achilles rupture/ no surgery healing

[Omes]

Domjuan - Thanks for the advice. I am definitely not going to rush into it. I like to think I have the right attitude for it. Also nice to see you're sticking around for us newcomers. I know a lot of people would have the human reflex of running away as far as possible from whatever can remind them of such a ruthless injury, including this forum. I know I'll endeavour to stick around after recovery to offer advice too.

[Domjuan]

http://www2.warwick.ac.uk/fac/med/re...h/primary/rat/

This was the trial i entered in 2007.
RAT (Ruptured Achilles Tendon) lol
I met most of the people who ran it. Today I contacted Matt to see if the Report had been published. I was in it , so I deserve a peek! They are doing furthur trials related to Achilles in other areas.
One of the reasons i looked back in is to give a link to the trial results. Maybe soon.......

[raronz]

Another quick question besides walking around on crutches, what did you guys do in the way of cardio when you couldnt weight bear? Swimming is another I can think of. Any other ideas?

[Ischia]

Hi Omes, Wendy small 'c' here...

I know you addressed Annie but if I may be so bold as to chip in

What you have described is just how it was for me at my follow up appointment with the Consultant, albeit at 8 weeks after going into my trusty Vacoped rather than 6 and I too was asked to stand on my tiptoes and was given a sheet of exercises by the physio which included heel raises and drops! Like you, I too felt it was a little too soon to go from having the safety and support of the boot to being asked to stand on my toes and obviously I was stupidly unlucky (based on Dom's reply) to have RR'd.

When's your physio appointment this week? I'll be interested to read how it went and what they got you to do.

I've just got back from my 4th session and today which I walked into and thankfully out of without my crutches!! I had to focus on slowing down my good leg to allow my bad leg to work as it should so I did lots of slow small steps concentrating on cadence (note to self to look that up later) rather than speed up and down the gym. Then we moved on to the leg press which was nothing like the leg press in the gym and I had to push right through from my shoulders to my toes and hold it for 10 seconds then slowly release which felt surprisingly good. My physio's approach is to use the achilles as it should be used in conjunction with all the other muscles around it rather than working it in isolation which I suppose makes a lot of sense. He then gave my knee a bit of manipulation because it's quite stiff, wobbled my lovely slack calf and then sent me off walking again. My homework is to do the same slow, controlled walking which is actually harder to maintain than I would have imagined.

Dom - again it's great to have your experience and encouragement, thanks

Wendy

[raronz]

Went to hospital yesterday and saw my fourth doctor. He put my boot to neutral I was expecting 10 degrees so this was different, he also asked me if I had been doing my exercises. I said I had been told nothing, he looked at me puzzled then simply said when i have the boot off lift my toes as much as possible till neutral then drop the foot back to rest. I had been moving my foot around but to have the doctor say it was necessary was good.

I am at 6 (1 in plaster cast, 3 in fibreglass cast, 2 in boot at 20 degrees) weeks now he reckons after 2 weeks at neutral I can start to put weight through it (2 weeks earlier then they said initially). I'm happy but I won't be pushing as hard through the weight bearing stage as maybe I would have 2 weeks later. He also was the first doc to actually feel the tendon, said there is a small gap but not much. It was a bit tight when they put the foot in the neutral position but I guess it is expected. I'm not forcing my heel into the boot quite just yet so its slightly above neutral, I found this the same with the 20 degrees, I didn't force my foot right to the bottom but over the two weeks the heel eventually settled to the bottom by itself.

Anyone else start weight bearing at 8 weeks? It does seem slightly early but like I said I won't be doing star jumps just slowly adding more weight.

All seems to be good here anyhow, can't wait to ditch the crutches!

[Ischia]

Hi Raronz

My first time around and being treated conservatively I was encouraged to start putting more weight through the boot pretty much as soon as it went to neutral which was around the 6 week mark (details in my profile) and was able to do a slightly uneven crutchless hobble around due to the height difference with one foot in a boot. I was also able to stand on it whilst I was cooking rather than having to rest my lower leg on a chair.

The way the specialist nurses explained the reason for weight bearing as early as possible to me was that as the tendon mended there would be weaker strands that would snap when you put weight through your leg and this causes the body to react by sending more blood and all the other healing chemicals needed to repair the newly snapped bits and this results in a stronger tendon in the long term. Plus you have the added benefit of keeping the rest of your leg muscles working.

