sheena’s AchillesBlog

Hi Sundance,
this is probably a bit too late to help you? When you say you had a full tear, do you mean a complete rupture? I’m not a doc of course, but if you did, the symptoms you’re describing don’t sound like a re-rupture to me but who knows. My re-rupture, I knew immediately. A specialist said he wasn’t sure so I had an MRI but to be honest, I was sure. I felt it go and the MRI, for me at least, was clutching at straws. Let us know how you are?

Good to hear from you Sheena. You were one month post-2nd-op when I had my surgery and Im still not running yet (very close). The bAttle against Atrophy is one of endurance and perseverance. I’m still fighting that uphill battle also. Good luck with the rest of your recovery and happy healing.

Time for an uphill walk in a few minutes

All good things, Sheena!

Sheena,
I take it you are 28 weeks from a re-rupture?

I am 22 weeks from surgery for full tear. I have found PT practices for 40yr olds to be a bit conservative, and based upon my readings have modified the program a bit (more balance training focus).

Recently I experienced sensations that have me worried about retear and my PT can’t explain.

Numbness in ball of foot and outside toes, brief sharpe needle pains up the length of the scar.

Having experienced a reinjury, have you ever experienced such sensations in the injury?

Hi sheens
It’s made my day that your ok, you more than deserve it

Hi Riparoar
I really should write an update and I will soon. Being a bit lazy with rehab but OK….thanks for your comment.

Hi sheen loved your blogs what’s the latest with you

Hi All,

I completely ruptured my AT and I am scheduled for surgery in 4 days. The surgeon has a PRP option and I am wondering if any of you have had success with this. I have heard both good and bad so I don’t know what to believe. I’m guessing all the big name athletes get it done because they can afford it and it seems it can do no harm. My question is will it do something good or would I be wasting my money. The price is $750.

I do have one other question; how long should I expect to be out of work for after surgery? I have my own office and I am mainly behind a desk all day. I am reading that I may be out for 2 months! If so have any of you gone the short term disability route? It’s my right leg so driving is going to be difficult.

Sorry for the rambling, lots of thoughts going through my head.

Thanks,
Dan

What ryanb said. Ski boots (and hard snowboard boots, though they’re rare) are quite AT-supportive and protective — despite the experience of eva10’s surgeon and a couple of people on this site to the contrary.

yup, certainly did have complications, jogging is a way in the future yet.

@xsoccerplayer

is there a way to know if the healing is more scar tissue than tendon? I just assumed that if the tendon has closed it’s all tendon material.

@davidr

I’m wondering why you wouldn’t be able to job at 37 weeks. Did you have any complications during your recovery?

@Sheena

I think you should be fine by next season. At 20 weeks, it seems a little early. But, in all honesty, I don’t think snowboarding puts too much pressure on the tendon, especially if your lead foot is your good foot. You only need to worry about the toe side turn. The heel side turn will put absolutely no strain on the tendon because you’re leaning back, or plantarflexing. The toe side turn is the dorsiflexing side, but your turn will be initiated more by you leaning into the top of the boot than it will be from bending the ankle. Snowboard boots are somewhat flexible, but they’re still pretty stiff. Wearing a snowboard boot is basically like wearing a cast. I would say that snowboarding is safer for the ATR than hard court sports like basketball, or tennis.

Hi Sheena,

How are things? I’ve been asking myself the snowboarding question. But seeing as I’m now in week 37 and can’t even jog I’m thinking it’s a long way off!

David

Skier myself but think Ryan is talking about freecarving or slalom set up with hardboots. Seen guys do it, looks like a blast. Just don’t end up in the broken wrist or collar bone blog site.

I got back on the snowboard at just over 4 months (ruptured at the end of August, did some very limited snowboarding over that Christmas break). As you know I was able to ski much earlier, due to the support that the ski boot offers.

