PT and neutral

Hello All,

Good PT visit today.  I was wondering if PT would be helpful or just kinda, I don’t know, I thought they might only supervise what I could do on my own.  Well, I would recommend PT to anyone going through a recovery.  Definitelymore then just supervising.  They give me very good instruction and massaged and really loosened that tendon!  Huge help.  In the last 24 hrs. I’ve gone from 20 degrees to neutral!  it feels good!  Still told to be NWB for another 12 days or so.  I do some PWB to stabilize myself, roll the boot while I’m walking.  This really helps and got the green light from the surgeon and PT to continue this. But both said not to do too much more than that.  I really was pushing for a more aggressive protocol, but I have to sa,  it seems like I’ve come so far already!  It feels great to be at neutral and sole contact definitely makes using crutches so much easier.  The last week has been really huge.  The breaking up of scar tissue, balancing with the boot and crutches and getting to neutral.  The incision is healing nicely!  Walking without crutches is getting closer!

Getting it loose

Hello All,

I took of my boot this evening to do some ROM exercises.  I was going at it pretty good for about 5 mins. or so.  Then I felt the tendon kinda pull away or free up.  I guess I must have gotten the tendon free from some scar tissue.  It startled me at first, but the tendon felt so much better and I had such an easier time with the ROM movements and it felt a little more powerful too.  If there’s no pain, I suspect no problem.  Any insight into this?  This is the best it’s felt since the surgery and I’m looking forward to my first PT session in the morning!

The Road to Recovery!

Hello All,
I managed to rupture my Achilles tendon on 5/28/2011.  I was bringing home a full load of hardwood flooring to install at our home.  53 boxes of solid maple hardwood flooring.  Well, we live pretty far out in the sticks, right outside the Great Smoky Mtns National Park, and it was a fairly long haul from the warehouse to our home.  I was confident the load was secured, but it was a little taller then I would have liked.  I was almost home and the load shift to the left.  It looked like the leaning Tower of Pisa.  I pulled over to give the load a push to straighten it back up.  Well, the thousands of pounds of material pushed back and I was stuck like the long side of a triangle, with my arms extended over my head and my body leaning into the load and my Achilles just snapped.  I sounded like wood breaking.  I though maybe some wood was breaking!  But, alas, it was me that was breaking!  I asked a fellow nearby to give me a hand and got the load striaghtened up and made it rest of the way home.


It wasn’t really that painful.  I even unloaded the 53 one hundred pound boxes into the house right after the rupture.  How stupid was that?  Well, it gets even more unwise!  I thought it was a sprain.  Popping sounds are never good, but it really wasn’t that painful.  I took it to bed, and followed the RICE approach and thought I’d check it in the morning.


I slept well.  Woke up, hobbled around, and went about my day.  I think I went on a boat ride with my in-laws.  My father-in-law is an IT director at an orthopedic center.  He asked what had happened, I told him.  He suggested I come in the office to have it looked at.  I wrongly told him, “Aw, its just a sprain, I’ll be fine.”


Well, fast forward two and half weeks.  My father-in-law took me and my brother-in-law out for a fathers day diner mid week.  I do have a beautiful wife and beautiful 6 year old daughter.  At the dinner, my father-in-law had invited a Physical Therapist from his office to join us.  We’re all friends, the PT was not there to see me, it just worked out that he was there.  He said,”TJ, you’ve got quite a limb there.”  I said, “Yeah, I sprained my ankle a couple of weeks ago and it’s just not getting any better.”  He said, “After dinner I’d like to take a look at it.”


After dinner we went outside.  He laid me down on my belly in the back seat with my feet dangling over the edge and performed what I have since learned to be the Thompson Test.  I failed.  He said, “You will be seeing a doctor in the morning, and you will need to treat this in some manner.  It will not heal itself, and by ignoring it you could have a limp for the rest of your life.”  I said, ” What???????”  Needless to say I was in the Docs office the next morning.  I hadn’t done any research on the injury before my appointment.  Surgery was recommended and I agreed.  It was scheduled for 6/21/2011.  5 days after my visit and 23 days after the injury.  I feel I received excellent care.  My surgeon was Sports Medicine Doc of the Year 2008 for the Knoxville, TN area and Board Certified and has been head of the Oversight Committee and easy to talk.  


I was really beating myself up for not seeking out care immediately.  I will never make that mistake again!  Sadly, if not for the dinner, who knows how much longer I would have waited.  Well, never again.  Doc said not to be too hard on myself.  I was still in the time frame for a good surgical repair.  Acute rupture.


I started researching immediately.  I also have psoriasis on my shin of the injured leg.  It’s the only spot on my entire body, but it’s a pretty big area.  12 inches long by 4-5 inches wide.  I keep it in check with hydrocortisone cream, and it’s not very noticeable when treated.  But I treat twice daily and the thought of it being cast over for any real amount of time concerned me.  I mean, the itchy, dry skin in a cast could be a lot to bear.  It turns out, a week in a splint was actually very good for my psoriasis.  I have been able to treat it since the splint has been removed and it appears to be clearing for the first time in years!  Maybe that is the reason it all happened!?


While researching a solution to this problem, I came across the Vacocast, Vacoped boot.  I ordered one to have with me for my first post op visit.  One week after my surgery.  I brought it with me and asked my surgeon if I could use it instead of a hard cast.  He said that was fine with him.  He didn’t really even look at.  He said, “Use what ever you like, but keep it on 24/7, except for showering and remove it a couple times a day, dangle your leg off the edge of the bed and lift your foot up, but do not push down, only lift.”  Man was happy to hear this.


I have been off from work since the surgery.  The first two weeks I spent in bed with my leg raised.  I purchased a foam wedge, leg lift/pillow from a local foam outlet.  I learned about these pre-op and got it the day before my surgery.  This things been great.  It’s dimensions meet orthopedic specs and it has helped keep the leg elevated.  It was $30 with a cover.


Starting July 8th I started stabilizing myself with the Vacocast with Achilles sole attached and the boot set at 20 degrees.  Not really PWB, but sole contact and rolling my boot/foot in stride while supporting my weight with the crutches.  I feel no pain and I’m getting more confident to start PWB.   This would be a pretty aggressive protocol, but that seems to have a lot of backing in recent studies.  The Vacocast/Vacoped timeline suggest PWB at the start of week three at 15 degrees and FWB at the start of week 4 at 15 degrees.


I am a project estimator for construction projects and I need to start working towards getting back out in the field.  I’m taking it slow, I know I’ll be in the boot for many weeks to come, but if I can safely get to FWB with the boot, having it on really isn’t any big deal.  This Vacocast is very comfortable.  It took a couple of days to get used to, but now I’ve learned how to have my leg secure and very comfortable.  And I have two cloth inserts to change out and keep the inside of the boot clean.  I would definitely recommend this boot.


I do have a lump on the top of the incision.  It’s a hard little ball and was there when the splint was removed.  Any thoughts on this?  Has anyone else noticed a lump?  I’m not too concerned because I don’t have any pain.  It’s just not very pretty.  It’s more important that it works I guess.  As far as the incision itself, it seems to be healing nicely.  Open surgery, suture tape still holding.


Well that’s where I am after 2 1/2 weeks.  Starting to get around a little bit more each day.  Oh, my toes still turn purple when my leg is left to hang.  It has diminished, but still very noticeable.  Do others have the same experience?  Did you proceed with PWB when this condition was present?   Keep me posted and thanks for reading.


PS - This site has helped soooo much.  Thank you all for sharing.  Talk with you soon!