5 Months

It has now been 5 months since surgery. I’m starting to get more and more nervous that things aren’t progressing the way they should. I can do a few single leg calf raises on the stairs, but I fatigue pretty quick and can only make it about 50% up. Long walks (2-3 miles) are often painless but cause pain the following day. I can get in a 30 mile road bike ride pain free and I can stand while peddling without pain. However, I feel like I’ve been able to do all of this for a few weeks now with no noticeable progress beyond.

I have no control from 80-100% when trying to get to my tiptoes. Even when unweighted, the ankle sort of “jumps” from 80-100% and my gastroc goes completely limp. I noticed this a while back and I haven’t seen much improvement. My PT suggested working this range with bands, which I did pretty hard on Wednesday. I then did my usual calf raises. By Thursday night I had significant black and blue just below my ankle.

Here are a few current photos taken just after icing last night, I am hoping others might have some experience they can relate, or maybe give some insight?

twoleg
badleg
goodleg

Week 6+

I had my week 6 post Op appointment on Friday. I was told I can exit the boot and begin PT next week. At work I spent the whole day in sneakers, and it was quite freeing. I can’t push off when I walk just yet, but I can do full seated calf raises and can put in quite a few reps with an elastic band. I’m excited to get to PT next week to be evaluated and given direction on what I should be working on. I am trying to take it slow, but it seems like this process is gone much faster than most accounts I have read. Besides being in sneakers at 6 weeks post op, I am walking around the house barefoot with no pain. This might have to do with the fact that I was put at neutral so early.

A small lump has formed at the base of the incision nearest to my heel. I think this is the area where the tendon had curled up when it was ruptured. I think its just a collection of fluids and swelling as a result of the new movement. I’ll have to keep an eye on it. Anyone seen this before?

The First Three Weeks

Hi Everyone

The information here has been very insightful during the past month, and I thought I would share my story.

Edit - Just a little context, I am a 33 year old male. I am 30-40 pounds overweight but very active. I road bike 400-800 miles per month. I play softball and kickball regularly. I occasionally find my way onto a basketball court. I haven’t played soccer in a while, but that is a favorite.

10/21 - Rupture!

I had slowed while rounding first base on a hit to right field. The fielder played the ball back into the infield and as I realized a play was being made on my teammate at home I planted my right foot in an attempt to turn my single into a double. As soon as I pushed off I heard the snap, felt the impact on my calf, and wheeled around to see who or what had struck me in the back of the leg. There was no one there, and nothing had hit me. I managed to crawl back to first base and the realization of the injury I had suffered struck me. I rolled off the field and teammates rushed to assist. I was not in pain, but I knew I wouldn’t be walking off the field.

10/22 - Urgent Care.

The next morning I was in Urgent care where the Thompson test confirmed my suspicion. The nurse splinted me up and they set me up for an MRI on Monday.

10/24 - MRI

The MRI results were relayed to me before I managed to drive the 15 minutes from the medical center back to work. The Urgent Care physician who had seen me on Saturday morning referred me to their Orthopedic office, who would set me up for an appointment on Wednesday.

10/26 - The Black Boot

It was a tough 4 days between the injury and the appointment with the Orthopedic surgeon. The splint they provide is not very comfortable. While the nurse had put me in the splint with toes pointed down to avoid causing the tendon to curl up, the MRI confirmed that the tendon had already settled down near my ankle. The tear was up closer to my calf muscle. The Orthopedic surgeon offered me the conservative approach or surgery. When I mentioned wanting to get back to all of the activities I enjoy, he said surgery was the right option. He had the nurse bring in the black boot and immediately returned my foot to neutral. No more pointing down from this point forward.

10/28 - Surgery

One week after the injury I am lying on a hospital bed for surgery. I can tell you the nerve block administration is not something I would ever want to do again. Throughout this process I’ve dealt with any pain pretty well, but having a large needle inserted into your leg and triggering nerves isn’t fun. The surgery went by in a flash. Back home, I built myself a pillow ramp on the couch and planned to spend the next 7 days there.

Heres the part that I have yet to see many account of: I was immediately put back into the black boot at 0% (neutral) and told PWB when bareable for the first couple of days, and FWB after that. Everything I had read to this point indicated I would be NWB for weeks. I was skeptical at first. Not only was I to walk on the operated leg, but I was going to be immediately returned to neutral. This meant no wedges, no bi-weekly stretching of the tendon post OP.

10/30 - Pain

Monday morning I finally had full sensation. My PWB on nerveblock reverted to NWB. However, I would still test it here and there when I had to make my way to the bathroom.

11/1 - No Pain

Wednesday morning I stopped taking the small doses of Vicodin. Any residual pain was manageable with Tylenol. Here I should mention that I have gout which was diagnosed at 19 years old, and aspirin is not an option. So I am on a blood thinner and cannot take advil. I progressed to PWB when making my way upstairs to the bathroom. I usually had to adjust the boot. During the night when swelling might go down the heel would pull away from the boot. and point my foot down slightly. I had to loosen the straps and push the heel back down into the boot before I could put weight down.

11/2 - FWB

Thursday, less than a week after the operation, I could go full weight bearing for short periods of time. Eventually the rush of blood caused some serious discomfort, but walking itself was not painful and as long as the boot was was tight enough I did not notice any movement of the achilled/calf.

11/3 - Post Op Appointment

One week post op and I have a visit with the surgeon. He is very happy with his work and happy that I’ve kept the foot at neutral. He does a quick Thompson test, and sees flexing. I have yet to replicate this myself even now as I write this. I guess it’s hard to do this test on yourself. I walked into and out of the appointment carrying my crutches. I wanted them with me in case the surge of blood flow made things unbearable, but when I could walk I was walking.

11/7-11/11 - Back to work

I’ve ditched the crutches. I’ve returned to my own bed, taking up more space than usual with extra pillows at my feet. My wife is glad to have me back in the same room again. The dog is not as happy. While at work I can’t really raise the foot, so it spends the entire day under my desk. For the first few days I am very happy to get back home and elevate. The swelling is bearable but eventually becomes uncomfortable.

11/11 - Follow up #2

The doctor again takes a look at the incision. He’s still so happy with his work. I’m beginning to think he does this with all of his patients. It is reassuring in a way. He doesn’t do another Thompson test but is happy with my progress and sends me back on my way. I mention the VacoCast boot. The Black Boot allows for motion and sometimes shifts into an uncomfortable position. The VacoCast would also allow me to resume swimming. He reads over the literature and signs off on a prescription. It’s not a boot he’s used before but he seems interested in seeing how it works. I place the order that afternoon. My next appointment won’t be for another month.

11/16 - VacoCast!

So I need to start off by saying that I was very excited to end my day at work and get home to try this thing on. +3 weeks in the Black Boot and I was ready for something new. However, I’m a bit disappointed. Maybe I still need to figure things out, but my heel hates this boot. Underfoot I cannot get the beads to sit in a comfortable manner. There is a bit more flex in the plastic and I feel like I am pulling on the achilles slightly as I walk. Three weeks in this probably isnt the worst thing, but the Black Boot, while simple, did not allow my foot to flex in any way. I spent a significant amount on this boot so I plan to keep trying to get it to work. I’ll give it a few days and report back!

So this leads me to today! Dennis just set me up with this blog and I’m excited to get some feedback on my progress so far and share my story.