2 Months Out…Quick Recovery
I found this website just this past week and wished that I had stumbled upon it earlier.
My Story:
I decided to get my lazy butt back in shape around christmas of 2007. I went on weight watchers and began playing basketball 2-3 times per week. Things were progressing fabulously through April. I had lost 35 pounds and was in the best shape that I had been in 10 years.
Then, it happened. I was playing basketball at my regular Monday night pick-up league, which was one of the 3 nights that I played. I dont remember if I was going for a rebound or going back up to shoot and I heard the loud “pop” that everyone hears and said “what the @#$@ was that?” The guy next to me said it was you. I got up and couldn’t walk right. I really wasn’t sure what had happened, but it felt like my left foot was standing on a downward ramp, and I could only walk on my heal. The thing that surprised me the most was that it really didnt hurt that bad.
I went home and looked on the wonderful internet and figured out that I had ruptured my achilles. This was April 14th, 2008. I went to the ER that night and they confirmed the self-diagnosis. They made me an appt with the ortho who was with the Michigan State Univ. sports med department and I had surgery 2 days later. I had the worst pain that I had ever experienced a few hours after surgery. The heavy dose of vicoden only made me loopy, but didn’t help with the pain in the achilles. The doctor prescribed Keterolac, which is an anti-inflammatory, and this gave me instant relief.
The main reason I wanted to post here was to give some hope to those that are just going through this. I’ve read that there are some real long recoveries, but mine has been pretty quick. I am just over 8 weeks from surgery, and I was cleared and played my first round of golf on Friday. I was fitted with the boot immediately and woke up with it on from surgery. I had to leave it on at all times until my first post-op appointment. I was then allowed to take it off when showering. I crutched it around for about 3 weeks. However, when I was at home in a safe environment I would begin walking without the boot around 3 weeks out, and began going to rehab. No I did not have the ok to walk, but I dont have a lot of patience and I was feeling pretty good.
After 3 weeks of PT, things were progressing very well. I was walking more, but still wore the boot when I went outside. I was able to do calf raises and do wall stretches of the achilles. A few days after that and I ditched the boot. It was killing my back and my right hip and I just couldnt take it anymore. I got chastised by my physical therapist, but it was worth not wearing that darn thing anymore.
I went to see the doctor for my 2 month check-up. He was very impressed with my progress and said to keep doing what I had been doing. He said to have PT work on strength now. At the end of the appointment I said “Doc, when can I play golf, because it’s killing me to not play.” He told me that I was fine to play and I was pumped. I played golf that afternoon and shot 42. Not too bad considering. It is hard to get me weight onto my left side right now, so I hit a little fade, but it will come.
It sounds like the people that are put into the cast and then switched to different angles and different cast are working with an “old school” doctor. My doctor is younger and did the boot, this allowed me to progress as fast as I have. Everyone keep their chins up and you can make it back. I am no where near 100%, but I am real happy with where I am. I will be playing basketball again probably in November or December. Thanks for reading.
54 responses so far
You have made great progress. my doc won’t send me to PT until boot comes off - at around 11 weeks. I walk at home without the boot, but not confident to go outside or on stairs without it.
Keep up the great recovery!
I just ruptured my achilled playing soccer. The pop sound was heard by several players and I am now trying to decide if I want to get surgery or not?
If you have any thoughts of playing soccer again, I would have the surgery. My doctor told me that with the surgery, there is only a 3-5% chance of re-rupture, and I will pretty much be back to normal in 6-12 months. Also, find a doctor that doesnt put you in a cast. Some will put you in the boot from day one as mine did. It sounds like that is the quickest recovery.
Good Luck!
Tennisjunkie-
It sounds like there are a lot of doctors out there that are like yours. I think I just got lucky and got a younger doctor. He had also worked for an NFL team before coming here. So I think that he looked at me as an athlete and tried to get me back to that stage as quickly as possible. Just let pain be your guide. If it hurts, dont do it. That’s what I did. Oh, and watch where you are walking.
mbots, I am very interested to know what boot your doc gave you. Was it VACOachill (vacocast.com) which allows earlier weight bearing and PT?
