After diagnosing the Achilles tendon rupture, my doctor gave me a CAM Walker, an adjustable boot with metal rods on the sides and Velcro straps to ensure a tight fit to the leg. This is how it looks like. Since this device immobilizes the foot and ankle, it prevents any pressure or strain on the broken tendon and the surrounding muscles, and allows you to walk safely.The doctor told me that I would also use the same CAM Walker after the surgery, instead of a regular cast. Some people don’t like this, because the CAM Walker is very heavy. However, since you can control the pressure with the Velcro straps, it is a better option than the cast while you still have a fresh scar with stitches.
My boot didn’t have angle settings; it was just fixed at 90 degrees. Some doctors like to use an adjustable boot that allows the foot to be positioned at different angles so that they can start by placing the patient’s foot pointing slightly down, and move gradually to 90 degrees (see picture to the left). Supposedly, this allows for a more gradual healing of the tendon.My doctor didn’t think that was necessary and gave me a boot that would position my foot at 90 degrees immediately after the surgery.
34 comments:
Hi - ruptured my achilles on 6th Dec and have been in a cast since. Due to go into the boot on 7th Jan 09, can't wait. My consultant is using the conservation method for healing ie NO surgery, not even for full ruptures (which mine isn't, but my cousin's is and he is on same 'treatment'). Interesting you were given the boot from day 1, will speak to my doc at next consultation.
Frances D
This is what I have now at 6 weeks post op. My ortho kept me in a cast with the foot slightly pointed until my foot could go into the "neutral" or 90 degrees position.
I have noticed that the thing is REALLY heavy and I still have to use two crutches. Even though I am an American, after reading several online resources, I switched from auxillary crutches to european style forearm crutches.
Hi All,
I ruptured my achilles on 23 Dec and had the repair done on 29 Dec. The surgeon had me in a split cast for three and a half weeks, and then into a walking boot. The boot I have allows for a range of motion - right now set at 15 degrees plantar-flexion and 0 degrees dorsi-flexion (neutral). Over the past two weeks with this boot, I have progressed to walking completely without my crutches (except for when I have the boot off for showering, etc) and can maintain my foot at neutral. At first I was unsure about the movement but it has turned out for the best as I feel like my ROM and strength are getting better every day, I just hope I'm not over-doing it.
James
James. Your boot sounds really good. Can you tell me the name of it? Thanks!
My treatment sounds a bit more conservative. I ruptured my AT in Dec and had surgery following day and wore three cast 2 for months in different angles. Now wearing the boot or CAM walker. I can now walk without crutches. I went swimming and couldn't wear my fins because the base of my foot is swollen. I will start PT in early March. I have a question - will physical therapy and time cause that thickness to shrink? It is not sore or painful just big.
Hey all, Jan 8 I ruptured my right AT. Am excited today as ortho will remove split cast and replace with boot cast. Was hoping that I will not need the crutches anymore. Probably not, huh? Cant wait to be on my feet. 9 years ago, I ruptured my right AT. Did not heard of boot cast then. I totally lost control of my feet with my right AT rupture, but had control for left AT rupture. Ortho explained and took a pix during surgery. It was the plantaris tendon, a very thin but strong tendon controlling movement of my feet. Good luck to all...and speedy recovery.
I ruptured march 10, surgery on march 13. I will be in 2 different casts lasting until may 11 when I go into a boot. I am trying to make a golf trip that has planned for a year. We leave on may 20th. I can play in the boot, but will I be ready and able to play? What are the odds of wearing boot at all times except when I play?
Help with thoughts??
