my ruptured achilles story

[Morg007]

Hi

a little background, i'm not sporting at all! I kinda suck at most sports, but still enjoy them nonetheless. Its good excersise and keeps me fit and healthy and in good enough shape.

I go out on my mountain bike and can do 30 miles in 2 1/2 hours, not brilliant but an idea of my level. I also go to the gym 3 times a week. I lift a few weights, do some cardio (bike, rowing machine, treadmill and cross trainer) followed by some swimming.

in June, my mate who plays football (you will probably say soccer!) roped me into coming, he said don't worry about being any good, a couple of the lads only train and don't play, but come along for the banter! So I thought it woudl add to my weekly regime and maybe push me a little bit harder. Thing is I am 25 and hadn't played in a team envorinment since I was 16. First session, fine, very hard, and my hamstrings were stiff for afew days. then second session, while doing some passing/moving/covering exercises (in a cicle with "piggy in the middle" who is trying to get the ball while it is being passed). I felt the worst pain I have ever experienced hit the back of my ancle.

I went down like a led balloon, screaming obsenities at the top of my voice. One of the lads straight away said it was an achilles injury, he figured just a "pull", so i rested, tries to put weight on my foot and couldn't, so witha little help from the coach I got to the pub (well priotrities an all!), I went to A & E and a ruptured achilles was the prognosis! I was put in plster, and given crutches. i went back the day later to the fracture clinic and offered the usual two coices of plaster and complete rest or sugery, the one doctor didn't want surgery, well MRSA is a big problem here in england! But when talkign to the surgeon, Iupted for surgery, he advised it too because of my lifestyle.

they got me in quick and almost to the minute I had surgery 24 hours after the injury happened. I was again in bandage/plaster for 2 weeks, then put in a boot with wooden wedges to put my foot at an angle. thsi was 4 weeks ago and I have just had a couple of wedges taken out to put my foot at "almost" the proper angle to stand on. I'm still on crutches but I can put some weight on my foot and "walk" with crutches. My surgeon has said hopefully if everything goes well, in 4 weeks i will be able to ditch everything and just have a stick to help surport me. This will be 10 weeks after surgery. Now he has said aftr 14 weeks I should be back to normal, but will have to take it easy.

so i have a few questions?

how long after the injury can I start back at the gym> When can I run? What about my biking? I'm not gonna play football again, but still want to do the other stuff.

Also is there any excersises I can do for my upper body, as I'm starting to get flabby again, especially around the stomach (I haven't lost my apertite!)

also having cancelled my holiday, I am looking to go away in teh first week of December and as I dod the injury July 10th can I expect to be fully mobile by December?

Thanks alot for any help

[Unregistered]

Hi Morg 007, Sorry to hear you have joined the AT rupture club !!!!!
You dont realise until you have done it and gone on this forum just how many people there are in the same boat..
Iam 18 months post recovery, treated conservatively so no expert on surgery.
I know the questions you are asking because we have all been there.
How long , how much, when can I etc etc.....
Point is everyone is different. Some heal quicker than others. You only need to read the posts of people who have re-ruptured to see that going too fast too quick can be catastrophic.
Have you got access to a good physio. Mine told me during recovery my deadliest enemies would be....Curbs, Potholes, Ladders, Bycycles and worst of the lot......Impatience !!!!!
I was back at the gym at about 4/5 months. You might be quicker as surgery patients seem to spend less time in casts and boots. Startedwith walking slowly on the treadmill. Doing upper body exercises for fitness. Swimming in the pool is a good one as it has no body weight on the bad tendon or leg.
Be very very careful of the pool steps, that can be very dodgy.
I was also on exercise bike but once again you have to watch you dont overstretch the ankle and cause the tendon to be damaged.
I liased very closely with my physio on what I could and couldnt do.
I cannot emphasise enough to take your time and not rush it.
I went on holiday in May after doing it in Feb but I had a crutch with me just to give me support. Some of the holiday places can be quite dark at night with holes in the road and you are usually half pissed as well !!!!
Hope this helps in some ways. It may not be excatly what you want to hear but with time and lots of patience you will recover.
Good luck and keep posting so can see your progress. Anything else you want to ask, just fire away.
Remember we have all been thru it and gone on to recover.

Regards.

Gerry.

[Unregistered]

Morg007 - just stumbled across your post and thought I'd relate my experience for what it is worth. I did mine playing football (soccer) about 14 months ago and had it surgically repaired (I was 32 when it happened). I was out of my cast after 8 weeks and walking reasonably well at about the 10-11 week mark. However, I was certainly nowhere near back to normal after 14 weeks.

It is incredibly frustrating doing the rehab exercises but I would advise anyone who ruptures their achilles to follow physio advice as much as possible. The key is to arrest the wastage in your calf muscle as much as possible so even doing seated heel raises whenever you can will stand you in good stead in the long term.

I started jogging (for 15 seconds, then walk for a minute, the jog for 15 seconds etc) at about the 14 week mark but progress was pretty slow for a couple of months. I gradually built up both the length of time I was jogging and my pace and by the six month mark I could run, albeit pretty slowly, for 20 minutes or so. At 8 months my running was appraoching normality and at 9 months (my target date) I ran within a minute of my pre-injury time for 5k.

The fact that you ride a bike is a good thing because I started cycling to keep fit at the 4 month mark and never had any problems on the bike (in fact, I did one legged cycling in the gym with my cast on!!!). It also helps build the calf muscle again. As I mentioned I was back in the gym while I had my cast on...I just got angry with the world and did things like boxing, weights, and one legged rowing to keep fit. Just focus that frustration!! Bizarrely, I was probably fitter when the cast came off than the day I ruptured my achilles...

Although I will never regain full flexibility in my right leg, after 12 months I was back to normal (a little less power on my right side but no other issues). Sitting here now, 14 months down the track, it rarely bothers me so it does get better!

The worst part of the process is actually the first couple of months after the cast is removed. Progress seems really slow and you feel pretty useless. The good news is that if you are diligent with your rehab, I am confident that at 9-12 months post op you will be at 90-95%.

Oh, and go on holiday in December...you'll be fine!

[Unregistered]

Morg007 - it is the second replyer again. Having read Gerry's post, I will agree that you need to be careful...re-rupturing would be awful. So listen to your physio and your own body along the way!