I too am very pleased with my recovery. I am 8 weeks post op and now am into two shoes. Limpy sure, but my ortho said I will not re-rupture unless something really unusual happens. I attribute my rapid recovery to the Vacocast and the ability to move my ankle after the first three weeks of plaster cast. My surgeon was skeptical but . . . I persisted and at times bargained and pleaded for my own recovery protocol. This was my second rupture (I tore my right achilles 7 years prior and re-ruptured it because I was too aggressive in my recovery - non casted) so I was very cautious about going too quickly. Would recommend you order the day after your rupture so you can take with you to the surgeon. Worry about insurance later, the 3-6 weeks of additional freedom from casting was definitely worth it to me. I have a vaco if anyone would like a slightly used but in great condition cast.
I’m feeling like a wimp! I am three weeks post op and I can’t even imagine putting weight on my ATR leg! I am in a boot that has my foot point down still and won’t start “dialing” my flex angle for another week! I tore on May 21, 2010 and I am expecting to start PT by late August. It’s my goal to start training in November for an event in say Feb? I have no idea it the event will be a 5K or a 26.2 at this point, I just need a goal and I need someone to tell me it’s gonna happen!
Julie,
First of all let me highly recommend, strongly encourage you to get your own blog. Just click on the link at the top of the main page that says “Create your own blog.” It will be much easier for you to get questions answered and get feedback on your own blog rather than using someone else’s.
You’re in a boot now but not starting PT until late August? That’s ridiculous. There is no reason on earth for you to wait that long to start PT. I had surgery on August 3, stitches out on August 11 and my first PT appointment was less than a week later. Things went downhill from there but that’s another matter. The fact was that was standard procedure with my surgeon. If your surgeon is saying he/she doesn’t like to rush things, there is a wealth of information on here you can use to set him straight. Remember, it is your body, and you have the ultimate say in what happens. More than once I have had to tell a doctor “No, I am not going to do (insert procedure here.)” They are not used to patients actually researching and finding out what does and doesn’t work. You will get his/her attention if you go in armed with facts.
hi julie am seven weeks post op and i went to see the doct today i been walking with the boot full weight bearing after my six week . an walking without crutches . basically as weeks go by your body is gonna push you . to try something new , just lisen to your body just dont overdo it . but keep moving get your blood going. it’s a rollercoaster
Julie, I’d say “+1″ to Gerry’s comments about studying up and to taking some (most?) responsibility for your rehab protocol. If you haven’t been doing gentle unweighted mobility exercises, out of the boot, while keeping your ankle plantarflexed, toes always below “neutral” or 90 degrees, that should be a harmless place to start. (This from a NON medical practitioner, though one who’s gone through TWO ATR rehabs, having torn both of mine playing the same sport, at 8-year intervals!)
Like Gerry, I started PT at 2 weeks “in” — which in my case this time, meant 2 weeks after I did NOT get surgery, because I didn’t!. And you can find the exact protocol I followed — which produced excellent results in a randomized study, on BOTH post-op patients and “non-op” patients — at achillesblog.com/normofthenorth/the-non-surgical-protocol-ive-been-following/ .
Also like Gerry, I’m fond of solid scientific evidence when I make important decisions like these, and you can find a lot of discussion of scientific studies on my blog, achillesblog.com/normofthenorth . On the other hand, I’m not sure there’s much solid evidence that PT actually produces superior results! Early-ish mobility and early Weight-Bearing have been tested, and both seem to help. PT at its worst can definitely do some harm (been there, done that, though that was all after my FIRST ATR!). I’m sure it usually does some good (and it usually feels good, physically and emotionally), but I don’t think anybody’s proved that yet.
It’s part of “my” protocol, though, and that protocol produced good results in a big study (and for me and a few other folks “here”), so it’s probably a Good Thing and worth doing.
But at 3 weeks, PT is a pretty gentle thing, consisting partly of very gentle massage and partly of the application of a series of (mostly untested) gizmos like Interference Current, lasers, and Ultrasound. Some ATR patients are just told to take off the boot while sitting cross-legged and “spell the alphabet” in the air with their big toe. I’d love to see a randomized study that compared THOSE two groups, and I’m not sure I’d bet big bucks on the PT group!
