popouch’s AchillesBlog

Well, 19.5 weeks is rather early for many things in the recovery process, including single-leg calf raise. I am 6 months post-op (i.e. roughly 7 weeks ahead of you) and I am not there there yet. Be patient, as recovery is getting faster at later stages. Just don’t push it too hard, but don’t just sit on it, waiting for it to heal on its own.

I just read through your blog and saw a lot of similarities with what I am dealing with from my surgery on July 12, 2018. What type of procedure did you have - Krackow, PARS, Speedbridge etc.? Your latest post gives me a lot of hope on getting some type of normalcy back in my life, because only being here two weeks post op, “recovery “seems so far away.

Eager is right! I’m two and a half weeks post-op. The atrophy is quite stunning. At least two and a half weeks until I’m partial. I’m still sleeping with the boot (very loose), but it is really nice to take it off a 4-5 times/day for some light stretching and ice. Man, do I love the ice!

She slid the probe lower, and then across my belly, and there it was again, but once again it vanished

Thanks

Great to hear you are progressing and also seeing your goal of jogging come into view! Also nice to hear you are in the pool — I am 4 weeks post-op and hoping to follow in your (ahem) footsteps! Best of luck!

bdelputte,

Thanks for the advice on the pool exercise. I started doing that and I love it. It helps build strength too with calf raises.

jarrodfrommich, I’m really sorry to hear that happened to you! I hope the damage is not as bad as you think and that you will be able to continue with the recovery. Please keep me updated with what the doctor says. I think it is interested the different stories people have. My physical therapist said, and I’ll quote him, “It is very low probably that you will rerupture your achilles at this point” as he stretched my foot upwards.

John

Hi Popouch,

I dont mean to alarm anyone, but I was at 10.5 weeks post OP this past weekend, 3 weeks since getting the cast off and 2 weeks in mostly shoes. Well I was walking in my yard on Saturday and stumbled while watching my dog. I took a large step with my bad foot and felt the pop again… I have an appointment tomorrow morning to see how bad the damage is. The gap is about an inch higher this time near the top of the sutures. I dont think it is a complete tear, as I can still flex my calf though. It is so hard to think positively right now… Anyway, be careful and I hope you continue well with your recovery!

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Hi Popouch,
I ruptured around the same time and still walk with a limp as well. Not sure if I would call it significant but it is definitely there and noticeable. It gets worse depending on shoes and whether late in the day or not. I also completely stiffen up when sitting down which then gets me to limp when i get up and have to start walking around again.
My physio wants me to focus on my walk for the next 2 weeks rather than doing aggressive training for my leg. I found that the pool exercises help / especially heel raises in the water. She cautioned me against doing too much as I need to be fit for my Rockies tour in a few weeks and cannot reinjure myself. She advised that simple walking also helps as long as i am focussing on the correct gait.

Probably nothing new in my answer but just to confirm that you are definitely NOT alone.

@tdance, sorry i took so long to respond. I haven’t seen the MRI or spoken to my doctor about it. I totally forgot to ask about it when I had my appointment afterwards and I haven’t been able to get my surgeon to call me back since. When I got the MRI though the technician said everything looked normal and even questioned if I tore my achilles! I’m still trying to talk to the surgeon about it. I also wanted the MRI just for my medical records because I will get good retirement benefits as long as my injury is documented properly…

However, I am pretty confident in my achilles right now…there is still a slight gap (indentation) in my achilles but it does not hurt and I am walking pretty decent right now without a boot. I have a limp, but that is because i can’t really step forward on the toes when I walk.

I pushed myself pretty hard early on even when there was slight pain walking in the boot…this helped me i think. People obviously heal differently but know your limits and try to push yourself if you can. Let the pain be your guide as you start walking. Don’t push it too hard and re-rupture, but a little bit of d

@popouch - I remember you and I are close in timeline. You mentioned that you had a small gap in your tendon and went in for an MRI - did you ever hear anything about that gap?

I’m going in tomorrow for an MRI (almost at week 11 now…) and am just now getting to one crutch with the boot on (been weight bearing for only 2.5 weeks).

That’s awesome for you. I’m 8 weeks post op and looking forward to just walking again.

