trin74’s AchillesBlog

Had another appointment with the physio on Friday. The level of intensity of the “massage” has definitely increased that’s for sure! She is still happy with my progress, except for my dorsiflexion, and moved me up to the blue theraband seeing as I was at the limit on the green. I had already progressed my balancing exercises past what she wanted, and was happy I could already do the next step. I have noticed since being in 2 shoes how quickly the muscle tone has recovered, and even she commented on how my leg looks like a leg again. (Rather than a twig). She is so happy with my daily regimen of exercise (as well as my set exercises, the core work, weights for upper body and exercise bike I have added in swimming and exercises in the pool) that she doesn’t want to see me for 2 weeks. Not sure if I’m totally happy with it, but as she said, I am doing her job for her.. Just have to slowly work at increasing my dorsiflexion, but know I can’t rush it. Have to go for London for work for 2 days early next week, will take the boot with me, but she says that unless I have to rush anywhere (won’t be taking public transport), she’d like me to try to stay 2 shoes. I’ll see how I feel Monday morning.. Meanwhile the past week of being two shoes has been great, but definitely slower!! Although I have managed to start driving again, emergency stop tested beforehand!! Trying to limit how much I do, but great for getting to and from work.  And now the sun is shining, so might make the most of it!!

I have been very diligent in doing my physio set exercises since I have been in 2 shoes, however one exercise I just can’t do. Standing with my feet in parallel (in my shoes with heel lifts) I have to bend at the knees. I just can’t do it! The amount of bend is so minimal it’s barely noticeable.. I am loathe to use more pressure than I am currently comfortable with.. Which led me to the question, does everyone really struggle with this?? I know I am only 4 days into 2 shoes, but it’s more just wondering if I am alone here. All the other exercises are going really well, but I know that of I can do this one my walking is going to be so much better. I also know not to force anything!! Feedback much appreciated!

Well, had my 8 week visit with my consultant - and he moved me into two shoes! I know he told me I could last time, but there’s always that fear that they’ll change their mind… When he told me to just get up and walk (after I put heel wedges in my shoes), I was like.. okaaaay… But it was fine - stood up and no pain and walked over to the chair and just a slight stretch… Leg felt really weird though - so light and naked without the boot. He told me to start walking lots, to start swimming, and to use the exercise bike. Next appointment scheduled for 6 weeks time.

So then I walked slowly over to the physio department for my first session sans boot! That was great - I can balance on the bad leg without wobbling, and my ROM is pretty much just off the good leg. Strength is so good she thought I’d be able to rock my weight up onto my toes with my heels slightly up, but I didn’t feel ready for this so said no… One exercise that did let me down was standing with my feet apart and bending my knees - I think it’s fear more than anything, but will slowly work at it. My gait is pretty good in that I am walking with heel first onto the toes- just a little tight so taking it slowly. Actually find it easier than walking in the flat sole in the boot in some respects! Not brave enough to try Norm’s trick of going down stairs yet in 2 shoes, so that’s a bit stilted.

Came home and tried on shoes with the heel wedges to see which ones worked. Good to know I have a few pairs I can alternate between! Thus the Crocs can remain house shoes!

And now - I am so excited about showering standing up! The simple things….

Update as I had my consultant appointment and physio again today at the 6 week mark. All is progressing well! Surgeon still very happy, and was very pleased to see me without crutches! Had another look at my ROM and was very pleased, told me to come back in two weeks, with a left shoe!! So that’s exciting news..

Then straight to the physio, and up the stairs not the elevator this week. I’m moving up in the world (slowly). Again she was very pleased with ROM, strength, and that I was walking. She asked if I was supposed to be doing that this soon.. I was happy to confirm.. So she has added a theraband exercise to my routine, for the strength aspect, not stretching. Nothing past neutral. I also have a balance exercise to do. I told her I was concerned with my gait in the flat sole, and so we put it on and she analysed my gait, and pretty much came to the conclusion that it’s my quad that is letting me down, so have stronger exercises for that now. She felt the quad and thought it was strong, but nothing compared to the other leg.. Another thing to work on! That’s ok, it’s great to still feel like I am progressing and healing.

