Mikej’s Blog

@sumerhenna - set up your own blog page and then it is easier for everyone to read about your journey. I’m just beginning the healing process, again, after bone spur removal. My surgery is planned so it isn’t quite as hard to deal with as when a rupture occurs - but healing process is just as long. I am sorry that your rupture occurred at such a young age but you’ll probably recover more quickly than us oldies! LOL! I’m 57.

@sumerhenna, hi yes we are still here. just that people who recover in a year or two move on to other things in their lives. I maintain AchillesBlog, and I’ve been on this site since my injury in 2008. Wow, it’s already been 10 years!

Also just now noticing these posts are insanely old like from a year to like 10 years ago. Is anyone still on here or is it just me?

Hey guys! I have a really interesting achilles tendon rupture story for you guys haha so enjoy reading!

So I do a lot of traditonal Indian dancing which is essentially just bouncing on your toes for an eight minute routine. I have been doing this dance for five years and the day of the rupture we had been warmed up and practicing for an hour already! And then I jumped up only on my left leg and I felt the tendon literally snap and I was convinced for the following 10 min that someone had hit me from behind, when in that routine that was entirely impossible. I didn’t even know what an achilles rupture was at the time so I just thought I pulled it really bad as I was still able to walk (with a terrible limp, but still walk).

When it didn’t get better for a week I went to an urgent care and they thought I was fine and was just overreacting about what happened. Additionally I feel like I didn’t have as much pain and swelling in the area after about a week of walking on it, which really made it seem like I was bluffing. So i believed them and continued walking on it for THREE WEEKS. Funny enough I walked around campus for these three

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Aricuzzi - By failing the Thompson test I assume your foot did not move. In a strange way that is actually called a pass but we get what you mean. It is quite normal for this to happen at 2 weeks so I would not worry. The next time your tendon is exposed to the world you should be able to feel the continuity.

Hi, John W and Mark; Its been two years scince your comments in this thread. I would like to know how everything turned out? I went in to remove stitches two weeks after operation and failed the Thompsons test which freaked me out and still is. I was put in a fast after and currently in it for 4 weeks. This will be my last week getting it off on Friday. Any advice will be greatly appreciated.

I read that in a normal tendon that is not surgically repaired, after the inflammatory tissue clean up stage, right around 3 weeks is the stage when the collagen matrix or scaffolding is finished setting between the disconnected strands and the first type of baby tendon fibers just start to fill it in. The reason for early mobilization and PT is to train those baby fibers to line up to hold tension properly. If they’re not trained early enough, they stay frayed in a disarrayed weakened state, similar to tendinosis when they mature to the adult type at about 1 year. Training the matrix that sets around week 3 seems to be key. This leads me to believe a negative Thompson test is possible in non surgical recoveries at 3 weeks because something should be connected by then.

I have one of those higher up, close to a full tear with still a few fibers keeping it together and am able to start very slight dorsi/plantar flexion exercises according to the NWO protocol at week 2. My inversion/eversion was initially stiff from being in the boot but after a week, almost the same as my good side. Taking it out of the boot to shower at 3 weeks, i

hey mark and john, don’t worry about the thompson test at all. i was the same as both of you and tried to thompson test myself which was unsuccessful. I had the same protocol as mark. After recast i was supposed to stay in a hard cast for 4 weeks, but changed my dr. appointment and got it off a week earlier. After that i went to a boot with no wedges and within a couple of days i was fwb walking around. My best advice to you is move it and stretch it inside the cast. each day it will get stronger. It takes force to re-rupture so don’t worry about it disconnecting either, its there and you’ll get a chance to feel it when you move to a boot. i’m at 6 1/2 weeks now and i walk in my boot full time and have walked in two shoes in my house. best advice is don’t let it just sit. move it, stretch it, and work it but not to the extent of discomfort or try to push it because it won’t benefit you at all. small movements, small stretches….hope this helped

Hi Mark

A suggestion. Have you been to the main achillesblog, achillesblog.com? Your post here has joined a relatively old blog, and I would be concerned that you are reading ‘old stuff’ whereas in the past 2 or 3 years there has been lots about best practice.

