at the hospital to get my fixed fibreglass cast off and stitches taken out. I was hoping that it would be the same procedure as my first rupture, and they would get me into an aircast boot with four heel wedges. However, on speaking to the doctor and going through my surgery notes it was apparent they’re going to be a lot more conservative this time.

    The situation now is that they want me to be completely non weight bearing for another 6 weeks. So I’m back into a new fixed cast and not the aircast.. Must say I was quite downhearted initially on hearing that but I’ve reasoned it must be for the best and the surgeon has an excellent reputation. It seems like they’re using a mixture of surgical and non surgical after care procedures? It is going to take longer by at least 6 weeks by my reckoning, but I’m ok with this now. I just obviously want to have the best chances of success!

    The good news is that the wound looked like it was healing nicely, and I found out a bit more about the surgery (for southafrican who asked!) they did cut the big toe tendon in one place only and then attached this by.. (this bit sounds a bit pre historic!) drilling a hole and fixing it I think onto the achilles, or is it the bone??

    I saw my physio yesterday too, and she gave me some limited exercises for my hip and knee to keep them moving. She also sat me down and went through my re-rup ultrasound results. They weren’t too good, and showed multiple tears going along and up the achilles and scar tissue that had caused the tendon to thicken quite a bit. The re rup tear (worryingly!) looked like it had happened underneath the initial surgical repair. So I’m still left wandering if it had been healing properly or not?? Everybody at the hospital is saying it was though, and that it’s just this injury that takes so long to heal?

    Anyway, really heavy snow here at the mo so I’m not even going to try and get outside. I’ve just ordered food shop online for delivery tommorrow - how did we get by without the internet!

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  10. By the way I’ve bought a shower stool from Amazon that I would highly recommend! It makes my life a load easier for showering, its very sturdy and adjustable. It only cost £25 with free delivery which I thought was really reasonable :)

  11. I, too, have a shower stool… WHEW! What a big help it is!! Highly recommended!

  12. Hey Mark,
    Happened to see your story about tripping on a Kerb, I did the same thing ( mine was a curb) but was 8 weeks into non-srgical rehab and had just started venturing out without my walking boot.
    The second time definitely required surgery. I am 5 weeks post surgery, and in my second hard cast. I am hoping to be in a walking boot after two more weeks. I read many of these posts and think my Doc is being too conservative, but then I think, he is the ankle specialist and I should stick to his advice.
    Hang in there and keep getting better. Greg
    Heads up to everyone - please be super careful when walking with two shoes.

  13. dude keep your head up im kyle atr 4 months ago, got my no restictions realles from my doctor yesterday he doesent know how i did it and i told him LDS blessing

  14. Hey Mark, I gasped in horror as I read your post. I am so sorry that you had a re-rupture and am in awe of your equanimity. Keeping this sane perspective is a massive benefit I’m sure and I hope lots of people take inspiration from you. I am certainly being massively cautious as a friend of mine did exactly the same thing as you at 9 weeks - he tripped going up the stairs indoors though - it can clearly happen at any time! Glad to hear the NHS were good. They put me into a cast for 12 weeks and it was only because of this site that I realised i could do something different so have been in a boot since day 10. At least the weather is making it easier to stay indoors and take it easy! Very best wishes on your recovery.

  15. Hi Mark it does look like you had the same surgery as me.Big toe tendon cut of side of foot and attached to your heel bone .(Through a hole drilled into your heel bone )My surgeon went to the latest Achilles tendon conference ,the main speaker was Prof Bill Ribbens from the U K (He alluded to operating on David Beckham)He does as standard procedure the toe tendon operation on all athletes accept long and high jumping athletes.
    The 6 week NWB is because it takes that long for the bone to fuse on the toe tendon

  16. Thanks all for the positive comments and support.
    I’m sat here (Christmas eve!) with my leg still in cast and rested on a stool, not much has changed in the last few weeks, I’m still taking it easy until I get this hard cast taken off and into an aircast.. Hopefully about Jan 15th 2011.
    The weather here in UK has been horrendous, with snow and ice everywhere for weeks. I’ve discovered this all takes on new meaning and worry when I’m thinking about venturing outside on crutches to get things.. Had a couple of little slips on wet shop floors but nothing serious. I’ve thought if I do fall anywhere - just to keep drilling it into my mind not to try and break any fall with the bad leg, and just fall over!.. maybe easier said than done!! I’ve also just had to replace the rubber ends of my crutches as they had worn out and had split!!

    Merry Christmas all - best wishes and healing for the New Year,

    Mark :)

  17. Glad to see that you’re still making progress and keeping your sense of humour. I complained about wet leaves and crutches, but snow and crutches sound a horrendous mix. Take it easy, you don’t want any setbacks now. In reply to your previous post, I am very wary of kerbs and you have to be pushy to get answers in NHS appointments, I was so angry at this doctor walking away from me mid question, I was NWB at the tine so couldn’t go after him. I insisted on an appointment with consultant the next time and brandished my list of questions. I have to say that physics are often better at explaining things and giving advice on everyday matters.
    I’m in deepest frozen Surrey

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