achilles rupture/ no surgery healing

[jess2012]

Hi all,

recently i ruptured my AT playing rugby league. At the time i felt someone land on the back of my leg i jumped up to play the ball and buckled over as soon as weight was applied. Went off and 15 mins later i could bear weight and walk sort off. I left it for a week and a bit and went back to work funny thing was after the swelling went down i didnt really have any pain i just couldnt walk properly no matter how hard itried. After i googled a few things as you do did the thompson test and coulnt tip toe i got it checked and yea ultrasound confirmed ruptured.

anyway long story short, after seeing a few docs which also found it weid as i could exert pressure both back and forward of my ankle, they could still feel the tendon they have put me in a moon boot for 4 weeks to let the tear heal its self, basically i just want to know if any one else has had the same sort of rupture im a couple of weeks in any havent noticed much of a change i just dont want to get to week 4 /5 and still the same.

any other experiences would be appreciated.

[Badge]

Hi - this forum is a ghost forum compared to its lively heyday.

But the ghost town has been a real support, I've enjoyed reading through the posts. They give a real sense that time will pass and the injury will soon become a part of my history.

I got a full rupture 3 weeks ago and decided to go the conservative route. The cloud of re-rupture hovers over my head most days. My leg has been in a cast the whole time and I'm due to meet with the consultant next week.

It's a shocking thing to have happen. I've never been without fully working legs. I'm trying to stay positive and I hope it's working. You have to shift your thinking to accommodate a new 'you'. Life slows down.

I'm lucky (or unlucky, maybe) - because I"m on annual leave at the moment and will be for the next few weeks - so I can completely shut off from work thoughts.

Putting the injury into perspective helps. I've got my arms, I can still talk and can still 'think' - and I'm getting pretty good at hobbling on crutches.

Plenty of nightmares about feet though.

Before the 'pop' - I used to be a regular gym goer. And wine drinker. Both have stopped. To compensate - I've started exercising with dumbbells on the upper body (while sitting in a chair) and it helps a lot. It's the feeling of inactivity that can be so draining. Ginger beer is the new drink.

I watched a Ted Talk (link below) that also helped reframe my thinking. It's definitely worth a watch.

http://www.ted.com/talks/lang/en/jan...s_of_life.html

[Badge]

It's been exactly four weeks since I tripped. It seems a shame to let such an informative forum dry up, so this is an update for anyone who stumbles across it in the future.

I had an appointment today with the hospital - they removed the fibre-glass cast and after a brief, but positive, talk with the consultant, I was put into an air boot. Definitely felt like a bridge had been crossed. It's heavy and cumbersome but I know I'll learn to love it. It's good to be able to remove it and let my foot take a breather. Scary though. There's something about having it in plaster made it feel nice and safe.

I don't need to go back to the hospital for another 6 weeks. In the interim, I take out a heel wedge every 2 weeks to help my foot get back into neutral. As time passes, I can weight bear - but he said don't rush this. Four weeks seems a bit early. I did try putting some weight on it and got 'needles' sticking into the sole of my foot. Not nice. But not that bad either.

The Doc talked about re-rupture rates and even though he put a positive spin on it, 13/100 doesn't seem like a healthy statistic. Terrifying statistic. The thought of going back right to the beginning doesn't bear thinking about.

I might try to get to the gym at some point and do some gentle exercises on the healthy leg/maybe leg extensions on the bad leg. Doc said this was fine.

I'll keep updating as I go - this will be a diary I can look back on in time to come, in a time when I can hop and skip to the shops again.

A bit of pointless info here - when the cast/dressing was removed, I was shocked at all the dry skin on my heel. I'll take pleasure in tackling that tomorrow with a pumice stone and plenty of soapy water.

[Badge]

Replying to my own post here - but I've just read I should be gentle with the dry skin on my foot. So no pumice stone, just hot soapy water and a soft towel.

I've tried putting weight on my boot leg as I wobble/limp/shunt forward. It's easy with two crutches, one much harder. I'll give it a break for a bit. No rushing the repair seems to be the overall message of this forum.

