achilles tendon-surgery recovery

[Limster]

it is very comforting to know that a forum like this exists. After reading a few stories (Betty & richardp), I am much more at ease knowing that there are people out there with similar situations or been in similar situtaions and gone or going through the experiences. I would really appreciate even more if anyone can further advise as to the next phase in my recovery...anyway, here is my situtaion - I had torn my left achilles while doing a jump serve at a volleyball tournament but I didn't have my surgery until 4 weeks after the tear. But I did eventually my surgery 6 days ago, and everything seems to have gone very well as I was out of the hospital within 24hrs with a plaster on my foot. My surgeon didn't say much other than all went well...however, I was hoping that he would explain the procedure in more details as to what he did and what I should be feeling in the next two weeks. Anyhow, I am recovering at home since, and boy, do I really appreciate life even more now that I'm immoblised. I've been having my leg up as much as possible and haven't really gone out of the house at all. At the same time, the pain from the surgery has gone completely. I am cautious though as to when I should start pushing my self again, like going back to work. I wil have a review on my recovery 4 weeks from the surgery - what should I expect from that appointment? Are they likely to cut my cast off and make the assessment? etc. :o :o :o

[richardp]

Hi Limster,

Not sure if this is useful but here is a basic update from my own experience. As per the previosu thread i had the accident 4th Sept, operation the following morning, then saw the consultant each week upto the 4 week review time you are mentioning.

So had the staples out gradually in weeks 2 and 3, at 4 weeks the consultant asked me to order the MC Walker Boot to be fitted the following week (end of week 5). This was duly done - advise at this stage was to do the exercies per the previous thread and to start to put weight on wearing the boot. Started at 20% weight after 5 weeks and 3 days and added 20% every 3 days. Now at 7 weeks and a couple of days and am weight bearing 100% in the boot - able to walk around pretty well with one crutch and in fact i can get around with none but am airing on the side of caution. Next consultant appt is a week today and he says I should be off crutches but in the boot - and changing the angle past the 90 degrees.

Boot has been a revelation though and has allowed me to be more mobile and do things for myself again. Have also managed to go to the gym using the boot...

Thats about it to date... may give you some expectation for your 4 week appt!

Cheers

Richard

[Betty]

To Limster,

Sorry to hear about your injury. I too am so pleased to have found this forum, its not only a great source of information but it also somehow helps to know others are going through the same thing.

Like you I wasn't told anything about the surgical procedure itself but don't be afraid to ask is my advice.

Its still very early days for you post surgery and I reccomend you just take it easy.

You may want to do some upper body excercises though, when you feel up to it. I do some every day using tins of beans as weights :D (I don't have any weights!) This (I hope) helps strengthen my arms, stops the flab getting any flabbier and most importantly provides a bit of excercise which improves ciculation thus helping to prevent any infection to the surgical wound.

At this stage in particular you may also find that at certain times of the day your foot swells a bit in the plaster and for me that was quite uncomfortable - especially at night. The pain also had me convinced I had developed an infection! So don't assume the worst if it does start to get sore around the wound area but at the same time if in doubt speak to your doctor. Just carry on keeping that leg up and you should be fine.

I also didn't go out much at first .... its alot to do with confidence. But I have since been away for a weekend and out for a whole day. It was brilliant to get out of the same four walls. You do start to get amazingly quick on the crutches! That said be careful, especially if it is wet.

I think the next stage you can expect is for your foot to start to be raised back towards neutral or 90 degrees. I had my first plaster for two weeks then it was taken off to remove the stitches then back on for two more weeks, and now the adjustable moon boot. This is much the same as a plaster only you can take it off at night and to have a wash. Really reccomend it despite all my hassles :o I see my consultant again in 4 weeks so that will be 6 weeks with the moon boot. My guess is he'll suggest another 6 weeks in the boot.

As for work, it all depends on what you do. I am negotiating to come off the sick and work from home - bit of red tape going on but I hope to have it sorted soon. I intend not to go back to the office until I can confidently weight bear, I am now 6 weeks post op and not able to do so yet. Although this can be different for each individual...that I am learning fast about this kind of injury.

Anyway speedy recovery and try not to get too bored!:) Someone suggested to me the other day to do a family tree which I thought was a good idea - anything to get me off the playstation!

Betty.

[Limster]

Great advice Richardp and Betty...most appreciated. You both certainly make my waits more pleasant now. Just so you know, I did go out on a trip for a few hours (to family gatherings) in the last two days and feelin pretty good about it. I am going back to work next week but just starting with 2-3 hours a day and then gradually build up to it so that the leg doesn't become swelled up by night in. I am now anxious on the next appointment but not scared now thanks to you all out there with AT problems.

I'll continue to read and contribute (mainly on my updates etc). Anyway, good luck with the crutches coming off Richardp, and Betty, a much speedy recovery to you too, thanks to both of you for those comforting words.

[richardp]

Thanks for the reply Limster..

Couple of additional comments from the posts over the last 24 hours:
Start of physio being early - well there are lots of things physios can do before the weight bearing stages - getting starting on massage and ultrasound to help reduce the scar tissue can start as soon as you are comfortable after the scar healing sufficiently - I have been doing this in advance of the consultant say so. You can really notice the difference in the flexibility of the tendon - I've now had 4 sessions starting at the end of week 5 from the accident.

