timothysy’s AchillesBlog

Thanks for the update, TimothySY. Its good to know that at 11 months you are almost back to where you started from. Are you still doing Physical Therapy? When did you stop?
Thanks!……………. Manny

Hi good day.
This is Melba from the Philippines I suffer from complete achellis tendon last june 4 I’m on non op treatment just doing some home remedies my achilles went will and attach but unfortunately rerupture again yesterday due to carelessness and I hve no boots for protection on my legs.
We have no money to have me operated and to buy boots for may protection
This is so embarassing but I beg for help right now
I experiencing a lot of pain since day 1.
We don’t have money to cast my legs
I begging for those who have already finish their journey and have boots that I can use for my achilles recovery.
I promise to bring it back once I already recover from this injury.
Please Help me.
I’am hoping for your positive response.

Thank you and God bless.

I’m envious of your run, you’re doing very well. Keep up the great rehab! Did your PT/OS suggest the treadmill is safer than running outside or do you prefer the treadmill ?

Oh also…you probably already know this but be careful not to go too deep into the stretch, just to the point of that “good” feeling…you shouldn’t feel any pain…never force a stretch anywhere on your body. Pulling or jerking, even pulsing a stretch probably isn’t a good idea. I did lots of reading on current stretching research in general, it’s good to get informed as you’ll be working out more and more, or just ask your PT to educate you. YAY!

Hey Timothy I’m so happy you’re happy with your care and progress. As we know your doc is at the very extreme of aggressive protocols and you seem to have come through with flying colors!. I think I started double leg standing heel raises at around the same time…I think you’ll find they progress pretty quick…I also did the theraband to build calf strength, are you doing that? If not I found it the fastest, easiest way to build it. I think it was 10 - 12 weeks I started lunges, squats. That limp should go away with strength and ROM. You can google image “stretches for plantar flexion” and you’ll find lots to do. Be sure you stretch not only the gastroc which is the one st retch you are doing, but also the soleus. You could also google image “calf stretches”.

Hi timothysy, I can’t believe I’ve only come across your blog now. We ruptured our Achilles on the same day, and you had an op the day after I did. But our protocols are slightly different in that I’ve been in casts NWB for the past 6 weeks (a cast change at 3 wks). After 6 weeks, I’m now into 2 shoes too, but with crutches. Anyway, I’ll be following your progress with interest. All the best!

Thanks for the great explanation as always Donna. Yeah I thought walking would be quite easy since I have mastered walking in the boot but it sure was different when I had to flex my bad foot on every step with two shoes. My gait looks a bit weird and I really have to make it a conscious effort not to limp while walking.

Linda, I decided against swimming while in the boot, but once I got into 2 shoes I swam the next day. Thinking back I think know the problem would just be getting out of the pool. Getting in would probably be easy and once inside the pool the water makes it much easier. Thanks for the reminder on re rupture. I do have to remind that I just got out of the boot as I tend to get excited about going back to my normal routine. This injury surely teaches you about patience

Congrats Tim, I recall you are on a really aggressive protocol, so happy it’s working out for you! Regarding using the stairs you said: “I had to go down with the bad and the put my good on the same level before going down another step.”…that is part of the trick…when you go down with the bad, hang it over the step, this will alleviate the stress put on the tendon…the reason steps take weeks to master, and I mean weeks, is because we don’t have that dorsiflexion stretch yet, we don’t have the flexibility and ROM…that stretch pulls on the tendon at the repair site and causes discomfort at the least and a re-rupture at the most.

I find that two shoes is a transition and though I often get the impression people think they will just start walking like pre-injury, that just isn’t the case. Gait training is also a transition and it will take time to work out that limp…the stronger your calf gets, the greater your ROM and flexibility, the less you will limp.

Best wishes to you.

Hi Betty at 5 weeks what PT are you doing at home? and how do you know PT is useless? The tendon can be tight, mine felt like I had a really tight sock on around my ankle, at 5 weeks I’ d avoid stretching it, however, over time I believe a good/gentle stretching program can gain you back flexibility, thus alleviating the tightness. I never slept in the boot. I got my boot at 3 weeks. Protocols regarding Boot sleeping varies widely doctor to doctor. I used an ace bandage to sleep in. There are a variety of braces you can get that would be more comfortable to sleep in than the boot….you can google search to find them.

PS. Congrats for graduating to two shoes. You must be really happy!

I am still in the boot ( I am at week 7) and am getting up and down steps in boot pretty well- though super careful. Not sure what the technique would be for two shoes so can’t help you there, but I am sure someone else can chime in. Just be careful- as I understand re- rupture rates are still risky from week 6-12. As of right now my doctor and PT said I would be in boot until week 12, but perhaps that will be moved up, depending how I am progressing.

Did you try swimming yet? How did it go? My PT is leaning towards me getting in pool next week, as I am leaving for vacation. How did you get in/ out of pool safely?

Hi,
I had non surgical repair. 3 weeks in non weight bearing cast now in second week of boot 75% weight bearing. I feel PT is useless. I do it at home but am really worried the tendon is really tight…also, hard to sleep with the boot. Anyone use anything else at night besides boot?

My doc was pretty open to laps once we lost the boot at 6 weeks. I’ll test that thesis next week when we meet! I’ve seen the descriptions of walking impartial submerged state and hope to wrap it into my recovery.

@glenskieus as with what most people here have said, each OS is different and may use diff protocols. But my OS has never allowed me to use crutches or a cane since day 1. His belief is that the more I use a crutch, it makes me trust my repaired achilles less which would lengthen the rehab process. So after 5 weeks I have gotten quite used to walking in my boot.