Also check out the UWO protocol on the main page and blogs like Suddsy’s (/suddsy) which cover UWO (Canada) and Exeter (UK) but others too.

Hopefully you will receive plenty of replies to your post here.

H

I’m 2 weeks post surgery and just went for my 1st check up to remove the cast, re-position my foot upwards, and re-apply a new cast. While the cast was off, my Dr tried the thompson calf sqeeze test. I could tell that while he was doing it, my foot was giving him no response. I asked the Dr if this concerned him, and he said No, I think it could be because your calf has atrophied. Really, it’s only been 2 weeks? He did another test where he asked me to raise and lower my foot. That worked, and I could feel the tightness of the tendon catching as I raised my foot up. I was supposed to be in this new cast for 4 weeks but before I left the Dr told me it would be 5. When I asked him why the additional week, he said he just wanted to play it safe and give my leg more time to heal. IDK, I’m just a little worried that calf test did not provide any response.

Hi john w, It’s pretty difficult to do an accurate Thompson Test on yourself. I’m 14 weeks post-surgery and my gait is almost normal and strength is progressing very well but if I do a Thompson Test on myself, I don’t see any movement. I can’t be sure but I’d say your probably OK.

If you’re four weeks out and trying to test yourself, I’m assuming that you went into a boot pretty quickly. Start your own blog and keep us up to date. Dennis has made starting your own blog very easy.

im four weeks out of surgery and i’m not getting any movement when i do the test. i just saw the doctor and he said it looks great, but he didn’t do the test.

Yes, your earlier blogs mentioned the study you’re in, too. Do you know what it’s studying? Is it comparing two different rehab protocols, or types of surgery, or what?

Your results seem quite good, so they’re likely to help make your side of the data look good!

After my first ATR (late 2001), my self-described “conservative” surgeon said I should wait ’til I can do a bunch of good 1-leg heel raises without grunting and groaning, before I return to high-risk sports — like volleyball, in my case. With all respect to your Doc, it sounds like you’re about there — unless you’re grunting and groaning when you do yours.

That’s great you could jog a mile. Could you explain more about this “study?” I’m very curious about what it is and who can do it.

Mikej, I’d be surprised if you could materially affect the healed length of your AT by stretching it after 5 months. No hard evidence either way, that’s just based on how solid and “finished” mine felt (both of them) at that stage.

Mind you, I also backed off the serious stretches once my range of motion returned to where it should be — both to “normal” and to pre-ATR levels.

thanks for answers
I don’t care what other think looking at me “bobbling” in complex pool. You should not be distracted by others - just concentrate on your foot - IMHO.
I jump in middle of pool water about my waist, those small jumps.

Any links about “knots” removal massages are very welcome.

I forgot to add, haven’t done to much for post exercise, my pt suggested limiting the stretching(stiil do some) there biggest concern is me stretching the tendon now since it appears to be at the perfect tension right now. That is one thing I will find out next month because they did all these tests and measurements then and will do them again at end of July. I am lucky enough to get a calf massage pretty much every night since I have a great wife and has done wonders since I had a tendency to develop “knots” as it was healing. The PT also uses a bar and rolls it along my tendon and calf and it hurts when there is a knot but feels better afterwards.

Mike753.

My one legged lift on my atr is almost as high as my other leg on land. It may be a 1/2 inch lower. In the beginning of may I had them measured as part of a study I am in I believe one was 8 and the other 11 on the one legged heal lift. I go back next month for more testing. Getting them at equal levels has been the hardest part the last three months. In the pool I can get them equally high which tells me it is still weaker and needs some more work, partly why I skipped out on the sports this month and is likely the reason sprinting does not feel right(since that peak area is still not strong enough) so I backed off on agility exercises and sprinting til late next month. I think the pool work will put me over the edge and allows me to work those areas at the peak of my lift really well. I move to different areas and depths in the pool after I do sets on dry land. Some people look at me a little funny since I am bobbing up and down in the water but I think they can figure it out:)

how high you can do 1 heel lift vs normal leg?
Can you do as high as normal in the pool?
how do you relax Calf and etc after exercise?

tnx for answers

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Mike: Can you clarify what you mean by “electrical stim”? Thx,

