That unmistakable POP - no surgery

This is my first blog… ever…

A Little back story about me..

Im 31 years old, Fairly active woman.

Im in the Canadian Forces, Ive been on tour to Afghanistan and made it home without a scratch. But on 23 March 2011 during a regular Physical Training session during the warm up I heard that unmistakable POP and down I went.  We had done a few laps around the gym  followed by some line sprints then we moved onto some plyometrics first with 2 feet then onto 1 foot, I pushed up with my left foot and i remember thinking .. “wow thats kinda tight” and as my foot landed there it was … POP

 

I made my way to the base hospital and within 2 hours i was on my way across town for an ultrasound to try and see the extent of the damage. It would be 2 days before the images were sent back to the base to I was sent home, my leg in a fiberglass splint to keep my foot pointed and was told to put it up as much as I could, Ice it and take some anti-inflammatories.

Two days later I returned to the base hospital and it was seen that yes there was a ruptur, but it was not a full tear. The ruptur was up right where the tendon attaches to the calf. They said if it were a full they would of had me in surgury that day, but with it being a partial we would go with the splint.

After the first week the splint was changed from fully pointed to about a 110* I went to Physio where they used ultrasound treatment to help with blood flow and promote healing.  She had instructed me to keep my leg elevated, ice it and from time to time I could take the splint off and very gentally move my foot back and forth and side to side but not to push my foot past the 90* point.  And if it still felt good after the weekend I could go back and move the splint to a 90*.

After the weekend, it was now 2 weeks and 5 days, my leg was feeling good, I was even able to stand in the shower with both feet flat but all my wieght on the right (good) leg.  So feeling good monday morning I went back to the base hospital to have the splint changed again, this time to a 90*. 

It was just the slightest bight tight but there was no pain. But the end of the day I noticed my toes were getting a little swollen. I loosened the tensor bandage that held the splint in place to the point where it was almost falling off and put my leg up. The swelling did go down but without any pressure at all on the tear site it would just throb like crazy. I ended up just putting the tensor on my leg and the next day was back at the base hospital to have it checked out. The Dr I saw this time had never delt with an achilles ruptur of any kind before and as I was seeing my regular physio the next day just put me back in the 110* splint and said to follow up with physio.

I told my physio what had happened with the splint at 90* and she said oviouslly my leg did not like that progression, so we will keep it at the 110* for up to 6 more weeks and take it week to week.

So it has now been 3 weeks and 4 days since ATR.  After reading a lot of the blogs I am feeling a litte down that some are in the air boot and WB by 2-3 weeks and im almost at 4 and everytime we try and go to 90* even with NWB, my leg freaks out and I am set back. This weekend anytime I tryed to have the splint off and try to get my foot anywhere close to 90* it would go all pins and needles and start to swell again.

Tomorrow starts a new work week, hears hopeing for a better week.

 

McKee

2 Comments so far

  1. normofthenorth on April 17th, 2011

    McKee, there are a couple of modern protocols that have produced excellent results in big randomized trials, without surgery. My fave (and still the most recent) is a Canadian one, posted at bit.ly/UWOProtocol . The study it’s from is linked from the “ATR Rehab Protocols, Publications, Studies” page here, which is linked from the top of the Main Page. There’s a link at the bottom of that study to a different presentation of the same protocol.

    Compared to that protocol, you’re pushing your ankle angle much faster. There’s no necessity to be at 90 degrees before you become PWB or even FWB. It does mean you have to work harder to “build up” your other (RH) foot, so you don’t walk with a constant mis-alignment.

    BTW, many ATR patients with high ruptures, near the calf, are given non-surgical treatment even with tears that are confirmed 100%. The non-surgical results in that UWO study were equally good with high, medium, and low ruptures (according to a small sub-study that was published before the main study was). My own experience with multiple UltraSound inspections of my second ATR suggests that UltraSound isn’t very reliable at distinguishing types of ATRs, like partial vs. complete.

    And if you can, please install the ATR Timeline Widget so we can easily see your essential facts and timing.

  2. julesjames on April 18th, 2011

    Hi McKee, dont get down as Norm posted you were going rather fast with the angle change. I’ve had surgery and was at full plantar for 3 weeks then, 60 degrees for a week, then 80 pwb/fwb from week 4-6. Im only now at 90 and in a boot after 6 weeks.

    I can only imagine that with no surgery you don’t want to be at 90 too soon as too much force on the healing tendon may make it heel long. They can get you PWB/FWB with a heel so you can move around.

    Patience is the test for us all with this injury.

    Hang in there and heal well
    jules

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