Lump question

Hello Every one,

I have a question/concern. When I run my finger or hand across my injured/recovering tendon, I feel a slight lump/bump where the tendon is connected to the Calf and another one where the tendon is connected to the heel. This has been there I believe since week 2, the size of the lump is reducing, its not eye visible and it doesn’t generate pain. However, over the last 10 days, I don’t think I have seen any progress on that. My orhto checked the repair site yesterday and he didn’t mention anything about and I forgot to ask.
I’m in two shoes indoors, do you guys think this deserves shceduling a visit to ask about that or getting it checked or I’m over reacting ? I have searched in the blog for answers and there are some contradicting answers, some people say it was a sign of overuse and some people say its normal or a scar issue.
Due to my work commute, I do about 7000 steps per day. Is that too much? The Doctor said its Ok, but I’m still quite nervous.

Appreciate your answers!!

6 Weeks 5 days!! Two Shoes!! But I hate all my shoes!!

Hello every one,
I had my 7 Week post op this morning, two days shy.
Let me give you a quick recap of the last two weeks:
Week 5: VacoCast position 1: As usual, any change in the position has some discomfort in the beginning, I learned my lesson from the first position change,simply, I have to walk around the house with two crutches for 10 mins, then gradually increase the Weight bearing. Things were normal that week. No major achievements.

Week 6: Dropped the boot to a neutral position, lost the high sole, I’m becoming normal again. Same procedure to get acquainted with the new ROM, few hours I was FWB with a slight limp. It felt great. Thanks Donna for the videos about pushing against the Shin. Totally worked! I used the crutches this week when I get tired, walking in public places with a lot of people or taking the train. But generally I can walk FWB for about 15 mins with no problems. Was such a great feeling. The pain that week was mostly from my heel bottom and my calf, it was short pulses of pain like if you are working out. Of course there is also I’m getting tired pain.

Today: I met with my Ortho, he checked the repair area and Thank God he said it looks great!! He said do you want to be in two shoes. I said Hell yeah! Gave me the heel lift and I tried it from the first time since the injury more than 8 weeks!! I was very very scared.. It didn’t feel that bad, I did my procedure, walking with two crutches to get my self acquainted with the shoe, but this time it felt so different. One, I hated my shoes. I brought two shoes with me to try each one is horrible. I feel like my foot is one size bigger or something. It felt very strange, I was able to walk with one crutch after few steps then with no crutches after few mins, but I’m much slower, the limp is the same as I had with the boot. I decided to wear my boot back as I have to take public transportation and walk to work for 10 minutes. I took my shoes with me to work though :D I couldn’t wait to try again. Well, It has been few hours since I’m at work, I’m walking one two shoes. Most of the time in one crutch and every while and then I take few steps with no support. I did few normal steps, however I feel I need more training. Its scary now when you feel you have no protection, I feel my AT more. I feel pulses and stretches in the surgery area. I’m going to take it easy for the next few days, I will wear my boot outside all the time and when I’m going up and down the stairs. I have my first PT appointment next week. Pretty excited about that.

The Doctor told me I can do slow walks on the trade mill and stationary cycling in the gym.. Seemed pretty good. He said I can start trying to drive again and after tough negotiations he got convinced that I can ride my motorcycle after 4 weeks from today :)

Wanted to share this moment with you guys! I know now I’m going into another scarier stage. Re-rupture rates are higher now so I’m going to be careful. Is what I’m feeling about the two shoes normal ? How long you think it should take to be comfortable in them ? I don’t mean walking excellent, just as comfortable as I was in the Boot.

Best of Luck to all of us!!

5 Weeks Post-op update

Hello every one,

It has been 2 weeks since my last update. They were quite interesting weeks.
Between week 3 and 4, everything was Ok, however, all my tries to walk with one crutch or put more weight on my leg didn’t result in any useful outcome. I can walk with one crutch, but it was quite difficult because of the position of my foot in the Vaco Cast, I was at position 3. I didn’t have any balance at all, I would do 4 or 5 steps and then give up.

At my 4 week mark, I was scheduled to see surgeon, according to the protocol, I knew that this meeting would be exciting as I would be able to shower and sleep without the boot and also he will give the green light to move the boot down one position each week. Indeed it was a very happy day for me, didn’t get to see my surgeon, I saw the physician assistant. She checked the wound, moved the boot to position 2, explaining to me that I now have Range of motion between levels 2 and 3 while I’m walking! and that every week I drop it one more level till I reach neutral. She advised to shower in the boot and then wash my leg after that especially that I like standing up in the shower.
My next follow up will be at 7 weeks, she told me I should be walking in neutral position for a week, and to bring a shoe with me :):)

I was very very excited to have this ROM. It was a great/weird/difficult feeling when I took a couple of steps where my foot actually moves. It took me almost a day to get used to it before feeling comfortable to increase weight bearing on it. As I felt I was able to walk relatively better, I decide to ditch the knee scooter (I only use if I’m walking a distance more than 10 minutes, Like between the train station and my work). It wasn’t a very smart decision, the under arms crutches although putting more weight on my foot were very uncomfortable, I decided to ditch them and bought a pair of forearm crutches, they were the best.
I started using the forearm crutches and I immediately felt more improvement on my weight bearing, ease of movement, pain tolerance and speed as well.

During that past week, walking with one crutch was better, but not sufficient to ditch the second crutch my balance was still so impaired, however I think I was able to walk without crutches at all for few minutes around my house, but still balance was a problem. I didn’t feel much pain on my leg, It was more of feeling pressure on my heel and occasionally, some pins feeling in my tendon.

