Story so far…

This is my first blog post because I’ve only just got round to starting. I’ll warn you now, this will probably be a lengthy opening post because my injury happened a few months ago now, but I’ll try to keep it interesting. A bit of background about me - I’m mid 20’s and before the injury I was playing football (soccer) usually 2 times a week, so pretty active.

It was on May 18th of this year when I was playing football when I hadn’t really warmed down from the first match and I was asked to help out my mate’s team so I agreed. Anyway, coming on as a sub (no warm down/up) I go to sprint forward and I heard the dreaded snap. I initially though it was my shin pad elastic snapping, but couldn’t put any weight on my foot, so I knew it was something pretty serious. After 45 minutes of waiting for the game to finish, I went to A+E (an hour and a half wait), then went to see a nurse who did the Thompson test and confirmed it was a partial tear of the Achilles.

I was put in a cast that night and told to return the next day so they could take a further look at it. After deciding it wasn’t a full tear, they told me they wouldn’t need to operate and I would be in the cast for 8-9 weeks, then into an Air Cast (big moon boot) for 3 weeks, then I should be able to walk. I was pretty gutted at the time because I knew I’d be out of action for a few months, but I concentrated on trying to get fixed.

The recovery went according to plan; I was out of the cast after 9 weeks, straight into a boot. It was pretty strange trying to walk again as it felt like my leg was going to give way! I was up and walking again without the boot by mid-August. It didn’t feel quite right though, because my ankle was swollen and I had a pretty bad limp. The doc booked me in for physio, which I went to on the 20th August. It has to be the most painful thing I’ve ever experienced, but I was willing to put up with it if it sorted my leg out haha.

I had a music festival to go to in the last week of August, so I really needed to be on my feet or else there was no chance it was going to happen. By the time the festival arrived, I was walking and driving, so happy days. Festival went by pretty quickly, and upon my return I had my second physio appointment. The ankle was very swollen from all the walking at the festival, but I thought nothing of it. During my second physio, she had me on a treadmill doing a fast walk for 5 minutes, then had me do a few stretches. It felt very tender, but who was I to know better than a trained Physio Therapist? After the stretches I was told to stand on some steps and raise both feet onto their tiptoes several times. I was very wary of doing this because my leg didn’t feel up to it at all.

I did it a few times and it felt pretty strange, then SNAP! It re-ruptured! I was devastated. It felt like I was dreaming, I felt so many emotions. I felt angry that it had happened again, gutted because I knew what would be coming for the next few months, and just overall fed up.

Fast forward to today (nearly 6 months after first rupture). It was a full tear this time (they said it could have gone at any time), so they operated (on 3rd September) and put me in a cast for 2 weeks. They then took the cast off and put me straight into a boot. I’ve been in the boot since mid September, the wound has healed well apart from a couple of inches at the top so have had it cleaned and redressed this week so it can heal correctly.

I am currently on my crutches without the boot to allow the wound to heal and I have my first physio appointment next Tuesday (expect an update then). I’m really dreading physio after what happened last time, but I suppose I need to go.

Apologies for the very long opening post. I wanted to share my story, because I’ve been reading many others on here for months and it’s given me inspiration and confidence that I can recover and hopefully kick a ball again one day.

21 Comments so far

  1. liverpoollass on November 11th, 2010

    Hello Shaun, God I can’t imagine how you must have felt during that physio session. I’m just at the point of putting some weight through my AT and like many of us on heer live in dread of the horror of a rerupture. You sound like your dealing with this as well as can be expected. I think as far as physio’s go you have to listen to your body first and the physio second. I know mine never askes me to do anything I’m incomfortable with, and if anything its me doing the pushing not her. Your relationship witht he physio should be a partnership. Good luck with your future healing.