Until next post!!

Hi all, I joined the ATR club on February 21st whilst participating in a dance class. I had done a very thorough warmup, and was 3/4 of the way through the class when it happened. The movement I was doing was actually pretty minor - just a hop, and when I landed I thought the floor had given out on me. I felt the usual slap on the back of my leg and a loud noise. Turned around immediately to see what I had done, and the floor looked fine. Then I realised that the floor didn’t feel straight to me, so I sat down and immediatley felt my Achilles. It felt loose, so I knew what I had done. Went immediately to the hospital where it was confirmed with a Thomsen test. The surgeon on call told me I had the two options surgical or conservative, assured me that the recovery rates were the same and that my chance of re-rupture would be similar. So went the conservative option, and a cast was put on in the equine position, and was told to come back in the morning for a cast check. The cast was on in less than 2 hrs.

So, I went home and of course didn’t really sleep, and starting researching my options. What I was finding showed that if you are youngish and fit that surgery was the way to go, so when I went back in the morning for the cast check I asked to see another orthopedic surgeon. He said the same - and said that if it were him, he wouldn’t touch his Achilles with a scalpel. Well that was great, except he didn’t look so fit.. And it was through the NHS - so decided to try the private route. I was able to get an appointment with a private surgeon 1 week to the day of my injury - and he also pushed for a more conservative approach. I of course was much more fully armed with information by this stage - so I really quizzed him about his protocol and comparing to the early mobilisation treatment. He did not know of the Vacoped boot - and so I handed him a print out. He had wanted to keep me totally weight bearing and in 4 different casts over 8 weeks, but managed to convince him to let me have the boot! Success! Managed to get the boot delivered by the Monday - and was fitted within 2 hrs!

The consultant saw me again 2 weeks after the original injury. He had obviously done his reading on teh boot since then, and I was allowed to move up 5 degrees at the 2 week mark to 25 degrees, and then to 20 degrees the week afetr, as well as start PWB. He said no ROM exercises.. I may have added some as per the UWO protocol.. He also allowed me to start physio for the other leg, as well as the knee/hip on teh bad leg and core excercises. I started physio 3 weeks post injury.

My next consultant appointment was 4 weeks post injury. He had a good feel of teh tendon (confirmed reattachment at the 2 week mark btw!) and said it felt great - continuous and still minimal swelling. We moved me straight up to 10 degrees, and he said that I could move up to neutral the following week. Also that I was to try to start FWB. My physio appointment was directly after, and I told her the good news re: FWB. She then gave me some exercises to commence on my foot. She was very suprised at my ROM and also the strength in my ankle - and had to confirm a few times that I was only 4 weeks post-rupture. From the 3 week mark when she first saw it she is very pleased with the lacking of swelling, as well as the small width of the tendon - but also that it feels quite pliable. She has cautioned me on not being over confident..

I am currently 5 weeks and 5 days post injury. I am at Neutral position, and as of the weekend am FWB. My walk is not great as yet - but trying to focus on heel to toe movements in the boot, and I am sure it will improve. I have another appointment this Thursday with teh consultant, and physio again straight after. The plan is for another 2 weeks in teh boot, and then much more intensive physio. I am a little aprehensive about the whole in 2 shoes thing - but I feel like I am progressing well, and I feel very lucky in that I have really had no pain with this injury at all. Just the pain of the inconvenience… I am lucky that my day job is a desk job, and have not missed a day of work yet. Been relying on lifts to get in and out, and looking forward to when I am allowed to drive (it’s my left leg, but I have a manual car, and it is illegal to drive anyway no matter which leg in the UK witha cast/boot).

I know I have a long journey  ahead, but I feel optimistic of a good recovery, with a lot of hard work and caution!