tdance’s AchillesBlog

I have not posted recently. I continue to progress, but very slowly 10 months after surgery. I did early weight bearing and a full PT protocol but am also convinced that I have ‘healed long’, although I have not had a clinical diagnosis. I can’t really do a one leg heal lift on the injured leg; maybe get 1.5″ off the ground unaided. Having said this, I am active with regular activities including trail walking up to 3 miles and cycling on flat pavement up to 25 miles.I can get some fatigue but no real pain or swelling. At the same time my stride push off is significantly weakened on the injured leg, and the atrophy is somewhat shocking. It appears that I compensate with toe claw,and foot and ankle activation. So, I wonder what people’s experience has been with additional surgery to shorten the tendon - risk, results, post surgery experience? I see there has been lots of comment on this topic in earlier threads on the blog but not much recently. I also wonder how prevalent this is and how it is acknowledged (or not). I realize this is not a topic that people really want to talk about given the trauma of the injury and long rehab, but

Hi tdance,
Sorry to hear it’s taking you that long.
In my case, I was NWB wearing cast for 6 weeks, then 2 more weeks of NWB without a cast, and no boot at all. No PT for me at all, just what I read online and not doing anything through pain. However, I started going to the gym and swimming pool 8 weeks post op, i.e. right after I was allowed to even gently step on my foot.
I think I could do single-leg heel raises at around 12 weeks post op, and I started doing it in the water. Many people say starting in water helped them with their heel raises.
Even though I ruptured my Achilles around the same time as you did, I started running/jumping at around 5 months post op and I went to play in a 3-day ultimate frisbee tournament - no restrictions on my side, but not at my pre-injury level of course - 7 months post op.
The only issue I have left is calf muscles imbalance, as my healing leg is still lagging behind the healthy one. The progress is slow, but it’s coming.

I can’t imagine going with another surgery now… Good luck with that and take care!

If your doc says things are OK they probably are. Just keep doing the exercises the PT gives you and eventually you’ll get the strength back. How long it takes will vary based on how your exact surgery/recovery went. Since you were 10 weeks NWB it will take you longer since there was more time for muscles/tendons/bone to atrophy. For my right foot I was 6 weeks NWB and it looks like I started doing them at week 15 http://achillesblog.com/cserpent/2017/06/02/week-15-pt-2/ and by week 18 (4.5 months) I was able to do 8 of them. However long ago when I had an IT band injury my soccer coach told me that for every week you have to cut back on exercise due to injury it takes 3 weeks to get back up to where you were. That assumes that you aren’t being a total slacker. When you are NWB, by definition, you are being a total slacker on that leg so I would expect it to take more than 3 weeks/1 week off to get the strength back. So you figure you had 4 more weeks of NWB and let’s say it’s a x4 multiplier since you aren’t doing anything at all. That would put you out to 8.5 months before you’re where I was at 18 weeks. So keep at it!

Tdance. I am several weeks behind you. I did just start doing two leg calf raises without weights. I put my hand on a chair and make sure to really lock out. My PT said to try doing on the stairs and gradually push more of the burden to the bad leg. With that said I checked out my calves in the mirror and wow not a lot going on.

When I tore my other twenty years ago it was a full 12 months before I felt 100% or close to it.

I hope this helps and wish you well

Yes yankeefan, like you I am at 8 weeks post surgery this coming Thurs. FWB in 2 shoes now with heel lifts. Doing the customary exercises, just started 2 foot heel lifts, and like you - feels OK but fatigues quickly and I too have the knot at the surgery site which feels sticky like there is an adhesion. Also still lots of swelling. Overall feel pretty good to be walking (if you call it that, lol). One thing that is really working for me is the stationary bike, low resistance, just spinning for 20 mins each day. My PT also has the anti gravity treadmill which helps in restoring a natural gate (over the toe). All in all pretty happy with where I am at, realizing that I still have miles (literally) to go…

Hi Tdance, I’m 8 weeks out but I feel like I have something similar to your lump. It’s very thick for me at the top of the scar, which is where I assume the rupture actually occurred. I’ve been massaging it and doing scar mobilizations but it seems to be pretty immovable. Hopefully it goes away with more massaging and stretching. I just started doing double leg calf raises and I have discomfort/stiffness at the surgical site. Seems to be improving slightly but it’s still pretty painful. Do you remember how it felt when you first started doing heel raises?