  2. shaunt32 on November 11th, 2010

    Thanks for your message. It’s a strange feeling; on one hand I can’t wait to start physio because I’ll be on the road to recovery, but on the other hand I’m dreading it going again. It’ll be just over 10 weeks post-op for me at my first physio appointment, what should I realistically be doing at that point? I appreciate all advice. Thanks.

  3. andy1000 on November 11th, 2010

    Hi Shaun, as of today I am 11 weeks post op. My story so far:- Operation then 2 weeks in a slab, then into an Aircast boot starting with 5 wedges and removing 1 wedge per week for 6 weeks, so in the final week I was at position neutral i.e. without wedges. I was full weight bearing from week 2 although I must stress that the weight was solely through my heel and not the ball of my foot. At week 8 I came out of the boot and began walking in barefeet. I also started Physio at 8 weeks with passive stretching exercises only, definitely no forced stretching at all. I had some more physio at week 9 and the stretching and strengthening exercises increased. He had me push my foot into a towel whilst holding both ends and also using a red theraband to improve calf strength and increase plantar flexion. I also had to try and balance on one leg (the bad one) to improve procipriation. I am a bit concerned at how tight my tendon feels around and just above the ankle so much so that I paid for some private physio treatment yesterday. He gave me a good indication as to why the tendon snapped in the first place and not to worry too much about the tightness as this will improve with time. He has told me to stop all other exercises apart from 2 which are, heel raises (both heels)10 reps every hour. And 10 straight leg stretches for 10 secs also every hour. This is the one where you place your hands against the wall and place your bad leg behind you and lean into the wall as much as you can. If you are doing it right you should feel a good stretch in the lower part of your calf. The physio talked about good and bad pain whilst doing the exercises. He said that if the pain came and went went during each exercise then this was good pain, but if the pain built up and up and up then this was bad pain and to stop exercising. He mentioned as well not to exercise after a hot bath as I could easily overstretch the tendon and damage it.

    Hope this helps and best of luck for the future.

  4. shaunt32 on November 11th, 2010

    That’s really helpful (and interesting actually) Andy. The first time it ruptured, when I had my physio I was doing those stretches with the towel too, and it did seem to help. I was also doing the exercise that you explained, where you push up against a wall and put one leg behind the other to stretch it. Is it expensive for private physio? I wouldn’t mind doing that, because I CANNOT have it happen a third time. Thanks for taking time to give me your thoughts, I really appreciate it.

    P.S.
    When you say full weight bearing, is this walking without crutches but still in the boot?

  5. southafrican on November 11th, 2010

    explain this leg streachers please! my PT ONLY WANTS ME TO STREACH ACHILLIES AFTER HEAT ,LIKE BATH?

  6. bronny on November 11th, 2010

    Shaun
    I was talking to my physio about this yesterday. He said that the research shows that discomfort and fatigue when exercising (calf raises etc) is fine, but any actual pain (i.e. sharpness) is not. That helped me as I do get some funny feelings doing calf raises, i think as a result of the scar tissue (apparently it feels odd cos it is not smooth like normal tissue, so it catches etc).

    I’ve found hydro therapy to be excellent, I started physio at 9 weeks and was in the pool at 10. Chest deep water means you only have 18% of your body weight when you do exercises so its good to start off there, ,go to shallower water, then do on land. The towel stretch is good too, and balancing on one foot. I think its def worth paying for a good physio (though lucky for me, we only have to pay a part charge here).

    good luck. I can’t imagine how awful that must have been.

  7. andy1000 on November 11th, 2010

    The cost of my Physio for 1 a hour session was £36, I have booked in for 2 more sessions. Not only did he give me advice and a full explanation of the mechanics of the muscles in the calf, I also had 10 mins of Ultrasound and 10 mins of Electrotherapy. He also gave me a deep massage of the Soleus muscle in both legs. You should be warned though on a scale of 1 to 10 the pain is 12!! I’m no wuss but I was seriously gripping the side of the bed and stifling a scream. The reason he does it is to stretch and breakdown scar tissue in the muscle. The good news is that as the scar tissue begins to breaks down, the pain subsides to a dull ache pretty quickly.

