Little by little, as the tendon gained flexibility and strength, the limp would diminish (although to this day, six months after surgery, I still limp immediately after waking up and when I don’t have a shoe on). After the first week, I started wearing a shoe around the house instead of the boot, and after about ten days, I started wearing the shoe outside too. My therapist said that if I was already wearing the shoe and felt comfortable there was no need to go back to the boot (major milestone!... no more boot entering week 14 post-op).
Something I observed during therapy is that the progress is very fast in the first two weeks, and then it gets slower afterwards. This is only normal, since after been immobilized for such a long time, the initial excercises have a big impact. In order to keep improving, it is necessary to keep the discipline and increasing the frequency/weight of the excercises.
I always started my therapy with 10 minutes on the stationary bike. This served the purpose of loosening up the tendon and stretching it a little bit, making the following excercises easier. Remember, you're not doing cardio, so don't try to pedal too fast. I was doing around 40 RPM, trying not to put too much pressure in the tendon.
After the bike, I usually did the Biodex Dynamometer (see picture to the left, click to enlarge), for passive range of motion (PROM) excercises (15 minutes per session).Basically, I sat down in the machine with my right (injured) leg extended, while the therapist adjusted the seat and strapped my foot to a metal platform that would move slowly back and forth, generating plantarfexion and dorsiflexion. Since this is a PROM excercise, it is the machine that does the work, not you.
The idea is to progressively increase both plantarflexion and dorsiflexion angles until a normal range of motion is achieved (getting there took me about three weeks). After that, I used the same machine for active range of motion exercises, meaning that this time I had to move the foot myself. The machine can be set up at different levels of resistence, to make movement harder each time.
One of the simplest and most important exercises you can do is using the Thera-Band bands. These bands come in different colors, each of them representing a different resistence level. I started off with the green, and then moved to the blue (the yellow is softer and usually recommended when you are just starting therapy). You can see the bands below:
Basically, what you will do with these bands is a group of four excercises called "Resisted Ankle Strengthening", encompassing plantarflexion, dorsiflexion, inversion, and eversion. The excercises are fairly simple and you can see how to do them in this excellent video (you need to Quicktime to view them):
Another excercise that I found very helpful is the Achilles stretching using the ProStretch (see below):
The ProStretch is a round-shaped accessory used to stretch your calf muscles and Achilles tendon. Basically you position your foot on the ProStretch and then roll it backwards (making your toes point upwards). If you keep your leg straight, you will be stretching your calf muscles.
If you do what I described before, but bend your knee a little bit until you feel a light pull on the Achilles, you will be stretching the tendon. That is the idea. I initially did three repetitions of 15 seconds each, and now I do five repetitions (I purchased the ProStretch to use at home every day).
I also did proprioception excercises. Proprioception is "the process by which the body can vary muscle contraction in immediate response to incoming information regarding external forces". Basically, I was instructed to stand on one foot for 30 seconds at a time on top of one of these special Thera-Band cushions:
At first, I used the green one (more firm), and once I felt comfortable I moved to the blue one . With this excercise the idea is to re-train your muscles to "remember" how to react when you slightly lose balance. This is very important in order to regain confidence when starting to walk again.
61 comments:
WOW!!! You did a fantastic job! I recently ruptured my Achilles Tendon and am going through the same thing. This is very helpful, thanks for taking the time and effort to post all this good stuff.
Regards and best of luck on your recovery.
Paul
Canada
Your information has helped me a lot. I am starting on my fifth week
and have been reading your site since week two. At week two I thought I would never get through it but your site has helped alot.You have the best site I have found to explain week by week details. You have put a lot work into this. I have it bookmarked and keep refering to it week by week. Thanks alot for taking the time.
God Bless
Vicki
Ky
Vicky / Paul:
Thanks for stopping by. I just hit the 8 month mark and doing better (I'm swimming and bicycling). Still limp a little bit in the morning but after five minutes everything's OK. Stay positive and take care, that things DO get better.
Cheers,
Mario.
Hi. Thanks a lot for developing this site. It's really good to read what you have gone through. I'm in week 3 of my injury, so I'll keep referring to your blog.
Regards,
Phil
England, UK
Great information Thanks!
Im in week two after surgery and your story and information as really helped.
kevin
corpus Christi
Vicky / Phil / Kevin:
Thanks for your comments. I wish you all a quick recovery. Just take it easy and elevate the foot as much as possible. You'll be OK in no time (time flies...).
Please keep posting your comments and sharing your progress...
Cheers,
Mario.
I tore my right AT last night playing tennis. I will be operated on in 3 days. I am already getting worried about muscle atrophy and the long slow recover period specially since I am not known to be very patient. My concerns are when should I expect to be able to drive and what cardio workout can I do during the rehab to stay in shape.