Gary,
I am in a similar situation, I ruptured mine on 3/16, surgery on 3/19 and have a golf trip beginning of June. My doc seems confident that I can go and play. He advised that I might not be able to play to my handicap but I should be able to enjoy the game and outdoors...those are his words. Sitting on my couch today reading all these blogs it is hard to believe that I will believe that I will be ready to go. Golf does not place a lot of stress on the achilles I believe. Will you be flying to your trip? I know we are not supposed to fly for at least 6 weeks due to deap vein thrombosis. I wish you luck and hope you make your trip. I would skip my trip if I could just play golf somewhere in June. the loss or muscle and flexabilty scares the crap out of me
Mark,
Thanks for your words. My doc said I would be able to play but would lose money. My leg feels great, just trying to figure out how it will be then. I would love to visit with u. Talk golf and injuries. If u get a chance email me, we can exchange numbers. Glinville@paramountmtg.com
Hope to hear from you
Gary
I ruptured mine on 11/14/08 (complete rupture) and had surgery 10 days later. Spent 2 weeks casted after surgery with my foot pointed down. Got my CAM boot with a layered heel lift to gradually peel off the layers to bring the angle of the ankle back to 90 over the course of a week or so. 6 weeks post-op, doctor said to ditch the crutches and start walking with the boot. No boot - no walking. The boot is quite heavy, but it does become a part of you, and it really doesn't take that long to adjust your walking to account for both its weight AND the fact that your "good" leg is now quite shorter than the other. 12 weeks post-op, I was given the go-ahead to lose the boot, put my shoe on and start walking. Was assigned to physical therapy twice a week for 6 weeks. Every single little thing that you do will make you feel so triumphant - walking backwards, that's a big one... going up and down stairs... standing on your toes... getting into a car normally instead of having to sit first and swing your legs in... Just keep telling yourself that you CAN do it, because you can, you just might THINK that you can't, like I did. My ankle is still quite swollen. When you lose the boot altogether, your calf will be much smaller than the other due to the lack of muscle use (it's your thigh that carries the weight of the boot) and the pressure exerted by the velcro. A couple of days with no boot and my ankle blew up like a balloon. The swelling has gone down considerably, but is noticably still swollen when compared with the other. Massaging will help A LOT with circulation down there to get things cleared out and back to normal. Also - when you lose the boot, keep your incision moisturized. The healing, the swelling and the activity in PT will make it sore and EXTREMELY itchy is the skin starts to stretch and move the way it used to. I tried so many lotions and found that Gold Bond Anti-Itch for extremely dry skin is the BEST. Green/Tealish bottle with a red pump and red lettering. Sure, it smells a bit like Ben-Gay, but it works wonders.
Complete rupture on 3/22 with surgery on 3/24. Hard cast for 5 weeks. I'm currently in a removable air cast for three weeks. I don't sleep in the air cast. Instead, I sleep in a plantar fasciitis boot that encourages the tendon to remain flexible.
So I was at the medical supply store and the physical therapist asked me what kind of walking boot I was going to get. He said more and more docs were going with the ankle high boot instead of the one all the way over the calf. Was wondering what the people in here have to say. I get my cast off on Friday and wanted to go in "armed" with information.
Thanks...Tracer
Check out this website for even more new on achilles tendon ruptures! Help me improve me. I just ruptured mine and thought I'd make website with lots of resources.
http://www.mahalo.com/achilles-tendon-tear
Hi everyone! This website has been a real find. I'm 6 weeks post op for a total rupture (30 May 09). After 25 years playing netball, this is how my career ends. I had my tendon repaired within 48 hours from rupture, which going by other posts this is a good thing. I'm 40 and as a small business owner I had to go back to work the day after my operation. On Monday 20 July 09 I am due to get my Cam Walker which thanks to this website I know alot more about. I am a travel agent and have a holiday booked to Europe mid September. Am I going to be ok to go? There is a lot of talk about limping etc which is a little scary. I haven't been in any pain and within my fibreglass plaster I have been trying to move my foot, ankle and calf muscle as much as possible. Do you think it is feasible that I will be able to take my holiday?? Any advice or views would be much appreciated.
Hayley M
Hi everyone! I'm 2 weeks post op for a total left rupture (6 July 09). Since I do not have a health insurance, I am looking to buy a used medium size CAM Walker or Boot". Any advice or views would be much appreciated. I live in the Northern Virginia and can be reached at iqbalchowdhury@comcast.net.