Julie, if your boot can be “dialed” instead of just having internal heel wedges to tilt your toe down, then it can probably be set (later) to hinge, so your ankle can flex downward while the boot is still protecting it from flexing upwards. If so, congratulations, because I think (and so do some studies) that that sort of hinged boot is a Very Good Thing! (One of the studies that’s linked from the front page here calls hinged boots “Functional Orthotic Braces” or some such phrase, and says the data shows they help a lot — and some of them are letting the boot hinge starting right after surgery(!).
Good luck and good healing, and start a blog of your own!
I completely ruptured my Achilles on 5/10/10. Had surgery on 5/13. Went into a walking hard cast and although it was very tight almost immediately started flexing my foot up and down. I was in that cast 3 days shy of a month and they put me in a walking boot. After the first day in the boot I was able to walk quickly in it. When I was home, would remove the boot and very carefully walk around the house. My first physical therapy was today, 7/8/10 and my therapist was in awe how much i was able to flex me foot/ankle. I guess all the self flexing and the fact that I gingerly walked so early on my own helped me strengthen my tendons. The therapist said I was so far ahead of the curve. I had an amazing surgeon but I’m glad I moved it as much as I did prior to therapy. Less than two months from rupture date and I can walk around with or without my boot. Outdoors I always wear the boot though. My surgeon said I completely shredded my tendon and for me to be so far along I’m just ecstatic! Good luck all!
Willian, are you walking NORMALLY in bare feet, or is there a gimp/limp/dip in your stride when it’s time to push off with your healing foot? If you can walk normally, at 8 weeks, you’re close to the Gold Medal! Otherwise, if you’re just starting to wean off the boot at 8 weeks, you’re on the schedule I followed without any surgery — posted at bit.ly/UWOProtocol . That protocol produced excellent results for surgical AND non-operative patients (see the studies discussed at bit.ly/achillesstudies ), so I don’t think there’s any good reason for anybody to go any more slowly.
Is your boot “fixed” or “hinged”?
My first ATR (late 2001) was also repaired surgically, and my surgeon told me the tear was unusually messy (”like two horses’ tails”), and it recovered just fine after a much-too-slow rehab.
Do “watch your step”, though, because you’re probably just starting to go through the scariest highest-risk month for making a false step and re-injuring (or even re-tearing) the thing. A few of the re-ruptures here were on top of the world just before they blew it, so do be careful.
I had a fine surgeon in 2001, but I reserve the term “amazing surgeon” for the few that have read the new studies and figured out that it’s better NOT to give their patients ATR-repair surgery — like the amazing surgeon I found this time, in Dec. 2009!!
P.S. Start your own blog page, instead of tagging your notes onto these old blogs by other folks!
I’m 2 weeks post surgery and wanting to know if I can play golf with my boot on? Can anyone tell me if its gonna cause further damage if I do?..I cannot stand not able to play golf.. please help
Oct 21, 2011 I ruptured my left Achilles completely, on Nov 5th, 2011 my right Achilles ruptured completely. Nov 10, 2011 I had bilateral Achilles repair done. I am still in a rehab center. Talk about a complicated and long recovery. Right foot infected at surgical site so am still trying to get a one inch hole to close now for over a month. I took my first steps on the paralel bars 5 days ago. What a crazy time. Telling you all this because you need to know dealing with ONE should be cake!!! Good luck to all of you.
http://www.facebook.com/video/video.php?v=592440388265
Thanks for the blog man, reading this made my day! I am 7 weeks post-op and have been walking around the house without the boot and doing some self administered rehab when I can and reading this helps my confidence that I might be hitting the links sooner then I expected!
I exploded my left Achilles playing soccer (age 47). I live in Trindad and Tobago and am US Military. I had surgery 6/21/12. Had boot for one week and then post op, remove suchers and put in cast. I wore cast for 7 days and decided I couldn’t live with it, or fly back to Trindad with it. I cut it off and have been in the boot since. I ditched the crutches immediately and started weight bearing in the boot. i take the boot off in evening and walk around house w/o bending ankle past neutral. No problems. Time to go back to doc and get a referral to a PT.