Thanks for the wonderful blog,
Matt
I was experiencing extreme pain in my heel from the shims in my walking boot, so I am not using it much. I had surgery a month and half ago, and my doctor might not be happy that I am walking without the boot, but it seems to be OK, just hard to go down stairs. Hope I'm not really doing major damage, or slowing full recovery. But that boot is impossible! Anyone else have this problem?
I had a complete rupture December 1, 2007. I had no idea what to expect and I used this blog as guidance. While a lot of the info was helpful, I must let people know that its not as bad as this site makes it seem. First, i went to work 3 days after surgery. I certainly don't see what benefit there is to stay in bed for one month. Unless you work requires walking, you should get out of the house the first week. I got my cast removed after 2 weeks and now in my eight week i am walking pretty much normally. Do not sit in bed for weeks, move around and start moving that foot after one month. It is ridiculous for people to stay in bed for one month and act as if the have no leg. By 8 weeks you should be on an exercise bike and starting gaining that strenght back.
I agree with the post above(anonymous). I too read this site and found quite a bit of good information. I will say that I found no reason to sit in bed for 4 weeks. I took my first 4 days at home with my leg elevated and than wnet back to work. I have had no pain and minimal to no swelling.
I am curretnly 3 weeks post op, I was out of my cast and stithches removed after 1 week. Was placed in a Cam boot and told to start Physical therapy. I am currently walking with about 50% weight bearing and should be 100% by week 4.
No mistaking that this is an awful injury, but rehabilitation protocal has advanced some over the last few years where more and more studies are pointing to early, moderated Weight bearing being good for the healing process. Not to mention what it does to you mentally to know you are actually improving physically.
Its been 4 months and the slight limp as gotten less..I still feel stiff and weak but the achilles as healed nicely..It takes time but hang in there youll be back running soon.
Hi
Im an australian woman living and working in the UK. Ruptured my archilles 12 weeks ago while jogging and slipped on wet leaves -the surgeon treated me 'conservatively' with a FULL leg cast for 4 weeks and half cast for 6 weeks. No operation. i have been out of the cast for 2 weeks waiting for news on some physio and walking with sticks - have it down to just one stick now and wearing hiking boots and heel lifts for support. Cant walk in bare feet even with the sticks. Im concerned because most people seem to have had the operation.
Susan
Hi there
Don't worry about being treated conservatively. I chose that route too. I ruptured on 8th March, I had a series of casts for 7 weeks and am now out of the cast - 2 days ago - (with nothing else by the way) and hopping around the place. My tendon is ridiculously tight and my calf muscle on the right hand side has been hurting like hell but I can put about a 3rd of my weight on it with crutches. I am supposed to start physio this friday which will help.
Its remarkable how different ortho's deal with the injury. Some have you laid up for years to recover, others, like mine seem to think its all fine in a few months...one will see1
Good luck
Today I reach almost 4 weeks walking in regular shoes, 4 months post-op, and two months of PT. My question is, any input would be appreciated, how long before I can walk at a normal pace? If I have to walk close to the speed of a "non AT-rupture person" I have to limp. This is discouraging as I've been super good about my exercises, etc. With this injury though and reading all this on the Web, it's discouraging as a whole to see how differently this is treated, from surgery and recovery protocol, to PT exercises, which also very for everyone. You would think there would be more of a standard.
Also, sometimes when I try to speed up the walking (with the proper walk gait) I get pain in the heel, around the heel and under it. Has anyone else felt this, and when does it go away?
Hang in there everyone!
I'm wondering the same thing that the person above me posted. I've been out of the boot and in my regular shoes for one week today. How long have you all had a limp? I limp walking slowly, and the limp becomes more severe when I try to speed up. My ankle has also been swelling much more since I've been out of the boot. Can anyone share their experience w/ how long swelling lasts? My ortho said that it would swell for a while, but it will eventually go away, but I would like to know an approximate time frame.
Great site! I am approaching week 8and now in an air cast, what a difference!! Four more weeks in an air cast (hopefully) and then onto the next stage.
Having come out of a plaster after almost 8 weeks, have experienced a variety of different sensations, pain in ankles, tingling... am putting this all down to slightly more mobility with air cast... anybody else experienced the same??
Being treated by British NHS, GREAT to date, had to battle for an air cast though as they werent on offer at my hospital!!! Well worth the effort.
