Slow recovery, nearly 5 months post-op

Hard to believe it’s so long since my operation, and now about 2 months of walking without aids (crutches, boot, etc).  But as this site makes clear, recovery is a marathon and it feels progress has been increasingly slow over this period.

Current status:

  • I’m having physiotherapy under my work private insurance about every 10-14 days, but likely money will run out soon!
  • Physio is now more physical with focus on use of Cybex (?) machine to strengthen left ankle.  I’ve tried unsuccessfully to attach a scan of my results taken on 15 May which indicate my left ankle is about 50% of the strength of right (although I was always right side dominant, so expect my left was never as strong as my right anyway).
  • For several weeks after giving up the Aircast boot, I preferred to use walking boots out of doors, but now am wearing trainers outside and in the house (occasionally walking boots).   Or when it’s warm enough, bare feet :-)
  • Walking is better and is getting back to full pace, but I’ve limited resilience - perhaps half an hour limit.
  • I bought a (cheap) static bike for the house as I didn’t want to risk cycling outdoors at first, but may go for it now I am stronger.  I don’t swim as my skin reacts to chlorine in swimming pools.
  • Standing still or walking slowly for any length of time is still a real problem.  Ache in back of foot and in Achilles.
  • Generally I still feel tired more quickly, both physically and mentally, than before my ATR.
  • Ankle is often swollen (I was told it would never look quite the same as the other) and certainly doesn’t feel “normal”.
  • It’s hard to combine my demanding job (almost entirely mental and sedentary) with the requirements of walking, exercising and massaging my swollen ankle.

Questions, as there seems less to read about further down the recovery track:

  • Is paid physiotherapy worth it, or should I just keep up the exercises at home and let let nature take its course slowly?  I found using the Cybex machine complete torture, and haven’t used it since mid-May (I’ve had some dental surgery which prevented it until this coming week).
  • Are there good tips for recovery from the point of becoming normally mobile again?  I’m 61 years old and not very physically active, although reasonably fit.
  • Footwear - the most comfortable trainers I have are running shoes with gel heel and a padded heel so less pressure against operated achilles - other trainers and shoes less comfortable.  Walking boots with ankle support are good but the heel gets sore even with gel heel pads.  What have others found best at this stage in their recovery?

Walking without external aids

During the week of 7 April (11-12 weeks post surgery) I stopped using the Aircast boot and soon after the crutches.  At first it felt very strange, but now 10 days on it feels entirely normal.  I continue to use walking boots outside to provide support (and comfort), but wear trainers indoors.  Ankle still swollen and the specialist (signing me off) reminded me the operated ankle will never look quite the same as the other.  I’ve been given the go-ahead to walk as much as I can comfortably, which is great and my walking speed is much better.  Continuing with daily exercises from the physio and about to resume my pilates class next week.

Things I still find difficult or issues include:

  • Operated ankle swelling/ discomfort.  Heel still gets sore on longer walks.
  • My other Achilles continues to feel like it’s overworking
  • General fatigue
  • Stairs especially if not a deep tread
  • Considerable discomfort if standing still for extended time

Notwithstanding these relatively minor problems, considering my age (early 60’s) and a mentally demanding job, it feels like a miracle that I’ve made it to this point.  My operation was some 10 weeks after the injury due to delayed diagnosis.  I’ve been told it will be 6 months after the operation to recover most of the function.  ATR is a really unpleasant injury but I am very grateful to my surgeon and the medical staff who were fantastic, and I appreciate the advice and support I’ve received directly and indirectly on this site.  Thank you all.

Apart from continuing with the physiotherapy and massage of the ankle, I will be interesting in any advice/ tips/ experiences on handling this later phase of recovery!

Down to one wedge in Aircast boot

  • Have progressively reduced from 3 wedges in boot to 1 now. This is the best yet, less discomfort for my operated heel and finding walking much easier.
  • My specialist advises I mainly need the crutches for balance so I feel OK when walking around the house without them.  Also lately I’ve managed to walk up and down stairs without crutches using the handrail.  Feel very liberated, although can be unsteady when tired.
  • Physiotherapy exercises stepped up last week.  Improving strength but hard work especially on my hips.  This is getting me back into pilates - hope to rejoin my class next month.
  • However, ankle still quite swollen and achilles very tight, but expect this is normal in week 9 post op.
  • Trainers or other shoes feel uncomfortable on operated foot so it’s either the boot or nothing on my operated foot.  Normally my walking boots on my good foot as they raise it towards the height of the Aircast boot and I feel more secure with the additional ankle support.