Good luck
Spencer

[Morg007]

Thanks guys for your replies.

I am at 8 1/2 weeks post suggery. Taking it steady, I remove my boot every day like the surgeon asked me to to do some light exercises. I have slight concern that sometimes I feel some pain where I ruptured it, but its more of a stiff pain and just slightly uncomfortable and goes away after a few seconds. its quite good, because I work with an ex nurse who has been advising me about stuff in general, the back of my leg is almost square hshaped and it worried me, but there is no pain (acept the discomfort once in a while I just mentioned). She eased my worry and told me its simply down to the boot I have one which is coursing the flesh and skin to be "shapped"!!! kinda weird looking, but she said once out of the boot it'll soon get back to normal!

I am dreading losing teh boot, every worry comes into play, from accidently re ruptruing it again, slipping over to even a really stupic fear that what happens if I get jumped on the way back from the pub and i can't run!!!? Stupid really I know! ;)

I've started doing simple ab execises like bycycle crunches to keep the belly flat, but with the boot being fairly heavy its actually like weight lifting!!!

so thanks for your experiences. If anybody else reads this who has just done it. the way I am getting through this is to remember there are poeple alot worst off, likein new Orleans for example, my cousin also lost a breast through cancer and she's 24, she coped with it brilliantly, so that helps get me through it!

[injuryupdate]

Best thing you can tell yourself about a ruptured Achilles is that when it is all over, you get a normally functioning leg back. You probably lose half a second off your best 100m sprint time after an Achilles rupture, but you can still run etc. If you have an ACL reconstruction or even lose a bit of joint cartilage, you are probably resigned to getting a degenerative joint later in life, but with the Achilles (or another tendon) it can be repaired and usually becomes pain free for life.

[Barry USA]

Enjoyed reading the posts. I'm one week out from surgery. Been in the gym a couple of times doing upper body stuff. Can't wait to get out of plaster and into a boot. I've been trying to get as much cardio out of my upper body routine as possible, anybody have any suggestions. I was thinking about riding stationary bike with just my good leg.

[rhodge]

I think I have found a support group! Just ruptured mine on March 21, 06...martial arts sparring. And yes...you should have seen the other guy. I have surgery tomorrow and will embark on the cast & recovery road.

Question...with the initial cast (toes pointed) are you allowed to get around on crutches? Is it practical with toes in that position?

Many thanks...

[unlucky]

Hi there,

Yes you can get around on crutches, I have since day 1, although you find that you have muscles in your arms that you didn't know were there! I have 2 little boys, so being still really isn't an option.
I had an initial front slab, & now am on my 2nd fibreglass cast (@$115 each!) I am going in the boot a week early this Thurs, but still can't put pressure on for another week. Good luck, I always wished for crutches as a kid, now I have them, I could throw them.
I was lucky & had surgery straight away, reading other's posts does answer alot of questions but don't be shy to ask as many as you want from your surgeon.
CYA & go the morphine in hospital!
Sasha

[Manchester, England]

Hi everyone just enjoyed reading your posts and found them very useful, so if possible I’d welcome some advice. I ruptured mine playing 5-a-side football in Dec last year, in hospital I was advised to go for a non-surgical repair (as I’m 44 and past it) not to sure if it was the right move, but it’s a bit late now. 3 weeks ago I had the cast removed, but after 12 weeks in plaster my ankle was very stiff, the thing is 3 weeks later I’m still finding it difficult to walk properly, it is hard to put my foot down with sole of my foot flat to the floor, I seem to walk on the outside of the foot all the time, which is putting pressure on the outside of the ankle, which in turn makes the ankle swell up, do you think this will get easier with time, or do I need to exercise the foot a certain way?

Rhodge’s Question...with the initial cast (toes pointed) are you allowed to get around on crutches? Is it practical with toes in that position?

All I can say is, after stubbing your toes a few times on the road, pavement, etc. you’ll learn pretty quickly to keep them up!!!

[Chubby_and_Fifty]

Hi all,

I'm 5'8" and 50, and I ruptured my achilles tendon on March 25, 2006. I had the repair
surgery on March 29.

Denise, a girl i know, was skipping around the pool tables where I play pool. I decided
to be funny and imitate her. I skipped about 20' and then there was this loud POP. I fell
face down. My pants got all tangled as I went down and got yanked halfway to my knees.

There I am on the ground trying pull my pants up. Then I tried to stand up and my leg
didn't work. It scared the hell outta' me because my foot dragged like my uncle's did after
he had a stroke. And it hurt like hell.

After a few seconds I realized I hadn't had a stroke, and my leg still hurt like hell. I
thought I must have had a terrible leg cramp that caused a "charlie horse" in my calf
muscle. I ignored it and hobbled around for a couple days. Then, at my mother's
insistence, I went to the doctor and he diagnosed a ruptured achilles tendon, told me I
would most likely require surgery, and referred me to an orthopaedic surgeon.

I had not even considered I'd had a serious injury so it was quite a surprise.

Now I'm two weeks from the original injury and about ten days from surgery. Since
I'm chubby and generally out of shape the crutches are a chore, but I'm trying to use
them more and more to get into shape. My first post-surgery follow-up appointment
with the doctor is tomorrow. I hope they will release me to return to work.

Did anyone have trouble driving with the toes-pointed cast? I have two cars but both
are manual 5 speed transmissions and I'm wondering if I'll be able to drive.

Oh, it's ok to laugh at the incident, I certainly have. And I had the nurses rolling with
laughter at the site of a chubby, 50 yr old skipping around the pool table after a 30 yr
old woman. And no, I wasn't chasing her, well, I was chasing her, but not pursuing her.
She's a good friend and it was all in fun. Just no more skipping for a while.