I know what you mean when you say about not putting your heel to the back of your boot, I was the same but it's amazing how quickly your leg adjusts to the new angle isn't it?

Anyway, I hope that helps/reassures.

Wendy

[Omes]

Raronz - I was put on 7.5 degrees cause neutral didn't feel comfortable. 2 days later I changed the angle to neutral myself and felt 100% normal...no discomfort. Like Wendy said, you will soon adjust and find neutral ok.

Wendy small 'c' - glad to see you're in the flow with your excercises and walking practice. How's the limp? OK u wanted to know how I got on with the physio. I went to see him this a.m. and I went with no boot . He showed me some excercises which I need to do 4 x a day and then start gym at the hospital in 2 weeks. Excercises are 1 - theraband round the foot and gently push forward (slow and controlled) 2 - towel round foot and pull till feel the stretch 3 - heel raise on good foot, transfer weight to bad and lower the heels on both 3 - good leg in front and push against wall till feel stretch 4 - sit on floor with feet flat against wall and push with toes til calf muscle tightens. There is one more excercise standing on steps with heels over the edge but he said leave that for now. The main goal now is to get strength and stretch back.

So there it is, my homework for the next 2 weeks. I can walk better but have a limp so no cadence there Wendy . Am sure it'll go away in the next few weeks. I also rode my bicycle a couple of days ago...maybe a little stupid but just needed it!! Only sitting as standing does cause the tendon to overstretch. Next day I felt my leg muscles ache so a deserved risky workout.

[Ischia]

Omes you are far more brave than me. I did think about getting on my bike just for the freedom it would bring but then thought about how I would cope if I had to stop suddenly and put my my feet down on the ground hard or at a difficult angle. Guess I'm extremely risk averse having gone through this twice so well done you for getting out there and doing it.

It's really interesting how different physios work in different ways. Mine is all about working the whole leg rather than the injured bit in isolation but again that may be because my leg's been out of action for such a very long time now. As for the limp, simple answer is yes I have a limp to be proud of although it is much less obvious when I'm wearing my trainers with my heel raise. In bare feet it is far harder and I find it very difficult to do anything close to a normal walk because the tendon is so short and tight, especially after I've been sat down for a little while. My main achievement so far is that I am able to walk upright and with my hip, knee and toes going in a forwards direction if you know what I mean?

The pressing against the wall that you have to do sounds very much like the leg presses I did yesterday and they feel good don't they?

Please take care, I would hate for you to push things too hard and do yourself some damage.

Wendy

[Omes]

Thanks Wendy, I will take care. I don't do mountain biking and crazy jumps...I just ride like those grannies. I need to get myself a basket to hang at the front for some shopping

I know what u mean with hips, knee and toes going forward. U r basically not inclined to point to the side which is great. Yeah in the mornings or when i sit for a while the tendon definitely feels tighter. Massage helps. Before I forget re-massage, the physio told me that deep tissue massage to get rid of scar tissue is best done sideways rather than the length of the tendon so basically u massage across the tendon if that makes sense.

Any excercise I do now just feels great knowing it will improve things. Fingers crossed all will be well.

Happy healing!

[Annie-Mary]

Raronz,
I was weight-bearing in the boot at 7.5 weeks. It felt so good to get rid of the crutches! I had two wedges in the boot at first then dropped to one after a week. After two weeks I was flat, although as you said, it felt quite tight for a little while. You will really appreciate being able to carry things again!
Omes, I went out on my bike as early as I could too. I actually wore my bike to cycle in for a few weeks. I got some odd looks but at least I was out and about! Your physio homework sounds very similar to mine at first too. It is surprising how quickly the flexibilty comes back if you do the stretching exercises regularly!
I was signed off from phyiso yesterday. She just told me to keep up with balancing exercises and to carry on tyring to build up my flabby calf muscle. I actually went to a very fast Zumba class yesterday which was great fun, and really put my ankle through its paces! I couldn't do the steps where you go onto tiptoe but could manage most of the rest!
Wendy, glad to hear all is going well with you this time! Please take care and don't push too hard!
Good wishes to you all!