First Post! 3 and a half weeks

Hello all!

I guess I should start out by telling you a little bit about my injury and myself. My name is Pratik Patel. I am 23 years old and managed to rupture my achilles playing football. Luckily for me I just graduated and have a job which is due to start in september so I can focus the next 7 months on healing and rehabilition as I have all the time in the world. I was operated on within 24 hours. The dates of the rupture and operation are below.

Date of rupture: 12th February 2013.
Date of Operation: 13th February 2013.

I had by first follow up appointment on 4th March 2013 which was 19 days after the operation. Here they removed the first half cast which had my feet in a position so that it was pointing down. Then they put me in a new red fibre glass cast where they tried to get my foot to 90 degrees. It is close to 90 degrees but not quite there due to the tightness I had in the achilles.  I was given an ankle brace  and was told to start putting weight on my foot with the aim to get to fully weight bearing within 2 weeks without crutches.

I have begun putting some weight on the leg and it was going well, I felt I was able to put a little bit more weight on it as time went on. However yesterday (8th March 2013) 23 days after the operation I decided to try putting more weight on it with the use of the 2 crutches and found I had some pain in the leg. It was only after a good nights sleep that the pain went away. I am cocerned that if I continue to push myself that I will do some considerable damage to the surgical repair of the tendon and be back to square one. Is it normal for me to experience pain when I begin to put weight on the foot or does this mean I am pushing myself too far? I would be very grateful if people could comment and tell me how they felt when they began to put weight on their operated leg in order to get fully weight bearing. Did it involve pushing past some barrier or was it a natural progression? I am quite unsure on the matter and would really help appreciate some clarification.

Below are the images below of my foot in a cast and the ankle brace

Leg in Cast
Leg in ankle brace

2 Responses to “First Post! 3 and a half weeks”

  1. Welcome, Pratik, and best of luck! I always cringe when I hear about casted patients getting pushed hard into a more AT-stretched position, because it can cause reinjury or “healing long”, both of which are best avoided. In the rehab for my second “left-leg) ATR, my protocol said I should jump straight from 2cm of heel wedges in a straight fixed neutral-position boot, to the neutral posotion, no wedges at all. I discovered that I’d been walking around on 3cm of heel wedges, not 2cm. I also discovered that going straight to neutral felt uncomfortable and scary, so I just spread it out over a couple of days. With a boot that’s a trivial adjustment that can be done easily and with great precision. With casting it’s another appointment at the hospital, and the precise angle is hit and miss, as much art as science. That’s one reason (of many) why casts are now an endangered species for ATR rehab, and boots are taking over.

    What you are calling an “ankle brace” is what I call a “cast shoe”. It just goes over a strong “walking cast” and adds a non-slip sole.

    Most of us have discomfort or pain under the foot (esp the heel) when starting to bear weight. Normal and semi-harmless as long as it doesn’t become chronic. Pain in the leg happens too, but it is potentially much more serious. Where’s yours? Near the back of your heel, or near the incision, or… ?

    Again, with a boot it’s easy to inspect and discover. If there’s a pressure point or an irritation, it’s easy to fix it. Not so much with a cast. You could call your Doc’s office for an opinion and a plan.

    2 more points: (1) When you’re PWB and esp FWB, it’s important to bLance the height of your two feet so you can walk straight. I used one of those cast shoes on my OTHER foot to raise up a shoe…
    (2) install the ATR Timeline Widget here if you can, so we can all keep track of where you are, which leg, how long it’s been, etc.

  2. Welcome Pratik

    I didn’t start PWB until week 6 and I had a fair amount of joint pain and heel pain for a few weeks. Some of that pain is still there when I push myself and I’m 21.5 weeks from surgery. I would be concerned with pain around the surgical site and/or the back of the heel. Good luck and happy healing.

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