Had surgery on 6/22 for an ATR.Doc says I can ditch crutches next week- which is 5wks post op......boot for 2wks,thn a sneaker without any lifts.When I'm on my crutches my foot turns,and I mean dark disgustingly blue.Just wondering if anybody else had the same issue
BC
I had a complete rupture during karate class. I had surgery 1 week later on june 19th. Right now I am in my 2nd hard cast due to go into the boot tomorrow. I am amazed how quickly some of you are walking, It seems painful to even set it down.
When I go into the boot, do I have to wear it at night?
Hi, ruptured my achilles during a lacrosse playoff game. I thought I had been kicked or slashed and didn't think much of it. 4 days later my wife forced me to go to the doctor before we went away on holidays. Well a day later I am in emergency surgery on Aug. 30th. My poor wife. She is 7 months pregnant and we have a very active 20 month old son. I am 12 days post op and feeling really frustrated that I cannot do anything for my self and my wife is having to take care of me. On top of all that the team that I help start and have been the captain for the last 7 years is finally going to nationals at the end of the month and now my career is all but done. Not the way i saw it all ending. A little depressed so trying to do some research about it. Not sure if it is helping or hurting.
Hi all from the UK.
I Ruptured my Achilles playing with the kids on 27th June. Thought it was a sprain at first but a the visit to A & E (ER) on the following Monday ended up with my lower right leg put in plaster on the the 29th. I was offered an op to repair it or the plaster option and I chose the plaster over surgery. I had the first plaster on for three weeks with my foot pointed down about 140 degrees, this was re assesed on July 14th and another plaster was fitted with my foot at about 150 degrees. On the 11th July this was replaced with another cast with my foot at a 90 degree angle and also I was given a slip on shoe to encourage me to walk but without applying too much pressure to the tendon and heel area, so i'm still using one and sometimes two forearm crutches. Due to the fact i'm going abroad this plaster will come off on the 25th Aug (2wks) not the recommended three weeks to give me a little more time for physiotherapy prior to my holiday. I'll let you know the outcome. Peace 8bb
Hi from the UK.
I ruptured my Achilles playing with the kids on 27th June. Loud pop in my head and a feeling like something had hit me on the back of my calf. Thought it was a sprain at first but a the visit to A & E (ER) on the following Monday and subsequent Thompson Test ended up with my lower right leg put in plaster on the the 29th June. I was offered an operation to repair the rupture or the plastercast option and I chose the plastercast over surgery basically as i was wary of the risk of infection and due to go abroad on the 5th September.
I had the first white A & E plastercast on for three weeks with my foot pointed down to about 140 degrees, this was quite heavy and awkward at first but it soon became a normal feeling, this was re assesed on July 14th and another black plastercast was fitted with my foot at about 150 degrees. This was lighter and smaller possibly due too calf shrinkage from lack of use.
On the 11th July this was replaced with another purple plastercast with my foot at a 90 degree angle and also I was given a slip on shoe to encourage me to walk but without applying too much pressure to the tendon and heel area. This was lighter but the walking felt funny due to the height differences.
At present i'm still using one and sometimes two forearm crutches. Due to the fact i'm going abroad this plaster will come off on the 25th Aug (2wks making a total of 8wks in plaster)after alot of coercion on my part, not the recommended three weeks they wanted or advised but to give me a little more time for physiotherapy prior to my holiday.
I'll let you know the outcome. Peace 8bb
Hello everyone,
I ruptured my left Achilles tendon 2 months ago and I'm still with cast after surgery.
I don't wear the ROBOCOP boot but the doctor placed another kind of boot which won't be taken off until another month.
I ruptured it when I played basketball. I really enjoy playing it and I'm still planning to play again next year or on November for a season league.
_I want to know if I can still have the ability I had before?
_If I can still play the way I used to play before.
_What are the important care I need to follow in order to fit back in play?
_Some people told me that it could be caused by a medication I took, because I had fever one month before the rupture and had to take a couple of week off. Is this possible that some medication may cause Achilles tendon rupture?
Thank you for answering these questions. All are welcome :)
Michaël
This blog has kept me sane! I am 3 weeks post op with 3 more to go in my fiberglass cast. I cannot wait to move into my CAM walker.