3.5 months out of surgery everything going well. I had an ultrasound 2 weeks ago(as part of as study I am in) on both tendons. Repaired tendon looks much thicker and muscle tissue looks different. Doc says everything looks good though and will take a lot of time for the final stage tissue to develop. Joined a soccer league for end of June, not sure if I am going to be able to play or not but Doc thinks it is a possibility. PT 3x a week diminishes to one time this week and home assignment next week. They have been holding me off but i expect to be able to start light jogging this week. Did a few light jogs up and down the driveway and it felt good. I think the thing that is helping the most is standing electrical stim on calf while doing raises which helps me “peak out on my calf raises” since those last couple Cm’s are hard to get on single raises.

Dear Mike

Sounds like you are getting “Russian” or electrical muscle stimulation. I’d like to know the details, if that is possible.

I agree that early WB is key. When I did in my other foot 10 years ago 8 weeks NWB took off many pounds of leg muscle, and required a very long time to recover.

This time, I went PWB 2 days post-op after I slipped while NWB. I decided it was safer putting the cast into a Bledsoe Boot, and using only 1 crutch. Was at the beach walking my dog 6 days postop when my surgeon found me there walking his dog. Other than telling me he wishes me to be safe he allows me to do whatever I want. I’m 65 and teach - have to stand a lot also.

Because I went PWB early, lost little mass, but what was left jiggled all over. Lost most of its tone from lack of use in cast and boot. Coming back quickly now that I’m doing the toe rise progression.

I go to PT, but most of the rehab is from walking the beach. I try 1-2 miles a day at beach & 4-5 miles total each day - use a pedometer. PT told me ROM was normal when I started PT at week 7,

I agree that full tendon strength won’t be until 1 yr out,

just to follow up on a question from sullypa. I had the usual surgery with no other treatments. They do not use ultrasound in PT on me assuming you mean for scar tissue. I asked why not and if I remember correctly they did not recommend it. can’t remember why. I will be having the other type of ultrasounds done as part of the study I am in to examine the healing of the tendon etc.

I agree totally from my experience. obviously there are a lot of factors and individual plans sometimes need to be made but I believe that eventually early weightbearing will be a key component considering my calves are almost equal size and at the start of PT they said I had lost only about 1cm. My gastroc feels strong but the soleus which was really immobilized tightly in that boot is the weaker portion. I also believe age has had a strong impact on my recovery and we usually bounce back a little faster.

Hi Mike,

So if you and I are in the fastest one out of ten in recovery, the question, in my mind, is the role of early mobilization and calf strength work in that recovery. My strong belief is that too many doctors are way too conservative in their rehab plans, leading to extensive muscle atrophy, which then greatly lengthens the rehab process. I suspect many more than one out of ten could come back this quickly with proper guidance.

Maybe someday,

Doug

Hi, i will try to answer your questions. First about the stim. Basically they hook two electrode pads to my calfs and every thirty seconds it causes a strong contraction of my gastroc and soleus with some pulses set in between also. It feels like a really bad leg cramp and is for strengthening the area. Doug is correct about the one footed descend. I started out my PT doing the two legged raises pretty well and last monday they moved me onto the descends. At first I said ” are you sure and said I am only eight weeks” but they said I was ready. After a few sets my confidence grew and I feel pretty comfortable doing them. I also am now part of a study through a prof who is here for the next year from Europe where they are going to test for strength and do ultrasounds of the tendon in the coming months. I find out more later but I know there are 50 rupture patients surgical and non surgical and she came to my PT session last week for some preliminary analysis.Obviously, she is very well informed on the whole achilles “controversy”. I was very surprised to be doing the one legged heal descends at eight weeks but both her and my PT fel

Hi Mike,

If you did a controlled descent of your entire body weight with your injured leg’s calf at eight weeks or so, your rehab is going very well. When you say they want you exercising every day, between PT sessions, that is the way to go. Some folks get a little lazy once they are walking relatively well, and their strength comes back slowly as a result.