Hi yes i had the pain an tinglin in the ankle, im 14wks post op and hopefully cumin out of the boot next week, can walk short distances in house in normal shoes still with the crutches. My ankle swells when the boot is off and the pain is becoming less, it feels like il never walk in normal shoes again, its a long road to recovery. Im wondering how long it will be before i can return to work, im a nurse so on my feet alot. I was treated in the UK and had no problem getting a moonboot think it depends where you live.
hi
in reply to comments about the limping - i'm the lady treated in UK 'conservatively' so i guess my experience might be different but here goes....
its july 15 - i did my A.T. 4 January. Came out of multiple series of casts without operation on 17 March - 10 weeks later. Was on crutches for about 4-5 weeks (two then one).
I can now walk without a noticeable limp as long as i keep it at my own pace - i can also walk up stairs 'normally'. Cannot walk down stairs without going one foot at a time. If I have to walk at a normal pace I limp.
However, even though it seems slow, i remember when i couldnt get up and even walk across the room to make a cup of coffee - let alone carry it -
sometimes it feels it will never get better than this - other times i remember when i felt the same way (when i couldnt even weight bear)
to be honest, just being able to walk feels good to me even if i am slow - obviously one wants to get back 'to normal' but i guess it is still going to take time....
its been 6 months for me - i heard one - two years recovery is 'normal'..... gues we all just have to hang in there
susan
I just wonder, anyone got both leg ATR here?
Because my both leg also got ATR when playing basketball,
its really a horrible experience....
you will remember the sound ("POP")
in your whole life,
you know what, when you got the ATR
on your "Good Leg"...
you will feel that its a nightmare,
coz after that your life will got lot of changes!!!
Here is some advise,
if you wanna get back to the normal sport event again, you better make sure your good leg do not
have any problem on the tendon!!!
and maybe you are totally can become normal walk again, but its not mean that you can sport again..
you better have more training b4 you have any sport!!!
Week 14 on ditching the boot for me too! Sore in the mornings still though but by mid-day it works itself out.
I've found this a really useful site, to see how others have been treated and what symptoms and experiences they have had.
I ruptured my AT on 13 April, and was treated conservatively: leg in a series of plaster casts and on crutches for ten weeks. Very frustrating time, not being able to do much by yourself!
It's now been six weeks since the cast came off, and progress has been steady and so far without any setbacks. Initially I felt very unsure of myself - my lower leg and ankle was quite swollen, and getting into normal shoes was not easy. The built-up shoe the hospital gave me was not very comfortable, and made walking very lop-sided, and gave me back pain.
But, back in normal shoes, things steadily improved, and I've been going out for a walk each day, building up the distance and speed bit by bit, and cycling (more to help get the calf and thigh muscles working again).
Four weeks after the cast was removed, I started driving again - again, a little bit at first, and then when that felt OK, doing a bit more. It's been wonderful to get my independence and mobility back again!
I still have something of a limp, especially towards the end of my daily walk. I also tend to get a very itchy lower leg, ankle and foot towards the end of day. I don't know whether this is related to the injury and the recovery process or not (I've not seen any mention of this by anyone on this site), but it can be quite distracting and disturbing during the night. But some anti-itching cream (Eurax) does the trick, although it takes 30 mins or so to take effect).
Having been at times quite depressed during the last four months, I now feel so much more happy and positive, in the recovery phase! Good luck to everyone!
Thanks for your site - I ruptured my achilles 3months ago, have done the surgey and the waiting and first round of physio - am now onto the last 2months of strenthening and regaining flexibility. It's great to find sites like this and realise that there's light at the end of the tunnel.
Ruptured mine July 4, 6 weeks post surgery yesterday. Out of hard cast after 4 weeks and on 7th session of PT. Day by day it gets better. I am in boot when in high traffic areas, out in confined areas (office-home). Go to gym daily on top of PT to 1 ride stationary bike 20 to 25 min and other strength exercises to balance body.
Bought wobble board for range of motion, and also the best thing I have found is swimming or treading water daily for 20 to 30 min with just my legs, this helps strengthen and keeps swelling to a minimum.
Wear regular shoes with heel lift and have severe limp. I felt I was going to fast but PT and surgeon say everyone knows their limits. They both say after 8 weeks they do not worry about re rupture, and then walking will be what will eventually bring you to some shade of normal.
I guess you can see I am taking the agressive (cautious) approach.
Own my own business so did not have luxury of not working. Was back in 4 days after surgery and have not missed a day. I do close my door and rest more than I did pre rupture.
Great Site to measure progress!
Great site!!! I ruptured my achilles in July without insurance the hospital didn't offer the therapy that you speak of in your site. So I am on my own, your site is a wealth of info.
Thank you,
Amin
Former USA citizen, now living happily in Mexico.
Week 15
Just an update with my recovary.
Not much improvement over the last few weeks, a little stronger and a bit more ROM, but nothing fantastic. I’m still sticking to more strength building than cardio, although I had a few jogs on the treadmill last week, only slow and just for a kilometer.
