rogernichols52’s AchillesBlog

Aug 21st was my week 10 post op. I feel like I am walking without a limp though my PT says he can still see it. I also can’t do a single calf raise. I can at least begin to raise my heal off the ground however its definitely not high enough to call it a calf raise. Thanks so much for sharing as I am beginning to get nervous about my progress.

I notice you posted a couple of weeks ago. So you’ll probably on week 12 or 13 now. How are you doing?

Ya, Watch Your Step everybody! You are flying along, Roger!

Congrats! Those little slip and falls are what worry me most. Good luck and be careful out there.

Congrats! Yeah, I hope to start heading back to the gym soon. Luckily, I have a stationary bike at home.

Feeling great today, have had some swelling and pain but today nothing. Walking without a limp, little swelling and no pain it feels great. Regime today was 60 heel raises, 30 squats, exercises to strengthen my hip muscles. Yesterday did a long swim I think that helped. By the way I am at 7 weeks and one day. Next week I am going to try street shoes.

You can see my protocol on my page I posted it a few weeks ago. Good luck with your progress too, I think the secret of my progress was the mini-invasive technique using an Achillion device I have seem photos on other pages of really long scars from open surgery, you can hardly see where my incision was made.

Roger you are an inspiration to where I am at the moment and feel like my protocol is too slow for where I intend to be. Have a wonderful holiday and I’m sure things will continue to improve. I agree with Stuart , would like to see your protocol as I try an advance mine at speedy rate

Wow, I can’t wait to go to pt for my first time tomorrow and see what that is like. I mean it will not be a cake walk, but I see it is helping you return to a what is speedy recovery. Keep it up.

Just back home Roger and caught up with your progress. Seems you are still moving forward quite well. One thing I have learned from all my PT visits is they love us to look after our core muscles with good reason. I also thought it would be good if you copied and then pasted your protocol onto a seperate tab within your blog. Not sure if you know how to do that or know what I mean (see my page - Xplora) but I feel it will be lost in your blog over time and it could be a good resource that is easier to direct people to. Have a think about doing that in any case.

I hate swimming but can’t wait to be able to start! Uggh, I need some exercise. Congrats on your progress.

Congrats! It seems like the swelling part will be around for a while. I’ll be glad when I don’t have to sleep with my food elevated.

Roger, I also had the worst swelling in the period right after I ditched the boot. It seems like a setback, but I now think it’s just part of the recovery process. As I recall, this lasted for less than 2 weeks. I don’t think you should stop your exercises completely, but tempering them now is probably good. Although you’re likely unaware of it, just being out of the boot you are using and working muscles that were previously on vacation. So, I’d also recommend that you continue to elevate as much as you’re able and ice a couple of times daily. Good luck! -David

Thanks alls well feel so free being out of the boot and no crutches but have had a couple of bad days as I do less elevation and rest and try to get back to normal life. I have found I have more swelling and soreness. Due to this I have stopped doing so much strength work, not sure if this is right or wrong. But my brain and my PT says listen to your body so I guess it must be. Thank for your support hope your recovery is going well.

Wonderful news! Congratulations on moving away from the boot and crutches! Continued success to you for your recovery.

Congrats!

it was a very small incision, just big enough to insert the Achillion device then some small holes further up where he inserted the needles to do the stitching. Did you have open surgery? Maybe this is the difference, or perhaps it was the early work I did with my PT. I have been seeing him twice a week for an hour each time from the beginning of week 3 once the plaster was off. Hope you are also progressing well. Good luck Roger

Still have a hard time believing that you are recovering this quick, How large was the incision

Woohoo! Congrats! And thanks for being supportive!

Ring of truth is I am walking FWB with no pain and little limp in under 6 weeks at the age of 62, so I’ll go with the diagnosis and advise of my OS and PT.

ATR from low core muscle strength around the left back, hip and thigh doesn’t have the Ring of Truth to my ears… Elite athletes tear ATs while in peak shape, and many of us also had muscles as strong as ever - including the calf muscles that tore the one thing that wasn’t strong enough - the AT!

Awesome! Not feeling as confident as you but my pt said he’d like to see me take some steps out of the boot. Maybe tomorrow.

Congrats!!! I’m on a conservative route also. I have pt for the next 5 weeks. It will be up to physical therapist when I am able to transition I out of boot. I actually don’t feel like I could be in two shoes so I’m okay with it.

Wow - two shoes already! I think my OS will have me on a much more conservative schedule. I am stuck in a cast for the next three weeks (four weeks total post op) before allowed to get in a boot! Good luck!

Roger, congratulations on reaching 2-shoes status, and at under 6 weeks too! My only advice is to be careful, because you’re still in the at-risk period (< 12 weeks) for re-rupture. -David

Incidentally, Exeter, one of the other more progressive clinics (but NHS) also uses the Achillion device, and is referred to in its http://www. bjjprocs. boneandjoint.org.uk/content/95-B/SUPP_18/16.abstract. Although mine was a complete rupture we went for the non-surgical approach so no personal experience.

Thanks for the detail Roger. I am away for a week so I will try to get a closer look at it after that. I do note that you hope to be jogging at week 8 but it does not suggest it until week 12. Always good to set goals but there is still the need to be careful. I am sure you are doing that. It would be good to know how much weight is placed on the injured tendon during the two leg heel raises. Many other protocols will have most of the weight transfered to the good leg but this is not mentioned. Too much weight too early has been shown to cause damage or re-ruupture but what we understand now is the tendon likes to be loaded and needs that to align the collagen. I will be interested to follow your progress. Thanks again.

Roger - I was familiar with this method but it is not one of those I was thinking about. As a less invasive surgery I think it is pretty good.