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@popouch, we’re close to one another in timeframe as this is now 10 weeks post surgery, 11 weeks post injury date…

I have been seeing a PT for the last month and a half, twice a week and frankly I am not quite sure I am any farther down the road of recovery as you are. I have a PT apt today and will be bringing my shoe with me as today is the day that my shoe will be introduced to back into the mix.

My foot is tight and still can’t do any foot alphabet motions. Plus my heal has pain, when I try and walk without the boot and still have numbness at the ball of my foot.

Good luck and will be curious to read how you progress.

I too have a blog and have posted twice as my road to recovery early on was a bit bumpy…

It is realizing good feelings, How much it is positive to work on and weight bearing also. Congrats.

congrats! it feels so good to get going on weight bearing and then to one crutch. your incision healing is great. i’m worried about mine as it is a little bumpy near the heel. i’m hoping with some PT and some massage and time it will flatten out. are you using a specific ice method?

I have some numbness on base of my big toe and heel, other than that i have decent ROM on my ankle although it’s very weak. I’m on 5th week post-op, had my cast removed and into boot just starting this week.

Your numbness is normal - I was numb on the outside of my foot including the outer 2 toes, but you will gradually get the feeling back. When you let your leg out the boot, feel the Achilles. If there is tension then you’re good (and from the photo it looks like there is). Surgery is quite effective at keeping the ends together so the tendon can heal - it’s very slow but you just need to sit back and let your body work on it. It will get there.

I am about 3 weeks post-op (Speedbridge) and have been back to ortho for one post-op appointment where sutures and plaster splint were removed and I was placed back in the boot I had been in pre-op. Regarding the boot, I was given extremely specific instructions to only take it off while showering (in a chair, no submerging until incisions are completely healed) and to not do ROM until/unless directed otherwise at my next ortho appointment.

I feel for you because there are so many different opinions on the recovery process and you seem to be trying to figure it all out and navigate on your own.
Have you been given the support and instructions you need from your ortho team? I understand your concern about how effective the surgery was; have you spoken to your doctor? I don’t know that you’ll find anyone who has gotten an MRI without an order from their doctor.

Your fears are not irrational, Popouch, we’re all right there with you!

After surgery I was numb on the outside of my foot from below the incision through the outer two toes. After a couple weeks, the numbness started receding quickly. I’m 8 months out and now just have some partially numb area on the outside of my heel.

I had some unhappy nerves on the outside of my foot too. Mine was mostly around my ankle. Eventually those nerves calmed down. I still have one, sort of numb, spot on my heel after over a year. It’s around the scar area. It gets a bit less numb over time but still doesn’t feel quite the same as the other heel does. So - nerve damage does heel after a while but some things take a very long time.

And - if you read my blog - the “PT” I got at six weeks were just some basic rotation and stretching exercises the doc told me to do. At each visit the doc gave me a few more exercises to do and a few times I emailed him to ask if I could do some others. Some he said I could, some I couldn’t. I didn’t actually go to real PT until I was fully weightbearing which was at maybe 10 weeks?

http://achillesblog.com/cserpent

Glad you’re in the boot popouch! I was sooo happy to get in the boot too. Since my post-op instructions said come in if you have any issues with the splint/cast I did exactly that - LOL! As soon as I felt some continuing discomfort I went in for a change. Once I was just starting to get a raw spot on the top of my foot. Had I left it alone it would have turned into a bloody raw spot on the top of my foot. Once I was in the boot I could put on nice soft socks FYI - if you want to keep your boot from being scrungy - always wear socks - make sure the go up to the top of the boot too.

Thanks for the responses, emupilot, afkv, and pjhalifax and cserpent. I was just freaking out a little bit, and I think i finally started getting very frustrated that I did this to myself.

For an update, today I went into the doc and complained about my cast because it was very loose. Also, on friday I fell and put weight on my bad foot, causing some pain. I wanted the doc to check it out.

He said everything looked good on my achilles and told me to take it easy. I begged for a boot instead of another cast and he agreed. So I immediately went home, and took a shower..washed my leg and rubbed my calf.

One thing we noticed at the doctor was a pretty bad blood blister under my heel. Remember I mentioned some pretty awful pain the first 2 weeks after surgery under my heel? Well it turns out that it was actually the splint that they put on after the surgery. When I called to complain about the pain a nurse told me it was just the nerves coming back to life…but turns out not for me! Just a lesson learned…if you are in any discomfort make sure you insist on getting it checked out.