I ruptured my Achilles and had surgery to reattach it on July 7th, 2012. I am 73 years old and very athletic. I am now 7 weeks post op, and I am playing 9 holes of golf every day. I am still wearing my boot, but having no discomfort. Three times a day, I take off my boot and raise and lower my foot 20 times. I have very little swelling, but I do have some ankle stiffness, but will start therapy once I am at 8 weeks. I am a low handicap golfer, and playing golf in my boot takes a little getting used to, but I am able to hit the ball as far as I could before, but not as accurate. I expect that to improve and I also expect to make a complete recovery.
I am now 9 weeks out. I wear my boot to play golf, and play 18 holes every other day, and have started my therapy. I shot a 38 on one nine last week. My ankle is still quite stiff and it gets swollen around the incision, but tomorrow my massage “terrorist” will start to deal with that. I put a heel lift in my tennis shoe and now I walk normally but carefully. I feel the important thing to do right from the beginning is to make sure both feet are of equal height when you first start walking in your boot. I got a sore adductor muscle from being lopsided and the therist told me it happens all the time. I have since corrected that and it is much better now. More later….
I love reading these golf stories. I am now one month post op and was in a splint for 2 weeks and then a cast for the past 2 weeks. I am hoping my doctor will give me a boot today so i can start PWB better than I did with the cast and walking shoe. I really miss golf. I went and bought new wedges and a 4 wood while I was on bed rest. I just now started feeling strong enought to rest my bad leg behind me on the couch and balance with my good leg to practice putting.
Thanks for the blog. I was questioning my doctor because after surgery I was put into a splint for 4 days then into the walking boot. I’m just a week from my ruptured achilles tendon surgery and will be in crutches for another week. My doctor tells me after 2 weeks I can start bearing some weight. After reading many blogs I was thinking my doc was going too fast. Hopefully this is the new post op recovery method.
No, not Tooquick. Often the boot is on for 2-4 weeks (have seen 12+!) but some go straight into boot, and no reason why not if you have the right type. You’ll be weight bearing at about the right time although we all vary a little (and some are very sensitive, depending to their specific injury or treatment). Your specialist so far seems to know what he or she is doing and is confident enough to follow the newer protocols. I am now at 30 weeks and followed a pretty quick protocol too, as did many other successful recoverers, surgical and non-op.
Norm has added a useful link further up this page, worth reading.
Take care and be confident but not careless.
Tooquick
I made a mistake and said ‘boot on for 2-4 weeks’ - I meant the cast for for 2-4 weeks or more. You are doing really well with an early boot!
H
I am 2 days post op and was wondering how long ill need bed rest? I have a splint now and in 2 weeks will get a cast for at least 2 more weeks the Doc says.
Yes it gets better each day. That’s a nice way of saying it hurt the most right now. Don’t try and be tough….take the pain pills for a few days. You’ll sleep better and generally feel better. See notes on cast. Make sure leg is a bit swollen before you get cast. You’ll know what I’m taking about with splint over next few days.
I stayed at home for five days and was then out and about. Be careful and keep leg p whenever possible. When you get your splint off (and if you’re brave, I wasn’t) you can see incision and you’ll know why it hurts.
Remember, every day gets better!
Good Healing,
JL
Man, ruptured my right playing pickup basketball also. Happened so fast I didn’t realize it at first! About 3 weeks out right now and trying to work I. My patience.
Hi guys, need HELP. I’m currently living in Bogota, Colombia. It seems the process here is a little old fashioned… I got surgery yesterday and am now supposed to were a cast for two months! The weight of the thing is killing me. I want so bad to go and get the boot regardless of what doc says. Any thumbs up???
didn´t write my name sorry… i’m the one that started out “Hi guys, need HELP”I’m Daniel!
Hey Daniel,
I just recently underwent surgery on my right achilles. I can tell you that I did tons of research after tearing it, and one of the notes I captured was that you shouldn’t be wearing a cast for months. The reason being is that your calf may end up being weaker due to the pressure of the casting. That is why most doctors now-a-days remove the cast 8-10 days after surgery and into a CAM Walker (aka: Boot) in order to a) prevent any weakness in that muscle group area and b) to allow the patient the ability to move with limited motion, which then makes it quicker to attend PT. So yes push for wearing a boot instead of a cast.
I am also taking some vitamins (A, B12, and C; I was taking E at one point, but the Doc said not to take it just yet) to stregthen my tendons. I don’t think it will make a significant improvement, however it depends on how your body reacts. Everyone is different, and I hope to be walking on my two feet after PT.