Thank you!

Katie

Hi,

All these years later, I still drop by this site now and then, and found your question about how long it takes for the limp to go away. If you don’t mind reading a long post, check my post of 4/29/09 for a discussion, toward the end, of that issue. Others have pointed out to me that when, in that post, I talk about walking fast, I’m really talking about taking longer steps.

Best wishes,

Doug

I had a limp for over 4 months. Then it slowly disappeared. The thing is I did not really notice the limp, unless seeing it shop window =)
What helped me is walking on a treadmill, where you do same length strides at a steady interval. Perhaps you could give it a try. Walking more slowly in another alternative. Good luck!

The easiest way to lose the limp is to not limp in the first place. Take steps that are small enough so you don’t limp. That’s what I did so I never limped - but man were my steps tiny in the beginning - LOL! The limp is because the tendon flexibility isn’t back to normal. As it gets stronger and more flexible your step will get longer. Read agnesatr blog as she talks about it and show videos.

I had pain and tingling under my ankle on the outside. When I asked my doc he said it was a nerve that gets moved a bit during surgery and it takes a while for it to calm back down. Your tingling may be another nerve. Check with your doc and s/he should be able to tell you what might be causing the tingling.

And it does take a LONG time to get the strength back.

It takes a LONG time to get back the strength and size in your surgery leg. Atrophy happens very quickly and takes so long to get back what you lose. It will take months to get most of the size back. My surgery calf still isn’t as big as my non-surgery leg but they are close and I don’t feel any differences in strength. Good luck with the MRI - hopefully it won’t show anything serious.

i don’t have any words of wisdom but i hope for the best for you.

I know my doc had me transition slowly to FWB. I started the transition at week 6 and was FWB in shoes at week 10. My doc had me transition by wearing shoes (with heel lifts) 25% of the time for a week (all the rest of the time in the boot), then 50% of the time for 2 weeks, then 75% of the time in shoes and the rest in boot. At week 10 I was OK’d to be bootless and set up my PT appt.

If you look at the “marathon” page (http://achillesblog.com/atrpt.php), there are a number of people who took 3 weeks to go from PWB to FWB, and a couple that took 6 weeks. I was still wearing a boot 24 hours a day at 10 weeks as well. It seems like “normal” is elusive with ATR recovery - so much depends on the particular injury, the method of repair, and the doctor.

Is your heel swollen? For a couple weeks I often had a weird feeling in the bottom of my heel when I would first put weight on it which was apparently from swelling. The feeling would go away after a few minutes.

@Zach

I’ve read tons of stuff about operative vs non-operative protocol and has seen similar advice re ruptures higher up the leg - ie non-surgery is recommended.
There are some really good blogs here from people who’ve been through the non-operative protocol and I’ve taken that as guidance. Agnes is one of them (she has also posted videos on Youtube) but there are some others who seem very knowledgeable. As far as I understand, the key thing is to start moving early enough - after you’ve given the achilles some time to heal. This is typically 2 to 3 weeks NWB and then start moving/ exercises which will help the tendon get stronger. It has something to do with growing the right collagen - which you can only build by moving.

As to my experience, it has been easy and straightforward (apart from obviously the terrible limitations you have to go through - especially being an active person).

I never got a cast/ split but went straight into the boot. Whilst
i was allowed to do minimal weight bearing (10%) from the beginning, i stuck to strict NWB for the first two weeks. After that, i started ROM exercises 5 times a

@pdelputte

How was your process for non-op? I tore the area where the Achilles meets the calf muscle. I am 27 y/o male who works out 5-7 times a week so I was surprised and a bit frustrated when the doctor let me know this is not generally an area to operate on due to the area of the tear with the muscle. I am in a hard cast now as of today after splint the day of injury this past Saturday 4/21. What was the timing from splint/cast to boot with NWB->PWB->FWB to no boot…

I’m at 6 weeks and my achilles also has a slight indent where the rupture occurred. I was wondering the same thing. When I flex/move my foot up and down though it feels firm and straight. I am going to get an MRI (I haven’t had one at all yet) at the end of this week.

