tendonblues’ AchillesBlog

I’m only at 6 weeks so I don’t have too much to offer but have you discussed it with your doctor? I’ve read a lot of the blogs here and it seems like whenever someone mentions a similar problem it’s related to some kind of complication, like an internal suture issue or infection.

I’m just about 5 months in, and I would say that my only set back is calf strength. I’m still unable to do a single heel raise, which I thought I would be able to do by now. I went the non-op route, and I’m starting to think that I healed long because of my strength deficit. My dorsiflexion, plantarflexion and overall ROM is pretty much identical to my good leg. My gastroc muscle has atrophied, but the strange thing is that my overall calf circumference is actually the same as my good leg. I can clearly tell that my gastroc has shrunk in size, but other muscles must be compensating because they’re both the same circumference around when I measure it. My bad leg looks smaller when I look in the mirror, but the tape measure shows otherwise.

I’ve been jogging fine and have no pain at all. However, my bad leg does tire out way before my good leg. I still have a little bump around the break point, but it doesn’t bother me at all. And, the tendon is still rather thick, but there’s pretty much no swelling. I can still feel that there’s a very subtle dip in my stride when I walk. But, not enough that anyone would notice if I didn’t tell them. And, even if they knew, I think it would still be difficult to see. So I would say that my walk is not at least 90% normal. Interestingly, my jogging stride is probably even a little bit better than my walking stride. I think that may have more to do with the forward momentum assisting my biomechanics. Also, i’ve been able to walk on the balls of my feet(tip toe) for over twenty short steps.

So the struggle continues. I’m hoping to keep working on that stubborn calf and make it stronger. I think the jury is still out on whether or not I’ve healed long, but I’m starting to think that’s the case. Time will tell.

Good luck, CaliforniaGuy! I think your description of 6 months in is pretty similar to mine back then. My story’s “out there” — I’m having a blast, no complaints, though my calf strength has a clear deficit, it just doesn’t seem to show up in sports(!). I think I also have gotten identical measurements on my two calves, even though they look quite different. Gastroc vs. Soleus is my theory about me. . .

Didn’t you start a blog, so we don’t have to hijack TendonBlues’s?

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My leg would go bad as the day progresses. This was particularly because I have a desk job that immobilises me almost the whole day and I would notice my ankle starting to swell by lunch time. I tried to do work pace breaks every 30 minutes to loosen up my legs. Each time I stand up the ankle is frozen stiff and painful. I would need about a few minutes walk to be loose again, then I have to go back to work.
Between the 5th to 6th month, I re-discovered ICE! I would apply cold compress to my ankle every night before I go to bed. I know this was the doctor’s advice which I have conveniently forgotten about. So work out or no work out, I apply cold compress. This helped reduce the swelling that occurs the next day and legs are really loose in the morning. I still have the thick scar tissue where the surgery was done but the swelling around the ankle is gone. I really do not know when it finally disappeared.