Keep it going,

Doug

Hi Mike

I ATR’d left foot 1/22/2010, operation 1/24. At 11 weeks in 2 shoes without inserts and no limp unless I’m really tired. Just started toe rise progression at 10 weeks, but only doing 2 legged heel lifts now, Doing left foot balancing, wobble board. Plantar flex against springs. Doc is conservative so I self-elected to go 2 shoes at 7 weeks also, but doc knows what I’m doing. He plans to release me for sports in mid-May. I play light tennis and softball now - have trained myself not to push off or stop on the recovering ankle.
I do a lot of massage/heating to reduce scar tissue. What do you mean by “15 min stim?” Do you use ultrasound? If so, what frequency, etc.?
In surgery the usual Kessler suture was done on me. Did you have any of the advanced sutures, grafts, or blood treatments?

7 weeks I was into two shoes, took about a week to start walking “normal and had to retrain myself how to walk without boot. Started PT 3x a week and have made good progress. Among many other things I do double heal raises very well and do three sets of 12. Lots of stretching, Then I do a double heal raise, and while up on the balls of my feet lift my good leg off the ground and slowly lower my bad foot back to the ground from the raised positon. This was a little scary at first but my confidence has grown tremendously. I also do sets of balancing on one foot(bad one) on trampoline for 1 minute sequences and finish with 15 minutes of stim for calf. PT has me slated for first one legged heal raises at ten weeks and are preparing me well. I am doing my PT at the Univ. of De. My doc asked me to do be part of study with a prof from UDE and will be doing strength testing for some time. They want me doing the exercise everyday inbetween my sessions. I’ll see if I can post some pictures.

No idea. I think I was around 4 or 5 weeks into “the boot” (non-surgery), and PWB heading toward FWB, before I even got permission to take it off to shower. So I didn’t play around with squeezing my calf much.

The whole idea that the non-surgical approach can mend a torn AT and make it the right length is so incredibly magical, and so counter-intuitive, that I wasn’t in any mood for “testing” until it was quite clear that there really was a good connection there again!

I suspect the Thompson test would find an intact AT very soon after a surgical repair. Check doug53’s early blog posts to see how soon he began “twitching” and “firing” his calf muscle, but I think it was less than a week. So in a way, your result is “no news”, steady as she goes with your protocol!

I am 3.5 weeks post surgery and tried Thompson test today out of curiousity. It was “negative” which is a good thing. My surgery foot moved toward the ceiling as it should. ROM was not as good as my good leg but it was good to see. I think surgically most people should have a negative test but I was wondering when you get a negative test with non surgery healing and whether this means anything for my recovery,PT process etc. other than telling me its attached

Hey Mike, it sounds like your doc is a lot like mine. I got stitches out at day 10 and went to the boot directly, FWB allowed. Took me 2 days to trust my foot enough, so day 12 was FWB for me. Sadly, however, it seems my doc wants me in the boot longer than yours now. I just hit week 6 with the boot still on and 2 wedges, though I walk around my house every day in bare feet (and was just outside with my kids in bare feet trying to get something out of a tree). I don’t even see my doc again for 2 more weeks…I’d say your guy is doing a good job. If we lived in the same place I’d give him a call. I know I am ready for life without the boot.

This is where I am on March 1 2010 as part of a conversation with another blogger.

Hi, I am feeling pretty good also and seem to be healing pretty fast also. My scar is fully healed at three weeks and looks like a 4 inch paper cut with very little swelling if any. Compared to some of the pictures I have seen on the blogs it looks very good so far. I am walking in the boot very well and since I have removed two of the wedges I walk fairly normal(as much as possible). I would like to start PT now since several people posted they started very early but doc says he wants to wait til my next appointment. I am very tempted at times to “safely walk” without it because I feel like I can but I won’t. Since it is not sore my wife and I have been massaging the area quite vigorously twice a day(read that helps with breaking up scar tissue” and soaking it in hot water morning in night followed by ice for blood flow. Not sure if that is helping or not but I feel like I could take this thing off right now and start walking. I tried some non weight bearing ROM and everything moved well and I notice the calf tensing slightly again. I think being

Below was a conservation with someone who had a aggressive approach to post surgery