Larry
echinvar at ya*oo d*t c*m

[Unregistered]

Hello been reading all the fellow R.A.T's trying to find out how long it'll be untill I could play the beautiful game again! I did the dreaded injury in May 05 at WORK for **** sake doing a simple thing, I stepped back off a concrete ledge which I didn't see & BANG goes the bottom of my leg, being in Moss Side (M/cr) at the time I thought I'd been shot or had a brick thrown at me! Went hospital & they put it in cast with my toe's pointing down. After going back a few times to change position of foot & having it in cast for 8 weeks they gave me a support boot for 2 weeks which was great cos you can take the bastard off & have a shower, (unlike the cast of course). The day before my wedding the boot came off & I was so relieved it happened in time. I struggled walking on the beautiful sand in Cancun, Mexico where I went for my honeymoon, apart from that it was great. 5 months later in December, POP, yep I re-ruptured it doing calf raises of a step. This time they booked me in to have it repaired & grafted at the begining of Jan 06. Stayed in cast again for another 8 weeks, so again no proper shower (which i love) for ages. When it came off my ankle was very weak for about a month & my calf muscle was none excistant. Its now 3 May 06 & its getting alot stronger with help from the physio. I'd recomend to anyone that does it to have the repair & graft, because "apparently" there is only a 2% chance of re-rupturing! Be patient, its bad the 1st time its even worse the 2nd! Cheers, get well soon

[Unregistered]

What great post, it makes me feel better and get a better understanding of this injury. I ruptured my achilles on April 25, 2006 playing basketball. Im 37 6'1, 210lbs and had been playing again for about 1 month (after not playing for many years) just shooting around until I joined a league with my brother. The very first game I felt really good and was playing well...UNTIL IT HAPPEN! I was on a fastbreak ahead of the pack and laid the ball up and scored...but within 2 seconds i felt like I had been hit with a bat in the back of my ankle. I fell to the floor and crawled to the sideline seats...everyone thought I twisted my ankle but I knew better I felt the huge gape in the back of my ankle and knew this was not good.

I went to the ER and they told me it was a Rupture of the Achilles and gave me my options. I decided not to do surgery because my doctor told me I would heal just as good without it if i follow rehab instructions to the T. I was in the plaster cast for 3 weeks 3 days and now I'm in a boot. I can walk on it lightly with no problem but it has no power at all, it's kinda scary. It's also tight as hell and I would guess that goes away with time, my doc did tell me to start streching it and moving my toes around in circles for excercse. I go back on July 3 for another Visit I'll let you guys know how I'm doing

And for all of you who eat like a beast and watch a lot of TV it's okay...I've gained 15 pounds since this all started, but I don't worry about it because I know after this is all over I'll get back in shape...Good Luck to all of you!

Vee

[Old and falling apart]

Two months before turning forty I for some reason thought it would be fun to play basketball with some other old gents at 6:30 AM on a Friday before work at the company gym. Made it through the first two games fine though I was not scoring much due to all the rust I've accumulated after not playing for 3 years. My team was down four points in the third game and I get the bright idea to cut as fast a I could from high to low across the key hoping to get the ball for an easy lay-up. I pushed off hard with my right foot then I heard and felt a whack on the back of my right shoe. I immediately pulled up because I could not take another step with my right foot. Then I asked everyone if someone kicked me or did something in my pop. See no one was within 6 ft of me I knew I was in trouble. Hard to belive your achilles can snap so hard that you hear it and it feel like you've been kicked.

Went to my primary care physician who I waited for 4 hours to see. She reffered me to an orthopedist who I saw 3 hours later. Diagnosis full achilles rupture. Choices: surgery (3% chance of rerupture) or non-surgical corrective casting (15% chance). Since I was not yet forty and wanted to continue being active after this event, I opted for the surgery. I then had to wait 5 days for the surgery. Hard cast 10 days after surgery and then a another hard cast (for another 10 days) after 1st one taken off to check incision. For the second hard cast I had major circulation problems so they took it off a week early and put me in a boot. Free from the confines of the cast my ankle and lower leg swelled big time for two days then subsided.

I have limited range of motion with the boot off but at least I can move my ankle around a little bit. I really want to just walk again, however there is no way I want to rerupture. So I'm going along cautiously optimistic. Got an excercise bike to ward off anymore atrophy with the rest of my leg and looking forward for the doc to give me the green light for phyisical therapy. I've been telling everyone I know to strech good days before an athletic event they haven't done for awhile and if they can take a couple weeks to do some ramp up conditioning. Hindsight being 20/20 I would have not played basketball knowing this was a highly probable out come. And I surely would not have done it if I new how hard it was going to be keeping up with my 9, 5, and 3 yr old children while on crutches. Keeping up with them on crutched has been much more painful than any pain I have experienced with this achilles rupture by far. Anyway what's done is done and at this point all I can do is to move forward and get this thing healed.

Thanks for all the positive stories, I soon hope my next one will be positive as well.

[Morfergus]

I am a pretty active 34 year old Aussie currently livinging in Montreal, Canada. I ruptured my achilles playing softball last Monday night, 24 July. As I pushed off on my right foot to field a ball a few metres away, I felt like something hit me in the back of the leg - just like almost everyone else. Then I turned around to see who had thrown the ball that hit me but could see no one near me and no ball!

So I went to Emergency that evening and was in surgery the next evening for the operation. This seems pretty quick compared to some people who have posted here who had a wait a few days for surgery, so I consider myself lucky. The doctor advised that surgery was the better option for me because the chance of re-rupture is much lower and I would recover most of my power and strength in the tendon, probably about 90%.

Now I am in a half-cast around the back and sides on my leg and foot, wrapped in bangades. In two days time, nine days after surgery, I have a follow-up meeting with the doctor for him to inspect it and discuss the recovery plan. Hopefully I will not be in another cast for too long because I really want to be able to walk without crutches and have a shower (baths are annoying me already!). The doctor did say before the operation that I would not be walking on for at least four weeks. While that is hard to take, I certainly don't want to re-rupture it or affect my recovery so I know I have to be patient.

Fortunately I haven't had a lot of pain with it, although I have had my fair share of sports injuries so I am probably used to it now. This is the worst one but adds to my list of hamstring tear, calf strain, adductor (groin) tear five times (three on left and two on the right) and multiple ankle sprains. Those are the result of many years of basketball, volleyball, sprinting and touch football and probaboly trying to push myself a bit to far. This achilles rupture will slow me down for a while tough.

Good luck to all with your recovery.

[Brian Mann]

This isn't good. I just started to look on line to investigate an injury that I had last Friday, and two stories in this forum mirrored my own: Not what I wanted to read. I've been trying to live in denial about it for a week now.