I started out doing just a few runs at the end of the day to test things out (would switch from skis to board). I can say with certainty that snowboarding is more stressful on the Achilles than skiing.

I have seen (racing I think) snowboard setups that are closer to a hard shell ski boot in function. I think even a click-in rental setup might be better than a traditional 2-strap snowboard binding.

I might have been able to snowboard a bit sooner. Part of my hesitance was due to my lack of snowboard skill (I’m a muddling intermediate boarder). I am a much better, more confident, skiier, and felt like there was much less chance of doing something dumb to hurt myself on the skis

I have Northwave boots (though Burton’s felt just a great) and I have the Burton Lexa bindings. We were able to twist many of the other bindings by hand. The Lexa’s we weren’t able to and I have found just add a peace of mind when I’m on the hill.

My rupture was on my lead foot and I can’t say I ever notice it. If anything, snowboarding the last couple weekends has been great for continued recovery as its engaging my legs and helping strengthen my calf.

See how it goes. I wouldn’t rule out being able to squeeze it in this year. After about 7 months, there isn’t anything my ortho won’t let me do, so here’s hoping it works the same for you!!

Hey Eva,
great to hear you’ve been boarding…Can I ask you what binding and boots you bought please? I spoke to my physio and she said she would not try boarding this year and to go next year. Might ask my surgeon when I see him next though. Was your rupture on the foot you lead with or your back foot?

Hey Sheena! When I had my last checkup with my ortho (@ 33 weeks) I asked him if I could snowboard and he told me to go for it!! I had never been so I made sure I got the strongest binding money could buy with a boot that added support and I’ve had no issues at all. The bindings have come in handy as I’ve had a few spills where I’ve been relieved that i had the added support.

On a side note - his clearance to snowboard was quite a surprise as he had just ruptured his skiing 2 weeks earlier. So, keep your chin up, as you might be able to get out there just before the end of the season!

Awesome Sheena! Glad that you are doing so well. The single calf raises should come in due time. I’m in trhe same place. I can calf raise with both, or single in the water, although I tend to get pretty the sore the next day if I have a hard session in PT (Hence I try to schedule on Monday, Wed, & Fri). :Cheers to getting better and happy healing.

@Andrew, I’m good thanks. Been busy with new job but will post progress soon.

@xsoccerplayer,
yes is the short answer my tendon feels stronger. I reruptered and the surgeon didn’t even discuss the FHL graft with me, reason being, he didn’t know I’d need it until I was on the table. In full point my tendon didn’t meet so he did the FHL graft. It is never going to be as good as an achilles graft but they come from …well I think dead people? Not 100% on that one but think so. My toes will not curl up as well as they did before but I don’t plan to hang from any trees by them so that doesn’t bother me. My surgical repair feels much stronger than when I recovered no op but that is just me, I don’t think I healed very well and may have just had a load of scar tissue there.
I am very happy with my FHL graft. Hope that helps and good luck with it all.

Sheena,
I have totally ruptured my achilles twice (with wound healing complications). My current doctor is suggesting the FHL transfer surgery. My current condition is a very weak achilles because of the healing issues, and its probably made up of mostly scar tissue and not actual tendon.
Overall, would you recommend this surgery? I know its a little early for you, but would you say the tendon feels stronger? BEcause that is what im looking for if i have the FHL transfer surgery, a little more strengh.
Thank you so much,

Just popped on and was looking around to see how you were doing Sheena - trust all is well

I’m fourteen weeks and only just doing two legged calf raises! The in the pool advice is best!

I’m with DavidR. It’s way early to be able to do a 1LHR, or to worry that you can’t. (After my 1st ATR, I “lucked out” and COULD do a few at 12-ish weeks — but then I set myself back a painful month by actually DOING them! Details on my blog.)

If you do ‘em in the pool — do a bunch in deep enough water that you can — you’ll be able track your progress with the water level. As you strengthen, you’ll gradually emerge toward the shallow end ’til you can do ‘em on shore.