[ScubaPro111]

I've sustained an acute complete rupture of my left Achilles at 6:23am Friday 17 August 2012 whilst doing a "safety" jump from a scuba platform 35NM off the coast of Cairns on the Great Barrier Reef. The fin got snagged on the platform and I went forward with 200 bar in my tank and a 6kg wight belt - so it was quite a lot of force on my poor tendon. Its a shame people don't more regularly share little safety tips. I'm an advanced diver and I don't ever recall anyone telling me to ensure my fin tips were clear of (hanging over) the dive platform edge before jumping. My diving buddy told me about the fin tip 'after' the snap (thanks mate). Thank goodness my BCD was fully inflated and I had my mouthpiece in or I could also have had a lungfull of sea water. I ended up at Cairns Base Hospital at 4pm that evening after enduring 8 hours on a heaving monohull.

I was very surprised and even a little shocked to hear the lead orthopaedic surgeon telling me to go the non-surgical route for my ATR treatment. My mother did her Achilles on a tennis court many years ago and sports a 30+cm scar on the back of her calf where they operated on her. She's never sustained a re-rupture and she's now over 80yo. Anyhow the oropaedic nurse at Cairns Base Hospital set my foot into a half plaster in equinus (the foot with foot pointed slighly downwards). The plaster covered the back of the foot, ancle and calf wrapping about 3/4 around the leg and then finnished with bandages to secure). They gave me ctutches and told me to bear no weight on the foot at all. I then returned to Brisbane by plane (Virgin Australia were wonderful in assistance) and saw an OS at the Wesley Private Hospital on Monday. He cut the plaster off, examined the ATR, pronounced the same diagnosis and put me in an air walker boot with a 2cm wedge in the heel and crutches. I go back for the first review mid October.

I have to say I was relieved to able to get my foot out of the plaster and it already was putrid as I'd been in the sea and they didn't bathe the foot before applying the plaster. I'm now reading all these threads and I'm a little bit encouraged but still very worried about re-rupture especially in the early stages. My boot is combersome to say the least and taking a shower is a real worry as the foot out of the boot is flacid, swolen and utterly useless. If I slipped it feels like I would rip the rest of it to shreds.

I'm 52yo so the healing process might be a challenge. I guess all I can do is take good advice and act on it. Bummer of a holiday eh? I did however manage to touch a turtle who was very friendly indeed - was that bad Karma?

[ScubaPro111]

I'm two weeks into this now and I thought I might add the non-surgical rehabilitation protocol (of which I've since learned there are a few versions)
Weeks one to two
- Aircast boot with 2cm heel lift
- Non weight bearing with crutches
Weeks three to six
- Aircast boot with 2cm heel lift
- Protected weight bearing with crutches as required
- Active plantar and dorsi flexion to neutral, inversion / exversion below neitral DO NOT EXTEND YOUR ANKLE UP BEYOND THE FLAT-FOOT POSITION
- Modalities to control swelling (I'm awaiting clarification about this as there's a lot of variation in available treatment but typically a TENS machine)
- Knee / hip exercises as appropriate
- Non weight bearing fitness cardio work
- Hydrotherapy (within motion and weight bearing limitations)
Six to eight week (start physio now)
- Aircast boot (remove heel lift) ... I've been reading this should be graduated over a week or two so I would discuss with your orthopaedic surgeon and get another opinion - better safe than sorry!
- Weight bear as tolerated
- Dorsiflexion stretching, slowly (yes this beans you can now start carefully moving your toes to nose for the first time in 6 weeks)
- Graduated resistance exercises
- Proprioceptive and gait retraining (ask your physio)
- Modalities as indicated
- Fitness/Cardio to include WBAT Hydrotherapy (WBAT - I wikepedia's this and found a radio station so best I can surmise is it's shorthand for Weight Bearing At Times or Weight Bearing Assisted Twoddle, who knows it could be my doctor is part of the Guantanamo Bay correctional crew and it means Water Boarding Actual Torture Hydrotherapy)
Eight to twelve weeks
- Wean off boot
- Return to crutches / cane as required then wean off
- Continue to progress ROM (range of motion), strength, proprioception (I'm guessing this means I'll be spending time on a wabble board)
Twelve weeks
- Continue to progress ROM, strength, proprioception
- Retrain strenght, power, endurance
- Increase dynamic weight bearing exercise, include polyometric training
- Sport specific exercises
Good luck everyone! Looks like we are all going to need it. Chin up but don't point your toes to your chin until you're allowed.