There are also a lot of studies put there that early WB is good for achilles repair and lessens elongation. Ultimately, I think being aggressive depends on you. I always use pain as my barometer. If ever I feel pain, I stop and rest or avoid doing whatever activity it is that causes pain. Talking to your OS is of course always a big help.

Best of luck!

Hi Timothysy, How are you? Hope all well…:) Are you on FWB all the time now ? Or you still using chruches? I wanna be a little more aggressive with my WB in week 3 but im not so sure yet..got my Walker boot after 2weeks post op, Im 17days post op and pretty happy when doing eversion and inversion..

I know some people just ditch the boot and never wear it again but for me it was a transition. It can come early or later…it seems to happen on this site from the data collected on average by week 9. I’ve seen two shoes as early as week 5 and as late as week 12…for me it was around 6 weeks that I first started indoors and between week 7 and 8 that I took it off at PT and by the end of week 8 went outside in two shoes. I was in and out of the boot as needed until around week 13/14. Never wore it in the house after week 8 but still did outside - some of that was because of weather (ice/snow).

(As needed meant any ‘risky’ situations like a busy store or if it was icy/snowy. As needed meant when I was in pain/swollen and needed to “rest” the tendon or even just needed to be on my feet for a long period of time and knew it would get sore. As needed meant when I needed to walk fast like to run a bunch of errands, going in and out of places.)

So I’d say use the boot as long as you need to. You can go in and out…it doesn’t have to be one or the other.

Donna, yes my doc mentioned that. Apparently, he believes that tension should be there once tendon is surgically seen together. This he believes speeds up the healing process.

That is quite interesting what you mentioned about being in two shoes again. See my boot cast is due to come off on the 15th of april. Thing is I have a wedding to go to on the 18th (I am part of the entourage) and I need to take a trip on the 30th. You think it would be prudent to hold off?

Thanks for the answer to my questions!

Yes, once used to the boot you can go really fast…once in two shoes you slow down again…In those early weeks (7-12) I sometimes wore the boot even though I was in two shoes when I didn’t have much time because walking in two shoes was (and still is to some extent) slow.

They based the newest early weight bearing protocols on studies done on tendon healing. If I understand correctly if the tendon is not under stress or tension the body will lay down fat or weaker collagen in repair, but if under stress (tension) the body will lay down stronger collagen. What is unclear is when it needs that kind of stress and how much, how often that needs to happen…day 1…day 28? Who knows…I’m glad your Doc has had good results and I most certainly wish that for you!

I’m excited for you and wish you all the best. Keep us posted!

Donna, after 3 weeks being FWB on the boot, I have gotten quite used to moving around with it. The heel soreness still happens though if I walk or stand on my feet too long. Compared to day 1 though, of course the pain from the stitches are gone. Plus it was really disorienting at first, but the longer I was in the boot, the “better” I got walking in them. I think the biggest difference for me in terms of walking in them was when my doc allowed me to wear cocompression socks instead of the elastic bandages. They were less abrasive and really helped with the circulation in my leg.

Thanks all for the comments.

Actually, what made my mind at ease when was able to talk to some of his old patients while waiting at his clinic. He particularly had an ATR patient who tore his on the same day kobe bryant tore his. He was running on a treadmill by his 3rd month and when I asked him, we went through the same process (1 day post op FWB). So when I asked my doc he said he’s been doing ATRs this way for a little over 7 years now.

I am doing PT but what the PT did was to teach me the isometric exercises and asked me to do it every other day. I do have another schedule with the PT on the 28th, so I will have to see what he will teach me next.

thanks for the cardio tip. I will look that up.

Ohhh also…can you tell us how FWB was at day 1…and how is it now at 3 weeks?

I was FWB week 3 (cast 3 weeks, boot at week 3 and FWB within a day or two) so pretty early….I’m 19 weeks now.

Also, you said: “, I would like to keep myself as active as possible during this time so maybe you guys have any suggestions as to programs you use to work your upper body (and your good leg) with the boot on. Also, I am trying to think (outside of walking) what other cardio exercise I can do to get my heart rate higher without harming my rehab.”

Are you doing PT? If not when will you start? They are invaluable for knowing what is best to do when.

There are lots of YouTubes on upper body work while sitting or without using the lower body. At 3 weeks you can do the indoor bike with your boot. I started the indoor bike without my boot at 6 weeks in sandals….Also for the best cardio I danced with my boot on at 3 weeks and it was a great cardio workout.

You can use the search box top right on the main page to type in key words for things you want to look up like “cardio exercises”.

I’m glad you found the blog! Yes, nice to have someone on what may be in the future of protocols…day 1 FWB.

I’ve read several studies about early weight bearing…I’m also familiar with EBM, and so far I’ve not seen a study that would support this protocol.

(EBM definition: Evidence-based medicine (EBM) is a form of medicine that aims to optimize decision-making by emphasizing the use of evidence from well designed and conducted research. Although all medicine based on science has some degree of empirical support, EBM goes further, classifying evidence by its epistemologic strength and requiring that only the strongest types (coming from meta-analyses, systematic reviews, and randomized controlled trials) can yield strong recommendations; weaker types (such as from case-control studies) can yield only weak recommendations.)

Though promising the studies I read regarding early weight bearing were of the weaker type…in other words they did not meet the criteria for yielding strong recommendations in protocols. However, I’m sure I am not privy to the latest research and it sounds like your doc. is…I’m assuming there is r

You are one lucky guy. I am at 6 weeks and yet to even start PWB. I have an appointment this Wednesday and if my OS doesn’t prescribe PWB, I am going to see another OS ASAP. I ordered a Weider Ultimate body workout machines and have maintained most of my muscularity. Its a good machine for home workouts until I am able to get back into the gym. Good luck and a speedy recovery.

Isaac