Thanks everyone! I’m trying to stay positive.

Feeling for you tdance - as 6 is an eternity, and now another 2…
As they say - every doctor is different and there does not seem to be a right or wrong answer here.
Going against your doctor is not recommended but i wonder if you have started physio?
Maybe that is a way to at least start the process of rebuilding some of the strength?

hang in there, the next goal post is in site.

Hang in there. Its tough. I was Total NWB for 8 weeks. It sucks but now I am 6 months post Op and looking back it was worth it. Every Doctor is different. Dont try and push back to fast! Just take it a week at a time. Mini milestones.

Don’t get frustrated. Patience is key. Listen to the doctor. They have the experience and you don’t. Celebrate the mini milestones like NWB to Partial. A step backwards might mean 2 steps forward.

I am 6 months post op and have not gotten to run at ALL. I hope to get clearance tomorrow to start jogging.

I am also about 4 weeks post op. Started PWB on my cast at home without doctor consent about 4 days ago, and started FWB today. I have no pain, and a slight tingle at heel with my first few steps. My doc is conservative and wouldn’t let me put on boot at 3 week mark, so I decided to take the risk of testing my body and feel I know my own body best. I do take very careful steps at home, and use crutches when going outside. I was able to flex my calf and move my foot around since day 3 after surgery, and have been flexing and moving my foot from inside the cast ever since. I’m pretty sure I’m on the risky side of recovery protocol.

popouch - same here! Just this week (Thursday) got word that the doc wants me to wait another two weeks to start PWB… man how frustrating!!

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Interesting, that seems fast for non-op! Glad to hear it’s going well!

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Pjhalifax - that’s interesting to hear. On Thursday, my doc told me he wants me to wait another two weeks (will put me at my 7th week post op) to start PWB. That seems like an awful long time, but he is also a “cautious” or more conservative doctor. I’ve started doing very limited movements on my own, controlled and cautious (trying to circle my ankle, up and down, toe wiggles and scrunches)

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I just managed to reach full weight bearing today at 5 weeks post injury (I follow the non-operative protocol). It took me a week to get there and have tried for most of the past week to walk with one crutch. Once you manage that, i expect that you will be loose the other crutch pretty quickly as well. I did not experience any pain but just had to get over the mental block of allowing me to actually push through the boot. Until i managed to fully roll through the boot and have the weight on the leg - i was just limping around.
Good luck - it will come and faster than you think!

We are pretty much in the same boat! I just got a boot on today at the 4 weeks post op mark, but my doctor doesn’t want me to put any weight on it still until the 6 week mark. I am able to move my ankle more, and I’m really anxious to start putting weight on it. The doctor was very insistent on NWB still for me.

Wearing one boot with a 3-inch heel is pretty awkward, especially at first, but being able to stand on two feet while brushing your teeth etc. is a relief! For me there wasn’t any pain or discomfort - the boot keeps everything in place, and each day you can put a little more weight on it.

Welcome to the exclusive club nobody wants to join! Sorry that you’re here but the blog is definitely a good resource. Your story gives me flashbacks to last March when I ruptured my right Achilles - I had similar feelings of frustration and, ultimately, gratitude that I at least had a path back to normal (or a new normal).

For question 1 - sounds normal to me but I’d add it to a list of questions for your next doctor visit. I had all sorts of weird sensations the first few weeks after surgery. Sometimes it was little spasms and cramps, other times almost like electric shocks. And sometimes numbness/tingling. I just imagined everything was magically rebuilding itself.

2 - I don’t think I had any augmentation beyond the tendon being stitched up.

3 - Yep. Those feelings lasted a few months for me. Getting around on crutches and the iWalk handsfree crutch had my left (good) side stiff and sore on some days. Once I could do some PT work I tried to do the same stuff on both sides to at least feel like I was helping the good side along, too. I still think about this, actually, and a general fear of re-rupture has kept me away fro