Hi Tendoneblues. I’m just passing 7 months, and I’ll ramble on about how I’m finding things, as there may be something in here that you find useful, even if it’s just that someone else is finding that some things are happening (or not..!). Briefly, I had a full ATR, relatively high, and I went non-op. I’m 51, was relatively fit (but non-a gym-jockey) - I cycle, mountain bike, football etc. I ruptured whilst playing football, btw, mid-season.
Fairly standard pattern of treatment - 3 weeks in a cast, came out of that a week early as I had to do a return trip from NZ to UK. Used a ‘moon boot’ with decreasing heel wedge angles for the following 7 or 8 weeks. I still have regular weekly physio. I was signed off from the hospital at about 12 weeks.
At this point in time:
I can walk ‘most of the time’ in a limp-free way.
I have done some challenging up/downhill tramps, only up to about 15km, but I could probably go further.
I can do small heel-raises on my injured foot (up to about 1 to 2 inches). I can fully raise up on both, transfer over from my uninjured to my injured one, and then lower back down using my injured foot only. I’m a bit wobbly, it’s hard to keep my leg straight, but it’s gradually coming.
Road cycling seems to be largely OK, I’ve been doing 40 kms quite regularly. Moutainbiking is a bit more challenging, often with a bit more pain invloved along the way and afterwards, so I have been avoiding that, somewhat. Before my injury, I could do a 100km road ride without any bother (including some of NZ’s infamous hills !). It’ll be a while before I feel up to those distances again. But it’s a good target, with gradual progress.
I can ‘trot’ a bit, but I still don’t feel at all comfortable running. My physio has made it very clear that I need to get on a lot further before I can start to run and play any kind of sport that involves running/take-offs/explosive starts etc - he’s not overly conservative, but I respect his opinion and advice as he’s seen a lot. Basically, he wants to see single foot hopping, springs etc., as well as a number of other actions well before I’m running. Like a lot of folks have noted on here, everyone’s very different in terms of how soon they get to a particular point in their re-hab, and also how quickly they are prepared to go, and how far they are prepared to push themselves. I think that it’s one of the few common facts that the chances of re-rupture are high before 3-4 months have passed (I read somewhere that 5 months is the key milestone in that respect). After that, it’s a case of working at it, consistently but within you individual constraints. I conciously don’t compare myself to where I think that I could or should be, as everyone’s different.
Dorso/planar flexion is back to normal - the doc. reckons that I’ve healed a bit long, but I can live with that.
So, in summary, on the up-side, I’m feeling more ‘norma’l in terms of the range of activities that I can to, but there are still severe limitations in some areas. More hard out activities and endurance will have to wait a while longer !
On the other side, which I prefer to call ‘in progress’ rather than negative, I’m still having a lot of challenges:
Swelling still frequently occurs, and sometimes for no apparent reason. After a long bike ride or walk, or even after standing for a few hours, it’s common for my ankle to swell very significantly. It’s not localised, and it covers my whole ankle area. I guess it’s fluid, as I can create big, deep thumb-craters if I push into it. The standard foot elevation and a night’s horizontal rest always cures the swelling. The doc. advised that swelling is often common for up to 12 months.
Bruising is often associated with this swelling - usually big patches of yellowing. Maybe a bit od scar tissue breakdown, who knows.
At 6 months, I had major problems with pain, stiffness, bruising, swelling, localised heat at the injury site and the inevitable onset of painful limping. This manifested over a couple of days, and stayed with me - there was no cure by overnight rest…. The phsio suspected a DVT in my ankle and off I went back to the hospital. The diagnosis (fortunately) turned out to be tendonitis in my recovering achilles (aaaarggghh !), which I presume was caused by severe inflammation of the scar tissue/injury area. The treatment was simply to step back (excusing the pun !) a month in physio treatment, with enforced rest - basically no uphill/downhill tramping, and lose the heel raising exercises for a few weeks. Gentle walking, on the flat, only. The reason that it flared up is a mystery, as I hadn’t ‘pushed things’. It may have resulted from some fairly steep uphill/downhill walking, but who knows. There was also suggestion that my walking boots and daytime shoes had caused it by the back of the footwear gradually pressing and rubbing on my tendon - a sort of chronic bruising over a period of days. It sounded plausible. Anyway, after a fortnight, the pain (which was quite severe and debilitating ) subsided, and things got back on track again.
The lump at the site of my injury is impressive. The hospital noted that I seem to have about 2 times the normal volume of scar tissue there. They suggested that, over time, it may reduce somewhat, but as long as I can get back to something that is failrly normal physically, I really don’t give a hoot about lumps and bumps !
The physio often massages the injuredy area hard. Or, as he says “I’m gonna massage the shit out of it”, which I think he does mean literally, as we have noticed that the size of the lump decreases significantly at the massage progresses. There may be fluid in there, in amongst the scarred, lumpy tissue volume.
I often use tape across the lump - it supposedly helps break down those adhesions, and it does seem to help (maybe a placebo ?). But I always keep those elastic bandages handy and use them if and when swelling occurs during the day.
My achilles still feels a little tight and stiff (especially when I first get up). When I walk, there still aren’t many of those steps that I take which I don’t notice - i.e. I always seem to be aware of the ‘pull’ on just about every step along the way.
What I have noticed is that the frequency of severe swelling/pain incidents has been decresing over the past few weeks. For those of us that aren’t professional sportsfolks, with 100%, 24×7 focus on rehab, with all of the bells and whistles facilities, it’s slow process, requiring patience and determination, for sure.
If there’s anything in here that you want me to expand on then just let me know, and I’ll do my best to explain etc. Keep on truckin’ along, and good luck ! And to everyone, all the very best with your healing and re-hab ! Chris.

