peterg’s AchillesBlog

Hi Peter,

being still on my cast I am wondering how things can go once I get back to the box. Box jumps, double unders, sure will be the last things I will be doing, snatch, clean, perhaps few months before.. but during this process, how can I ensure I am on the safe side?

As there was no previous advice before ATR, appart from how you feel day after day, did you do any particular check on your Achilles?I mean to ensure that there is no risk of a new rupture.

Today, I am guessing you are completely recoverd, are you following any particular routine on stretching, PT ..?

Thanks fo your advices!!

Will probably do a box jump or 2, absolutely no rebounds and likely step downs.

I dont actually blame crossfit. I have always been a runner and stopped running for 2 years (surfed a lot etc). Started running again with Vibrams and twitched my left AT and started crossfitting. 4 Months in I snapped the right one. My theory is that I transitioned way to quickly to natural running, injured the left tendon and over compensated on the right and boom!

6 Weeks in, non operative and moving to neutral in the boot on Tuesday, will probably transition over a few days from 2cm to zero. Hopefully by week 16 life will be fairly normal.

I dont have a blog here…to be honest is seems a bit confusing to setup. Would also like to hear more, especially wrt to recovery and protocols and actual PT exercises. Knowledge is power

I am still crossfitting btw…pull ups are my middle name.

Keep Strong!
AJ

Another competitive Crossfitter here. 12 days post ATR, hopefully can find your full story.

Not sure I’ll ever be mentally able to do a box jump w/o fear.

Congrats and good to hear!

Yeah Man!

Love to hear the progress! Snapped mine on Box Jump 78. 5 Weeks in and kinda coping. Just missing death by burpies and obviously surfing!!

Glad to hear it, Peter. I’m at 14.5 weeks currently, and Nautilus / the recumbent bike aren’t fulfilling my desire to gasp for air like metcons do.

replace box jumps by simple steps ups!

Your recovery sounds like it is going amazingly well! I am still too scared to return to CF. I am back to normal as far as lifting and have even started slow jogging a couple of weeks ago but I just don’t trust myself to not push myself during CF and am going to wait a good 9-12 months post surgery before returning. Just the thought of the day I return to doing box jumps and DUs scare me!

Remarkable speed, way to go!

Hey,
did my achilles at crossfit 3 weeks ago while doing double unders and read your story. Cool to hear that it is doing well.
keep up the work out!!

Today I also added weighted back squats at 60kg 5 x 5.

And as part of the Crossfit WOD front squats 50kg….
WOD 8 deadlifts @ 60kg
6 front squats @ 50kg
1 strict press @ 50kg
10 minute AMRAP…. score 8rds 1 front squat

Amazing progress - I haven’t attempted to do a single leg heal raise and am scared to do so. Double heal raises are no problem. I don’t plan to return to CF until I am at 9 months out or possibly a whole year. I injured myself doing DUs and though I think it was just a fluke, I don’t plan to try those again for quite some time and just want to wait until I am closer to 100% before I return.

That is impressive. You went from 2 one lhr to 50 in 11 days? How were you able to build up that quickly?

I feel like I have a pretty aggressive schedule and can’t even do 1 one lhr and I’m about at the same point as you. I could probably do about 40 two lhr.

I did NOT stretch aggressively that early, and would wait another month. I’d also hesitate to do any exercise I could only do 2 or 3 of. 8 reps is my rule of thumb when I’m not injured, and 10 or 12 is probably prudent when you are.

Very nice! Getting rid of the boot is a big milestone
Take it easy for the first few days. The strength takes time to come back fully and there are so many movements that need to be learned all over again. Congratulations!

Congratulations! I’m almost at 12 weeks and continue to feel better and stronger every day! It sounds like you are having a strong recovery!

Congrats! Stretch, stretch, stretch. I am at about 17 weeks and I still do a lot of stretching of the tendon. Tightness aways returns after a day of walking around.