At present I’m working on single leg calf raises, but I wouldn't say it’s easy. I try to do between 6 and 12 set every second day. I start off with 3 sets of double calf raises to warm up and then single calf raises. On my bad leg I tend to lean forward slightly to adjust the weight ratio. I do 3 to 4 sets of 10 reps, resting and stretching in between. I then do 4 to 5 sets raising double leg and lowering down single leg.
I’m walking normal most days without a limp but Sometimes at the end of the day the limp comes back.
I’ve invested in a handheld massager and use that twice a day just to help with the circulation.
The incision area is still very tender and saw, but I’m not getting much swelling which is a bonus.
All in all not much has really changed from week 13 to 15 . I think I’ve come to my senses and realized It’s a long recovery process and no matter how hard I train and stick to the PT given I still won’t be fit or strong enough to return to full duties until Feb.
To all the new ATR's out there keep your chin up it does get better. Im doing all the things I used to do before the injury but just not as aggressive.
Happy Healing paul r
http://paulrachillesrupture.blogspot.com/
Just reached the 3 month mark. Took last wedge out of aircast, and surgeon gave thumbs up that tendon has healed well. Says to go to one crutch with boot for 3 days, then no crutch for 3 days, then no boot-move to running shoe. Sneaked into physio earlier than surgeon suggested and am Very glad I did as we started with range of motion which can only aid in the above walking regime. Having a tough time with one crutch, thinking a cane might be better, but it's only for 3 days. Still lots of swealing and need to ice and elavate more. Still the long physio road ahead, but nice to have hit a major milestone and looking forward to increased and better mobility, strength and fitness.
HI, it's Laura in Nova Scotia. I am at week 10, no air cast for me because I developed Complex Regional pain Syndrome(look it up on line), bottom line is I had to start aggressive therapy right away as this condition affects bone, muscle, skin and nerves. I am on pain meds and steroids to control and work to put this condion into remission. The physio is difficult as I went from cast(with no walking) to walking with crutches. I am seeing progress and this web page has helped very much. I am hopeful to walk with a cane by Christmas. If so, I will decorate it. HoHoHo
vHo Ho Ho to all the ATR's out there
I'm now at the end of week 17.
I’ve now returned to work full time on light duties.
I’m very happy with my progress, strength is just about there and fitness is returning back. I’ve been working pretty hard at the gym lately, 5 to 6 days a week and I think it’s payed off. I went to GP on Monday and he says I should be back at work full operational by mid January which is great news. So I’ve rescheduled my appointment with surgeon which was originally the 6th Feb and changed it to 5th Jan. I’ve also stopped my physio sessions but have continued massaging at home. I’m still using a portable massage unit and use it twice a day. I couldn't see the point traveling 20 minutes there after work for a 10 minute physio when I’m doing exactly the same thing at home. So I have sacrificed the 2 phsyio sessions for 2 extra days at the gym.
I don’t get any swelling in my Achilles or ankle anymore and it’s not often I have to elevate. I still get the tightness and pain now and again around the incision area which changes from day to day. First thing in the morning it’s a little stiff but after a few steps it ok and if I’ve had a full day on my feet it gets a bit sore towards night time.
To all the new ATR's just starting their rehab it does get better, just takes time, motivation and patience!!!!!!!
Hope your all have a happy and safe Christmas and New Year
Happy Healing Paul r
Hey, it's Laura again from N.S. Week 11 has brought me good things, I have a new pair of shoes, godzilla would really like them, theay are a rocker type black shoe with expandable(and soft)upper, velcro strap...I am doing better in physio which I go to 3 times per week and yesterday started walking with one crutch. I will start on a cane likely next week in time for xmas. hohoho
Hi,
Paul T here in week 9 post surgery. After my initial walking attempts on Dec 20, I quickly became more confident and have ditched the boot completely. Initially I used a heel lift in my shoe but also ditched this as my tendon stretched and it got all manky and wet from my frequent kayaking expeditions.
I'm limping very slowly so still use crutches when walking more than short distances. But I have been able to return to normal life, driving, kayaking (with the help of friends to launch it)and standing on the shore fishing. It's great having 2 free hands to carry things.
For anyone who has or knows someone with a pedal Hobie kayak, I have found them to be great rehab, giving the lower leg a great workout without placing undie stress on the achilles tendon. I pedal at nearly full speed with my bad leg and every trip seems to improve my movement, muscle strength and tendon flexibility (plus it's much more fun than just moving your foot).
It's very tempting do move too fast right now and found myself surfing waves the other day at the beach in my kayak - once I made it safely back to shore I told myself that I was being really stupid and vowed to take things more easy.
Paul T from Perth, Australia.
