Healed Long - Month 10 Update

Figured I would come back here to provide an update to my journey on the recovery from my left Achilles rupture.

For those who need a refresher, I completely ruptured my left Achilles playing basketball in late February of 2018, with surgery March 7 2018. My surgeon did things the old fashioned way - with an open surgery. However, he also used a Stryker graft to augment the repair (make it stronger and more resilient).

I think this is a lesson for all of you starting this process now - regardless of how healthy you are, and how optimistic you may be, BE VOCAL WITH YOUR DOCTOR.

I was non-weight bearing for more than 10 weeks, a full month longer than typically recommended. My doctor also took me straight from plantar flexed in a cast for two weeks to neutral in a boot, with no gradual decrease from plantar flexion to neutral. I voiced twice that I had read this was not typical, and he pushed back each time.

Fast forward to today, 10 months later. I have been doing rigorous PT for more than 5 months. While my calf is very slowly returning, it is still a full 1.5 inches smaller than the “good” side. My push off strength is nowhere near normal, and I can not complete a one legged calf raise. Again, it is slowly getting better but VERY slowly.

At my PT’s urging, I saw two of the best Podiatric surgeons in Los Angeles. One is the Chief of Podiatric Surgery at UCLA Medical, the other is the former Chief of Podiatric Surgery at Cedar Sinai. If you need recommendations for LA doctors, these two are the best at the University Foot and Ankle Institute.

I saw both Dr Briksin and Dr Bob yesterday. Their conclusion was that I have definitely healed long. The most likely culprits being the time I spent non-weight bearing as well as the rapid move to neutral without gradual decreases over time.

The options now are to continue trying non-operative with PT to see how much progress we can make, or surgery to shorten the tendon with FHL transfer. I have vacations coming up, so will likely give PT a couple more months and elect for the surgery in April/May.

At this point, I am tired of not having much strength in my left side and not being able to fully get back to sports like Basketball or running. I can shoot around, but have very little push off strength. I can surf, but still wobbly. I can walk, but still with a bit of a limp and hard to push off. And my calf looks like a 10 year old. I know it will never be 100%, but it has to be better than this.

Here is a photo of what my ankle looked like about two months after surgery… I brought the apparent lack of tension up to my Dr multiple times and was told it was normal.

Also including the last 5 months of my calf recovery (Sept-Jan)
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Image and video hosting by TinyPic
Image and video hosting by TinyPic
Image and video hosting by TinyPic
Image and video hosting by TinyPic

Anyone who has gone through the shortening surgery with FHL and can comment on your strength pre and post would be greatly appreciated. Are you glad you did it? How long was the recovery? How was it vs the first go around?

2 Responses to “Healed Long - Month 10 Update”

  1. 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!

  2. 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 it seems relevant to the dialogue. I also wondered what decision tdance made relative to his comments above.

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