Work wise - I went back to work with my wife driving me around 3 weeks after - this was probably a little early and was a little uncomfotable - started just going in one day a week but working from home otherwise. Right now (7 weeks and 2 days post op) I could work in the office full time no problems - if I could only drive! I think once i get the nod from the consultant on driving life can return to pretty much normal - then the hard work of getting the strength back into the leg and ankle starts...

I think that by week 6 and using the boot you will feel pretty confident to be getting around and starting to weight bear but everyone has their own pace i guess.

All the best on your progress

Cheers

Richard

[Betty]

To Limster,

No problem and good luck in getting better.

I am inclined to think richardp has had much better advice and treatment than me so I think his time-frames are perhaps more realistic than mine have been.

I am due a check up next week and will be asking lots more about physio/ultrasound/weighbearing.

Anyway take care,

Betty.

[Limster]

Hi there everyone,

just updating you guys on my progress...I had my mid-point check up yesterday (4 weeks and 3 days post surgery) and all went pretty well. I was hoping to start wearing a boot like many of you all have and do but my ortho thinks otherwise. All it was is just re-plastering for 4 more weeks and after that, I should be able to walk again without the support of crutches. My physio work can begin then. They also had my foot adjusted to 90 degrees without any problem or pain, and from that sign, he thinks everything looks good. I might agree with him as the tendon does look strong already. That's all I have at this stage. Hope everyone is on track with their recovery.

Limster

[Grammannette]

I have never participated in a forum like this, but like Limpster, I'm really glad it's out there. I tore my achilles tendon completely off my heal bone and even broke off part of the bone. I stepped down off a step that was over 4 inches higher than code. I lost my balance on my left foot as I stepped down and then came down with all my weight on my right foot. Immediately had the worst pain I've ever experienced, but had no idea what I had done. I had been dealing with achilles tendonitis for quite some time but had just finished an extensive physical therapy program and was getting better. My husband and I thought I just twisted my ankle real good since it bruised up quite a bit. Finally after 6 weeks post injury, I went in to the doctor. They did the surgery right away and everything went well. He didn't cast it right away to allow for post surgical swelling. 10 days after surgery I went in to see him, they took out the staples, and casted it. I have 2 weeks left in the cast. He's not real specific with me and maybe he can't be, as to how I will be getting around after the cast is removed. It sounds to me from reading this forum, that everyone is an individual, but a person should definitely not expect to be walking for quite some time yet after the cast is removed. Is that right? My concern mainly is will I ever return to "normal" again? The ortho said to be aware of the re-rupture rate of 10-15%. Is that forever or just until you're healed? Does age/weight/physical fitness have a bearing on this? After a couple days post-surgery of getting used to living out of a wheelchair, my spirits were really good. I just thought I'd wait out the 6 weeks with the cast and I'll be like new. But now I'm feeling like that's not realistic and now it's hard for me to think positive. Does anyone have any words of encouragement or wisdom to offer?

[CanuckintheUK]

Hey Grammannette,

Sorry to hear about tendon; sounds like things were just getting better for you before the rupture. It seems that all recoveries are very much individual experiences, so no one can say exactly how you will recover, but as you have had surgery, you should have a low risk or re-rupture (~2%) although this will depend on your exact injury and rehab undertaken. Ruptures which are treated non-surgically have a higher re-rupture rate (~12%). In terms of time to walking normally, this will depend a lot on your treatment as well as other factors such as age/weight/fitness, as you mention. I am not down the recovery road nearly far enough to say anything from personal experience, but a review of the available literature suggests that surgical treatment and early weightbearing provide the best functional outcomes with complication rates as low as any other treatment protocol. It seems under absolutely optimal conditions, normal is about 4 months worth of work, but on average, 6 months is more reasonable (6-8 weeks in a cast/boot, then rehab). It might help to mentally break the 6 months down into managable chunks of time (i.e. set some sort of reasonable goal for being out of a cast and then just focus on that and don't worry about what comes after). Just thinking about how long the whole process will take can be a bit disheartening, so you just need to find a way to stay positive while your body heals.

Good luck!

Canuck

[slaphoundapbt]

while immobilization prevents over stressing the achilles, it causes the joint capsule to stiffen and scar tissue to form. These take a long time to correct and the torque required to break up scar tissue in the achilles is incredible and very painful. My physiotherapist uses his knuckle in a twisting fashion along the tendon as hard as he can until his pain causes him to have to stop. I have been through 12 sessions of this now and have many more to go. The best advice I can give you is find a good physiotherapist who has worked on AT repair before and go see him/her NOW! Even if you are still in plaster. They can have you doing exercises to prevent muscle atrophy in you quad, ham and glute even while in a fixed cast. Most importantly, once you are in a removable type of cast, they can start very gentle physio that will prevent scar tissue and joint capsule stiffness.

[dave2ka]

I am set for surgery in a week. This is all new and I am trying to prepare. Any resources would be great!

[Fiona-Sussex uk]

Hi Dave2ka,
Get on the achilles surgery bit of this site....it's great, and we are a nice bunch of people

Good luck, and see you on there
Fee xx