Question: Does anyone have nerve pain on the side of their foot? My little toes go numb and I have terrible pain on the outside of my foot.
Hi Kathy:
I recently ruptured my left AT, 3 weeks ago-2 days later surgery, then in a plaster cast for 2 weeks now a boot; however I experience numbness and at times pain on the outside of my left foot. PT- I cannot point my foot to the right because I get such shooting pains but once it is back at the normal position it doesnt hurt just goes numb again. I have spoken w/ my PT and she states there are 2 other tendons that run down the side of the Achilles that assist with stability and I could have some nerve damage, she has been trying to get in touch with my surgeon to perform MRI of area to see whats going on... Not sure whats going to happen???? I thought I was the only one that experienced this THANK GOD I saw your post. :)
Hi. I ruptured my left AT playing volleyball on 14 September (returning after a few years break following right knee problems, as a 43 year old trying to keep up with the young ones). It was a complete rupture and was advised to go for non-surgical option (infection rate is high and surgeon said that my rupture gave few options to find ends to suture together). I'm in Manchester, UK.
I was put in a paster cast for 2 weeks (equinus position, toes pointing down) and then in a boot (lots of velcro and dark blue padding, German-made, with graded positions, made by Medi). It is now at 30 deg (or 90 + 30). Much better and more comfortable than the cast. Next appointment is next week, Week 4. Apparently they will reduce the angle by a little each time. Total time in cast and boot expected 6-8 weeks, then PT.
I also get a sharp pain in a very specific point on my outside foot (2 inches above little toe) when my leg is in certain positions -- when leg is straightened. And sometimes it feels like my heel is on fire! I have to take the boot off and blow on it!
I try to go for walks on crutches to build up my fitness, but the pain the next day is not fun.
I need to find a happy mid-point.
I had my week 4 appointment today. Boot changed to 10 degrees. Some initial tenderness in the calf/achilles area, and short term pulling sensation, but otherwise very little pain. Weird being able to stand up straight with my legs together. Celebrated with a shower (I bought one of those giant plastic waterproof sock/sack things as soon as I had my cast).
Surgeon examined my Achilles and said that my rupture was healing over nicely with no noticeable gap.
In 2 weeks' time (Week 6) the plan is to move it to zero degrees, but allow for 10 deg of flexion. So I can get the tendon moving, but not to stretch too far.
Also told that I will be in boot until Week 10. Which I am OK with.
OK. So had my Week 6 appointment. On detailed examination it looks like my tendon is not healing properly. There is "incontinuity" -- a break in the tendon where it hasn't all met up and healed together. I am being referred for an ultrasound, with possible surgery. Sets me back a bit... a lot in fact. Next appointment is with the ankle specialist/surgeon. Problem is that my rupture is very high up, close to the muscle, so stitching will have to go into the muscle itself.
In the past 2 weeks I have also treated the Athlete's Foot (terbinafine cream)--and my whole base of the heel was seeping wit bacterial goo. That was cleared up with some tlc from the nursing staff. Hmmmm.
Chris G
I am on my 23rd day since rupturing my left AT. Doc gave me a choice of a cast for 4 weeks with my foot pointed followed by repostioning twice and 2 more casts or surgery and the same treatment. I opted for non-surgical route. The first 2 weeks I did not seem to need any pain killers however this last week I now find I am taking Ibuprofen & paracetamol & some prescription tablets at night time. Has anyone else experieneced this and how long does this pain last. From what I understand it is all part of the healing process and therefore is quite normal. Reading this blog everyone seems quite happy I am still in bed with my foot up to reduce the swelling as soon as I get out of bed it swells again. Can someone give me somthing positive to focus on. Thanks.
Hi Chris, having something "positive" to focus on is what has gotten me through thus far, so I will try to pass that along to you.
I had my surgery on 9/16/09 so I am approaching my 8th week post-op. At the six week mark, I was put back into the CAM boot after having had splints on before that. One time, the splint was positioned slightly downward and, the next time, the splint was placed in the neutral position. This would have been around the 4 week mark. I found out my tendon was somewhat shorter than average so my surgeon didn't want to put too much tension on it too fast when I was recovering.