[Badge]

Hi ScubaPro - looks like we're the only ones here at the moment.

I'm nearly ten weeks since rupture. Aircast boot started at week 4 and since then I've had no treatment on the foot or appointments at the hospital. Other than the removal of a heel wedge every 2 weeks (2 wedges down, the last one to go on Tuesday).

The foot gets a daily wash and maybe a bit of a random jiggle around in the air to try to loosen the ankle. Feels pretty stiff.

I'm not sure what will happen on Tuesday when I visit the hospital. This'll be the day all wedges have gone and my foot has finally returned to the horizontal position. Could be the last day of the boot? In a way I hope not - I've grown quite attached to my big boot. It's been the guard dog to my foot, providing unflinching protection day and night. Never thought I'd say this, but I'll really miss it when it's gone - It'll be just me and my hobbly twig leg.

After the appointment with the hospital, I go to the Doctor's for him to assess my fitness to work.
Hopefully physio will start soon, so I'll have more to do than the random jiggling moves I've been doing.

[Domjuan]

Hello Ghost town lol. It is 5 years since my ATR and 4 and half since i joined here. I remember visting here and we had a good gas about Conservative treatment.

I also said it was a 'top' choice; even though i went into a trial. Since then i have no problem at all with my leg. It is perfect. In fact this leg is stronger!

Just be patient!!!!!! Istill have the boot lol.

Good luck. Keep posting and some people will join.

[Badge]

Hi Domjuan - The spirits have returned to Tendonville. Good to hear the happy ever after with the foot.

My boot went back to the hospital the other day after having the ankle shrouded in the boot/cast for 11 weeks. It was a sad goodbye to the old contraption so I took a photo of it before I headed up to the hospital. It felt like having my old faithful dog put down.

I’d read so many posts about physical therapy - and I was expecting something quite intensive from the hospital - maybe a deep tendon massage, a bit of hydro therapy, cardio leg machines and whatnot …. but all I got was:
’stand on your tip toes…’
’stand on one leg …’
‘okay, put your shoe on and give us a walk’.
‘Good - I’ll see you in a month.’

And that was pretty much it. He said the tendon had healed well and there was a bit of strength/motion in the foot. So all was as well as could be. I’m okay with this no-nonsense approach, it makes me feel like I’m now returning to normality.
I’ve just spent the last half an hour walking in big circles outside to try and get myself ready to tackle the hustle and bustle of the city pavements. Calf is a bit sore now.

I’m allowed to keep hold of my crutches till the next physio in a couple of weeks. But the recommendation is to dump them asap.
Hope your day at the hospital when okay.

This post lives on another website - for anyone who comes across this site and wants a bit more interaction maybe you could try Achillesblog.com - it has a lot more traffic but the threads aren't as specific as this one. This site is the big daddy for anyone wanting to know about conservative treatment.

[Barn dancing queen]

I partially ruptured my AT nearly 4 weeks ago (barn dancing!! Not great for the image) and opted for conservative treatment. I'm told I'll be in a cast for 12 weeks which doesn't seem to be the norm for people on this site. A lot of you are in a ski boot after 4 - 5 weeks in. So seems my treatment is very conservative. Has anyone had experience of this long in cast? How long before I can drive again (I really miss my car!!!)?

Got my second cast just under a week ago, my foot is very bruised but apart from that aching slightly, I'm pain free. The thing that hurts the most is a pulled muscle in my chest from using crutches! So I've hired a wonderful thing called a leg trolley which means you have some weight on your damaged upper leg so hopefully it won't be as wasted as my lower leg by the time I'm out of cast plus you're hands free.

If there's anyone out there would be great to share experiences as you're not really told what to expect by the NHS.