mikes’ AchillesBlog

knee Walker are great. My mother used one after the Ankle Surgery. It made getting around much easier for her.

Congrats on your progress Rainer! That’s terrific news.

Hi, I ruptured my achilles last May 26,3013. Posterior cast for a week then aircast boot for 7 weeks. There was no surgery performed. For the first 2 weeks, I was just resting and elevate my affected foot almost all the time. 2nd week rehab started. On my 4th week I started biking outside with the boot on ( Not following doctors order) coz i was too bored already. You know yourself better than anyone right..just know your limits. If it hurts then stop. @ 7 weeks my PT told me that I can wear regular shoes and start walking without a cane or crtuches. @ 8 weeks I was walking and biking BUT with a little bit of swelling. The doctor told me that its normal and will take months before everythings goes back to normal. Im on my 10th week now and im happy for my progress. My PT told me to learn to trust my achilles again if i want to go back to my activities. But be extra careful… Aircast cryocuff also helps a lot. Every after exercise session I always take time to wear it for 15mins. And it felt great afterwards.

I’m just over 5 weeks out from injury (non-surgical) and just began FWB today without crutches. I’m able to use 2 shoes at home for short distances with the heel lifts. I noticed today that I have had some swelling around the ankle, which is probably due to me using it too much too soon.

I found that raising the foot and using ice has helped tremendously. I also have heard of iontophoresis (using dextamethasone) helps quite a bit with swelling — my PT had mentioned it.

Thanks. Sometimes the pictures show up and sometimes they don’t so I don’t know what the problem is. Thanks for your positive thoughts any way.

obviously can’t figure out how to post photos,

Hi Debuff
Not sure if anyone else is experiencing the same problem when trying to reply, all apart from this comment will not open , just thought I’d let you know
RRR

Every morning the scars are pale and not very swollen. By the end of the day the scars and red and purple and my ankle looks twice its size. I keep trying to increase the exercise to increase my ROM, flexibilty and strength. But then need the cold therapy sleeve. But I agree, swelling is indeed OLD!

See my blog page with a title like “This @$#% swelling is getting OLD!”

Battled swelling up to 6-7 months with both, especially when was active on feet.

Compression socks by 2XU were one of best investments I made, really good product, pricey at $50 range, but really helped me

eventually as foot gets stronger, swelling goes away. One other thing is like a foamy pad about size of a Frisbee really helped strengthen everything around foot(muscle/tendons), standing on this and balancing will help

I think some swelling is normal. I notice I have it after all day in the boot. It seems to go down after I elevate. Do you notice the same?

Sounds like you are doing well. It must be reassuring to know that someone who has seen a lot of wounds thinks that yours is looking pretty good. Hang in there and keep on keeping on with the exercises!

Weaning off the boot before 8 weeks is done, but may not be well tested. (UWO = 8 weeks.) I found the boot more convenient than crutches or walker (though I didn’t use a walker), so I don’t see the advantage unless your boot fits badly and hurts. For sure Watch Your Step because your ankle and AT are very vulnerable.

It sounds like you are FWB in shoes (at home) and use the walker just for stability? I can’t see how not using the walker could be detrimental given you have no issues with balance.
@micha: I think a walker is the self standing walking aid–you propel it forward with both hands by lifting or rolling it forward and then walking toward it with your legs.

Not sure what a walker is Mikes, is it a crutch? I’m non-op and the protocol that my hospital are following meant that I was out of the boot and into 2 shoes at 6+ weeks, wearing shoes with a small heel lift (1/4 inch only). The crutch at that point was more for stability it depends how stable your ankle is I suppose. So I guess you would be fine, depends what your Drs have recommended though.

Full recovery? I want your doctor!! Mind you, today I have walked down the stairs - one foot in front of the other….a huge triumph! Enjoy weight bearing Mike.

Yay! That’s awesome. 13 weeks sounds pretty good to me.

Good luck!

The knee walker is not always more helpful, but it was for me for several things. Work, walking to class, the mall, grocery stores where I didn’t need a cart, and a couple other situations. Crutches would have killed my hands/armpits I’m sure after all that distance. Slight inclines are fine. Grass and rocks are awful, but I could go up a curb if I took it slowly. Often in the beginning I would have to balance on one leg to get on it, but anything you can hold onto is helpful. It wasn’t any harder than crutches to get on for me.
I bought a Drive knee walker on amazon for about $200 which I plan to resell on craigslist.

I think they all have brakes, often on the handlebars like a bike. (The ones I almost bought for my ATR#2 were walkers that could be used walking, seated, or kneeling.) As long as you’re applying the brakes, you should be able to get up the same way you have been with a non-kneeling, non-rolling walker.