I have to say I have had literally no pain during this recovery process, so I'm sorry to hear that you do. What I can tell you in terms of a positive focus is this: every follow-up with your surgeon should hopefully have a feeling of progression to it. If it doesn't, then ask WHY and ask pointed questions (in other words, do some research). Some surgeons are aggressive and some, like mine, are more conservative. I followed her lead though because I feel like I am in good hands. Once she got me back in to the CAM boot, there was a huge feeling of freedom again even though, of course, the boot is bulky and yes, you have to sleep with it on at night. However, after going to my physical therapist on Friday, I learned I need NOT keep it on if I am sitting still (watching TV or on the computer), only when I am on the go. I walk with one crutch supporting my affected side and have had NO pain since I started doing this.
When you get to where you can start some physical therapy, around the 6 week mark at the latest, that should also help your mood because you have an action plan in place. Those first 2-4 weeks were hard on me, having to keep the foot elevated, having to ask others to do even the simplest things for me so I wouldn't have to keep getting up. Try to hang in there. If you are having pain, then just be sure and tell someone - don't just take the pain meds and tough it out. It may be something as simple as adjusting the position your foot is now in.
Let me know how you're doing and good luck to you!
CHRIS G
Thanks ever so much for your reply it is good to talk to someone.
My first cast was a back slab - a cast with a gap at the front made of plaster of paris. This was put on ,on the day of my accident. 5 days later this was changed for a full cast. I was told it would be on for the next 4 weeks but owing to a staff shortage I have to have it on for 5 weeks. Then a 3rd one will go on with my foot in a new postion for 2 - 4 weeks then the final one will go on. So I do not think I will get any physio for some time.
I am coping with the pain but I do think that a lot of the pain is the discomfort of the cast. I feel the rest of the pain is the injury knitting its self together.
I badly bruised my knee when the accident happened and this has made it very difficult to move around. In the last 26 days I have been downstairs only twice and each time it was impossible to get comfortable and after 1 or 2 hours I had to come back to bed. For a selfemployed active person this is frustrating.
Chris, it sounds like your situation might be more involved than some talked about here, but, like you, when I incurred my injury (when I fell at work), I also badly sprained my left arm which is what I fell upon. In fact, the pain from that (which was later diagnosed as being like "tennis elbow") was more nagging than the pain from my achilles tendon surgery!
You definitely are in the hands of a conservative surgeon and, while I know it is frustrating to go at such a slow pace, I would try to follow whatever they are telling you, because there is usually a reason for it. For example, my PT person told me I could do some foot stretches that go to the left, the right and upwards but, until further notice, I am not to point my foot downward. I didn't question it, I just said okay!
Glad to be of support, just stay in touch and let me know how it's going!
chris g-
how are you doing? i have a similar situation to you in that my tear is near the top where it connects to the muscle. do you have any info on how this differs to a more "normal" tear?
i hope you are doing well. hang inthere, it gets better. i'm approaching my 8th week atm, and trying to learn how to walk in the cam boot without crutches. it's not easy and i'm tenative as i don't want to re-rupture.
r_mutt
HI ALL
WEEK 8 GOT A NEW CAST ON 8 DEC DAY 56 TODAY QUITE A LOT OF DISCOMFORT IN LAST 48 HOURS. I CAN PUT MY FOOT DOWN AT THE WEEKEND (ANOTHER 2 DAYS) QUITE APPREHENSIVE BUT MUST BE POSITIVE CANNOT SPEND THE REST OF MY LIF ON ONE LEG. MY GOOD LEG (ANKLE) SEEMS TO BE FEELING THE STRAIN HOPE TIS ONE DOES NOT GO AS WELL.
hi im done with the regular cast after having one for 3 months. now i have a camwalker starting today and i realized it is very hard for me to get the first step because it seems the mind is set to where it has to protect my foot. are there any good ways or tips on using the camwalker or does it just need practice?
did anyone develop interior knee pain on the leg they wore their boot?
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