It’s much mo’ betta being

As others have pointed out, PT starts when the doctors says so. My rupture was at the top end of the tendon and didn’t start PT until 13 weeks. I’m 8 months out now and one calf is still significantly smaller than the other.

sorry there are some typos! i cant’ figure out how to go back and edit.

I found this rehab protocol which outlines some things you can do to keep up your quad and glut strength while NWB. It’s from the Banff Sport Medicine site
http://www.banffsportmed.ca/sites/default/files/bp_attachments/Achilles%20Tendon%20Rupture_0.pdf

i’ve also been doing some cat/cow and one-legged down dogs to get the blood flowing. also i’ve been doing some push ups on my knees, on my bed where it feels safe. i’ve added in some upper body work out with some weights and exercise band.

i guess i’m just getting board sitting here. i live in a house but the entrance is up steep stairs and i also live in a neighborhood with no sidewalks and lots of hills. i haven’t ventured out much because of it. i hope to start work next week (2w5d post op).

i see my DO in 6 days, 3w1d post op for stitches removal and hopefully PWB in this boot, i have the vacoped. i don’t have any swelling, but i’m not getting up and about much. i do have some heel pain and what i think is incision pain, but no redness or fever so i hope it’s ok.

As cserpent said, hard to know a PT start time because of how we all vary in our recovery. I started PT at 6 weeks post-op and they gave me basic range of motion exercises…I couldn’t do much else at that point. My foot barely moved at all! In hindsight there was no need for me to burn PT visits on my insurance that early (I was limited to 18 or 21 or something like that).

In my case it took a good 5-6 months for me to stop noticing swelling. I wore a compression sock to help manage the discomfort. But it definitely got better over that time - it wasn’t like the swelling from the first few weeks continued for months and months.

As far as atrophy goes, I’m at the one year mark and my calf is still a little smaller than on the good side. What surprised me most was how much I lost in my quad/thigh area. I’d say that evened out a few months ago. I think the leg lifts, clamshells, and other strength/mobility work helped with that.

Good luck on these early stages! Life will be so much better in the boot. I hated my cast soooooo much.

It takes months for the muscular atrophy to go away. And, possibly, your calf will never be as big as your other leg. As to PT - it’s up to your doc since only s/he knows what kind of repair was done and when it is ready for PT. I was very intolerant of a loose cast /splint so I was in getting mine changed about every 5 days - LOL!

The cast will limit the motion so you can’t rerupture. I worried about the same thing - LOL! My doc said wiggling the toes/foot is OK while in the cast. Don’t try squeezing the toes (as though you pick something up), but wiggling is OK.

i started my blog so you can read what my journey has been until now

i can’t believe you are in a cast! i would lose it. i’ve taken it apart a few times to adjust the beads inside and kinda figure out the straps a one was causing some friction at top of my foot. i have really skinny ankles and feet. it feel amazing to massage my foot and calf and let it breathe. i asked if i could take it off and open my leg to air and light and she said yes but only in bed and keep leg in boot with just the flaps open, so, that’s what i’ve been doing. i go back to work after two weeks post op, so next thursday and friday.

afkv,

I am surprised that you are in a vacocast boot already! Are you able to take it off when you like? I am tempted to ask my doctor if I can have a boot earlier, rather than this cast I will be in for 4 weeks.

I am able to move my toes a lot more now and flex my foot a little bit more so it seems like things are healing nicely under there. I have been going to work everyday this week and I still feel it swelling up when I get up on the crutches. I just can’t stand being at home anymore. When I get home, I just elevate my foot and it feels better.

hey that’s my achilles rupture date too. i haven’t started writing about it yet though. i had surgery March 20th. i’m in a vacocast boot now after 8 days post op. i had that heel pain after i had surgery too and i loosened the splint dressing which helped. i go back week three to get stitches out. i should really start my blog but i have family coming in for easter. i look forward to hearing about your recovery.

I missed out on the audible pop when my Achilles ruptured, but like you I knew what happened right away. Being NWB really stinks - it’s boring being on the couch with your leg elevated and you miss just being able to stand on two feet. The good news is that each day is better than the last, and your Achilles will heal. Unfortunately, it will take alot of work to get that calf muscle back once you are back on two feet, but don’t try to be a hero and let your body heal for now. Thanks for the detailed introduction, and please keep us posted.