Chris,
Thank you so much for your reply. I am now just about at 7 months as well and while you seem a bit more able than me, I very much appreciate your comments about NOT comparing myself to others. It was reassuring however to hear your details about pain & swelling at and around this 6 month mark and continuing on. We just got walloped with about 30cm of snow here and I have managed to use the big push shovel the last two days without increased pain or swelling (or re-injury!), though I still have my “regular” pain & swelling. As you said: patience & determination remain the order of the day.

I will also mention for everyone as well something my physio did about two weeks ago that really helped with what felt like chronic cramping or a non-stop spasm in my calf: “dry needling”. This involved inserting acupuncture needles into the calf muscle and manipulating them a bit. When she hit the spot that was most cramped, it hurt like $#@!, but next day there was marked improvement and I feel like I have been able to make more consistent progress since as I have less muscle pain.

Thanks again all, and keep your chins up!

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I just hit 6 mos. out, and have worked awfully hard to get some power back:

When you are seriuosly hurt, you take comfort in the thoughts and recovery of others.

I detached my left achilles at the heel on Sun 9/16/12 kicking a soccer ball…done it a billion other times. Being a lifter, runner, athlete and 51 yrs old, I knew I was in the shits. Recovery from surgery is never any fun. With my leg in temp cast from emergency care, I lifted every day to prove to myself that. was still a warrior. Tears came easily…220 lbs on crutches caused my hands to crack, and I had to use gloves over 8 weeks of non weight bearing crutch work with a boot.

Had it operated on Thurs 9/20 by a caring surgeon, Dr. Rebecca Cerrato of Baltimore, and began my mental revovery immediately. Monday was my kickoff for the gym. Leg up on a bench, I pushed the reps …

Once the stitches were removed on day 10, I immediately began Physical therapy with a therapist. With no power, and plenty of pain, I used bands, massage, foot movements, with boot off just for workouts, and upper body lifting at nights. Week by week, 4-5 days a week I watched small improvements.

Bumped up to balance movements, mini tramp, leg presses, step ups through about 11 weeks. Could not push off very comfortably on bad foot. Told 5 push offs on bad foot alone were the gold standard of recovery.

Stopped formal PT and hit the pool, 4-5 Xs a week, for soccer type running, hopping, stretching, pushoffs, etc. Hot tub warmed the foot, then the pool for running workouts, and back to hot tub for stretching, one legged squats, pushoffs for reps, and more.

Today, 3/27/13, I can do sets of 20-30 push offs on bad foot, step workouts, steppers, treadmills, and fast runs with full foot planting. This is all in pool or hot tub…Out of water, more rehab is necessary to do same.

A runner mostly runs on his toes; this is still not possible…despite tremendous leg strength and workouts from the day after injury. I can honestly say that no one is crazy enough to rehab like I have, but a warrior’s mentality is what it is. I aim to run a 5 K soon.

I have learned from now watching many people recovering from surgeries that YOUR MIND is all you have to fuel your recovery. You must be your Own Champion. No Surgeon that I know has ever torn their achilles, so they are not too helpful understanding your pain and discomfort. The pain is real..in your foot and your mind…and crying is okay.

GET TO A POOL AFTER 12 weeks, and RUN AS HARD AS YOU CAN BACKWARDS, FORWARDS, AND HOP ON YOUR BAD FOOT UP AND BACK. THIS IS WHAT WILL GET YOU HEALED. 6 months out from surgery, I still have some pain and discomfort, but the pool makes me feel like I am recovering. BE YOUR OWN CHAMPION, and you would be surprised what YOU can accomplish.