Yesterday, It was the time to change the boot again, to position 1 this.. I was very excited, more ROM, more progress. I knew what to expect when I put my foot on the ground, it will feel weird so I changed the boot, secured it and started walking for 10 minutes to eliminate any weird feelings, it worked quite well. I was ready to put more weight and resume my normal routine after 30 minutes or so.

Today, First day to walk 0.4 miles between the train and work with the new boot setting, It was quite easy, only pain is occasional pain in the back of the heel (Donna, you mentioned that this might be not good right ? ). I felt that I wasn’t putting that much weight on the crutches because my arms didn’t hurt as they normally do. This encouraged me when I got up to work to try walking with one crutch again and OMG, It feels so easy now, there are some balance problems still, but I feel Im putting all my weight on my leg.. I freaked out to the extent that I felt I re-ruptured it or something that’s why I can do all that on it. Same with walking with no crutches, it feels very easy too!!! Although I’m very excited, I will try to take it slowly and not ditch the crutches until I am in neutral next week, especially I will lose the high sole in the boot and change to the flat one!!
I think weeks after the first month are very exciting, each week there is a change/improvement, so for all who are before 4 weeks, its doable and I believe the worst is over!!!

Few Questions regarding incision, compression socks and weight bearing

Hello Everyone,

I have few questions that I would like to get your input at.

1- I actually still have medical tape on my incision and I feel that is causing some irritation on it (Scratchy feeling) It has been 10 days with the same tape. Should I take it off? or wait for my next visit in 10 days to ask my ortho ?

2- I bought compression socks, I bought one size up (Large) although I normally wear medium. Its too tight to pull it through my feet without feeling I will put pressure on my ankle or hurt. I’m nervous of trying. Did any one have this problem before? Can you hurt your self putting a sock one ? I’m 19 days Post OP PWB in VacoCast

3- I tried seeing how much weight I put on my injured foot using a scale. I’m not sure If this is a good way or not, It looked like I’m putting 25 LBs or so. I feel I can do more without feeling pain. Should I try to increase the weight bearing ? Or be more careful during these first weeks ? My orhto recommendation is quite vague, PWB as torelated is quite vague in my opinion.

Sorry for the long post or repeated questions!!
Have a good week every one!!

My surgeon operative and post-operative protocol

Happy Weekend everyone!.

I thought it wouldn’t be a bad idea to share my surgeon operative protocol. I know most of us here have already read a lot, but I think it might be useful.

Here it is: Joseph Kou ATR

How tendon heals, Collagen types?

Hello Everyone,

I took Scott’s advice and started reading about how tendon heals. I stumbled upon this article:

I think its good, I think I understand better now why time is important and the difference between the Type 3 Collagen (Produced in earlier stages of healing) and Stronger type 1 Collagen.

One question I have though, have any one tried taking Collagen booster supplements ? Either pills or eating a specific diet ? Is that something worth pursuing ?

I also started doing some exercises for my other healthy tendon as I read some where that the risk to rupture it is 200 times more when you are recovering.

Happy Recovery!!

13 Days Post-OP fear of Re-rupture

Alright.. So Lets start.

This is my first post on Achilles Blog. So a little introduction about myself.  I’m a 29 years old, Software engineer. I’m not lazy but not super active too. That’s how it all started, I decided to be fit again, my favorite sports is Squash. I used to play professionally about 12 years ago. About 6 weeks, I returned to playing. Apparently, I was way too out of shape. Friday, February 20th,  I was playing when I heard the "Snap" and as if I hit the glass wall in my ankle. The rest is known to everybody. Went to the ER, got a splint, Saw an orthopedic later in the week and had my Surgery on March 4th. I left the hospital the same day with the huge cast over my leg and some pain that is tolerated by pain meds.

First few days after the surgery weren’t that bad. I stopped taking Pain Meds. by the fourth day. I still take the 325 mg Aspirin, I’m paranoid, my grand father died of a PE, so I’m not sure If I’m over reacting, but I really don’t want to get a clot.

I used a Knee scooter/Crutches for the first week. I had my first post-op appointment on Thursday March 12th. They removed the sutures. My surgeon checked on it and he put in the VacoCast. I was told not to take it off, keep it on 24/7. He said I can weight bear on it as tolerable. I left the clinic with the boot at position 3 and using the crutches. I wasn’t expecting it to be that difficult to walk in the boot, but it is.

The Boot hurts the top of my foot. I keep the straps tight to feel comfortable while I’m walking. When I’m sleeping, I release the straps a little bit to ease it on. On that day, I was excited to be on the boot, so I decided to go upstairs to sleep in my bed finally. While I was climbing up with the crutches, I lost balance, I landed on my foot in the boot, but not very rough. I was so scared that I have ruptured it, kept reading on Achilles blog about similar stories. I didn’t feel pain, but re-rupture stories are scary.  I called my surgeon and he asked me to come so that he can check it out on Monday.

I went yesterday, Thank God, he said its Ok and gave me more advice about trying to be more careful, also he mentioned that your foot is pretty protected in the boot and that its unlikely that people re-rupture their ATs while they are in the boot. Is that true guys from your experience.

Also, I work in San Francisco, I started going to work this week. I tried using the crutches on Monday, but it was too tiring, so I decided to take the Knee scooter as the physician assistant recommended. However, Today, I was crossing a street on the Knee scooter and suddenly, it capsized!!! I didn’t fall on the ground, I don’t think I landed hard on my foot and I don’t feel pain.. But I’m back to being worried again.

I’m going to see my Surgeon again on April 2nd for my 4 weeks Post Op. I’m very nervous to stay without checks for such a long time especially when I’m active and keep going to work every day. Do you guys feel that its risky to be commuting to work and be in the level of activity I’m doing that early in the process.

I will post more updates! Looking forward to your thoughts/replies.

Happy and Fast recovery everyone!

1 Week Post op 1 Week Post op

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