phoenixlv2000’s AchillesBlog

Hi Phoenix,

Not a professional at all, but have almost reached 1 year post-ATR and am back at playing some sports and full on training in the gym.

Can I suggest that you visit a physio, ask for an assessment of where your achilles and calf is at and also ask for a program you can work on by yourself (or with very little intervention or medical help if that’s the way you like it). In the last few months of my recovery, I really only saw the physio for massage of the calf and foot (I now get plantar fasciitis) but she was great in giving me hints and tips on how to return to sport with confidence.

Need to be able to do calf raises with balance & strength, move to small box jumps and then larger. Work on ankle mobility too. Interval training is good, you need to be able to change direction and pace quickly.

Anywho you’ll figure it out, because mostly I think you just know when you’re ready to rumble right?!

Good luck and happy healing
Miss Emm

Having been in a cast 1-week, I am curious if you had any lasting effect from your unanticipated slip in January when transferring from the knee walker to a chair?

I had a similar incident.

I watched some videos on youtube and added my own stuff in. I haven’t started yet but I have a lost of stuff to do. If you search youtube for achilles rehab you’ll see more stuff to do like I did. Just remember that some of the people there are ahead of you and can do more advanced things than you.

Yeah, I took PT into my own hands at week 5 (post op). My insurance didn’t pay for it, so it was too expensive ($150 a session).

I just went to the gym without a routine…..pool, bike, calf strengthening machines, stretching and the doctor said I looked okay at week 12. I told him I wasn’t going to PT and he was fine with it. He expects me to work hard so by week 16, I can do a single leg heel raise.

For me, it was listening to what other people said on this blog. Don’t push too hard, listen to your body, and don’t over train in the first 12 weeks. I started being more agressive after week 12 and I think by week 16 i can get a single heel raise in.

I completely agree with Norm. Take it slow and be very careful for the next few weeks until the tendon is fully healed. Treat the swelling as much as possible, since it more than likely stunts the healing process. Walk as much as you can and the Crocs for me were awesome for the house and driving.

Also, I had minimal pain in my Achilles area, but joint pain on the top of my foot and stiffness in my Peroneal tendon. Most of this was from the lack of strength in my calf from all the atrophy and 6 weeks of NWB. Your NWB days do affect the rest of your leg also. My doc said, “for every 1 week of NWB you will need 3 week to get it back”. Good luck with your recovery and therapy.

Ya, work hard to control the swelling. RICE. I padded around the house in a nice soft squishy pair of Crocs (actually cheap Chinese imitation Crocs from Chinatown) when I first got into 2 shoes. It seemed simpler than carpeting the house with the kind of squishy soft stuff that Crocs are made from. . . They’re also pretty forgiving of one size here or there — and at ~$5 a pair, I could easily have supplied myself with different sizes, even for left vs. right.
I wouldn’t worry much yet about stretching/ROM or about regaining strength. If you just walk as normally as you can, and elevate etc. whenever you’re not walking, it will tend to re-train your leg and foot to do their jobs. Any exercise that makes your swelling much worse is probably too much too soon.

Hi there, i am only in 2 shoes for a few short weeks, i use a compression bandage/sock. I also use ice alot and rest as much as i can. When you are forced to on your feel alot, perhaps try to use arnica ice gel or oil. It is very good for tendons. All the best, take care. By the way can you do heel raises yet, i am 16 weeks…just for interest

Okay, that should read 8 week checkup, not 8 months. Wishful thinking. Sorry for the confusion and thanks for the shoe advice. Appointment is tomorrow. Exited and nervous at the same time.

I doubt that the choice matters a lot, as long as it doesn’t “anger” your scar, and nobody kicks or trips you. I wore Crocs around the house because the bottom of my foot was hypersensitive and the squishy gel felt great. And I got squishy gel inserts for my outdoor shoes and boots. I used the boot, and somtimes a cane, for scarier outings.

I assume it is a typo and should say 8 weeks not months.

My sports physio recommended to use a good quality running shoe with a well cushioned sole. I didn’t have any particular pronation issues previously so went for a neutral shoe and added a pair of simple 5mm heel lifts. The shoe brand choices are endless but I went for Nike Pegasus range due to cushioning, comfort & looks. They have been so good that I have bought them in different colours and I wear them into work with a suit on.

Confused here. On February 12th, 2013, you posted “Just finished week 5″ and now you’re a week before your 8 MONTH checkup? Please explain. (And install the ATR Timeline Widget too, if you can.) Thanks.

mindfulatrofhealing, the gist of NWB-PWB-FWB is simple: At first, you’re holding your injured foot off the floor. Starting PWB, rest it gently on the ground as you crutch-walk past it, AS IF you were walking normally. Then very gradually, try to turn that “pretend-walking” into more “real” walking, by shifting a bit of weight onto that foot when it’s going through the motions. Listen to your body, avoid pain, but keep gradually sliding toward normal.

When you’ve managed to shift all your weight to the injured foot (and especially when you start forgetting where you left the crutches!), you’ve made it to FWB.

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

I ruptured my right AT also, so I know the pain of not being able to drive (work, dr, appoint., PT, kids, etc….)
As far as what kind of shoe to wear, I started with a sturdy hiking boot (something with good ankle support and a nice size heel). I also loved my Crocs for driving and walking around the house. I also got some gel heel lifts that I used the first 2 weeks in my shoes which helped the pain.

