Rupture Rapture!

Achilles Tendon Recovery Without the Guilt

Rupture Rapture Day 41 - Quick Summary

Tomorrow marks my 6 week calendar anniversary of my surgery date (7/22/09) and I think I’m doing well all things considered. I started a recovery tracking blog on a different site but I found this community and figured I’d switch over. Long story short I’m FWB and have been for 3 weeks with no pain whatsoever. Its been interesting reading all the other stories, particularly as it pertains to coming out of the boot. My doctor said at my appointment last week that I’m 6 weeks more in the boot (10/6/09) - that’s right at 3 months in the boot before starting physical therapy! That seems too long based on some blogs but I clearly don’t want to risk a re-rupture. I’m walking a lot at home without the boot and have been for 2 weeks, but i have been very careful not to flex my foot (walking peg leg style). I do minor stretching plus I’m very active in general and have started back at the gym last week plus light bike riding.

Anybody have any thoughts on waiting 3 months to start PT? I feel great and I’m ready to get started!

14 Responses to “Rupture Rapture Day 41 - Quick Summary”

  1. doug53 Says:

    My thought about waiting for three months to start PT is that it is a ridiculously long time to wait. Is there something special about your situation to make this long wait necessary? I started PT very early on, and could hardly be happier with how it turned out. At three months postop, I was doing sets of 30 single leg calf raises, and doing pretty much anything I wanted to do. And you’re supposed to do nothing but watch your calf atrophy for that long? I hope there’s a good reason for such a long delay. Sorry for the rant, but this “conservative” (i.e. debilitating) approach really bugs me, unnecessarily making invalids of healthy people.

  2. bubble Says:

    I’d have to agree, waiting 3 months to start PT is a very long time. I had my first PT session today at just short of 5 weeks from surgery. They were very cautious and made sure that I wasn’t in any pain but it was good to start working on some of the scar tissue and range of motion.

    Best of luck.

  3. chuckv Says:

    I agree with Doug. There is no way that I could do leg raises even now unless it were my good foot but the old saying “use it or lose it” still holds in my opinion

    Chuck

  4. Tina Says:

    Just wanted to weigh in on this discussion. I will be 12 weeks post op this week and only just started PT yesterday. They said there was so much muscle wastage and it hurt like hell, even when they said they wouldn’t go hard the first time. I always queried whether it was right to wait this long but maybe it was due to my DVT that there was a delay?? I’m just worried i will be stuck with a limp due to this long wait. I’m curious to know if you guys did your right ATR and when did you start driving after having early physio? All the best. Tina

  5. mattachille Says:

    3 months seems like an awfully long wait. Of course everyone is different and you may have particular circumstances that your doctor is concerned about. However I started PT between week 5 and 6 just prior to getting out of the boot. For me it’s been an absolute revelation. They have helped me so much in regaining flexibilty and strength and preparing to walk again, I can’t imagine not having had the PT at this point.

  6. stonebuddy Says:

    Thanks for the excellent feedback. Their is nothing unusual about my injury, etc. I just think i’m dealing with a very conservative approach and would like to think that perhaps they have encountered issues with patients in the past. I’ll just call up and ask. In the meantime, I’m going to push to get started no later than the 8 week mark. Based on the comments and other things I’ve read, a qualified PT is only going to let you do things that make sense based on your condition and ability.

  7. tomtom Says:

    I’ll offer up a slightly different opinion on the therapy issue, mainly for discussion purposes. I agree that therapy, as you begin PWB and FWB, can be beneficial. However, I don’t believe that waiting 12 weeks post-op is a death sentence. Has your surgeon restricted you to no movement while in the boot? If not, there are plenty of exercises that you can do on your own until you are able to start therapy. It sounds like you are already doing some work on your own. As you said, I would give your doctor’s office a call. If you can get into therapy earlier, great. If not, ask if they can recommend some exercises to do on your own. Most of the therapy exercises early on are just simple range of motion and balance activities.

    I’m guessing your surgeon isn’t all that conservative if you have been FWB since week 3 post-op. Like many surgeons, he/she may just prefer being in control of the recovery. They may have concerns that a poorly trained therapist could cause a setback, which could reflect negatively on the surgeon.

    Don’t get overly concerned about when you start therapy. It may slow your recovery slightly, but it’s not likely to change the end results.