Hi Sheena, how are things?

Caitlin, I’m 7 months tomorrow and can’t do a single leg calf raise, and my surgeon and physio say I’m not behind, so I wouldn’t worry!

This probably isnt the right place to ask this but i will anyway! I am just passed the 13 week mark and i am still unable to do a standing one legged calf raise (on my bad leg) without holding on to something and helping me do it.
My physio thinks that this is ‘not right’ and by this time i should be able to do them on the one leg, and he wants me to go back and see the surgeon to look at what is wrong?
I thought i was heading in the right direction and i am really disappointed with this. I am in two shoes and have been for nearly 5 weeks. I still get the odd ache and pain and tightness. I have been doing all of my physio, going swimming - when i say swimming i mean paddling around with a few kicks and doing one standing calf raise in the water.
Just thought i’d share and would love feedback if anyone else has had a similar situation?
Thanks everyone.

Hi! I am also a re-rupture. I am not near getting into 2 shoes because I had another surgery for infection about 3 weeks ago. I did not know about the danger zone the first time around and now I do. I laughed out loud when I read about posting reminder signs. No kidding. This is very heartening to read — good luck in the coming weeks and hope to join you soon in the road to full recovery.

Sheena, good on you!, I’m just at 10 weeks now following re-rupture and yesterday was told that I can go back into 2 shoes with heels. Can you remember that feeling of being told we can go back into 2 shoes the 2nd time round, talk about a nervous moment!!, I have put up some posters on my starirs to remind me to go one step at a time, I’m not falling for the over confidence thing this time round!!. Hope to follow your posts as we both go through that period up to 20 weeks when perhaps we can start to relax again !!. Jon

Congrats Sheena - I’ve admired your resolve throughout your challenging journey and continue to wish you an uncomplicated, progressive rehab.

Happy healing

Congrats Sheena. Slow and steady is the way to do it and glad to hear your making so much progress. I can’t wait to have the strength to walk the kids back to school also. I might take a day off of work just to do that!

Hi David R and Dolly D Dream,
I’m doing OK thanks and I’m about to write a quick post. How are you David R?

Hi Sheena & DavidR

Wondered how you both were? Is the flat living up to expectations David?
I’ m just a bit ahead of you Sheena 4 weeks or so - thanks for tip re biooil been massaging twice per day used one by Visirdium in the end, scar looks v good also helps flexibility and ROM as I spend a good 5 minutes before doing my exercises..
In 2 shoes as of about 4 weeks ago, 15 weeks post op but able to go for walks trying desperately to walk smoothly and avoid limping but I seem to have lost a lot of strength and confidence, not creating a very good bend below my toes and trying to walk heel toe thru the foot - will it come back?!

Walked 1.5 miles yesterday and ventured into London twice with one crutch so very grateful! It’ s hairy when commuters walk into you though, useful weapons and people do let you have a seat..

All the best to you both

Hi Sheena, this is great news, how are you getting along?

Good work Sheena - glad to hear you’re doing well!!

Sometimes you can feel a lot of tightness — I used to call it “congestion”, because that’s what it reminded me of — from pretty small amounts of swelling. Make sure you’re doing enough RICE to keep your ankle “slim” and see if that helps. It’s also possible that you’re hyper-extending or dislocating one of the small joints in front of the ankle, trying to squeeze more DF out of a tight AT. (More details on my newest blog page, about “healing short”.)

If it’s the latter, your PT may be able to show you how to do DF stretches that leave those joints alone. My podiatrist jammed his finger in one of those joints to keep it from dislocating, and he also recommended that I stretch with my knee over my big toe or even slightly “inside”, rather than over my other toes.

Hi Sheena,

I did get a tightness around the front of the foot, you can see it in my blog here:

http://achillesblog.com/andrew1971/2012/08/01/foot-pain-while-dorsi-flexing/

One thing I realised on reflection - as well as the achilles tendon and calf muscles weakening, so is the ankle itself - all probably doubly so for you because of the re-rupture.