Totally agree with you on sleeping without a boot. The first time I could do that was like heaven! good luck to you as you move forward. Two shoes is just around the corner!

Thanks all..
And Norm I take onboard what you say, I don’t feel like I’m over doing anything all walking is still in my boot even though I have tried without it.
My goal for training is still for December which will leave me 15 months to build towards the CrossFit open in 2016.

On a side note I gave sleeping a try without my boot and it is heaven!!!

Just remember to feel vulnerable for another 1.5 months or so! This is no time to feel completely normal or overconfident!

Good to hear. Soon the swelling won’t be an issue either. Only thing is a little tightness and strength. Keep it up

That’s great news! It’s really nice when you can get back to your “normal” activities again. Things should only get better from here on out for you as you improve your strength and endurance. Continued good luck to you! -David

Peter - I would suggest if you have been walking in the boot without crutches you have moved to the next stage, FWB. There is really nothing wrong with that and in aligns with the more modern protocols. I suggest you keep it up as tolerated and deal with swelling the usual way. If you leg gets tired or sore then rest, elevate and ice. What the research has found is locking up a tendon for 8 to 12 weeks with no weight is counterproductive. It does not promote ‘good’ healing. There is no need to stretch the tendon at this stage so what you are doing there is good as well. Early weight bearing and motion will assist the remodelling of the collagen and get you back to a normal life sooner.

Peter

Showing good initiative with the FWB, don’t overdo it though.

Scott, dead right, the most important thing is for the tendon to heal well. although there will also be other tissue damage due to the incisions.

My doc and my PT both say the most important thing post op is for the tendon to heal. I think that contrary to one may think, it take more discipline to do little than to do too much. I feel great, my swelling is down, etc. but at week 3, my main focus is for my tendon to heal together properly so that I have a good foundation for rehab and avoid any possibility of healing long or similar. This is just my take. I have learned from this blog that there are many ways to a successful recovery.

Each case is different, I did 4 weeks cast, then boot 3 weeks. I ditched the boot at 1 week in the boot and practiced partial weight bearing by doing a 3 gait walk with my crutches and then one leg, now at week 8 I can walk fully. I have a limp, but I always practiced weight bearing till I could fully walk no crutches. So again everyone is different, but I always tested my ability to weight bear by laying down on my bed and bridging with both legs then seeing if I could take my good leg off and still bridge. Helped build strength for the first steps, But too much too soon is also bad.

Congrats! Good luck with your healing

Peter, the NWB stage is the worst (IMO), and there’s just not much you can do but wait it out. Your Achilles needs some quiet time to heal before you start putting it to work again. Once you get to PWB, FWB is not far off (1-2 weeks) and then you can be a much more active participant in your recovery. Although it’s a slow process, your calf muscle will come back! Lastly, be prepared for swelling to increase as you begin each new stage in your recovery: PWB, FWB, 2-shoes. Just when you think it’s under control, new activity and new muscle use will bring it on again. I originally thought of it as a step backwards, but now I know it’s all part of the recovery process. Best of luck to you! -David

Went and had it checked out, I’m happy to report all is ok!!!! massive weight off my mind.

That happened to me twice, my first two days pwb right around day 7 and 8. One even sounded like Velcro ripping. I too feared the worst but it all turned out ok. Ice and elevate!

Don’t panic. Rest up, elevate. Hope everything ok!

F@#k just had my crutch slip forward on me and I came down on my injured foot, a sharp pain shot up my leg now I’m fearing the worst

I spent a fair bit of time kneeling on “that” knee during rehab — like at the bathroom and kitchen sinks, and at the kitchen counter, on various padded stools or a wheeled office chair. During my first ATR rehab, post-op with an ultra-slow OS, “that” knee began blowing out before he FINALLY stopped putting me in casts and let me get into a boot. I wouldn’t expect that to start as soon as you are, but it can happen later.
Second ATR, non-op with a nice modern evidence-based rehab, my knees were fine.

