shazd9’s AchillesBlog

Thank you for the original post and the comments. I am counting down my last days of a long NWB phase and I also have the pins and needles feeling when my foot is down. It is extremely helpful to know that others have had the same feeling and it makes complete sense that the body needs to “reawaken”.

Absolutely….lets just hope our physios in ” deepest darkest ” Africa are as well versed with the necessary pt as their colleagues in America are! If my Surgeon is anything to go by I feel completely at ease that I am in good hands!!

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Thanks for your input. Hugely appreciated. I am not really big on comparisons but as you say, it is so nice ( and encouraging) to read about everyone’s experience. Now that the cast has gone I need to set about learning how to put my foot completely flat in the boot…..hopefully it won’t take too long as being on tip toes is somewhat unnerving! Have booked an appointment with my physio for Monday so I am looking forward to being proactive!!

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My surgeon prefers to completely limit mobility for 6 weeks hence the reason I was in the cast for so long. Different strokes for different folks I guess!! But cast came off an hour ago so I am the happiest little bunny alive!! Now it’s time to heal!!

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As Pegleg says, these strange sensations are normal and just part of your leg muscles and nerves “reawakening” as they’re asked to work again! As you begin weight-bearing, they may increase, but they should dissipate over time as your recovery progresses. -David

I was like that and was also in a cast until 6 weeks and started my own active healing a soon as I got the boot!! Being in a cast until then did me no harm at all, so don’t worry, the pins and needles is your foot ‘learning’ all it’s senses again, after all it hasn’t had pressure on it for a while! I didn’t have any PT either as my OS was impressed with what I could do, but I did start private PT at 11 weeks once I could drive myself to one, (I live miles away from a town etc and had no other way to get there or I would have started sooner). My progress has been good and on par to others who had early boot and PT (if you are someone who likes compare progress) I personally have now purposely started not comparing as I have decided it causes unnecessary stress and worry but it does make interesting reading!
Good luck

Probably the blood rushing into your feet. Why have yo been in a cast so long?

For what its worth, my calf went from top notch from long distance running to feeling like I was grabbing jelly 3 weeks after my ATR, so its something no one can avoid. As I am starting to light run between 1-2 miles and progressing to plyometrics at PT, the calf strength tends to rapidly improve at almost 4 months. As everyone has said many times, its just very slow going.

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This was a big hit for me. I’ve spent a lot of time in the gym and had calves a lot of guys envied. Now it’s gone. Just something you’ll have to deal with. Hopefully I can get back to the gym soon and get back to getting my calves back.

Not much you can do about muscle atrophy. Big thing to remember is most of what we see as “atrophy”, is just your body shutting on the nerves into your calf. Your body knows it was injured and it takes steps to ensure to rest. I have had giant pro-football guys undergo ACL surgery and in a matter of days they got a chicken leg. Once you are healed more your body will allow for the motor units in your calf to start working again.

Most surgeons are very conservative when it comes to AT repair. Main reason is the Achilles has a very poor blood supply (can look up “vascular watershed” if you are interested). So they often want it to heal for as long as possible before stretching it or engaging the muscle. Also, a lot of people have compromised lower extremity blood flow which can add to issues with healing. Even though I am healthy, active and 39, my surgeon kept my stitches in for 4 weeks. I was also casted for 4 weeks, then walking boot for another 6. I am at 4 months now and doing just fine.

Its a long process but you will be back at it before you know it!

Hello ShazD:

Don’t fret too much over the muscle which atrophies. Keep in mind how satisfying it will be in a few weeks when you bring a lot of it back in a very short time (as soon as you start using it again). Even large muscular sportsmans’ calves shrink quickly to half their size but most of it is brought back quite quickly (and allows you to do everything you need to do).

What Hillie said. Try to educate your OS to the brilliant success of the new fast protocols like the 3 at AchillesBlog.com/Cecilia/ protocols. If he isn’t embarrassed by the fact that these studies are getting wonderful results goingmuch faster tthan his patients (and many of them withOUT the “benefit” of his surgery!), he SHOULD be! And you should be impatient. The best protocols are enough of a PITA!

David was unfortunate because of the time that he spent in splint and cast. Many of us spend the first 2 weeks cast but move into a boot after that. Most ATR guys get to 2 shoes by 8 - 10 weeks but what state are there calves in - up to you how you fare.

After 2 weeks my rehab schedule allowed for boot removal to do gentle exercises such as the alphabet, and by 4 weeks I used a theraband. From 4 weeks I was allowed to sleep without the boot, and the boot was set to a range of movement which would subsequently increase over the following few weeks. This allowed for increased movement early in the rehab, reducing atrophy and ankle stiffness. Crutches were weaned off after 2 weeks, with full weight bearing before the end of week 4,

Muscle mass that was lost was gradually regained through walking and exercises prescribed by the physio’s. If you suffer swelling and a little soreness rest, ice and elevate; try contrast bathing too (check it out on YouTube, works great). It’s not an easy route to fitness but then again, doing nothing is tougher long term.

Just don’t start too late.

Sharyn, sorry you joined our “club”. I also suffered my ATR playing tennis, although am quite a bit ahead of you–now 18 weeks post-op and hoping for clearance to get back on the court in another month (or so). I was initially immobilized for 5 weeks–1 week waiting for surgery, 2 weeks in a splint post-op, and then (stitches out and) 2 weeks in a hard cast. Following that, I was in a “boot” for 6 weeks. I don’ t think there is a way around early calf atrophy. Your calf muscles, which are connected directly to your Achilles’ tendon, need to be still (not contracting via exercise) to best allow your Achilles’ tendon to begin knitting itself back together again. However, you will be able to regain your calf tone and strength–just not now. At this early stage, (and I know this is difficult) the best thing for you is to rest and elevate your leg–and you’ll need to rely on others for awhile. Unfortunately, this is a slow-recovery injury, so try to be patient and focus on near-term goals–and know that things will improve! Good luck and good healing! -David

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