  8. 2ndtimer Says:

    I find this approach confusing indeed.
    If you are FWB since week 3 (which is rather early) then why to keep you in the boot for 3 months?
    BTW walking around without the boot at home is not without dangers. I think there were several people on this site who got injured like that.

    I find physio less stressful than venturing around without the boot. Of course it depends what treatment you get .
    Some of it are exercises, that you can do on your own at home (but you are supposed to start very gradually) but some of the therapy you can’t administer yourself.
    I was told that ultrasound is beneficial for healing, and massage is useful to break down scar tissue, which are making these bumps on the tendon etc.

    We should keep in mind that the stitches of the surgery hold the tendon together, but we have to wait for the tendon itself to mend, which is a slow process. (6 weeks minimum?)

    I got the impression that the 8 week mark is pretty standard before getting into 2 shoes or starting any strengthening exercises without the boot. My understanding is that once you are out of the boot and the calf muscle pulls on the tendon that is the start of the real stress, that is when we get the swelling. etc. The physio before focuses on range of mobility mostly.

  9. dsut4392 Says:

    I’m in two minds on this; it’s awfully conservative following surgical treatment, but physical therapy means different things to different people, so even though I’m on a completely different timeline to yours (2-shoes at 6 weeks), I more or less agree with what TomTom says. Physiotherapy is a catch-all term that includes a great many things which there is little evidence for. That many physiotherapists have an almost religious belief in these same unproven treatments explains some of the skepticism about physiotherapy held by many in the medical professions. Of course it’s only speculation that is the reason, it’s also possible your surgeon doesn’t know any better;-)

    Have a talk with your surgeon and get some advice on what they think you should/should not be doing, and don’t be afraid to ask why your treatment appears conservative in comparison to the rest of us. I would suggest you take a print-out of Dennis’ exercise sheet (on this site under the PT section) and ask for your surgeon’s comments/approval.

    Good luck!
    Dylan.

  10. dsut4392 Says:

    Tina, I also did my right AT, started driving at 7 weeks post op, 1 week _after_ going to 2 shoes. I was doing ROM exercises from 2 weeks, walking in the pool and theraband exercises from 3 weeks.
    My surgeon never even mentioned driving, so I took a common sense approach and just waited until it felt comfortable and safe, i.e. I wasn’t worried about being able to slam on the brakes in case of emergency. If you don’t feel flexible and coordinated enough to rapidly switch from accelerator to brake, and strong enough to slam it on like you mean it, do everyone a favour and stick to the passenger seat, no matter what anybody tells you otherwise.
    Hope you’re free of your imprisonment soon!
    Dylan

  11. Tina Says:

    Thanks Dylan, its just good to compare some time. I’ve been so close to just jumping in the car but deep down, knew i wasn’t ready. Would hate to cause an accident or be in one so common sense prevails!! Working hard with all the exercises and can feel it loosening up already which is great. Going again to PT tomorrow so am nervous about them getting stuck into it this time!! Not long now until freedom, patience is a virtue! All the best, Tina

  12. Ed Mcwhorter Says:

    Rupture Rapture Day 41

    Be careful - I am 5 weeks post surgery. I went without the boot for about 30 minuets in the evening. I stepped on a sharp object, heard the “pop” everyone speaks of went to my knees, Second surgery has now been performed,

    Ed

  13. Tom Says:

    Odd indeed, the variations in treatment.

    I am beginning PT twice a week @ week 6. As of week 7, has me moving into 2 shoes.

    I am excited to be getting on with it. If someone told me I was staying in my boot for 6 more weeks (with no PT), I think I’d slit my wrists!

    On the other hand, we’re all talking about this like we have the same injury and that’s simply not the case. My guess is your doctor has a good reason for his approach.

  14. linda lou Says:

    I am 5 wks post op,& this week I had to have my 90 degree hard cast replaced, due to a severe burning sensation, my previous cast was too tight, every hair on my leg below my calf was a red itchy blister, both my incisions one on ea side of my heel (left leg)were puffy & very red. They tried to give me an rx for cipro I refused due to the long list of possible side effects to tendons, & was given another rx for a different group of anti biotic. I go back in two weeks to possibly get a walking boot, or he may make me get a walking cast. When I tried to ask him questions, he said he felt I was too worried about what he had done & is keeping me in a cast longer even though he thought I was healed up enough to go to a boot.He does not want me to ask anything, so I have no idea how long it will be for me to get to a walking boot.

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