Moving on to Aircast boot

Yesterday (February 24th) I had the hard cast removed and took delivery of an Aircast boot.  I was told it would feel like a move backwards for a few days, and with 3 wedges in the boot for the first week it certainly felt like it.  As I’d had my cast for over three weeks I’d become quite adept at walking with it, but I do remember how hard I found it at first so maybe I need to be similarly philosophical now.  I imagined the boot would be a great improvement right away, so somewhat crestfallen.

My foot and ankle look quite swollen and the leg muscles somewhat withered.  I enjoyed a bath and cleared off a lot of dry skin, although my leg still appears to have a severe case of dandruff!!

First night for over 5 weeks sleeping with an open ankle was a strange experience.  I had the irrational feeling that the bedding by my foot was damp and almost turned on the light to check there wasn’t blood everywhere. The wound is very dry but our minds play tricks on us.

I woke completely drained and discovered what appears like a small blood blister on the sole of my bad foot right over the heavy heel wedges.  Maybe it was there before but very uncomfortable, feels like a small stone in my shoe.  A compeed blister plaster from my walking days has alleviated some of the discomfort.   Anyway, decided to work from home - my job makes this possible - a mixed blessing as there is no respite but as earlier in my recovery from the operation the job can be a positive by taking my mind off physical discomfort :-)

Found walking in the boot this afternoon more comfortable and expect things will get easier in time.  As ever, patience is necessary!

Walking with crutches - advice appreciated

I’m now using elbow crutches, having moved onto a PWB cast about 10 days ago (this was 2 weeks after reconstructive surgery).  It is a hard, lightweight cast, consisting of a synthetic coloured bandage material over inner bandages and other padding.  I use a  light orthopaedic sandal to protect the cast.  The cast  starts shortly just beyond my toes and ends a few inches below my knee.  It seems some ATR people move straight from the post op cast to the boot, but I will be in this PWB cast for about 3 weeks.  It gives me a feeling of security re the operated tendon.

I get around VERY slowly using crutches, but have improved upper body strength with use.  However, I’m wondering if I’m using the best technique and whether the discomfort I have in my heel is normal or avoidable.  The longest walk I’ve attempted was about 400 yards and took 20-25 minutes, with several pauses along the way.  Naturally uneven surfaces, crossing roads, etc along the way provided further challenges.

I am finding that my operated foot gets quite sore on the heel even with quite short walks.  Also I am aware of rolling my foot forward towards my toes makes the end of the plaster come up against my foot and I worry about blisters.  I’m also slightly higher on my operated foot which makes me out of alignment and concerned about possible back problems (with which I had trouble in the past).

The brief instructions  from the hospital plaster room read as follows:

  1. Do NOT swing your hip
  2. Do NOT walk with foot turned out
  3. Walk “Heel” and “TOE” and STRAIGHT FORWARD
  4. MOVE YOUR TOES and TIGHTEN YOUR MUSCLES inside the plaster
  5. Use crutches as instructed

My technique based on my recollection of the instructions on using crutches is to move forward with the operated leg in line with and supported by the two crutches, then bring up the good leg, keeping upright and looking ahead (but also for obstacles/ uneven surfaces!!).

Any input/ advice/ best practice?  Is the discomfort in my heel due to my tendon or to placing excessive weight on my operated foot?  Have others had back trouble from misalignment, or found ways to compensate?  I’d like to be able to move more easily, as I enjoy walking, although perhaps I need to accept the limited mobility for the present.

BTW, I bought a cover for the cast which I’ve found excellent and absolutely necessary in the wet winter we are having in the UK!  Their waterproof protector is also good for showers/baths.

First two weeks from operation

I had an operation to reconstruct my Achilles on 16 January - some 10 weeks after the original accident - after an intense end of year workload on my job.  It was a delayed diagnosis so by that time all the pain had gone.  It was an almost complete tear of the AT.   Once I’d seen the surgeon in late December I was reassured: surgery was the only option and despite the delay in treatment the surgeon instilled confidence that it would be successful.  The operation was done privately (company scheme)  in the late afternoon and went well.  I stayed overnight in hospital and came home in the early afternoon (so about 24 hours in hospital altogether).