Will
I am at 12′weeks post-op and can bear full weight with my boot on. I am about ready to give up the walker and have a doctor’s appt. this week. I am surprised that he hasn’t had me start P.T. yet and will push for that to start. I exercise the foot every everning with the boot off and walk around a little bit w/o the boot. I still get quite a bit of swelling if I am on my feel too much. My concern is sharp prickly feelings around the incision site some of the time. Any ideas about what is causing that? Also, there is one tiny place in the incision that looks like a small indention—worrys me that it’s a place that hasn’t healed.
Wow Joan, 12 weeks with the boot on? I am at 4 weeks post-op and walking already with the boot. Actually I can already walk without the boot around the house and have been slowly walking up and down the stairs. Although I walk with a little skip because of it still healing. I just scheduled my PT so hopefully that will help immensely. Those sharp pricky feelings are your tendons still tightening. I have that pricky sensation on the upper portion of my foot but the doc told me it is still the tendon healing. The small indentation is the tendon still trying to strengthen. My recommendation would be to start PT and see how that goes.
Will
Hello, I ruptured my achillies in August of 2012. I finally had my surgery March 7, 2013…..delayed due to a mis-diagnosis by a doctor. I visit my surgeon tomorrow (march 20, 2013) to have my splint removed. I am generally feeling pretty good, but I have started slowling walking on it yesterday without my crutches around the house. It is not painful and I wonder if anybody knows if I am damaging it in any way? Being immobile for two weeks is driving me crazy. I als wonder if I can be put into a walking boot or will he put me in a cast tomorrow? Any information you have would be greatly appreiciated….
Mike.
I’m not sure anyone can tell you without knowing the details of your surgery and condition. I know my doctor was going to start early weight bearing but changed her mind post-surgery due to the complexity of the repair. Also, this is a time when you need to be super cautious to avoid re-rupture. Typically, after the sutures are removed and if the wound looks good they would put you in a boot.
Mike, the only good reasons NOT to get a boot right after surgery are (1) if you’re irresponsible, or 12 yeRs old, you might take it off and start walking and rerupture, and (2) Most surgical incisions ooze fluids for a week or two, which would soil the boot liner. (Some folks get two liners so they can switch and wash them.)
There are some people here who’ve gone to PWB sooner than 2 weeks post-whatever (op or non-op), and to FWB sooner than 4 weeks. But they’re pretty rare, and I can’t recall a good-sized study that established that going that fast didn’t do harm. So you’re kind of in uncharted waters. Maybe you’ll do OK (like Columbus!), but maybe not. For sure don’t be confident, and Watch Your Step. I recommend that people read and learn the schedule at bit.ly/UWOProtocol , because it produced excellent results in ~150 patients (1/2 op, 1/2 non-op). If you’re going slower, you’re probably wasting time; if you’re going faster, you’re likely at risk.
Thanks Lisa and normofthenorth, I just got home from my post-op. The Doctor said everything looked good and gave me an aircast. He said I am able to walk on it with the use of a crutch or cane. Unfortunately, this boot is causing me a lot of pain while walking on it? Possibly because my foot is flat inside and when I was in my splint the heel was elevated? Thanks, hope to hear back…..again
Mike
It is my second day on my walking boot. I’ve had it off more than on and it’s awesome today. I am gently moving my tendon with and without pressure…up and down and doing rolling all around. I may be crazy but, i am a firm believer that early mobilty is key. It feels all itchy inside and when I rest….I feel nothing. When the boot is on I feel pain but not like yesterday…..An accelerated recovery (my opinion) is key. I booted up today…went to the beer store (Canadian Brother) Had my Surgeon fill some papers for me and drove around smiling! I may be that asshole pushing it with impatience…..but who waits for it? By all means and not taking my words seriously….let your body do the talking….If it don’t hurt then move it if you can groove it and groove it it you can move it!!!
It might help to put some heel wedges or something that raises your heel in the boot. At 2 weeks you’re still healing interally (and externally) and I’m pretty sure you don’t want to go through the surgery again. There’s a difference between early mobility and taking unnecessary risks!