Basketball seems to be involved in many achilles tendon injuries. I was playing an easy game of "21" with two other friends of mine when all of the sudden, I felt what I thought was a knee or a toe to the back of my right calf. It wasn't down by the heal where the rupture normally occurs. I fell down and writhed around for about 2 minutes, and then tried to walk. The whole right side of my leg from the calf down was numb: Scared the living shit out of me.

Like I said, it happened over a week ago and there isn't any pain and I seem to be walking around a little better each day. I DO NOT want to have surgery.

Found this site by surprise - Thank you

[anigee]

I was 100% in 4 months, december's a good goal

[anigee]

brian mann.... surgery will get you back a month and a half earlier..just aheads up!

[tonkatuff2]

Hi all got my cast off today; I am 6 weeks post op. I did have a small drama, when the physio took the cast off he found I had a infection at the bottom end of the scar this was due to the so called dissolvable stitches 2 of them didn’t and my surgeon had to make a small incision to remove them and clean out wound and he also gave me a course of antibiotics, so meaning I cant start my physio for at least a week until the wound heals.
Legs feeling real stiff but been told I can walk on it but no over do it.

[dougdigital]

Tonkatuff, sorry to hear about your ruptured achilles. I ruptured mine playing basketball over a year ago. Too bad these things dont come with a warranty. I opted for surgery and was in a cast for about 8 weeks. 2 weeks foot pointed down, 3 weeks foot pointed all the way up and 3 weeks neutral. I start physio after that but it was no fun. I had a walking cast for 3 weeks but I couldn't walk normally because the walking cast was so stiff and it connected all way up to my knee. I had to turn my foot sideways and walk like a mummy. After the walking cast came off I was able to wear a normal shoe but I had to keep my foot elevate for most of the day. I had to walk very slowly and take small steps. I was able to lightly jog after 5 months post op and i was pretty much back to normal 7 months post op.
As far as playing basketball, I don't play nearly as much as I used to. The doctor told me to tone it down because I used to play everyday. I don't play in any leagues or anything like that and its not part of my career. Since I injured myself in the act of jumping I'm still a little skittish about even attempting to jump period. So I mainly run for leisure, that doesn't bother at all.
Tonkatuff I don't know how old you are but be very very patient. Even when you begin to walk again its gonna talk a while for the achilles to stretch out. If you're walking now actually you're probably feeling a tugg at times if you try to step too far. However, Thats great that you're out of the cast after only 6 weeks!! Best of luck to ya, if you have any questions let me know

[Restless but hopefull]

Hi,

I've got a question about rehab. I'll give you a little history first.

I'm 39 and have never broken or torn anything or otherwise hurt myself in the past. I am not the most athletic person, although I am fairly fit.

I completely ruptured my achillies tendon 10 weeks ago. Next day I had operation and was put in cast with toes pointed. 2 weeks later (or 8 weeks ago), the first cast was taken off to remove staples and a new cast was put on, again with toes pointed at same angle. After 8 weeks in cast with toes pointed (or 2 weeks ago), the cast was removed. It was 2 days before I could get to phisio (12 days ago). My first day at phisio, I couldn't stand straight with my heel on the floor. Best I could do, was drop it to within 3/4" (2cm) of the floor. The therapist gave me very light stretching exercises to do. After about 7 days (or 5 days ago) I was able to drop my heel completely to the floor (although I could feel the stretch).

I've been walking with a heel insert and crutches ever since I got the cast taken off. I can walk with one crutch and even no crutch (although I seem to be draging myself more than walking if I drop the crutches entirely). The Doctor had told me I could get rid of the crutches by now and the heel insert after 4 weeks (in another 2 weeks from now).

My concern: The initial progress I made, from not being able to stand on my heel to being able to stand and walk on it (albight with crutches) was great. However, my progress seems to have slowed (although it's hard to measure) since I've been able to hold my foot at the neutral (90deg angle) position. By reading all the threads here, it seems to me that 8 weeks in a cast with toes pointed was way too long. The Doctor told me I had a very acute rupture at the heel and have been going by the assumption that Doctor knows best.

My question: Since the Doctor knew I was not the most athlethic person in the world and I don't rely on my Achillies Tendon for a living as a pro sport athlete does, is it unheard of to go 8 weeks with a cast with toes pointed? Also, should I be able to regain most if not all of my range with phisio and stretching exercises even though my foot was in this position for so long?

Thanks for any and all responses.

[CanuckintheUK]

Hi there,

Unfortunately, I am now a member of this select club of people with AT ruptures. For me it happened while playing soccer at lunch; just standing guarding someone and turned and then felt a tremendous pain in my ankle. This went away after a few minutes but I knew I had done something bad to my ankle while trying to walk. A few minutes of Googling later and I was certain I had ruptured my AT. I went into A&E and they confirmed the diagnosis and sent me away with a cast until I could be seen in the fracture clinic. So, being a scientist by trade, I started reading papers published in scientific journals which dealt with AT ruptures. There are quite a few good ones, though in some cases you need to have access to the journals through a university library account. There was a very good review in 2002 (reference below)

Wong J, Barrass V, Maffulli N. Quantitative review of operative and nonoperative management of achilles tendon ruptures. Am J Sports Med. 2002 Jul-Aug;30(4):565-75.
PMID: 12130412

It describes in detail a review of 5300 AT ruptures, how they were treated and the outcomes. It also describes in some detail the various techniques used for treatment and the pros and cons. Having been able to read through this, I found I was much better prepared to speak to the orthopaedic surgeons at the clinic. The first doctor I spoke to (and in fact most I spoke to) said that there was no big difference between surgery and conservative treatment in terms of outcome. In fact this isn’t really true; it is quite clear that the “functional outcome” of surgery is better in terms of mobility, rate of rerupture, and duration of recover. It is true that not having surgery avoids some risks such as infections, but similar rates of wound/general complications exist for conservatively treated patients as well (clear from the review, but not from talking to the doctor). The problem is that doctors only have so much time to keep up with current research and there are so may specific problems they have to deal with on a daily basis, it’s ultimately unrealistic to expect them to know everything about every aspect of your condition. The senior registrar at the clinic did not know of a study published by his co-worker about the benefits of early weight bearing (discussed below) after AT surgery; had I not done my own research, I might have been stuck wearing a hard cast (and crutches) for 8 weeks, rather than (if all goes well) an air-cast after 10 days. It’s hard to get access to the information, but where possible, you should try and find out and understand all of your options first and then speak to a doctor about what you want to do, not just what the doctor says. As I am a physically active 34 year old, I likely would have been recommended to have surgery regardless, but the first doctor seemed keen to have me in a cast and out the door.