Wow! I've hit a milestone in record time. I had a full rupture of my left Achilles tendon Dec 3 and had surgery Dec 7th/09. Had a cast for 4 long weeks, and started the walking Bledsoe boot for 3 weeks. Went to my 1st physio where by I couldn't stand unassisted by crutch with my boot and now before my 8 weeks post surgery I walked all morning in the house in my shoe and went to gym to ride the stationary bike and work on my upper body, did stretching with my rubber bands and I'm home now with minimal swelling. I feel every step but who cares..I'm on two feet! No more boot!
Sorry for bragging..I don't mean it to sound like that!
Keep pushing through this and you can too!!!!!
Well, it's been 4 months now since the rupture and finally I feel like I'm walking without a limp. Well, at least not a noticeable one, people are not longer staring at me as I walk down the street and I can actually overtake 80 year olds with their walking frames now. I feel like life had returned 90% to normal (minus sports involving rupture risk)
I look back now at my couch-ridden weeks after the rupture and wonder how I stayed sane. But I did and it wasn't that bad actually (I enjoyed all the people saying 'oooh, that must have really hurt' when in reality it wasn't all that painful.
Paul T
Hi
My Achilles tendons are fine. I'm writing for a friend who had surgery for a completely ruptured tendon. He had his surgery sometime in June 08. He described to me the surgeon sewed the tendon together, took some tendon form the toe and drilled a hole though I believe the heel for the tendon to go through. He is still having major problems. He says when he gets up in the morning his calf muscle is completely limp. He also has a lot of shooting pain though the foot and calf. He walks on it OK but with a pretty good limp. I get the feeling his doctor does not know how to treat it hoping time will hopefully fix it. Does the above sound normal?
Thanks Ron
Ron
That sounds like a very strange treatment for your friend. I only know of people who have ruptured the same ligament twice who have had to have tendons transplanted from elsewhere on their body. Did he maybe tear it from the heel bone (the only reason I can think of to start drilling holes in the bone?)
I'd encourage your friend to get a second opinion with an experienced surgeon - considering it's been 8 months he shouldn't have too much pain or limp now.
Hi. Am 72 and active. achilles started hurting & after hobbling for few months got MRI and there was a hole in middle of achilles. Doc said came from getting old..
Had surgury March 6 & today is 20th.. Have had no pain since operation. He gave me hard cast & NWB for 12 days. Went in to have removed & gave me choice, walking hard cast or CAM remmovable cast.. I no dummy I took removeable cast.. after couple hrs being cautious I have been walking on it fully, no crutches, and spent yesterday shopping walking like no cast... I take it off when sitting around in chair and when in bed. No pain, except when bang my leg where staples are. get them out next week.
Many of you have probably seen the research where one group was NWB long time & other group walking cast at 2 weeks.. result at end of 6 months was strengh & performance same for both groups but the weight bearing group were much happer with whole process. I do worry that my fold down repair might be stressed with the movement but if no pain I think stands to reason that all movement in foot I can get is speeding the healing. I will be be cautious about everything but the weight bearing. Will keep watching the blog & contribute when can ....Ken
Hi. old Ken here. Never have had much pain and after 12 days went in cam boot.. not wear it much after while around house, but week ago was standing at toilet bowl taking pee and heard a POP and felt something in leg....NOooooooo went see doc and had another MRI yesterday. I got films to carry to doc and can't tell by looking at them if ripped it. doc in the few words he has spoken says took piece of calf muscle and sewed it on the hole in achilles... I stell walking around house no boot and no pain?? See doc tomorrow with films to read.. Don't know about him.. never says much, and he cut a good 6" up back of my leg which seems old fashioned.. but I never had a complete severing of achilles, but a repair of hole so maybe is different then all of you. well we see tomorrow if get operated on again or what.. see ya Ken
Old Ken here... got the bad news// rip the tendon...turns out doc said he cleaned up around the hole in middle, leaving two good strips of tendon on each side. says used something called a synthetic graft to fill the hole, then wrapped the tendon with graft material... as I have said never had any pain so though was doing great, until it popped standing at toilet bowl. He says that I snapped one of the strips he had left... its down toward the heel... anyway I will have to go thru whole thing again... Said this time at least 4 weeks in cast...I sure will be more careful cause the full cast is a real pain... wife has to run around and fetch for me. Oper on 23 so will report then. Ken
I am in my 13th week and I have therapy 2 to 3 times a week. I am very disappointed that I limp so bad. I feel like I am walking in slow motion because I am trying so hard to walk heel- toe. My question would be: If I walk more will this help the limp? I do not feel like I have normal balance..Good luck to everyone --I really enjoy reading this blog. rheasue
There are three primary reasons for that limp that seems to take forever to go away.