Not everyone can have an accelerated recovery. The most important factor when it comes to how fast or slow you go is how the incision is healing. I’m 3 weeks post op and still non weight baring and will be that way for possibly another two weeks. This is because the incision hasn’t healed completely and the worse thing you can do post-op besides re-rupture is tear your incision. So everyone heals differently. Some heal fast, some heal slow. So people, for the love of God please just follow your doctors advice. It will be less likely that you do more harm that way.
M/30/5′9″/160lbs pre-op
M/30/5′9″/155lbs post-op/current
Active lifestyle: Train 4-6 times a week in cycling/jogging/swimming/karate
Hey there! I got an ATR on March 23rd, did full open surgery method on March 24th, was placed in a soft cast with splint. Did not do general anesthetics, opted for spinal and watched the whole operation. Kept foot elevated for first couple of days to control swelling, by the start of the 2nd week, all the swelling was gone. No itch, no pain. Did some simple exercises with my leg and toes, but NWB.
On April 9th, I got my follow-up (roughly 2 weeks post-op), got cast taken off, and doc said my wound healed up real good, and gave me a FWB boot with 2 wedges, told me I don’t need crutches to start walking on it, but I am not confident in my ability quite yet, so I am weening off the crutches slowly. He told me to take off the boot everyday a couple of times to let the leg breath and to stretch out the calf/foot.
Instructed me to remove one of two wedges at week 4, and the final wedge at week 6 post-op, in which at that time, I have my 2nd follow-up. By then, my foot should be walking at 90 degrees - and I believe he hinted that I will begin physio and exercise then.
Definitely very aggressive doc, when he took my cast off, he cranked my foot at 90 degrees right out of the gates, to which I yelped in pain (it was a sore, tight pain, not a rip or anything). I told him WTF. Then he let it go again, and cranked it again - he told me the achilles is already reattached and repaired, it’s just tight, and told me I have to work towards getting the flexibility back. I am being careful.
I have been massaging my leg, and stretching my foot, and rolling my foot about to gain flexibility. Woke up today, can WB with no pain or soreness. Was a good night’s rest. Will let you guys know how I progress.
Wow Ernest sounds frightening, but great to see you survived good recovery
Rrr
Wow. I did not realize people still looked at and read this blog. I haven’t been here in quite some time. I hope everyone is doing well in their recoveries. It’s been 5 years since that fateful night playing basketball, but all is well. I still play basketball once or twice a week and have had no setbacks. I always tell people I am glad I tore my achilles rather than blow my knee out. My brother is 4 years younger and blew his knee out in high school and it’s never been right. Good luck everyone in your recovery.
I ruptured my AT yesterday and now on the long hard road to recovery! I am determined to come back 100% or better than I was. Ive read all the horror stories online about people taking 12 months to recover and not even fully. Well, I don’t intend to be one of these people so the first story in this blog has been a good find for me as there not many fast recovery stories out there with an ATR. Good to read other success stories here too. I’m only at day 2 but feeling very optimistic about it. I am trying to turn negatives into positives. So far so good.
