Yeah never felt better (then)

Hello people first post so will give a quick summary of where I am at.

Like many who have this injury  I have an active job and have always kept fit and active .Anyway I arrived at krav maga  and proceeded to tell anyone who would listen just how good I was feeling and that I have not been injury free this long for ages. Well 45 mins later and I am lead on the floor contemplating what has just happened .I knew in my heart that that loud pop and electric shock feeling up my leg  was an atr but maybe just maybe it was just a calf muscle .It happened in the classic way I  planted the foot and I shouted out who kicked me thinking one of the group had decided to attack me from behind only to have to apologise when I realised nobody was there.So of to casualty I go get checked over and my fears are confirmed complete rupture .

I was put in a cast and sent home to come back 3 days later to see the consultant.Those 3 days gave me time to find out if the folklore of the atr were true and it slowly sank in that they mostly were .This was going to be tough for somebody who at the best of times glass is not half empty its F****ng smashed.When I got to see the consultant he went through the options and I decided to go for surgery.I was put on the trauma list and could expect a call when ever there was a spare bed .Next day I was in and out back home in a cast .The next 2 weeks consisted of sitting on sofa watching tv and playing my sons ps3 games that I really had no interest in but just had to finish once I had started.

On my second hospital visit the cast was cut off and I was put in a rom boot given a print out of the protocol and would be back in 2 weeks to get the angle of my boot changed .First week in the boot I didn’t really put any weight on it as it was still swollen but as time went on I put more load on till I could put about half my weight on it.On my 3rd visit to hospital the nurse asked if I had changed the angle on the boot .I had been put in at the wrong angle I was in at neutral to 10 degree dorsiflexion somebody had dropped a bollock .Nobody said anything to me but Im guessing it could of snapped.I was meant to be back in 4 weeks but that got changed to 6 .

So here I am .I can walk in the boot without crutches but do get tired and sloppy and go back to them .I can get up stairs now without going up on my ass. Im staying positive and filling my days as best I can and  have realised the dream I had of being a pro poker player would be boring as hell and I would be broke.Going back to work seems along way off as it is very physical but I am back in the gym doing upper body and core work .

15 Responses to “Yeah never felt better (then)”

  1. That sucks. Honestly I’m glad I’ve been taken care of very well even though the surgeon isn’t the one to do everything. Where do you work? I bought a knee scooter and it allows me to get around enough. I started working 2 weeks post-op.

  2. Yeah I don’t know if your in the uk but thats the NHS for you.I don’t like to slag them off but it does seem you have to be on the ball and get as much info on subjects as you can as the care is very hit and miss.Im a bricklayer so I have to be able to climb ladders and walk across a muddy building site before I can go back when that will be is anybody guess!!

  3. Climbing ladders is one of the world’s more AT-intensive job tasks, especially if you’re heavy or you carry a lot on the ladder. So I wouldn’t be too impatient to get back to work. Many of us faced a “frustrating plateau” while waiting to get rid of the last “dip-limp” in our stride, and many also waited a long time before being able to do a good 1-leg heel raise. The latter isn’t 100% essential to climbing a ladder, but I think the former is.

    Good luck!

  4. On the visit when they got it wrong your rom should have been set at about 30ºPF to 15ºPF if following current best practice, and 30º - 0, the next visit. What is it set at now?

    My atr was a year ago. It occurred, not very excitingly, when taking some steps at work too quickly and slipping - but it was immediately after a weekend with lots of ladder climbing. This put strain on my calf and tendon, and was followed by a less active day, then bang, down I went on the stairs.

    The accelerated protocol given to me at my local NHS ortho centre emphasises that ladder climbing should be avoided for 6 months post rupture. OK for me (the tree work could wait) but difficult if its part of your work (although who wants to re-rupture). I was non-op I’m pleased to say, but the protocol was exactly the same as for surgical cases.

  5. Hi Hillie
    Great to hear about your recovery, I UK based thought i was lucky to have private insurance thru work but to. Be honest I can’t see the advantage, 3 days post ATR I went to the consultant who put me in an aircast boot 5 wedges , instructed totake wedge out after 2weeks then 1 a week, told I could fwb straight away, I haven’t been given any excercise instructions so here I am almost 6 weeks no physio, do you mind sharing your physio or exercise for the first 8 weeks, I’ve asked norm about the UWO protocol for pt also
    Once again great news on your recovery it gives us newbies a real shot in the arm

  6. This was my basic rehab schedule for surgical, and non-op (which included me). No difference between the 2 options, only (with the latter) less pain (only at atr time), no infection risk, blah, blah, blah, and still with a strong repair. I’m not recommending it for you - I am not a medic and I don’t know you. Researched with 170 guinea pigs? I don’t know, although it is pretty close to other frequently quoted stuff here.

    Just remember, we are all different. Surgery is absolutely necessary for some and we have different rates of healing too - but amazingly similar most of the time, hence the repeatability of the advice in Achillesblog. No more disclaimers! It worked for me.