    The FWB was without crutches but as I said through the heel only. I was a little apprehensive at first so I hung on to the back of the sofa and gradually placed more and more weight on to the leg to see what it felt like, and because the tendon isn’t under any stress or tension it didn’t cause me any problems. The Hospital also gave me a spare liner for the boot so I used to shower in it and then change the liner after drying the boot with a towel.

    Hope this helps

    All the best mate

  8. normofthenorth on November 12th, 2010

    Shaun, here’s another approach to exercise timing, that I’ve suggested before: Check out the well-tested and successful protocol at bit.ly/UWOProtocol, especially the descriptions of the exercises. (They’re in “PT code”, so if you can’t figure something out, either Google it or ask here.)

    That protocol starts PT and exercise at TWO weeks “post”, and you’re TEN weeks. But instead of skipping the first 8 weeks, which would probably be too risky, start at the beginning with the week-2 stuff, but move through the schedule at (say) triple-time. (Even faster is probably OK.)

    So after two days of “week 2″, consider yourself in “week 3″ for a couple more days, then “week 4″, etc., etc. After 4 weeks of triple-time, you’ll be “caught up” — on week 14 in the exercises AND on the calendar.

    If your PT suggests some exercises that are a week or two more advanced than that approach, you’ll probably be fine to do them, but don’t go nuts. If the suggestion is to skip ahead a month or more, don’t forget that you’re allowed to wait!

    Many exercises that are just perfect for a later stage of this recovery are way scary just a few weeks earlier. Heck, you re-ruptured doing 2-leg heel raises — that’s a really great exercise, but not when you were told to do it.

  9. normofthenorth on November 12th, 2010

    Interesting contradictions about warm baths before stretching! I am generally a “dove” about stretching, not a “hawk”. The purpose of stretching during an ATR recovery is primarily to recover your original tendon length and your ROM in the dorsiflexion direction. (It can also help break up “adhesions”, but so can deep PT massage.)

    The downside of overdoing the stretching is potentially serious, which is that you can over-stress your AT and either re-injure it or “convince” it to heal longer than it was before the ATR.

    Fairly early in my recent recovery, I had basically recovered all my former dorsi ROM, so I started skipping the stretches. I’ve never regretted that decision.

    Don’t forget that swelling in your leg will restrict your ROM, to a surprising extent. It’s very hard to tell how much restriction is from swelling and how much is from AT length, IF your ankle is swollen. The solution is NOT to stretch harder, but to work harder to control the swelling — with rest and elevation, and icing, and maybe compression.

    The studies on warming up before doing strenuous activities like sports are all positive, AFAIK — i.e., it generally tends to decrease injury risk. (Pre-sports STRETCHING does NOT decrease injury risk. Our coaches were WRONG!)

    OTOH, if that loose relaxed “warm” feeling encourages you to over-stretch a weak and recovering AT, then it could lead to a bad outcome. So Andy’s and SA’s PTs may BOTH be right!!

  10. shaunt32 on November 12th, 2010

    Wow, that’s a lot of information to take in, thanks to everyone that has posted. The private Physio sessions sound good Andy so I may look into that, as I’m very wary going back to the same place the re-rupture happened.

    Norm - I can’t imagine starting PT at 2 weeks post op, I don’t think I could hack that. It’s bad enough starting now. However, all this fear on my part is down to what happened the last time I was with the Physio, so I guess it’s confidence more than anything. At what stage of your recovery were you doing 2-leg heel raises?

    As cautious as I am about the Physio, I do really want to get started as I want to be mobile again. I want to be able to drive myself to work, walk places etc. As all of you will know, it’s pretty demoralising being stuck with casts/crutches/boots for weeks. Thanks again everyone for the advice!

