The doc was planning on putting another cast on today . . . six weeks this Wednesday since surgery to shorten tendon. However, I showed him the vacoped and he liked it. So, now I am at 2 cm and able to at least take off boot and flex ankle everyday–progress. pak
Well . . . I did it. I had the surgery to correct the elongated and split tendon. All seemed to go well. I am in a cast for at least two weeks.
I have some great photos, but I still can’t get them to show up in post.
I reached a point of despair a couple of weeks ago. It hit me that my calf muscle seems to be getting smaller and weaker. I set an appointment with a below the knee specialist in Houston–went yesterday. Dr. Jay Oates was encouraging in one sense–he believes I made a wise choice with non-op; however, the results after re-rupture are not so great. He suggested I was at 65% of original strength, but I will have to disagree . . . seems much less than 50%.
Dr. Oates believes my calf strength will not improve anymore from this point and offered the option of surgery to “cut a chunk out” and reattach. When I left, I thought I would work hard on rehab for a month or so and then decide. However, after arriving home and going for a couple of miles walk, I believe I need to have the surgery asap. It is not getting better and I don’t want to live with it.
I took a four day trip in the Pecos Wilderness (Santa Fe, NM) this past weekend. This trip I used trekking poles for the first time for added assurance. Everything seemed great; however, I had occasional anxiety that the tendon would pop again. There was no pain or inhibition from the ATR at all–very pleased. I would say the hiking was moderate/difficult even arduous at times while climbing from ~9,000 to ~12,000 ft. I was carrying 25-30 lbs in the pack.
This next week is the one year anniversary of my re-rupture and I went non-surgery protocol. The tendon still has some deformity and the calf is noticeably smaller than on the “good” leg. However, it seems to be healing in line with other folks. I may start jogging a little to work the calf muscles a bit more. Hope everyone is doing well!
Just wanted to give a quick update. I passed my one year anniversary of initial ATR around Valentine’s Day. For those unfamiliar with my injury/recovery, I decided to go non-surgery and pushed things too fast–re-ruptured at 19 wks (partial at 13 wks). I went non-surgery on the re-rupture also . . . I am still glad for my decision.
I have been cycling hard trying to get in shape, climbing some good hills. Today, while working the cows, I cut and ran quite a bit. Everything feels pretty good with no pain at all; however, I am a long way from 100%. My calf muscle is about 3/4″ smaller than the uninjured leg and heel raise tops out at about 2″. The tendon is still quite thick with a thin spot in the middle. I don’t know how common this irregularity is, but I am just being patient until it has time to reach maximum strength . . . maybe a year?
Blessings to all!
Thought I would give a quick update . . . I am still doing well and making progress. I can do short heal raises and walk w/o a limp. The tendon still feels split from top to bottom, but no pain and strength seems in line. I wonder . . . has anyone else has had a tendon heal like this? It is like two tendons side by side until I flex, then they harden as a one–oh well.
The area above the break is still kinda hard and thick, but nothing that bothers me. Good healing to all. pk
Today is seventeen weeks! This week seems to be the point where I can walk without a limp. I can support my full weight on the bad foot (180 lbs). The tendon is continuing to firm up; however, I still have the indention running from top to bottom on the posterior of the Achilles. I am not sure if this indention is normal or not.
Anyway, I am progressing and feeling more confident. My rehab consist of walking with good form, cycling, and occasional heel raises. Hope everyone has swift and complete healing. Blessings, Paul
Yesterday was 12 weeks since the dreadful day when I re-ruptured. I chose to continue with the non-surgery option. Overall, I have taken things much easier this go round. I believe the first time I thought I was superman and pushed/rushed things way too fast. This aggressive protocol set me up for a re-rupture (partially at 13 wks and fully at 19 wks).
This time I have worked on walking with good form, but stop short of any pain. I now believe I am stronger than the first rupture and have hope that this time things will turn out well. The tendon is starting to firm up and my walking is getting better each day. I can push on the scale about 120 lbs. with the ball of my foot.
Anyway, I am starting to be hopeful. Everything seems to be going well and I plan on incorporating some cycling from here on. Hope all have quick and complete recovery. pk
Today is the 8th week and I have begun two shoes; however, I am walking really slow and easy. I can press about 53 lbs on the scale, which is well ahead of my first go round of 40 lbs @ 8 wks. I also am not riding the bike or doing anything that makes the ankle hurt. When I feel that tinge of pain start, I always back off. The tendon seems much less thick and hard this time; the ultrasound may have helped in this respect. Also, ROM is not bad, but still a ways to go. I would guess it is 15 degrees shy of normal.
I can still feel the place of the break and it is not yet hardened and smoothed out like the rest of the tendon. It feels just a little soft when relaxed. I can’t remember at what point the tendon smoothed out last time . . . anyone have a comment about when their tendon seemed firm and smooth while relaxed. Of course, when I flex the tendon feels firm and continuous.
Anyway, I don’t want to push very hard until I am confident the tendon is strong enough . . .
It has been four weeks since that dreadful day when I re-ruptured. The encouraging words from everyone were very helpful in those following days–thanks again. I am sure many will disagree with my decision, but I couldn’t bring myself to have surgery. I decided to immediately put the ankle in a boot and let it ride. If at four weeks it didn’t seem like it was going well, then I would have to reconsider.
I have been following the UWO protocol pretty closely with only one exception so far. The protocol calls for the ankle in a splint for two weeks and then a boot. The splint may keep the ankle at a steeper angle; nevertheless, my ankle was set at 30+degrees. One tip for Vaco-Cast users: the beads were kinda deforming my Achilles . . . mostly from the swelling around the boot liner. I made a real effort to push the beads away from the Achilles with my fingers. This seems to have taken any pressure off the tendon and it feels much smoother now when I take my boot off.
Bottom line: my tendon has healed together with no tenderness or irregularities other than a small uniform ridge at the rupture point. I have been extremely careful not to stretch my Achilles and thus repeat my error from the first go round.
Since week three, I have done gentle movements per the protocol along with using the electric massager. I have also begun protected weight bearing using my crutches. I believe the protocol calls for weight bearing as tolerated from week four onward. However, I probably will continue PWB for another week or so before I go FWB. I don’t feel any pain and probably could easily go FWB right now, but I want to protect from pre-mature stretching.
Hope everyone has swift and complete healing. Blessings, pk