    Make sure you have a good physiotherapist and a written plan from the start of treatment. Don’t be packed off with a quick cast and no advice, and told to come back in 3 weeks or whatever. It’s not so bad an injury that you will be too traumatised to ask questions. Boots vary too. Mine was hinged, full adjustable range of movement (ROM), no internal wedges to remove.

    Week 0 – 2 Full equinous. In plaster, toes pointed down. Mobilise NON-weightbearing with crutches or frame. May use toes to balance.

    Week 2 – 4 review. Into boot set static at 30º PF i.e. toes still pointed. Able to weight bear, can wean off walking aid as comfortable, and probably use aid outside. Wear boot at night (sole removed from my Vaco Achilles Pro boot). Can remove for very gentle ACTIVE exercises.

    Week 4 – 6 review. Boot ROM 30º – 15º PF. Mobility improving. Can remove at night. Increase number of sessions of exercises. (I started on static bike at about week 4).

    Week 6 – 8 review. ROM 30º PF – 0 neutral. Boot adjusted by physio. Theraband exercises (I started these at week 3 or 4, agreed with physio). Show patient how to adjust at week 8.

    Week 8 Adjust at home to ‘step-through’ walking. ROM -30º to +10º. May start gentle swimming if safe to get in and out of pool without using rung ladders. No pushing off from sides.

    Week 9, at home. Shoes ok indoors with heel pads.

    Week 10 review. Out of boot indoors and out. Use heel pads as comfortable 4 – 6 weeks (I used for about 1 week). Can take boot out too as a precaution if desired or if conditions ‘hazardous’. Should be able to drive within a couple of days of being in shoes – if you can do an emergency stop!

    Increase exercise tolerance with gentle and frequent walks, cycle, swim.

    Between weeks 10 – 16. Start to increase exercise tolerance, concentrating on non-impact, non-explosive activities, such as swimming, walking, static bike or bike on the flat (nothing strenuous).
    Aerobic gym work as comfortable e.g. x-trainer, treadmill walking, stepper (you may not be able to do some of these).

    Not running or jogging for 4 – 5 months post ATR.

    OK to make the calf ache, but rest before carrying on. Change activity frequently to avoid fatigue and rest when and if you get tired/ache or ‘burning’ feeling around injury site.

    Not advisable to:

    • Play explosive sports e.g. squash/ badminton
    • Do maximum resisted weight work for lower legs, or use rowing machine
    • Go up and down rung ladders
    • Horse ride (heels go down in stirrups)
    • Do loaded passive stretching of calf (heel hangs on step)

    Take care…

  7. Trickybricky - As Norm has said, climbing ladders is hard on the achilles. At almost 6 months post op I started building my house. That meant lots of ladder work. I can remember some fatigue early on but the conditioning I had done prior helped. I could take a break whenever my tendon was sore or swollen but that would be difficult for you when you are trying to earn a living. The more I did the better it got. I have lifted and carried large beams and lintels up ladders without fear so I am sure you will return to your trade in time.

  8. Hi hillie
    Many thanks didn’t realise you had 2atr, n
    Many thanks in taking time out to reply, realise not one size fits all but at least this and norms gives e something to discuss with doc

  9. No, only one atr I’m pleased to say. What I meant in my first sentence [(non-op (which included me)] was that my printed protocol was the same for surgical and non-op. I was non-op but borderline apparently, due to a 10 day delay between injury and correct diagnosis.

  10. Thanks Hillie
    Think it’s me trying to take on too much info, I’m addicted to this site.
    Glad it’s just the one

  11. I’m glad too. Mind you, Normofthenorth (what was his mother thinking when she named him?) has often mentioned the relatively high odds of an atr for the other leg… Oh well, it’s good to be prepared - my currently redundant boot, knee trolley and crutches are ready to go.

  12. Ha ha , I’m sure you won’t be needing it,I saw a funny clip on you tube , the guy smashed his boot with a baseball bat once he recovered, he made it look like a gangster movie, il be keeping mine I’m still at stage paranoid , norms name could be worse he could of been given ripraproar

  13. Welcome to Achillesblog. I’m confident you will be back at work sooner than you think, but at the same time my advice would be not to rush your recovery, follow one of the excepted protocols, and true what your body is telling you. If it get real sore and swells, you have done too much. Some of the best advice I adhere to was from Ryanb (be incremental in your PT/exercise) and give your body time to respond to new exercises, weight, or increased reps. Good luck and happy healing.

  14. Many thanks k Kirk , I will be following proven , everyone at work says go to a sports clinic I’ve had offers from people who do pro athletes, but they deal with pro.s which I’m not,

  15. If I had that options, I would have jumped on it. I assume the pro athlete would get the best, most up to date care and rehab available (And Im no athlete either, not in that sense). :)

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