Early rehab seems most predictive of fast and effective recovery. Even more predictive than surgery vs non-surgery options. Issue is risk reward on multiple levels. Too fast too soon increases risk of re-rupture and inadequate healing. Too slow, reduced blood flow slows healing process, results in weaker tendon and atrophied calf muscle, which together actually increase risks. Like a bell curve. Recent research seems to be moving optimum point further to the left on curve. Given insurance issues and profits, surgeons more inclined to avoid the worst result-re-rupture, than to max recovery speed. Same issues with surgeon’s bias toward surgical option. It’s where the money is, though rehab services are very high margin. But a surgeon is born to cut. I opted for non-surgical because of my own bias, no money, and it was a fortuitous forced choice. Rupture my left 20 years ago, had surgery and it was brutal. Felt it was butcher job, but just the nature of the surgery in that location. Rupture right achilles 2 weeks ago pop Not as painful as 1st Now 2 weeks into non-surgical rehab for my right, and it is amazing. Iced and immobilized with rom boot 20 degrees plantar immediately. (I had kept my boot & had crutches) new boot arrived 3 days later via amazon. Some minor heal only weight bearing from start. Had to worry about left leg wearing out. Knee meniscus. 3 times a day ice and message. Virtually no initial swelling (always a killer for any injury) and little localized pain. Rupture in common location. Calf cramp 2nd day terrifying. Water bananas and pushing with finger hard under nose–mom’s acupuncture remedy–worked mysteriously well to avoid and deter future cramps. Initially I could feel chasm of rupture, about 1/4 inch or less. 2 weeks later none. Calf muscle manipulation definetly controls foot flexion, not the illusion of control by those other tendons that control toes. At critical phase to avoid catastrophic mistake. I’m 3 weeks ahead of surgery patients because they lose 1 week right off the top waiting for surgery. 1 week is gained by leveraging the body’s short-lived post injury bonsai defense response, which quick 3 day surgeries also get, and I gain healing time focused on tendon, not the surgical collateral damage, and I get more freedom of movement early, the decisive predictor of early and effective and sustainable recovery. No risk of infections. No claustrophobic pain. And no empty wallet . I’m keeping my fingers crossed
Naturalheeler, my fingers are crossed too, partly because your experience is similar to mine. I also skipped the surgery for ATR#2 — not for lack of $ (Ontario health insurance makes it “free”!), but because my new fancy sports-med surgeon had attended the AAOS2009 conference and met with the authors of the UWO Study after attending their presentation. He liked their answers to his Qs and stopped doing surgical ATR repairs! More details on my blog.
You’re right that many OSs use slower rehab to avoid re-ruptures, but you suggest that they’re rational to do so, and the evidence says they are NOT! Mind you, the evidence shows a relatively minor clinical impact from fast vs. slow rehab for surgical patients, and a HUGE impact for non-op patients, all in the “illogical” direction l. Slow “conservative” rehab non-op clearly produces much higher rerupture rates, as confirmed by a new meta-study.
Ryanb and I had a useful discussion about TOO-fast rehab on one of my recent pages. Immediate FWB was tried in one recent study and it did NOT produce good results, with or without surgery!! I wouldn’t Go There, based on that evidence. UWO’s 2 wks NWB then 2 PWB seems close to optimal. No, it doesn’t eliminate calf (&c.) atrophy. But it isn’t clear that you WANT a full-strength calf muscle pulling on your weak and still-healing AT. A spasm or a move to prevent a fall could cause a rerupture easy-peasy.
Thanks normofthenorth. Canadian health system is great, but there’s no migration path to that model in the US given our current population dynamics and historical evolution of our healthcare system. Too bad. ISSUE: the definition of “Weight bearing” or FWB, as I think you abbreviated it. I looked at some of those studies in detail, where I could, because I was perplexed that they didn’t seem to control for the “type” of rupture, if such categories could be practically made. Based on intuition alone, I thought the decisive factor in treatment would be the tendon’s ability to “bridge the gap”. Virtually nothing. Maybe you could explain that to me. But burried in one article was the tacit admission, almost as an afterthought, that “it has been known for some time (in animals and humans) that the tendon has the ability to agressively regenerate itself” or some words to that effect. I thought I would find more discussion about the conditions that would promote that. I guess I did. The agressive rehab is key. As far as WB, it depends on how that is defined. When I used it in regards to my injury, I was talking about placing some weight on the leg, with the foot braced completely for no movement and in the proper plantar flexion position. For example, resting the boot on floor at my desk of in the car. Or standing with crutches, or sometimes heel striking in walking with crutches. Absolutely no pain with this. Careful. This seems more related to the non EB regiment, then the partial WB therapy after 2 weeks. As a note, when I saw Kobe walk off after the rupture I winced. I read that the sheath around the tendons usually stays connected somewhat in a complete rupture. The sheath is very important to promote the direction and speed of heeling. When you walk like that after a rupture, you tear it off completely. Now, there was no doubt Kobe was going to have surgey, so I guess it’s moot. But for others considering the non-surgical option, it is very important to immobilize the rupture immediately. I mean right on the floor where you lay. Anyway, if you have an intel on these sort of dynamics regarding the non-surgical healing, I would sure appreciate it. I’m concerned that these issues are rarely controlled for in the studies, or discussed otherwise. I’m concerned because I don’t feel I have a way to evaluate the healing process, except going by feel.