Anyway, having a 2 year old and a new born, I am keen to get walking as soon as possible again, so I was also interested in articles which dealt with early, weight bearing mobilization after surgery. There was recent study published (by a orthopaedic surgeon who coincidentally works at the clinic I went to!) showing that early weight bearing after surgery actually reduces the rate of rerupture and complication rate as compared to surgery and immobilization (this is also clear from the 2002 review). Presumably the increased blood/lymph flow from muscle use helps in recovery, although it’s not specially stated why this is. Although it should not have taken as much effort or convincing as it did, I was able to get the senior registrar to agree that I could follow the early weight bearing protocol; he just needed to talk to the doctor a few doors down and find out exactly what he does. So at the moment, I am 5 days post-op and waiting to get out of my current cast and starting my long road to re-hab! In summary, my advice is to try and be informed as much as possible when talking to a doctor and even then, get second/third opinions until you feel satisfied that you are getting the treatment you want. Whether you are an elite athlete or not, it is just you that has to live with the injury, not the doctor, so make sure you are happy with your decisions.

[Marita]

Hi everybody,
just wanted you to know how happy I am to have found a doctor who only put me
in a cast for 10 days!
I ruptured my achilles tendon on Oct. 15th, had the surgery on the 17 th. Ten days after the surgery my cast was taken off and they gave me a splint for the front off my leg ( with toes pointing down). Since the splint is removable, I was able to start gentle stretching
exercises while lying on the couch immediately.
I am currently three weeks post op and am doing very well. I am able to walk without crutches (although I am not really supposed to). I can also actively stretch almost beyond the neutral position.
This is just my personal opinion, but I believe that I am healing well because I was able to move my ankle soon after surgery. So I would advise everybody to opt for this treatment if possible. Don't let them stick you in a cast for eight weeks or longer. From my personal experience it just doesn't make sense.
Good luck and fast healing everybody,
Marita Nizam

[Limster]

Hi Marita,

just so you know, I am in a similar position as you...I had my AT op on 19th October, however, my surgeon had plastered my AT for 8 weeks with a progress check at midway point (which is next week). Anyway, I really tend to agree with you and CanuckintheUK with reference to early rehab as soon as possible. I feel like it is healing well but I want o start testing and moving it to start the conditioning and strengthening process but I can't as it is completely immobilised.

As I am seeing my surgeon next week, I am concern that he is going to continue to plaster me for the remaining 4 weeks. I want to do whatever the Doctor suggests yet at the same time I'm not sure if plastering for 4 more weeks will have greater effect. Question. Would you go against your surgeon's advice in this case? I am really hoping that my surgeon will give the BOOT so rehab can begin. What do you or anyone out there thinks? Thanks. By the way, Where did you have you op? I had my in Melbourne, Australia. Just curious on treatment practice varying from country to country.

Limster:)

[CanuckintheUK]

Hey Limster,

In terms of what treatment you end up getting, you need to be happy with it. There is a lot of good evidence to suggest that early mobilization can help in AT recover after surgery (there does not seem to be any benefit with immediate weight bearing with conservative treatment, except that you might be able to get around with out crutches). Ultimately, your doctor's advice is just that, advice, although it can feel wrong to "challenge" their opinions. Doctors go through a lot of training (having helped out with some of the training for 2nd year med students for a couple of years, I have a good idea) and part of that training is to have learn to have overwhelming confidence in their opinion, because they need patients to have faith in what they ask them to do. This is ultimately good, as, as a patient, you want to feel like things are under control and people know exactly, no doubt, what to do to make you better. The downside of this is that it can make it difficult to "question" your doctor's opinion as they may not be used to that sort of approach and might take it is a challenge/insult to their training; My wife (who had never had a cavity) had a new dentist (who said she had 3 cavities) in Vancouver throw a fit when she asked her very politely to write down the details so she could get a second opinion. Doctors can be the same. In the scientifc papers I have read, I have not seen anything about starting wieght bearing after 4 weeks, but realisitically, if you can weight bear after 10 days, there is no reason why you couldn't do it after 4 weeks, and just adjust the angle of your air cast/boot appropriately. If you are really interested and talk to the doctor in an open sort of way, he/she might not have any problem with switching to a weight bearing regime. If they are against it (and you are definitely in favour of it), that's a bit more awkward; you can ask them to justify why they want to take a more cautious approach when there is evidence to suggest this may not be necessary, but that's quite confrontational, so don't expect smiles :) Basically, if your doctor is worth their salt, they should advise you on how to proceed in the way that suits you best and still achieves an acceptable medical outcome.

Canuk :)

post script: My surgery was in the UK

[Marita]

Hi Limster,
I had my surgery in Toronto, Canada.
What's my advice? That's a tough question since it is only my personal opinion. I think if I was in your position, I would really push for the boot. It still protects your foot, so that you really can't do any damage if you use it correctly. I was also worried about complications from wearing the cast for a longer period of time like bloodclots and infections. I have been putting cremes on my scar and feel that it really helps.
Maybe you can just bring up these points with your doctor. And if you really feel strongly about it, just go for the boot. After all in the end it should be your decision, it's your ankle!
Good luck with your appointment! Let us know what happened!
Marita

[Sandyxrs]

I can understand where you are coming from! i did mine in at work! the pain is severe, doctors are still lookinh into why i am such pain. been off work for 2 weeks now! my poor fiancee puts up with me moaning bless him! the pain has been severe. i was a active person. i have such pain i am lucky to walk a small amount every day!:)

[Roscoe]

I ruptured my achilles playing american football on 11/4/07. I'm having surgery on 11/15. The pre-op plan is 4 weeks in plaster and then 4 weeks in a boot. We haven't discussed anything past that, but assume we will after the surgery as my surgeon will be able to see how bad it is. Most of my questions have been answered after reading the previous posts. Sounds like anywhere from 4-12 months based on severity, treatement, genetics, and determination.

Any good recommendations on post recovery braces or the like if they exist? How about exercises that have been beneficial.