I recall that I was more than hapy to reduce the hinge movement on my boot (from -5 to zero +5), this was to make sure that (in the event of a trip or fall) when on even sufaces, there was no way the achilles could be stretched beyond a safe range, providing solid protection - of course it makes the walking less natural, but it’s a small price to pay to have freedom with reduced risk in the event of an accident… was trying to offset added freedom with better protection.

All in all though, great news that you’re back in two shoes, another milestone reached

I would know the tight feeling, what to do, or why. Although, I would like to say Congrats on the move to 2 shoes! I’m sure all considering it feels great and my doc says I’ll be at the same place in 4-6 weeks.

Oh, good! For others, YES, the Vaco CAN be set to hinge freely, within user-set limits. And so can lots of other (less high-tech space-age, older-designed) hinged boots.

Hi Norm
my last question…..doh I sorted it out! Cheers got my vaco moving as it should!

Hi Norm,
Vaco guys call it “step through” walking. They also refer to DF angles as -. So when you are in full PF and going into the boot, their instructions say you are at +30 moving down in degrees to neutral and then down past they refer to -. So step through, according to their booklet is set at -10…..rather than +10. Unless I have misunderstood but I have the booklet here.
Anyway, can I ask you a question, when you say set to hinge, do you mean that your boot actually moves or is set fixed at a DF angle? The vaco doesn’t move as in hinge move. I dodn’t know if I’m making sense here Norm?

Hi Sheena,
I did it playing netball, game before the grandfinal just to make matters worse!
I’m 7 weeks now so it sounds like we are at about the same mark. I have been sleeping without my boot and feeling comfortable. Im walking in my boot now with only a slight limp and have taken a few small steps without my boot. I always read about so many people re-rupturing their achilles so i think thats why im so skeptical and cautious! The physio tells me because i am only 20 and healthy i should have a quick recovery.
But its still a mystery to me as to why i actually ruptured it!!
How did u re rupture yours may i ask?
This blog is great and really helpful, thanks!!

BBride, with a good protocol, I don’t think the danger period should be any longer with non-op than with op — see the UWO results, for example. But there’s a long “tail” to the danger period, so saying exactly when it ends is a bit like mapping a shoreline while there’s waves and tides. The vast majority of reruptures happen before 12 weeks, but quite a few happen even later, especially with long slow old-school protocols, which are more common on the non-op side. The worst rerupture rates have always been from “conservative casting”, i.e., non-op treatment that goes ultra-slow, AS IF going slower was safer. Unfortunately, the opposite is true, so many people have suffered (and some still do) needlessly.

Sheena, I had a hinged boot BOTH times, right and left, op and non-op. First time, it was my surgeon’s first boot ever, it came way late (~12 weeks?) after 3-ish casts, and it was always set to hinge. (I gather the Vaco folks call hinging “walk through”?)

Second time around, I still had the old hinged boot, so I prescribed it for myself, at about 7 weeks post-non-op — i.e., about 1 week before UWO’s “wean off boot” at 8 week

Hey Sheena, I was told the same thing as Andrew - the “walk through” setting is meant for the “two shoes” stage. Use the boot as a precaution while in the “danger time”, which my doc says is 18 weeks. Seems longer than I’ve read on the blog. Perhaps non-op is a couple weeks longer. K

Hi Sheena - Was in two shoes at 9wks around the house only but became more confident over time

I was @ 11weeks when I ditched the boot for all except excessive walking or uneven surfaces.

http://achillesblog.com/andrew1971/2012/08/

But looking back I wish I’d used orthotics to support my arch during this phase I feel very flat footed on my ATR foot now and the physio is not improving that.

Hi Sheena,

I never went past neutral and I think my surgeon said you’re not meant to. I think I was at neutral 5 weeks post op, but that was quick and they slowed me down after that.

How are things?