I suffered a full rupture while playing indoor soccer of my left Achilles tendon on Tuesday the 9th of April. I immediately hit the deck once it popped. It was quite violent and loud. I did not put any weight on it whatsoever. I was fitted with a boot the next day as I was put in a splint the day of the injury. I did start walking around a couple of days later using the boot. I would have some pain in my calf but it wasn’t severe. I took no medication until after surgery. I had the surgery on the 18th of April. I am currently in a splint and bandages. I go to see the surgeon on Friday. I am taking part in a clinical research study that uses electro-stimulation on the calf post surgery to try and prevent atrophy. I do the stimulation 3 times daily and I crank it up to as high as I can withstand. This research also allows for two additional MRI scans and close monitoring of my calf muscles and progress after surgery. I really have no pain and don’t take the pain meds very often. I am 40yrs old, 5ft8, 160lbs. I totally intend to return to playing soccer and other sports. I am going to be as aggressive as my doctor and therapists allow. I will update as to the progress and what the e-stim seems to contribute in terms of preventing atrophy and aiding in recovery.
Naturalheeler-I ruptured my right AT last week and can’t afford the surgery( no insurance) what did you do week by week to recover and how long before you went back to work
I had partial rupture 10th March, no surgery, cast for 5 weeks, boot for 5 weeks, discharged from hospital 2 weeks ago, now struggling as cannot walk with out bad limp, unable to get on my toes, has anyone experienced this ? Is this normal?
Hi Tracey feb 16 th
8 weeks went two shoes still have limp and swelling
Completely severed my Achilles playing basketball….surgery 6 days later, soft half cast for a week, Boot splint for next few weeks;
*Right at 4 weeks started weight bearing and some baby steps..
*At 5 weeks ditched the crutches and doing PT 3 times a week. Walking everywhere in sandles, shoes, or bare feet at home….very slow and deliberate, and half steps at times but moving. My PT and Ortho are both very “progressive” and “aggressive”…and i am thanjful for that seeing/reading about folks being casted to 6,7,8 weeks. And mine was completely severed/ruptured. The only thing going slow is the scab on the incision. Good luck.
I see everybody having surgery right after their injuries, I went to 2 doctors which did xrays and said just damaged muscle and busted blood vessels, then they sent me to another specialist that said something isn’t right and we need to do a mri, now they saying surgery due to torn achilles and its been 7 weeks!! I’m just a little worried because its been so long, has anybody else went this long??
Danny - Not sure if your rupture was partial or complete but you have what is called a stale injury which can be repaired. Most are surgically repaired and you should have a good result. With any injury, the healing process starts immediately but without the initial immobilization this process would not be able to complete as you continually tear the new collagen. The location of the rupture will be an influence. Ruptures near muscles tissue are more difficult to sew together but not impossible. There are quite a few people here that have been down your path and come out good. It is a great shame that you have had to wait so long before proper diagnosis and treatment but if you had a partial rupture near the muscle connection then I can understand how it could be considered a muscle tear. A muscle tear would start to feel better after a week and resolve itself in 3 or so weeks. 7 weeks is a bit long to wait. Hope it goes well for you.
Danny,
There have been a few bloggers here with long delays between injury and treatment. Kkirk was one of the more recent with an extensive blog.
Hi Danny, I went 4.5 months from injury to surgery, so I think I qualify. My doc made me go extremely conservatively, which has slowed my recovery, mainly trying to rebuild my calf muscle and fighting the atrophy battle, but at 8 going on 9 months since surgery, I’m about 75% back to normal. Just increasing strength and endurance. Have you had surgery yet? Make sure to check out my blog and make one yourself to keep us posted.
Hi all, I had a complete rupture of my right achilles on 14/4/13 and then surgery on 20/4/13. Following surgery I was in a back slab cast for 2 weeks before stitches were removed and I was then placed in a full cast for 4 weeks. Then on the day my cast was removed I was placed in a boot with 3 wedges and commenced Physio that day. I will remove 1 wedge per week and continue with 1 physio session per week for 6-8 weeks.
Once in the boot doctors advised to weight bare as much as I could handle. I am now two sessions into my physio and seeing good improvement with each session.
Still having issues with swelling when foot is not up and resting.
Cheers