Full weight bearing sort of

March 6, 2013

Well I went to physio and everything looked great, feeling on top of the world - I’m sort of normal! Woohoo!!  I told the physio lady that I can fully weight bear she said good and told me how to walk properly. She also put me on the bike for a bit and gave me a massage as well as all the exercises.  I seem to be having a very good NHS experience compared to some people I am very lucky.  Yesterday I also took a wedge out, down to 2 wedges ( I can feel a stretch now, no pain though) and walked fully weight bearing around the flat fine although can feel the achilles is a bit unhappy.

But then I went to bed and found the section on this site on rerupture and it is scared the life out of me. I just really hope as well I am fully mended. I didn’t have surgery and this worries me somewhat as I read a story about someone who didn’t have surgery and it didn’t fully mend. But there are so many stories on here, almost every case is different and so many different scenarios. I dont think I have to worry the doctor a few weeks ago and the physio both say its fine.  I cant wait to see doc next week for some reassurance that it has mended ok.  I’m sure I would know if it has re-ruptured, I have had almost no pain and not much swelling.

For now everything is ok, I cant went to get through the re-rupture danger time zone.  Thanks for great helpful comments. So great to be able to share this situation who understand what it is like. Such a common injury it effects so many people. I am trying to do a picture of my freaky missing calf, not sure if it has worked.

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7 Comments Add your own

  • 1. Hillie  |  March 6th, 2013 at 1:43 pm

    Hi Rebecca

    So far, your case is much like mine. I had a full rupture last year and was treated non-surgically at my NHS Orthopaedic Centre although the delay of 10 days between injury and starting treatment almost made it a surgical case. My boot didn’t have wedges but used a hinge mechanism with adjustable range of movement (ROM). After 2 weeks in the boot I didn’t wear it in bed, and at about the same time I had weaned off crutches, and begun a range of exercises, including my static bike.

    You will read plenty here about re-rupturing, and op v non-op. Some who post here are very technical with their input, and some have years of ‘experience’ for want of a better word in describing their long term issues and knowledge. There will be a highish risk of re-rupture until about 12-16 weeks but, unless you are very unfortunate or do something inadvisable, you are not likely to be at significantly greater risk (if at all) than those who have had surgery - and when I was on here regularly during my recovery, some contributors who had been operated on submitted their own experiences, quite gory too in some cases.

    Hopefully you are being seen regularly and have been a copy of your rehab protocol which should be very tight with its timeline, encouraging a fast pace of progress rather than the old, but still out there, almost static, in a cast, no exercise regime.

    What is the timetable for the next few weeks, as proposed by your medics?

  • 2. Hillie  |  March 6th, 2013 at 2:00 pm

    Hi Rebecca

    Sorry, I didn’t read your earlier posts!

    H

  • 3. rebecca4321  |  March 6th, 2013 at 2:04 pm

    HI Hillie. Is everything ok with you now? Are you back to normal? Yes I feel confident I had a good doctor although there were several who I have spoken to at Kingston Hospital, I don’t think I was assigned one doctor I think they work more as a team. He told me about new research etc and with early mobilisation I should be almost same as someone who has surgery so I felt like I could trust his decision not to operate. The other doctor at my second appointment 2 weeks later wanted to keep me in cast but I said, NO BOOT?!! and so he went and talked to a consultant and they agreed to give me boot. I think you have to say what you want sometimes. Then they gave me my protocol which I have been sticking closely to.(Its actually meant for someone who has had surgery but from what I can tell they are mostly the same after 2 weeks anyway) It says to progress to FWB at week 6 so I am hanging back a bit this week even though I can FWB now. It says at week 8 so in 2 weeks I can FWB independently - I assume this means 2 shoes, but it says once fully dorsiflextion has been achieved. I think that means full range of movement.

    Then it says week 8 - 12 continue lengthening and strengthening work, exercise bike and gate re-education. Proprioceptive training on balance board not sure what that means. Then 12 + weeks single leg heel raises (scary) and start jogging

  • 4. rebecca4321  |  March 6th, 2013 at 2:07 pm

    Oh yes I and I am taking out one wedge a week. I have 2 left so should plantigrade in another 2 weeks.

  • 5. JoyA  |  March 6th, 2013 at 4:29 pm

    I have freaked out several times, worried that I have overdone it or just walked a bit heavy and thought that I ad caused a re-rupture.

    I went the op route (rupture on 29th Jan & op on 2nd Feb). I went two weeks cast, then boot (4 wedges) and now in week 5 I’m down to 3. Next week I hope to go down to 1 wedge and physio.

    I have to tell myself daily, ‘be cautious’ and take things easy. I was so used to rushing around pre-op and now I am getting to grips with being PWB and my crutches I can feel myself starting to rush about again, so I am purposefully taking it slow!

  • 6. normofthenorth  |  March 6th, 2013 at 6:51 pm

    Rebecca, your schedule is a week or so slower than the most successful one — bit.ly/UWOProtocol — but fortunately much faster than the old rerupture-prone schedules. I’m surprised how inconsistent the NHS is, in so many ways. But then, Ontario’s OHIP (Ont Health Insurance Plan) also lets OS’s treat ATRs any way they like: op, non-op, fast, slow, with or without PT, boot or casts, you name it — even at one single hospital!?!

    I think the key is that ATRs are boring, so nobody gives them much attention, including administrators and insurers (public or private). If you can educate your Docs about the recent evidence from the best studies (esp Twaddle 2007 and UWO IN 2010) you’ll be helping to save part of the world… The entire UWO study is on this great site, linked from the Studies and Protocols page. (I generally recommend printing it out, rolling up the printout, and slapping your old-fashioned Doctors with it! :-) )

  • 7. Hillie  |  March 7th, 2013 at 6:54 pm

    Rebecca

    Yes, everything ok with me now thanks. Am I back to normal - I doubt that I was ever normal, and I could probably provide references to that effect!

    The leg though is good - it has been a year though since my atr, and the first 4 months were the hardest, first of all the healing, and then getting the strength back. Followed by making it stronger than before the atr.

    It was 2 weeks in a cast, then into a boot with a thick wedge sole for 2 weeks, followed by the boot with a ‘normal’ sole for 4 - 5 weeks, increasing the range of movement (ROM) every 2 weeks when I also saw the physio. FWB began by week 3 or 4. 2 shoes at week 9. The hinged boot that gave the ROM is, to my mind, the main plus over the infamous (in these circles) UWO protocol which was otherwise pretty close to mine. Good to see continuous improvement happening - pity that some medics don’t read the trade news…

    After my ortho centre sign-off I had weekly sessions with an NHS physio, followed by much harder work with a sports physio for a couple of months. You mentioned jogging - my protocol advised against this until after month 4 but some who post here did it earlier. Take care though - at this stage a re-rupture can still happen, and there is plenty of gym work you can do, especially from week 10.

    By the way, most of us have been nervous about the heel raises. With a good physio you shouldn’t worry - they have ways of making you walk properly again, and they don’t all involve pain! You will have to be very patient at this stage and heel raises can take weeks to get right.

    I look forward to reading more.

    H

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