Week 9: Paranoia questions

Tomorrow is 9 weeks since my ATR surgery. I’m making good progress according to my Dr. and PT, but I have this overwhelming sense of paranoia in connection with this whole ordeal.
I find myself constantly “checking” my Achilles to make sure its still attached. Every time I feel something different either with my hands touching the area, or a pain, twinge, or tug of the Achilles, I’m freaked out that its re-ruptured, or about to re-rupture. To make matters worse, anyone I know that has either had an unpleasant experience, or knows of someone with an unpleasant experience has decided to share that with me. A gentleman at work and his son both ruptured theirs twice. His son did it in PT after surgery. My PT says that I need to mentally “get over it” and focus on my recovery.
So my question is, is it common to feel this way and how do I “get over it”? perhaps if i had a better understanding on the healing process that might help. At 9 weeks, am i merely being held together by stitches, or has some healing taken place?

thank you!
Scott

7 Responses to “Week 9: Paranoia questions”

  1. hi Scott

    this happens to all of us, there is no simple trick to get over it. although your PT is right, telling a patient this is not helpful nor supportive.

    you may want to book yourself with the specialist or another PT for reassurance and to talk things over, as this normally helps solve the issue.

    the difference on re-rupture between op and non-op is actually not significant (statistically speaking), so even though that the percentage of people in op re-rerupture fewer times overall this is exactly the same. of course plenty of studies and plenty of controversy out there.

    this blog contains a lot of information about the healing process, search for ‘collagen’ in the top right search box

    focus on doing your physio, eating and living a healthy life and celebrate every single milestone.

    today at 17-18 weeks i realised that my calf is fully attached now and the the muscle strength is coming back. i’m still not pushing myself to jog/run/jump, as i’m not personally in a hurry.

    keep the good work up!

    suerte

  2. Scott - On my page (xplora) you will find a tab ‘further reading’ and there is a link to a page on how tendons heal. It may help but it is a bit medical in nature. Most people re-rupture by doing something they should not. It will require some force usually through a trip or slip or an applied force greater than it can stand. It will not rupture on its own. Doing nothing will not help your tendon grow strong as it needs the forces to gradually increase the amount of good collagen which will align itself in the direction of the force. Doing too much too soon will put stress on the weak collagen type which was initially laid down after injury. Currently you are in the remodelling phase. Your tendon is joined with tissue but the stitches are still probably a little stronger than the bulk of that tissue. This is changing quickly and within a month you will start feeling the tendon becoming stronger and be more confident. You will feel it in the type of exercise you will be able to do and the amount you can do before fatigue. I cannot take away your fears but I agree that a better understanding will help you.

  3. really good info! thank you so much!! this site is a great resource. I find myself sitting here and just reading blog after blog.

    I explained to my PT that this injury is different than previous injuries that she had treated me for (tennis and then golfers elbow). this was a “failure” and that is where the fear comes from. I didn’t expect my AT to fail on me, but it did. Oddly, my PT was present when it happened. she serves on the board of the league I was playing basketball in and happened to have been at the game. So therein lies the problem, the failure. things are moving along, but Id really like to be able to fast forward to a time when this is all behind me and I can get back to the things that make me happy, like lifting, and snowboarding. The road is long, and I am not a patient person lol!

    now that im out of the boot and into a clog, my next goal is to walk without a limp, and at a normal rate of speed. its amazing how slowly I walk now.

  4. Hi Scott, you are not alone :) I used to feel along the tendon and do the Thompson test to myself multiple times a day, especially once I went to two shoes and then started doing more activities on the leg. I understand exactly how you feel about the tendon just failing on you. As the others have said, it really helps to become familiar with the healing process for tendons so that you understand what’s happening down there. Once you understand that, then take everything incrementally. Increase walking distance slowly. Introduce new movements one at a time and only do a few reps the first time and then slowly add more reps if everything is ok. This gives you confidence and also lets you assess what your tendon can handle without hurting it. Some of the stories can make you be really worried that your tendon will just re-rupture from something like walking uphill. The way I got over worrying about things like that was to tell myself that those re-ruptures are the minority not the majority and if I was going to be in the minority of re-ruptures then the healed tendon was weak and it would probably be better to find out earlier than later. This didn’t mean I did stupid things early, but when I got really scared and didn’t want to do something that I should have been able to do at the stage I was at, then I’d remind myself of that and go for it. One thing I’d highly recommend for building confidence is to get in a pool and do things first in chest deep water and then at waist deep water. Once you know you can do it in water, then you feel much less concerned doing it on land. Good luck, I’m sure you are going to make a great recovery from this.

  5. really good advice thank you! this injury is as tough mentally as it is physically!

  6. There’s uncertainty with everyone. You’re still in the risk zone for re-rupture, if it does happen. I will tell you that I remember week 9 very clearly. I was QUITE sure I was tweaking the tendon and re-injuring it with what I was doing. I wasn’t even trying to do heel raises at that point (but I was in the pool in several feet of water).

    About that time (week 9) is when we start becoming a little more mobile and wondering when things are going to kick into high gear. I recall I started trying to push off while walking about that time (I was really sick of the limp). I developed a little twinge type pain over the repair that had me a bit worried, along with some quite noticeable inflammation and redness. On a scale of 1-10, it was more of a stretching sensation than pain. Then it turned to pain as I pushed through with exercising on it, and I started having 2/10 type pain on the sight, but never worse. I asked my doctor about it - totally normal. This injury will have us working through slight pain, tightness, and soreness for several months.

    Listen to your body and you’ll be fine, and do everything very gradually. There is a big difference between pain and tightness. If you feel shooting pain over a 5/10 on the tendon or calf, I’d say you should lay off and/or check back with your surgeon. Pain like that isn’t good.

    I felt the exact same way you do, and everyone does at some point in this recovery. I wondered how far along the healing had come (were the stitches still there, and how strong was the tendon itself in terms of being able to hold together on its own if they were not?). Again, I can’t stress enough just listening to your body. Feeling pain of 2/10 is quite normal, and so is the thought of re-rupturing.

    I did not officially start PT until week 12. But the difference in 4 weeks is immense (I’m now 16 weeks along). I went from feeling very weak and worrying about re-rupturing to feeling very confident, being able to walk several miles, jump, and now jog.

    Check out most anyone’s blog pages. They’ve all had mostly the same concerns along the road and also similar experiences.

  7. I so remember being terribly afraid of rerupture, I read all the rerupture stories on here about 3 or more times. I was particularly suspicious of PT as I had read of a couple people rerupturing during their PT sessions. They finally told me it would take a lot more force than balancing on one leg, bilateral heel raises etc to rerupture. Slips and falls seems to be more of a culprit, although it’s not good to push anything that you aren’t comfortable with. Just take it careful and slow and you’ll be fine.

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