I’m British, 61 years old, of medium weight, not as active as I’d like to be, but I do pilates and in the past yoga and Alexander Technique so although not very fit  I have good body awareness and reasonable core strength which helped immeasurably in the post op period.

The physiotherapist at the hospital decided I wasn’t getting the hang of using crutches in the non weight bearing phase, so I was issued with a zimmer frame which was no doubt a wise call but didn’t do my self-image any good!  Our house is a bit cramped for space and my experience this was a sensible option.

I learned to get up and down stairs on my backside (wouldn’t ever risk crutches even now) and to crawl on all fours - learning from my grandchildren! - where the frame was simply not practical.   Moving about was tiring work so I tried to set up a base in a particular room.  My wife took holiday from work to look after me for the first week, which was invaluable.  As my children live away from home I didn’t have the demands of a young family which must be hard for a younger ATR parent and their carer/partner.

I would say I coped well, and continued to work on my office job, more out of necessity rather than choice although it was good to take my mind off my condition.  I had to be resourceful about posture in the early period, trying to work with a laptop lying on my back with legs elevated, supported by pillows, cushions, sleeping bags, etc.

Here are some other reflections about this period:

  • Be careful!  I became a bit complaisant after a few days and getting up to go to bed managed to slip and fall, hitting my bad foot against a wooden floor in the process.  This was both a shock and a great worry as I thought I may have damaged the operated tendon.  I had an anxious day trying to contact the surgeon who eventually confirmed that most likely I would be OK as the cast would protect me and I didn’t report pain.
  • Be philosophical - healing takes time, you need to accept the limitations of mobility, etc.  I found the experiences of others from this site both reassuring and inspiring as it became apparent just what recovery from surgery entails.
  • Be imaginative and resourceful - there are often ways around problems and useful advice on this site.  I managed to do far more than I expected.  Crawling seemed a very good and safe mobility solution for me anyway.  Dealing with being either very hot or very cold in the operated foot (it’s winter here although although more wet than cold) requires flexibility both in waking and sleeping hours.
  • Get help - fortunately I have a very caring and practical wife, but I do wonder how people cope living on their own or without much support in the immediate post op period.
  • Be informed - it’s surprising how little I was told to do, at least in writing by health services.  I guess their objective is that you take good care of yourself (e.g. don’t fall!) and take medicines like the subcutaneous anti-coagulant injections.  They rely on you asking them questions relevant to your situation.  Again sites like this one are very useful, because you may not otherwise know what you will need to ask about!
  • I was told I was lucky having the operation in winter rather than summer.  Comfort must be a huge problem in hot weather.  I visited my GP a week after surgery and the short “walk” to the practice brought me out in a sweat.  On the other hand I feel cold easily, especially in my feet, so keeping them warm was sometimes a big challenge, as was providing enough rest/elevation while working.

After 2 weeks, on 30 January, I had the first cast removed and a partial weight bearing cast fitted, moving from equinus position (c 30 degrees) to about 10 degrees.  By that time, I felt life returning to the ankle and was ready for partial weight bearing. I know treatment regimes and timescales vary, and I recently spoke with a colleague at work who was in the first cast much longer only a few years back.


This is my first venture into blogging.  Here is my background:

  • I live in a small market town in Oxfordshire, UK.
  • Early 60’s, male, average build and weight.
  • I suffered my Achilles rupture in late October 2013 at a barn dance.
  • Unfortunately it wasn’t diagnosed as ATR until early December (by my chiropractor).
  • Near complete tear of AT was confirmed by ultrasound scanning on 17 December.
  • At end-December met consultant who advised I needed reconstructive surgery.
  • Operation on 16 January (timing influenced pressure of work) - private rather than NHS through my work.
  • Worked from home 19 to 31 January.
  • NWB cast replaced by PWB cast on 30 January.
  • First day back at work today, 3 February.
  • So far all going well.

As I’m some way along the path I intend to write some more reflective and specific posts over the next few weeks.

I found this site from Google and it provided a lot of useful information and reassurance immediately following my operation.  I’m very grateful for the site and to the many people who have offered their insights and knowledge.  This has provided considerable reassurance and helped me to maintain a positive mental attitude.