If your ankle’s range of motion is limited, you can’t bring your knee over your “bad” foot’s toes while bringing your “good” foot forward. When that bad ankle is flexible enough, (although calf strength plays a role here, too), your left and right steps will be of equal length. In other words, the stride when the good foot goes forward won’t be shorter than the stride when your bad foot goes forward. To check if your steps are even, watch your step lengths when walking across something with evenly spaced lines, like a tile floor or a sidewalk. Of course, the “cure” here is to get that ankle more flexible by stretching the tendon.
More common, and taking longer to “cure,” is the weakened calf muscle. Normally, as one leg strides through, your weight shifts off the heel and onto the ball of your other foot, and that calf muscle, just for a moment, is holding up your entire body weight. This happens with every step of ordinary walking, without our thinking about it. If you can’t yet hold your body weight up with your calf, however, your “bad” heel has to stay on the ground until the other heel hits the ground up front. Once that front foot takes enough weight, that back heel can finally come off the ground and come forward. Here, the issue is strengthening that calf.
The last thing can be “in your head.” After doing that weak-calf walk for weeks, it is easy to slip back into that limping gait. Concentrate on rolling your weight from the heel to the toes of your bad foot while the other foot moves forward. I found that, for me anyway, a very slow run, no faster than walking, helped me get back that feeling of rolling the weight from heel to toe as the other foot comes forward.
I'm guessing it's you're calf strength that is holding you back.
Completely unrelated trivia to drive your friends crazy: What is a common English word that is eight letters long, nine if you add a "s", and has only one vowel that appears only once, no y or w? Give up? It's in the previous paragraph.
Well I am in my 3rd month finally got the boot off last week. After 6 weeks nwb and then another 6 weeks in the boot with decreasing shims. It feels very stiff. I have just started PT, the doctor was adamant that I shouldn't start earlier. In retrospect I have a few pointers.
1. Shop your surgeon-- I had a recommendation from the dr in the practice. My doctor was VERY conservative. I would have preferred the early walking therapy. I did not like my Doctor or his philosophy at all.
2. Make your PT appointments early. I went in for my appointment and my dr said "start PT now" yeah right. Like I could get an appt. with a PT at the drop of a hat.
3. Bear yourself for the first PT appointment- rubbing the heck out of the scar to make sure there are no adhesioins--ouch!
Hi,
New here. Love the blog! Thanks to all for contributing. My father ruptured his Achilles completely 5 weeks ago. We are in Colombia, South America. He had surgery to repair it and started therapy 3 weeks out of surgery. He is now walking slowly without the boot or crutch and doing extensive pool exercises. We have a very aggressive doctor and therapist but all seems to be working wonderfully!
I´m hoping someone can answer a question that has been hard to answer for me in a strictly Spanish speaking country. We are traveling across the continent and will be unable to have a therapist assist us after this next week. My dad is worried about scar tissue build up. He feels that tearing sensation every time he really stretches that tell us the fibers are being stretched. But he´s afraid that left on our own we are not going to be able to prevent scar tissue build up and it will limit his motion and cause damage in the future. If anybody has any suggestions or have talked to their doctor about this, I would really appreciate any feedback I can get!
Thanks so much!
Scar tissue can be relieved by rubbing in circular motion over the scar.. do this religiously. Also, as your tendon is stretched from walking... the lump where the tendon ripped will fade away... remember the tendon will be twice the size as the other forever......
Scar tissue is the last thing you should be worried about... I'd take it easy as It sounds like he is rushing it and reruptures are common for people like your DAD who are pushing it too much. Hope this helps.
LENNY (20 weeks post op) 30 years old....
I am almost 13 weeks post op after a complete rupture. I spent 6 weeks in a cast and about 4 in the CAM boot. I am a cyclist and I started riding indoors with the boot on at week 6. I rode without the boot at week 8 and outisde for the first time at week 11. On most days I am walking with a small limp, but improving everyday. My physical therapist was more aggressive than my surgeon and it turned out to be a nice balance. One or two more visits to PT and I will be on my own. Those of you just starting out - be patient.
Dear all,
good to know that you are not alone.
And even more amazing that somebody took so much time to blog that useful stuff.
Many many thanks.
I am in week 1 and I am very impatient.
I wanted to run the Cologne marathon in October but now ...
Take care all !!
