Wilco’s AchillesBlog

As I said before I am at 6 weeks after the operation. The surgeon did a standard open surgery and wanted me 6 weeks in cast at 30 degrees + 6 weeks (4 NWB + 2 PWB) on a boot, then directly to two shoes. However, in the meantime I had read a lot on this site, especially the blogs of Norm and Doug53. Since I have access to most scientific journals (work), including medical, I went to read up on the latest comparative studies, and indeed there is a strong case for early weight bearing, although it means something else in each study.

The first two weeks I was in the fiberglass cast and NWB, which I stuck to. Apart from wiggling my toes I did no exercises apart from a couple of sit-ups and some ‘air cycling’ (lying on you back, milling your legs in the air as if you are on a bicycle) once a day. Also I would elevate religiously to get the swelling to go (which was quite bad in the beginning). I got a tip from the hospital physio to put some pillows under the mattress to lift it up at my feet, and that did the trick. This way my foot would not roll off the pillow during my sleep.

At the 2 week mark (time for change of cast) I came with a Maxtrax ROM air boot to his office and convinced him to put me in it, after even the plaster-guy said that makes more sense than another cast. At the 3 week mark I started PWB with the crutches and at 4 weeks FWB.

At two weeks I started doing the mobility exercises in the protocol linked on the main achillesblog page. At four weeks I started with a yellow theraband (exercises from the same protocol, but for weeks 8-12).

A week ago (5 weeks PO) I got a simple second hand stationary bike and started biking 15 min each day, on a fairly light setting (with the boot on of course) I have had no pains so far.

Right now my ROM is almost exactly the same as my good foot and the incision was completely and nicely closed at 3 weeks, so to me it seems the surgeon did an excellent job, but his proposed rehab protocol seems archaic to me. I did ask him if there were any specific reasons (complicated operation, especially frayed tendon), but he said it was a straightforward operation, no surprises, this is just his standard protocol.

Falling ill in France during August is a bad idea. Everyone and especially any orthopedic surgeon will be in his summer house in the Provence and will stay there for at least a month. Luckily for me it was the end of August and I found one hospital that had the operating ‘bloc’ open and my neighbour who is a radiologist made an MRI (at a different hospital, where she told me I would definitely NOT want to get operated, unless I liked the idea of unsupervised exchange students fixing my AT).

So on Aug 23rd I had the MRI, then the Dr appointment, and he confirmed the complete rupture and decided to operate on the 24th. He gave me the option of non-operative treatment, but with the comment that he normally does that with elderly patients or people that pose a high risk to operate on, so I went with the operative treatment. In hindsight, if I would have read the blogs on this site before I may have considered the non-op way, as there are real risks involved with the operation (anesthesia risks, wound complications, deep vein thrombosis etc), and I am not sure anymore if the benefits outweigh the risks.

Hi, this is my first post on the blog,  but actually I am 6 weeks post op, so there is a lot to tell I suppose. It happened rather silly, on vacation in Romania, when running a bit with my in-laws’ dog and doing some sprints to see if he could keep up. It was time to get ready for the volleyball season, so I figured I could use some sprints. At the 5th or 6th all-out sprint suddenly my right Achilles (AT) gave way and as I was at full speed, it was rather difficult to stop so I just slided on my belly to a halt. Doggy was a bit surprised and so was I, although I have been having pain in my AT for near 10 years now, after I went from training every day to twice a week and had what I now think must have been a partial rupture.

Like so many before me I just rested the minimum to be able to play again, and it would come back after a tough match or two trainings in a row. Would then rest again, some half-hearted excentric toe rises (not sure what the proper english term is, it is a toe rise on both and going down on your bad foot) for a week or so, and get back at it.

Strangely enough it did not hurt that much at all, but I did have some other shock symptoms, sweating and getting dizzy, so I sat down on a step and waited for it to subside. My two-year old son had seen me running with the dog and was convinced it was the dog’s fault, so from then on he refused to take the along dog for a walk anymore, poor doggy.

Went to the A&E in Romania and the night dr told me that indeed it was a full rupture and I’d better get it operated back in Paris, so he put me in a temp cast and sent me off to get my flight the next day, no crutches.

I did elevate it but not all the time, but by the time I got home I had the cast so icing was not much use anymore I figured. With hindsight I wish I had iced on the way to the A&E and elevated religiously.

Next day i took the flight, limped aboard and got home alright. Wonder if it is a great idea to take a flight with a newly ruptured achilles, as the swelling had doubled by the time I made it home (cast starting to crack as I had been walking on it).