Wow, I thought my doc was aggressive. Unless you meant a few weeks instead of days when you transitioned into a “croc” (I imagine that is a type of shoe). I imagine whatever you are wearing has heal wedges but it doesn’t sound like it. I am not trying to play doc but I have spent extensive time reviewing the MANY different ways of rehabbing this injury but never heard of someone transitioning that fast. I am three weeks post surgery and went into a boot full weightbearing at the eleven day mark with three heal wedges. I get to remove one wedge Friday and it is a pain because one foot is like walking in a high heal. I will be in the boot for a total of six weeks and then i may be able to go into ortho shoe with one wedge pending review. My PT starts at week four of the boot. I am 34 and also play tournament racquetball as well as soccer and basketball. Mine snapped about 1.5 hours into a game of basketball but doing a sharp cut. Sounds like yours may have been “hanging by a thread” and had a lot of microtears to rupture in that fashion because usua

I wrote this after I got my cast off at about eleven days.

Got cast off today and stitches out, everything looked good with no signs of infection. Back in boot for 4 weeks full weightbearing w 3 heal wedges. Walked out of the office with no pain(in boot), remove a wedge next week and then another two weeks later. Last wedge at four week mark. then next visit occurs. Felt good to be mobile without crutches. Must keep boot on at all times except to bath but it is better than that cast! Back to work monday, only lost four days sick time due to the historic snowstorms we just had here in the eastern US. He said he would likely keep me in the boot for a total of six weeks, but I was a little disappointed he did not want any rehab until next visit(six weeks post surgery) He thought the full weightbearing was the best physio until that point and keep some strength in that leg and limit atrophy. I’ll check in if anyone has any questions but otherwise this is where I stand for next four weeks.

below was something i wrote after I decided to go surgical route

Well I am a week and a half post op. Things went smoothly so far, doc says surgery went well. Worst part was when the leg block wore off. That hurt like a $%&& about 8 hrs after surgery. Otherwise I was off the pain meds the next day and dont feel like I have any swelling and haven’t felt any pain as of yet in the area however I am still in cast keeping it elevated but moving around pretty well on crutches. The doc says I get the cast off this Friday and back to the boot I wore before operation. I also believe he said full weight bearing or as much as I can put on the leg without pain immediately only two weeks after the surgery??? but I can not take the boot off at all except to bath. I did not have my surgery until two weeks after my rupture and the interesting thing is when I took it off the morning of surgery I could walk pretty well. I actually walked into the surgery room on my own and they even said wow you are doing pretty well considering the mri showed a complete rupture. If you remember an earlier post I got four opinions on surgery by different o

Below was part of a discussion I had with someone when deciding my route of recovery

Yeah it is clear that there is no clear cut method for repairing the achilles tear. It seems from the countless replies on this site most doctors are being extremely cautious about rehab. The doctors here in the US seem to agree and encourage the surgery and then casting for two weeks non weight bearing.Then 4-6 weeks of rehab in walking cast weight bearing immediately! In between that time wedges are removed about every ten days until you are at 90 degrees. Once again they encourage weight bearing two weeks after surgery once you are fitted with the walking cast with arches plantarflexed. Rehab takes place after cast is removed(two weeks after surgery) and walking begins without boot at the six week mark in most cases with a ortho shoe with high heel arch. Does this sound consistent with others? because from what I have read this seems extremely agressive. It does however go along with the new studies that I have read concerning rehab of this injury. It is almost like they are in a crossover on how to treat this injury and are pushing for more a

Hi everyone, the below post is approximately 5 weeks ago and will start my story. I will post more leading up to where I am today.

Just ruptured my achilles on 1-24-10 playing basketball, ruptured occured about 1.5 hours into game and felt great up to the point it happened. Knew right away it was something serious but my pain was up a little higher than the normal achilles tear, almost near my calf. I still suspected achilles but hoped for calf tear. First doc recommended conservative approach for ruptured achilles and I was placed in boot day after injury. I have a degree in health and kinesiology so I started researching for countless hours and realized I should get a second opinion due to my age (34) and active lifestyle (phys ed teacher, soccer, racquetball and bball daily. Most of the data for the past few years says surgery is necessary for younger athletes. However, I also was very confused on proper treatment since the two most recent studies I found have shown NO difference in the recovery, strength or re-rupture rate of conservative or surgery approach. However, the studies did not tell me the mean age of the individual

Welcome, Mike! Now you just have to delete what’s here and tell us your story!