Paul
Cologne, Germany
so much info - it is really helpful. I am hoping to get my cast removed this week (week 6) was allowed to semi weight bear after 2 weeks then a little more at 4 weeks. I still get quite a bit of swelling, particularly if I dont elelvate my leg for long periods. I am working from home -I did attempt a trip into the office at week 3 (was not easy walking down long corridors on crutches). I just do short outings now but just wondering how long it will be before I can walk a reasonable distance and then without crutches?. ( I need to tackle rail and tubes/underground and then 3 block walk to office.) How long will it be before I can tackle that?. I will be given heal wedges this week - is there anything else I should consider?
hi all! I am 13 weeks out from my achilles tendon rupturing while playing tennis. 11 weeks out from surgery. I am out of the boot and have started intense therapy. Wondered if anyone else noticed a big lump around the bottom of the tendon after coming out of the boot? My therapist is even perplexed. Also, has anyone had it happen to their other achilles because of all the stress put on the opposite leg? I've now noticed some tightness on that side and am getting worried. I am also very anxiuos about starting back with tennis anytime soon for fear of reoccurence. I'm sure that's normal. What an awful, awful injury. I knew nothign about it prior to March 30. Thansk for all the good insight!
I too have noticed a lump 5 weeks postop, not painful, but not sure what it could be. Go to doctor on Tuesday and will certainly be asking what he thinks it is.
I had a complete tear of my achilles on July 14 and surgery the next day. I am 58 but active; ski, golf, hockey and so on. I started a full weight bearing cast at ten days. There were some painful days but I am starting to feel pretty good. I have been doing some upper body lifts at the local ymca. I am wondering what others think about riding a bike now that I am three weeks after recovery. As I read the other entries it seems early but I went for a short ride today and it felt great to be more active. I am trying to walk (not pun intended) a fine line between activity and risk. I would really enjoy getting some feedback. Sincerely, Doug
I rupture mine on january 09, doc put a cast for 3 months. Went back to work for a month and it started hurting bad. Went to a Specialist did mri, the tendons did not heal right had surgery on june 23. it's been 6 weeks cast came off scar looks nice, gave me the boot to walk on, but the problem is my tendon is really tight, I can't raise the feet up to a normal position, so doc say we have to start moving the tendon, so FT here I come. Anyone had the same problem with the tendon being so tight, I want to raise my feet up but I can't it's hard. Good luck and wish me luck. Thank you.
Hi everyone I am at 12 weeks post OP a full rupture. PT is 3 times a week and i am at full wt bearing Im walking with limp but if I concentrate on rolling my foot the limp is little to none. I find I feel the pins and needles effect only the first 5 min in the morning.My ? is after full wt bearing how long was it before they start you jogging in PT. I have 6 weeks before I go back to full duty projected return date Dr. issued. Does anyone think its possible to be up and jogging in 6weeks. Thanks for any input. BG
First of all, thanks for taking the time to document the stuff that all of you went through. It helped immensely.
I ruptured my left AT on July 18th 2009, was misdiagnosed in Cambridge, UK, came back to US and ended up having surgery on August 3rd. Was put in a hard splint for 11 days. Got the splint off today and put in a CAM walker. I've been asked to do self directed range of motion excercises, all non weight bearing. All in all, I have to say it has been better than I had imagined, perhaps, because I'd spent some time reading up on the realities of post AT repairs. Again, thanks all.
One note for those who don't like crutches: I've been using a knee scooter and it's been a life saver. I have 2 young kids and I was afraid that they might knock a crutch off.
-Chandana
Redmond WA
Hi, everyone I am going on 13 weeks PO and I have been out of my Boot and off crutches for the last three weeks. Therapy is 3 days a week and my Therapist starts off with massaging the scar and its wicked painful is this normal? I walk with a prety good limp and its sore when I walk, Dr. says at the 16th week mark I will start jogging and try to build me up to a light run by week 18 anyone think this is possible. Well try to be positive this ordeal has been like a rollercoaster ride of emotions good days and bad days. BG
I ruptured my ahilles tendon two months ago. I immobilized my ankle for one week. After the week I would crutch around in my boot (never had a cast) as little as possible. A few weeks ago I was rushed to the hospital with a "pulmonary embellism" a blood clot that came from my calf (calf hurt) and traveled to my lung. Very scary (40% chance of dying).
If you feel pain in
Terri, I had a lump as well on the tendon. Scar tissue developed and my skin and muscle became attached to the tendon. I had to go in for my second surgery to remove the lump and the scar tissue. This was 2 weeks at 9/14. My intial rupture was 4/22. It's been 5 months and I am still going through this. Now I am 2 weeks postop and it looks like the exact same thing is happening again. I don't know if it is my doctor or something with my body. I went to NYU and they are ranked in the top 10 best orthopetic hospitals in the US. I think I might need to go back in for a 3rd surgery to separate the tendon from the muscle. Anyone else have this happen??