As long as you don’t lose control on that “slight incline” with the brakes off, I don’t foresee any problems. OTOH, I’m “cooler” to knee walkers than most folks here, though I did make ample use of a number of wheeled chairs (office, steno/student) around the house while I was rehabbing from both ATRs. But with any luck at all, you’ll very soon be at the PWB stage of your rehab, which can best be done with crutches. As you progress through that stage — basically from NWB to FWB — everything stays the same, with your mechanics exactly mimicking a normal walking gait, EXCEPT that you’re using crutches, which initially bear 100% of your weight, then gradually less and less until they bear 0% of your weight, and then you ditch them. I think that’s very hard to mimic well with a walker of any kind (and definitely with a KNEE walker!

Hi Ryan
Your way ahead of me on the thinking of this, but I applaud the challenge, indeed it’s people like you who will push the boundaries for others to take advantage, you and a few folks on here make me marvel at your train of thought, ill be honest it’s not a gift I have, we are unique in our strengths and talents but I draw on the strength and am in awe of your thought process, I’d welcome listening to norms and a few others views, it’s going to be interesting
RRR

One real difficulty with answering the “healing long” question is that many with this complication don’t recognize/accept it until very late in the healing process. At 6 months, they might present as doing well on a normal healing trajectory… but a year later (Suthrnman is a recent example) they may realize they’re actually long, not getting any better, and headed to surgery to correct it.

Or, even more difficult to track, there are people who are long, but have accepted/decided that the level of strength and function is acceptable, and opt not to “fix” it. I think I’m just a little bit long, but it’s certainly not severe enough to warrant surgery again.

It’s a difficult (but not impossible) thing to measure.

Great questions Ryan
My knowledge is ltd but would refer to UWO study on re ruptures , I’ve no other info on healing long very interesting, I guess there’s no scientific study but I guess there should be. I guess the professionals should be laying the gauntlet on this but clearly are not, I think they are still at odds on the surgery v non but not on deep on this as you are .
RRR

I’d put complications into two categories-
#1: re-ruptures and healing long; the really bad stuff - complications that necessitate a re-boot (no pun intended) of the healing process.
#2: everything else (infections, adhesions, nerve damage, etc.).

Overwhelmingly, surgery patients would be expected to have a much higher incidence of complications in category #2. The surgery itself is the underlying cause for many of them.

My question is: how does surgical vs. non-surgical compare for complications in category #1?

I really have no clue: just honestly curious if anybody has looked at the data that way-

how do i get to your blog to view studies on wound complications? thx

Ya, (too) many people have — though it’s not a random sample, because people with problems are more likely to spend more time posting here. A few of the stories are sad, too, so they’re memorable way out of proportion to their frequency of occurrence. Most people do fine, and lots of them drift away from here quickly.

There have been several good meta-studies crunching the number of various complications, post-op and also post-non-op. I’ve linked to a few of them on my two “study-intensive” blog pages. Most of them focus on comparing op to non-op, but they incidentally document the answer to your question in more detail (and with more statistical “confidence”) than anywhere else. Infections and non-closures and scar problems do happen, only on the “op” side of course. Adhesions are overwhelmingly on the “op” side, way rare non-op. DVT is around 3-to-1, IIRC, i.e., it does happens non-op, but maybe only 1/3 as likely/frequent. (All from memory.)

You can shower AND you get your cast off? I’m jealous! Congratulations.

Hattrick30. You and I are in the same boat. I’m in my cast for 4weeks though. Just got it today so it’s off on June 7. I had an FHL transfer which was drilled and screwed into my heel which is why I got 4weeks in this cast.

My dr said my wound looked great. No puss leakage or anything else so I’m happy with that.

Lucky you, I had surgery 2 weeks ago to the day. I got my soft cast off and a hard cast put on on Tuesday. I’ll be wearing this for 3 weeks.

I required a hard cast because my Achilles had to be stitched into my calf muscle (very high tear). Stitching to muscle is more risky short term, so I’m in a fancy uncomfortable cast until May 28th.

My wound looks really good compared to some others I’ve seen. I was very pleased with it.

Congrats.

It’s kind of a slow chair-hop.

Yay! Glad it worked out I was worried about the “hopping” part.

Not really difficult. It’s more stable then crutches. Just slower.

[WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

Mike, are you trying to do NWB on a walker? 2 wheels and 2 legs on it? Sounds very hard. I crutched to the shower stool then leaned the crutches on the outside of the stall. Crutches on wet shiny floors are very scary, otherwise easy.

We are almost on the same schedule but you are a little over a week ahead of me. I’m going non-surgical and had my cast put on Wednesday.

I’ve had better luck getting into the bath tub and leaving my bad leg out. Our shower has a step and no hand holds to get in and out. Sounds like you’ve got a plan though. Hope it goes well

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