Roger, that explains why I got the same protocol. I’m on the London Foot and Ankle clinic too but under another consultant. These guys are very skilled and that’s why I choose to let them repair me.

I am under Mr Mark Davies at the London Foot and Ankle clinic at St John and St ELizabeth Hospital London, I believe it is his protocol.

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I have been following the discussion regarding this rehab protocol and after seeing this post I realised it looked a bit familiar. So when comparing the protocol to my own I see I got the exact same protocol, word by word. I’m in week 13.5 now and I have not progressing as fast as Roger though. FWB at week 6 and 2-shoes at week 9. (Was set back a week because of a wound infection at week 7). I’m in London UK and my consultant is supposed to be one of the best in town for ATR so I guess I can assure that this protocol probably is a proven one. I can ask my consultant where it comes from if anyone is interested.

As a side note it says on my protocol that it’s for repairs with Achillon Device (google it) but my consultant told me to just ignore that since I had a ‘traditional’ repair (regular vertical incision along the tendon).

Thanks for posting this, Roger. Do you know the author, or institution, behind this protocol? That information would be helpful to share with OSs and PTs, who may want to investigate further. It’s interesting that it starts out much faster than most protocols I’ve seen, but then it slows down and arrives at full return to sports at 6 months, which is quite common–home by another way. -David

Chris - there is no need to be sceptical. Roger may be moving quicker than others but we should find out why. Much of what he said is not unusual and his response only highlighted 2 things I felt were significantly different to others on aggressive protocols, including me. It is normal to feel a bit gipped when you read how some are progressing faster than yourself. Your age really doesn’t mean you should be ahead of older people. Roger’s tendon will heal at the same speed as yours. What it comes down to is your doctor and from my many years on this site I can say there is considerable differences with the way they treat this injury. Long term we tend to even out but those on more aggessive protocols get back to normal things a bit quicker. Roger’s protocol seems to be the most aggressive I have come across and I certainly would like to know more. The fact he is following doctors orders and not making this up as he goes intrigues me. I would also like to know the method of surgery. There have been some advancements in this area I have read about which enable people to get moving quicker. Having trained in the sciences I

Roger, I did not mean to question your integrity–at all. I was/am just genuinely surprised at the speed of your recovery, which appears to me to be pushing the envelope. I guess the answer to my question about what’s different with your ATR recovery is just your team’s protocol–which I would be very interested to see and to share with my OS and PTs. Keep posting us on your progress, and I wish you the best. -David

Well I don’t want to call anyone out, but hey man if this work out, best of luck and I hope everything works out for you, this injury sucks, but if recovery that quick is possible I am willing to dabble in it.

Hi Roger

A number of us have published our protocols in the past, some of them based on those from UWO in Canada, and Exeter in the UK, together with the excellent results that they achieved.

Those protocols were way ahead of what many seemed to believed were best practice in terms of mobilisation and recovery. However, as revealed by Belfast, progress is still being made and you should certainly publish your protocol as you yourself have offered.

Chris and Dave have been sceptical but then again there have been many medical practitioners quoted in posts who are equally or much more disbelieving - and they should know better with the published research readily available to them.

My only concern (and I was on the Exeter protocol) is whether or not your therapy overtakes your body’s healing ability but your PT will be aware of that and will not want to fail. You are still a long way short of when re-rupture becomes an unlikely scenario - however, maybe your super fast schedule gives you the strength to perhaps reduce that risk.

Whatever the situation, it is good to have an example like yours here. My schedule was push

Just had a thought I am happy to post my full protocol if anyone is interested.

HI Chris and David
It seems my integrity is being questioned here, I can assure you what I have reported is accurate. I am not trying to be clever or race against others and I did not realise what I reported was even that quick. With my PT we are following the protocol set by my OS. He did mention it is a little quicker than previously but not that unusual. I do believe my PT is at the top of his profession and I see him twice a week. Just to be clear I am a young 62 at post op 5 weeks and 2 days, yesterday I was walking for 20 minutes in trainers under supervision moving very slowly. I then did two footed calf stretches leaning against the wall followed by two footed calf raises also leaning against a wall. My PT also massages my ankle at every visit and manipulates (gently twists and pushes) my ankle for about 20 minutes. When I got home I was very sore but only in the clad muscle I used ice and elevation and took some painkillers and this morning was OK. I have been told to wear the boot around the house for safety but to walk in trainers twice a day for 20 minutes around the house, also to do 3 sets of 18 calf raises each d

See, this is where I become a skeptic. How do people recover this quick to be doing these even with no boot at week 5. Like I am 25, heal relatively quick, and I doubt that when I get the cast off that I could do no boot, I was told boot fwb, but then again I am a skeptic of that. Would love to believe that this is true and if so, hope it works out.

Roger, you seem to be moving at light speed on your ATR recovery–2-shoes and heel raises at 5 weeks? If it works for you, that’s great, but I’m puzzled as to why your recovery is so much faster than everybody else’s? It seems too good to be true. What am I missing? -David

Good to hear Roger. I suggest your PT has said your tendon has joined together. Healed would be a big call for 5 weeks but non the less you are making great progress. The fun starts now for you. Lots of work which is so much better than sitting around or dragging a boot. By calf raises, are you meaning standing up on your toes? That I would be careful of at 5 weeks as well.

Congrats!

That’s great news–keep it going! -David

Hello Everybody

Is there anybody on this site who has chosen not to have surgery?

Need someone to talk to

Lou

Thanks Stuart my cycle shop
Have suggested they fit a road tyre to reduce the noise as I have a hybrid, might try my tyre first as it is pretty worn.
Good luck Roger

Good news Roger all round. I have a turbo trainer and used it about the same time as you. I wished I had a road bike though as the mountain bike tyres are a bit noisey. I probably should have kept an old bald tyre.