More importantly be sure to protect your healing AT. Your coming into the weeks for the greatest risk of rerupture, so be sure to take it slow and be careful until you feel comfortable. (Ex: My first week of 2-shoes I had to put my boot back on for all the stairs at work). Anyway, good luck and happy healing.

The timing of recovery really is so different for everyone. I just passed week 6 post op and had my hard cast removed yesterday. So, I am a week ahead of you time wise and several weeks behind you recovery wise. My doctor said to start working up to being FWB over the next 4 weeks. I have 3 inserts in the air boot and can barely put any weight on it at all. Would you be willing to share your process of going from on crutches NWB to PWB to FWB? My doctor didn’t give me much guidance…I feel your pain with the inability to drive. I ruptured my right achilles as well. I’m very excited for you, you sound excited and very optimistic! Happy Healing!

When you start PWB to FWB most of us start out with two crutches. Make sure to walk as normal as you can (Ryanb was a great video to show this).

After working through 2 crutches you move to one crutch, and then to FWB, when you don’t need the crutches any longer. A couple of weeks later you should move to 2-shoes and not need your boot anymore. This was my experience, but other move faster or slower. All of my protocol once I started the progression said to progress as pain allow(ed) me to. Also, I’ve been in physio for 2 months. I started Therapy at 8 weeks and it has been immensly helpful in speeding up my recovery and keeping me motivated. I will take as many session as my insurance allows. Do exactly what they say in therapy and keep up with your home exercises.

Good luck with your recovery.

hi phoenix…im pretty much in the same situation like you…however, i was given a boot from day 1 and never had a cast…im on week 7 now and last Mondey when i visited my doc he said to start walking using one crutch…on day one that was impossible…my leg felt so weak and i was also scared to put weight on it…the next day i managed to do my first steps on the boot and boy that felt so nice!!! so my doc said that i should go like that for about 10 days and then 2 more weeks with the boot on and no crutches…so in 3 weeks (a total of 10 weeks since surgery) i’ll loose the boot…when i discussed with the doc about physiotherapy he said it was my decision…some docs dont really get along with physiotherapy, some others suggest it…all i can say is that im really glad im doing them…actually im going for about an hour everyday and i will do a max of 20 sessions…the physiotherapist said im doing really well and i feel quite good cause after 6 weeks of doing nothing it feels great to move my leg again…to me,physiotherapy is a great psycological boost and i believe its totally necessary…its like the transition phase from

H

Try putting a pillow between your legs. It keeps my cast from rubbing on my other foot.

Have you tried driving with your left foot? I have, and it has been much easier than I had expected. It really depends on the car. If you can swing your right leg out of the way, you may be fine. Be sure to practice in a parking lot.

My boot came off at 8 weeks and I started driving the next day. It was remarkably more easy and painless than I anticipated but I’m glad I didn’t try much sooner. I feel like if I had to slam on the brakes it would be more of a leg movement than an ankle movement but that may be just me. As for work, I’d probably wait until you get the boot if you can but I guess it depends on the environment. When I had a splint I was constantly afraid people would bump my foot and I probably jerked my foot out of the way more than I’d have liked. I felt more protected in the boot.

I wasn’t able to drive for about 9-10 weeks, but my doctor said wait until the boots come off completely, which was 12 weeks for me. This is a heavily debated question, and I’m sure you will get more than one answer. The fact is you will ultimately have to decided when its safe to drive, so take your healing, doctor’s advice, and friend suggestions intoi consideration when deciding. I ended up relaying on my awesome friends to help me get my kids to school. Good luck.

FWIW, early in my recovery, I found that I could flex the tibialis anterior as hard as I wanted, without pain or stress (so long as my range of motion was constrained).

So, for instance, I could do seated leg extensions- flexing my quads and pulling my toes back with 100% effort (in a boot!), and there was no pain or lingering adverse effects. I was careful to ensure that the lower section of the boot was cinched down tight, to ensure that my range of motion was properly limted and no stretch was put into the fragile Achilles.

As you probably know, the muscles that lift your foot/toes up (tibialis anterior) do not act through the Achilles. They are also, relative to the calf, very weak.

Were you in a boot or cast? If so, I think the danger is almost nil. The way you can hurt your Achilles in this manner is to lift your toes too far, stretching it too much. Sounds like you did a reflexive active dorsi-flexion. If your range of motion was limited by a boot/cast, then I really think there is very little chance that you would have over stretched it.

If you were hobbling around without support (I did it too), then there is some risk. But those muscles are so weak - that even then, I think you have a very very good probability of being OK.

Conversely, it’s quite possible to damage the healing achilles with your calf muscle - in or out of a cast/boot. A strong calf contration - with, or without motion - can tear apart a damaged Achilles. So, as others have said, be extra careful for the next few months, no matter how this turns out.

I slipped on a curtain about a week after the surgery, landed very hard on the repaired foot and had the same worries. everything turned out fine for me, as I am sure it will for you! nearly everybody has at least one scare during their recovery, unfortunately…

Stay super-cautious for another 3 months, regardless of how this turns out! Good luck. There are many more scares than reruptures, for sure.

My first follow up is on Tuesday. Thanks for the response. Being super cautious now due to the scare.

Many of us have had a similar fall (I fell off my Scooter making a bed 2-3 weeks in), and usually everything is fine. I would still suggest mentioning it to your doctor to give yourself piece of mind. When if your follow up appointment?

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