I'm a runner and was hoping to run in the 2008 Twin Cities (Minneapolis/St. Paul, MN, USA) marathon in October 2008. I've given up on football league this winter as well as my hockey league this winter, but am hopeful for the marathon. Also, does anyone golf? If so, how did that go and when could you golf again?
Regards,
Ben

[team momentum]

Hi everyone and Happy New Year to all,

I thought I would post my experience with a complete rupture of my Achilles Tendon as there appears to be so many conflicting methods of treatment on the web. This is by no means meant to be medical advice, just my story to add to the mass of different treatments out there.

Day minus 14 - Achilles tendonitis in my left leg. Very painful in the mornings and no real reaction to ice and anti-inflammatory's. Continued gentle running to try and warm the tendon up.

Day 1 - First rugby game of the season for me. Couldn't wait to get on the pitch and get stuck in. Thought the tendonitist wouldnt be a problem after a decent warm up and 5 mins of adrenaline. I ruptured my achilles 4 minutes into the game. 'Bugger'.
After the initial 'pop' and look round to see who had just kicked me, there was no pain. Took myself to hospital using the right leg to work the clutch !!
Doctor confirmed a completely ruptured Achilles and talked through various options for repair. Surgery was the only way ahead for me. I wanted to get back to my sports although I appreciate that realistically I am looking at at least 8 months of rehab.

Day 2 - Surgery. The surgeaon came and had a chat with me before the operation and obviously knew what he was talking about. He outlined all the possible problems aswell and once we agreed to continue with the surgery route I went in to theatre at 1.30 pm.

Woke up at 3.30 pm, impressed at how good general anaesthetic is. Absolutely no pain at all from the operation.

Day 3 - Discharged from Hospital on the 26th November with a below knee cast with my foot in a plantar flexion position (toe pointed at floor). This position maintains the achilles in a relaxed position.

Day 2 - Bought a 'Limbo'. Basically a waterproof cast cover for using in the shower. Absolutely fantastic piece of equipment, waterproof sleeve with a diving suit style cuff to keep the cast completely dry in the bath or shower. I ordered mine online and it was delivered the next day. http://www.limboproducts.co.uk/

Rearranged my bathroom so that showering would be easier. Luckily I live in ahouse where I do not have to go upsatirs and have a walk in shower. This made life a lot easier than it could have been.

Day 3-17 - During this period I realised that:

a. Crutches are very hard to use for the first few days. Don't even think of doing more than 50 metres in one go. Take it slowly when on crutches. After a few days, as you get competent with crutches you will try and go faster, but one little slip and it could be back to square one.

b. Wearing a cast in bed can cause plenty of sleep deprived nights. I had a bean bag in the bed to keep my leg elevated through the night, which means you have to remain on your back.

c. Keeping your leg elevated reduces swelling a lot.

d. Rupturing your achilles is a pain in the "£$%

Day 18 -I went back to the hospital for a review. The cast was removed and the Doctor checked the stitches and general state of the wound. Everything was looking good so he told me I would have another cast put on for a futher 4 weeks. I had by this time read a lot of reports online about the best course of treatment for a ruptured achilles and asked the Doctor if I could have an 'Aircast' walking boot instead as the surgeaon who operated on me initially had suggested this method of treatment.

The Doc went away and came back saying I could have an aircast as long as I promised to keep it on and 'dont do anything silly.'

I was fitted with the Aircast boot with 4 heel wedges in, each of 1 cm height. I was instructed to remove one wedge every two weeks.

The aircast boot was a blessed relief after the 2.5 weeks in a plaster cast. Being able to take the cast off for showers and whilst laying on the sofa at night is great. I feel very sorry for people I have read about who are in a cast for up to 12 weeks.

I still use crutches all the time to get about with.

Day 25 - Removed the first wedge. Although I have only been in the aircast for one week I tried the boot on with 1 wedge removed and had no problems at all. My wife told me off for not doing as I was told by the Doctor, but I decided to go with 3 wedges anyway !!!

Day 32 - Removed another wedge. Now down to 2 wedges in 2 weeks.

Day 34 - I started Physio after 2 weeks in the aircast. Another reason for requesting an aircast was to be able to get to the physio as soon as possible. I elected to pay privately for Physio as I wanted to get the scar tissue from the injury site broken down as quickly as possible and also some advice on what exercises I could do at home to ensure the best possible long term repair.

The physio I chose was very experienced having been the Physio for a professional rugby team and at the Commonwealth games for athletics.

After inspecting the injury site, the physio started some massage to break down the scar tissue and stimulate blood flow to the tendon. 35 minutes later, and a bit of teeth gritting I was feeling 10 times better. The Physio gave me some exercises to do each day and off I went.

Exercise Physio gave me to do:

1. Point toes away.
2. Pull toes up.
3. Rotate foot inwards.
4. Rotate foot outwards.
5. Some light resistance training by hooking 'aerobic' elastic bands around my toes and pushing foot away.
6. Foot up on chair and 'carefully' start to stretch achilles by pushing knee forward. This is the hardest exercise and you have to push through the 'discomfort' but stop when you feel any sort of pain. I am worried sometimes that I am either not pushinf myself hard enough as I do not want to damage the tendon again, or that I am being too conservative and am not pushing myself hard enough.

Day 36 - I decided to ditch my crutches as I did a 'test' walk with just the aircast on and found no problems at all. I havent used them since. I find walking easier if I wear a running shoe on my right leg that has a decent heel on it.

Day 37 - Removed the next wedge. Now down to the last wedge.

Day 39 - I went to the local gym and did a swimming session concentrating on walking a few lengths of the pool and then 20 mins on the Hot Tub getting my achilles 'massaged' by one of the more powerful jets of water.
The main advantage of the pool is that you can exercise the achilles and calf muscle without putting too much weight on it as the water is supporting most of the body weight.

Day 40 - Happy New Year

Day 41 - Back to the pool. Now need to start working on the calf muscle. I tried to do a small heel lift in the pool and couldn't believe how weak the leg was.

--------------------------------------------------------------------------------

[jwesty]

I have been wearing shoes and walking and playing drums since about 8 weeks out of surgery, I'm ten weeks out now. The last visit the doctor said to keep the boot on until my next visit which is Oct 27th, but the tendon feels good so I'm going without the boot. the calf is still kind of small and weak but my tendon feels completely stretched out in a good way.