I didn’t have much pain post op. Maybe the second day I had enough to at least try the Percocet I was given (although I probably could have powered through…but why!).

Good luck! I had my surgery on the 16th so we are about the same spot.

Pain from the ATR itself is hugely variable, from mild (but weird) discomfort up to excruciating. Post-op pain is much more widespread (though you largely escaped), though it fades much faster for some than others.

I found my ATR op quite a bit more painful than my more recent heart-valve replacement, which included a full sternotomy (sawing the ribs apart)! Mind you, I couldn’t believe how LITTLE pain I had from that surgery, and I stopped taking all pain pills (even Tylenol) while I was still in the hospital, a couple of days post-op!
I also hit the ski slopes (Whistler) much faster after the open-heart surgery than either ATR (one op, one non-op). Whistler at maybe week 8 post-OHS (though slow, padded, and stopping to check my heart-rate monitor!), not till 17 weeks post-non-op ATR (though skiing full bore).

Lol. I know what you mean. I was a gym rat before and I had big muscular calves. Now I have a bird leg :’( Glad you haven’t had much in the way of paun , I was the same also. I feel bad for those with so much complications. Keep it up and good luck with your healing.

Good luck to you in your recovery!

Hi atr2014, I went the surgical route, have had very little pain to report just what feels like cramp when I drop my leg down from an elevated position. I’m at day 3 post op and just really looking forward at hitting the rehab and all the different milestones a head.

Was wondering if you were going to go with surgical or not. How are you feeling? I was in a lot of pain after mine - I wasn’t one of the lucky ones that got pumped with meds in their IV that was good for 24 hours plus. The good news for me was by the 4th day, I was all set with my meds and no longer required them. Hope you are recovering well and feeling pain free.

Lots of different opinion on best route to take. Glad you’re happy with your op route and looking ahead to your rehab. Good luck with it all. Happy healing.

peterg: don’t stress. The non-operative option can work out great even as treatment after a post-operative rerupture for a sports active fit man in his early forties.

BTW, many surgeons tell their post-op ATR patients that it was really lucky they had the op, because of their specifics - huge gap, muscle rolled up like a window shade, etc. But in 945 acute (prompt) ATRs, Wallace found NONE that wouldn’t approximate (and none among the reruptures and only a few among the neglected ATRs)!! And his success rate non-op was better than most surgical studies!
Surgeon bedside puffery, I think. If your surgeon tells you that your problem was unusually tricky but he cured it, then you feel great about yourself, your painful rehab, and your surgeon, too - win-win, harmless puffery. Except most of it is BS, so we shouldn’t rely on it the way we rely on peer-reviewed published evidence.

Atr2014, it is puzzling magic that can reconstruct a good correct length AT without surgery. But the first law of science is “If it exists, it must be possible!” And the 3 studies listed by Cecilia clearly show that a reliably successful and quick non-op cure definitely exists.
I think there are many reasons why OSs are slow to stop operating. My guy did exactly that, but he’s a rare bird - and he had too many patients waiting anyway because he’s a superstar, so no complaints from his practice partners or his bank mgr. But even without professional or $ pressure, confirmation bias alone keeps most of us from concluding that we’ve long been doing something that’s essentially useless. My rare bird just said “I didn’t become a surgeon to do surgery without any benefit, so I stopped!”

atr2014

Didn’t meant that your username was unoriginal. What some here do if their usernames aren’t very inspiring, is they add their real(?) first name, but that’s personal choice.

By the way, my rupture was so far up that my GP and doctor at local small hospital thought that I had ruptured a calf muscle. My specialist when he diagnosed the rupture wanted to try non-op first - it worked, and I’m now 3 years on with the tendon fully healed and de-atrophied (is there such a word?) for ages now.

While you have time on your hands (and my lunch break is almost over), research how collagen, 2 types I seem to remember, works to re-join the damaged AT ends - very clever stuff.