Week 24 - still no heel raise and may need re-op?

so 4 weeks from my last post - i am getting stronger from my weekly physio and twice a week of body conditioning with a personal trainer who is trained to do injury rehabilitation. however, i still cannot do a heel raise. my 2nd physio is concerned as she believes something might be wrong with that particular tendon that is supposed to give me the push off and strength to raise my heel.

Anyone heard of anyone with a fully functional leg but just might have 1 particular tendon muscle / connective tendon partially ruptured? its just odd that i cannot even do a heel raise or push off (oh and the thomson’s test proved very weak so that was another concern). Still limping and upset. but my strenthening is now focused on getting my gait back, stronger glutes, quads etc… gonna see the OS on thurs now for another opinion. I really dont get it since my last ultrasound was fine. :(

reading up more online - my condition seems to be similar to this - posterior tibial tendon dysfunction?? anyone familiar with this?


5 Responses to “Week 24 - still no heel raise and may need re-op?”

  1. Yikes! Sorry to hear. I hope it doesn’t require a reop. Good luck.

  2. Sorry to hear about the heel raise woes. Sounds like something else could be going on though. Hopefully that can be sorted out without surgery. You did mention you could heel raise in the pool. So it sounds like there is some level of calf strength there. How much of your body is supported by water when you pool heel raise? Is it painful when you try to heel raise or just weakness?

  3. During rehab for my 2nd ATR, non-op, I worked very hard to build up enough strength to do a 1-leg heel raise. Ultimately unsuccessfully, because I still can’t do even one good full-height one with straight knee. But all the work/exercise overworked and inflamed another muscle-tendon pair (not the calf-and-AT), and I think it was this one. (My blog may remember more of the details than I do.) I apparently have a permanent strength deficit in my Gastroc-AT system (probably from healing a bit long), and I was overusing this smaller muscle-tendon pair to try to lift my body weight — NOT what it was designed to do! On my PT’s advice, I backed off for a while and the pain went away.
    My case may be less serious than yours, because my strength deficit is small enough that I have a fine push-off at the end of my stride, and can even do a decent “silly walk” up on my toes. And no problem bicycling, playing volleyball, etc., etc. Mind you, if you’ve inflamed that muscle-tendon pair the way I did, you may find that everything works better (and maybe even well enough that you don’t really have a problem, like me) after you give it a chance to recover fully.
    We’re all different, so it’s impossible to determine the truth remotely (even WITH a medical degree, and I don’t have one), but I’d say it’s worth a try, especially if the alternative is a tricky surgery.

  4. Hi,

    I am 19 weeks post rupture - squash/no operation - full w/bearing at 4weeks, boot off at 6.5 wks.
    I can do maybe 8-9 small straight leg heal lifts - these are about 1.5 inches vs 2.5 on good leg. At 12 weeks I couldn’t do any, even though I could jog w/o a limp. I think my current performance reflects my still relatively weak muscles. The big boost to my muscle strength started from running at about 13 weeks and this continues alongside a tough cycle 20-50miles a week and some controlled movement on a squash court.
    Academic research/ a comprehensive nordic study showed that in many cases - operative/non-oper - a key feature post rupture/healing is an elongated tendon. My consultant said this was a risk he was seeking to avoid with me - hence boot at 15 angle. In my case I am sure the tendon is maybe a cm longer - how do I know ? - well simply I can flex my whole up at a higher angle on the weak foot ! and it is not as “tight” when I move it to full stretch.
    So to counter this, I have stopped stretching the tendon - it now appears to be getting “tighter” slowly. Alongside this, I still think my struggling with heel lifts is also related to overall muscle strength, so the latter should improve.
    By the way, the study I referred to showed that in nearly all cases - operative/non-op - patients very really achieve their pre accident performance level in their bad foot. Key drivers to getting closer to this original level of performance are - age/early mobilisation/bmi



  5. Soj - I hope you have progressed since your last post.

    I am at 9 mos post non-op ATR and 1 leg heel raise is 1-2 cm. OS suspects I have healed long but ROM in both feet is similar, but less resistance to dorsiflexion in injured left so OS suspects healed long.

    How has your progress been since your last post?
    Have been able to gain push off strength and/or height on the heel raise?
    My experiences are discussed on my blog site.

    Appreciate comments from you and others.
    All the best!

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