[madmax75]

Nice to know I have so much in common with so many strangers around the world....

I too ruptured my achilles (Partial tare) on September 7th 2008. My first game of the Flag Football Seaon.. Wierd was the noise it makes, it sounds hell of allot worse then it actually felt. But the first step after the noise.. Froget it collapsed to the ground like a little baby. The worst part, I was only going to block somebody.. Well Here I am almost 8 months post injury and back on the field. Of course a few steps slower but none the less out on the field.

My ortho suggested no surgery, just a boot and plenty of nothing for 8 weeks...
That was the slowest 8 weeks,... Luckily I can work from home so I did not have to go to office with all the jokes and sarcasm...
Week 1 I just did nothing. Starting week 2 I went back to the gym (in the basement) lots of upper body and stuff.

Week 9 I started PT. Boring as hell but they foced me to stretch in ways I had not done before so I kept with it. after about month of PT they released me to my own devices as I promised to keep up with the stretching at home. Also gave me a musle stimulizer for my calf..

I still have some work to do, the calve is still a bit JIGGLY but starting to get better. I can just about do heal raises on my toes on the bad leg so its almost there.

Hang in there all who are in the ealry stages it does get better and you wil heal.

[Boston guy]

Hey madmax,

How soon after the injury did you start weightbearing?

I injured mind (near the musculotendinous junction of the gastroc); I opted to go the conservative route.

I was in a splint for three days, then put into a hard below the knee cast, plantarflexed, for three weeks. I then forced my doc to remove the cast and put me in a boot so I could walk. She didn't want me walking until week six (this Wed), but I have been walking since week three.

I'm curious how your eight weeks went (how soon weightbearing, how quickly you were moved to neutral position, etc.).

thanks

[kpturner]

I enjoyed reading through the posts from fellow victims. I thought I would post my situation because, like most, I am not entirely convinced about my treatment and, more importantly, what I should and should not be doing at this stage.

My injury occurred 19 days ago (30th June) playing 5-a-side football. I have spent most of my life participating in various sports at a reasonable level (rugby, football, squash, athletics, golf) but now, since I am at the ripe old age of 46, I stick to golf and a weekly game of 5-a-side to help keep myself reasonably fit. My right ankle ligaments have come in for some serious stick over the years to the extent that my right ankle is permanently a little swollen and the ankle joint is slightly loose (according to my physio). Most of the time it is not painful, but I am wondering if this was contributing to the strain on the achilles and the resulting rupture.

As reported by most, I stepped off to intercept a pass and immediately felt a hard kick in the back of my right calf. I fell on my arse (mainly for effect) and looked around to castigate the perpetrator. There was nobody near me! I immediately thought that it was the achilles, but was dubious because despite a little numbness around the calf it was not particularly painful. In the interest of keeping the game going I then went in goal for remainder of the game. I couldn't move much and got a few laughs showing people my floppy right foot.

Afterwards, having taken a shower and consulted with a friend who had ruptured his achilles, I feared the worst and drove myself to A&E. I was also able to walk with a bit of a limp and very little pain. They confirmed that probability that I had ruptured the achilles and put in in a temporary cast plantarflexed (toe pointed). I was dubious because of the lack of pain. Other people have reported agony, ambulance rides et al but I was experiencing none of this trauma.

2 days later (after chasing it up) I got in for an ultrasound examination where a full rupture and haematoma was diagnosed. I was then put in a proper cast (below) knee in the same plantaflexed position. This drove me nuts at night with itching and feelings of claustrophobia. It took all my will power to stop me sawing it off or getting out the drill and making some holes.

2 more days and I had a consultation with the Orthopaedic surgeon who advised me *not* to have surgery due to the risk of infection. I was told the recover time was the same but the risk of re-rupture is reduced with surgery - i.e. if I am only going to be returning to golf and non-competitive light sports then surgery is not really viable. I am dubious about this too but went along with it.

At this stage I was able to move my foot around in the cast painlessly.

13 days post injury I had another orthopaedic consultation and demanded the removal of the cast for the sake of my sanity. They had no issues with this and gave me an aircast boot with all the wedges inserted. Almost immediately (once at home) I discarded my crutches in the house and walked around with my right foot pointed outwards. Outside I still use the crutches as an aid so I can go faster, but the front part of my boot always needs to repositioned every few minutes.

I have had the aircast boot now for 7 days. I take it off at night and when sitting on the sofa watching the telly. For a while I tried to keep my foot pointed downwards but eventually forgot, and I have also taken showers with my foot planted properly on the floor without pain.

I know it is far from fixed because I am completely unable to lift my heel (i.e. go on tiptoe) but this lack of pain does lull you into a sense of security that is perhaps doing me more harm than good. I keep the boot on as much as possible, but I wonder if I am hampering the healing process by placing my foot flat on the floor for showers etc?

I have a physio appointment on Tuesday (21 days from injury) so I guess I will either get a bollocking and be told I have set myself back 3 weeks or I will get a thumbs up.

I am still unsure if I should have opted for surgery :-(

[kpturner]

I enjoyed reading through the posts from fellow victims. I thought I would post my situation because, like most, I am not entirely convinced about my treatment and, more importantly, what I should and should not be doing at this stage.

My injury occurred 19 days ago (30th June) playing 5-a-side football. I have spent most of my life participating in various sports at a reasonable level (rugby, football, squash, athletics, golf) but now, since I am at the ripe old age of 46, I stick to golf and a weekly game of 5-a-side to help keep myself reasonably fit. My right ankle ligaments have come in for some serious stick over the years to the extent that my right ankle is permanently a little swollen and the ankle joint is slightly loose (according to my physio). Most of the time it is not painful, but I am wondering if this was contributing to the strain on the achilles and the resulting rupture.

As reported by most, I stepped off to intercept a pass and immediately felt a hard kick in the back of my right calf. I fell on my arse (mainly for effect) and looked around to castigate the perpetrator. There was nobody near me! I immediately thought that it was the achilles, but was dubious because despite a little numbness around the calf it was not particularly painful. In the interest of keeping the game going I then went in goal for remainder of the game. I couldn't move much and got a few laughs showing people my floppy right foot.