  11. shaunt32 on November 12th, 2010

    Also bronny, I’m definitely going to be making a few visits to the swimming pool when I’m back on my feet, because I’ve been told that will work wonders on the ATR. I’ll speak to the Physio to see what they recommend (other than 2-leg heel raises!).

  12. teresa1 on November 12th, 2010

    Hi, my physio has also got me doing stretches against the wall plus putting my bad leg on a low chair and lunging forward. The main thing is to keep the stretches long and slow and gentle, no jerky movements and stop if it hurts, there’s no point in being macho about this.
    Regarding swimming, providing you can get safely in and out of the pool, it’s really helpful. I’ve found back stroke the easiest, it seems to put the least strain on my AT. Breaststroke is harder, but I’ve managed a bit , again taking it slow and gentle

  13. teresa1 on November 12th, 2010

    Hi, my physio has also got me doing stretches against the wall plus putting my bad leg on a low chair and lunging forward. The main thing is to keep the stretches long and slow and gentle, no jerky movements and stop if it hurts, there’s no point in being macho about this.
    Regarding swimming, providing you can get safely in and out of the pool, it’s really helpful. I’ve found back stroke the easiest, it seems to put the least strain on my AT. Breaststroke is harder, but I’ve managed a bit , again taking it slow and gentle.

  14. teresa1 on November 12th, 2010

    Hi, my physio has also got me doing stretches against the wall plus putting my bad leg on a low chair and lunging forward. The main thing is to keep the stretches long and slow and gentle, no jerky movements and stop if it hurts, there’s no point in being macho about this.
    Regarding swimming, providing you can get safely in and out of the pool, it’s really helpful. I’ve found back stroke the easiest, it seems to put the least strain on my AT. Breaststroke is harder, but I’ve managed a bit , again taking it slow and gentle.
    Keep going and keep smiling!

  15. teresa1 on November 12th, 2010

    Whoops, sorry for multiple comments - I pad malfunction!

  16. bronny on November 12th, 2010

    I think i started double calf raises at 10 or 11 weeks, but within a day or two, they were too easy and had to start putting 3/4 of my weight (say) through the bad foot. Doing them in the pool could be a good place to start - from deep water to shallower, then on land.

  17. normofthenorth on November 12th, 2010

    Shaun, I don’t actually remember when I started 2-leg heel raises — but I’m sure my blog remembers! One of us could scan through and Ctrl-F (Find in Page) and it would pop up.

    But don’t forget that not all 2-leg heel raises are alike! Just as Bronny shifted more than half her weight to her injured side to get a tougher workout, you can start by doing a pure 1-leg raise on the UNinjured side, while your injured leg just goes along for the ride — 100:0 — then move to 90:10, etc., on your way to a balanced 2-legger, 50:50. It’s safest to do these kinds of things in a doorway, or somewhere else where there’s lots of strong supports to grab, in case you start “losing it”.

    Using your body weight for calf-and-AT recovery is more advanced, and harder to control, than using your hand or a towel or a Theraband. At the right time, it’s just right; too soon, it’s scary, and too late it’s boring and wimpy! To everything there is a season. . .

  18. normofthenorth on November 13th, 2010

    Shaun, I just tripped over the REAL answer to your question, and not on my own blog, either:
    “After 10 weeks, I can now just do balanced 2-legged calf raises, and I can just sort of walk perfectly, when I remember to do it! (When I first get up out of a chair, I tend to limp.)”

    That happened to be on Doc Ross’s blog (AB.com/Ross) in an interesting long discussion after he posted his 2-year anniversary notice.

  19. shaunt32 on November 15th, 2010

    Thanks for the comments over the weekend, I need all this information before my physio tomorrow. I’m kind of dreading it, but also looking forward to it in a weird way. I’ll give an update tomorrow to let you know how it goes.

  20. Benidorm Hen on November 19th, 2010

    Thank you Dennis and all who have shared their ups and downs. It has been a great blessing and very informative.

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