Afterwards, having taken a shower and consulted with a friend who had ruptured his achilles, I feared the worst and drove myself to A&E. I was also able to walk with a bit of a limp and very little pain. They confirmed that probability that I had ruptured the achilles and put in in a temporary cast plantarflexed (toe pointed). I was dubious because of the lack of pain. Other people have reported agony, ambulance rides et al but I was experiencing none of this trauma.

2 days later (after chasing it up) I got in for an ultrasound examination where a full rupture and haematoma was diagnosed. I was then put in a proper cast (below) knee in the same plantaflexed position. This drove me nuts at night with itching and feelings of claustrophobia. It took all my will power to stop me sawing it off or getting out the drill and making some holes.

2 more days and I had a consultation with the Orthopaedic surgeon who advised me *not* to have surgery due to the risk of infection. I was told the recover time was the same but the risk of re-rupture is reduced with surgery - i.e. if I am only going to be returning to golf and non-competitive light sports then surgery is not really viable. I am dubious about this too but went along with it.

At this stage I was able to move my foot around in the cast painlessly.

13 days post injury I had another orthopaedic consultation and demanded the removal of the cast for the sake of my sanity. They had no issues with this and gave me an aircast boot with all the wedges inserted. Almost immediately (once at home) I discarded my crutches in the house and walked around with my right foot pointed outwards. Outside I still use the crutches as an aid so I can go faster, but the front part of my boot always needs to repositioned every few minutes.

I have had the aircast boot now for 7 days. I take it off at night and when sitting on the sofa watching the telly. For a while I tried to keep my foot pointed downwards but eventually forgot, and I have also taken showers with my foot planted properly on the floor without pain.

I know it is far from fixed because I am completely unable to lift my heel (i.e. go on tiptoe) but this lack of pain does lull you into a sense of security that is perhaps doing me more harm than good. I keep the boot on as much as possible, but I wonder if I am hampering the healing process by placing my foot flat on the floor for showers etc?

I have a physio appointment on Tuesday (21 days from injury) so I guess I will either get a bollocking and be told I have set myself back 3 weeks or I will get a thumbs up.

I am still unsure if I should have opted for surgery :-(

[kpturner]

I enjoyed reading through the posts from fellow victims. I thought I would post my situation because, like most, I am not entirely convinced about my treatment and, more importantly, what I should and should not be doing at this stage.

My injury occurred 19 days ago (30th June) playing 5-a-side football. I have spent most of my life participating in various sports at a reasonable level (rugby, football, squash, athletics, golf) but now, since I am at the ripe old age of 46, I stick to golf and a weekly game of 5-a-side to help keep myself reasonably fit. My right ankle ligaments have come in for some serious stick over the years to the extent that my right ankle is permanently a little swollen and the ankle joint is slightly loose (according to my physio). Most of the time it is not painful, but I am wondering if this was contributing to the strain on the achilles and the resulting rupture.

As reported by most, I stepped off to intercept a pass and immediately felt a hard kick in the back of my right calf. I fell on my arse (mainly for effect) and looked around to castigate the perpetrator. There was nobody near me! I immediately thought that it was the achilles, but was dubious because despite a little numbness around the calf it was not particularly painful. In the interest of keeping the game going I then went in goal for remainder of the game. I couldn't move much and got a few laughs showing people my floppy right foot.

Afterwards, having taken a shower and consulted with a friend who had ruptured his achilles, I feared the worst and drove myself to A&E. I was also able to walk with a bit of a limp and very little pain. They confirmed that probability that I had ruptured the achilles and put in in a temporary cast plantarflexed (toe pointed). I was dubious because of the lack of pain. Other people have reported agony, ambulance rides et al but I was experiencing none of this trauma.

2 days later (after chasing it up) I got in for an ultrasound examination where a full rupture and haematoma was diagnosed. I was then put in a proper cast (below) knee in the same plantaflexed position. This drove me nuts at night with itching and feelings of claustrophobia. It took all my will power to stop me sawing it off or getting out the drill and making some holes.

2 more days and I had a consultation with the Orthopaedic surgeon who advised me *not* to have surgery due to the risk of infection. I was told the recover time was the same but the risk of re-rupture is reduced with surgery - i.e. if I am only going to be returning to golf and non-competitive light sports then surgery is not really viable. I am dubious about this too but went along with it.

At this stage I was able to move my foot around in the cast painlessly.

13 days post injury I had another orthopaedic consultation and demanded the removal of the cast for the sake of my sanity. They had no issues with this and gave me an aircast boot with all the wedges inserted. Almost immediately (once at home) I discarded my crutches in the house and walked around with my right foot pointed outwards. Outside I still use the crutches as an aid so I can go faster, but the front part of my boot always needs to repositioned every few minutes.

I have had the aircast boot now for 7 days. I take it off at night and when sitting on the sofa watching the telly. For a while I tried to keep my foot pointed downwards but eventually forgot, and I have also taken showers with my foot planted properly on the floor without pain.

I know it is far from fixed because I am completely unable to lift my heel (i.e. go on tiptoe) but this lack of pain does lull you into a sense of security that is perhaps doing me more harm than good. I keep the boot on as much as possible, but I wonder if I am hampering the healing process by placing my foot flat on the floor for showers etc?

I have a physio appointment on Tuesday (21 days from injury) so I guess I will either get a bollocking and be told I have set myself back 3 weeks or I will get a thumbs up.

I am still unsure if I should have opted for surgery :-(

[kpturner]

http://injuryupdate.com.au/forum/showthread.php?p=40163#post40163

[Al52]

Hi
Achillies ruptured 1 Oct 2010 skiing. Not even a twitch when claf muscle squeezed.In a cast within 2 hours toes pointing down. Surgically repaired 2 days later by Consultant surgeon who used me as a "teaching" I believe.One night in hospital Further 2 weeks in a cast, and moon boot with downwards flexion for another 4 weeks. Come out of this on Thursday. It feels great taking weight OK, just tight and stiff. Luckily this was my left leg so have been able to drive my auto. Had 4 days in Oz 3 weeks ago-one advantage of crutches or wheelchair-you get to the front of the customs queue very quickly, but the rest of the punters catch you as you hobble through the airport carpark!!.
Can't wait to get back swimming this week-still active in surf life saving.
Start gym and physio Monday next (almost 6 weeks to the day post surgery) so onwards and upwards.
Cheers
Al