Thanks - Javier
I don"t know where to start I just got my cast off on monday after ten weeks dealing with a lot of stiffness plus the tendon is very tight. In just the two days after the cast was removed I could feel more and more motion coming back .It's great to see so many people coming back from ths injury.Wish I had found this week ago
Hi! I am a 51 year old male with an active lifestyle. I had a complete ATR while accelerating maximally to retrieve a ball while playing tennis on Aug. 30. I had surgery 5 days later and am now 13 weeks post-op. The only pain I experienced was in the 1/8 second it took to tear the tendon and a muscle "burning" sensation the day after the surgery. My doctor had installed a "pain pump" during the surgery that lasted for three days. I do not know how much this helped but I did indeed have little pain. I was in a hard nwb cast for 5 weeks and for all of you going thru that now, you have my sympathy. It was not painful but torturously inconvenient. I had never fully appreciated how much time we all spend MOVING things around and this becomes VERY difficult while NWB. Getting a cup of coffee from the pot to the chair you want to sit in becomes a monumental challenge. And of course bathing is not much fun. I pretty much bathed at the kitchen sink with my "bad" leg propped up on a chair for 5 weeks! And work,( I have a lawn service), was pretty torturous. I rode with my little crew from about 5 days post-op but could do very little but supervise. For all of you in this phase, just keep your chin up and try not to feel sorry for yourself. But that's easier said than done I know. Turn it into a game to "outsmart" the handicap by using your intelligence to figure out how to "work around it" And just have faith that when you get into the "boot" life will improve rapidly. A friend loaned me a "rolling" walker that allowed me to prop up the knee of my bad leg and scoot around. This was a tremendous help because it allowed me the use of my hands. I could move thru a grocery store (or my own house) at an amazing clip! The boot is a pain in the butt (and the back!) but your life will start getting back to normal quickly after that. I even hit tennis balls (thousands in fact) with the boot on. Of course, I did not try to run or chase them, but it was a tremendous boost for morale to get out of the house and do something normal and familiar and fun.
I am now 13 weeks out, just ditched the boot completely, and life is 95% back to normal. Have a bit of a limp, but good ROM and can lift about 85lbs. with the injured foot. Trying to increase that by about 10 lbs a week and hope to be able to hike and ski by March. Will wait for well into spring to try to jog or run. I have a bit of a "cankle" lol but the scar healed nicely and I am just thrilled to have my life back. For you folks getting started, keep your chin up. After the cast, it gets better real fast. Best of luck to all.
Interesting discussion of your injury and therapy, and interesting comments in reply.
I sustained a bilateral Achilles rupture just over 16 weeks ago. The left was a complete tendon rupture, and the right was a dissociation of the musculotendinous junction. The left was operated on and the right was inoperable. So far my recovery on both sides is about what you experienced, but with the complication of four post-op weeks in a wheelchair because of the bilateral injury.
Driving was a major milestone. I had pretty good improvement in range and strength at first in therapy (for two weeks), but then the improvement came more slowly. Gait and equilibrium remain hinky at this time, and strength is improving only slowly. I'm now able to walk in fairly deep snow, run a snowblower, and carry 50 or 60 pounds of firewood up 10-12 steps and for 30-40 yards. I continue to have some swelling after a lengthy or strenuous workout, and I see progress on a week-to-week basis, not from day to day.
The postings on this site lead me to think my rehab is pretty typical.
For me PT happened around week 11 or so. You will make great gains immediately and then it levels off so don't get too excited. The biggest lesson I learned here is that of the tortoise and the hare. Be the tortoise! I got a little carried away and battled excessive soreness which set me back at least a month I'd say. I heard a coach say something once about drills that stuck with me and that is "go as fast as you can, not as fast as you can't." Be patient and really listen to your body and the signals it's giving you. My chiropractor gave me some of the best advice anybody has given me and that is to focus on stretching 1st and strength later. I had it backwards for a while and would really encourage you to stretch often, especially the bent knee calf stretch. I believe my focus on strengthening before the proper range of motion was there led to a lot of my soreness issues that cost me recovery time. Some toys I acquired which I've found helpful:
-Wobble board: Get the 16" adjustable one from fitter1. Good for strengthening, range of motion & coordination. I do front/back, side/side, clockwise & cntr clk, balancing & calf stretch.
-balance cushion or pad: Great for when you graduate from 1 leg balancing on the floor.
Jimmy, I completely disagree with your chiropractor's advice to postpone calf strength work. I think that is a mistake that makes ATR recoveries take so long for most people, due to excessive muscle atrophy.
I have a book called "A Sceptic's Medical Dictionary" that defines "clinical experience" as "Making the same mistakes with increasing confidence over an impressive number of years." That's pretty much what I think has been going on with ATR rehab.
I started working my calf muscle, very lightly, the day after surgery. Stretching started four days later. Both were advanced as I was able. I did nothing that was painful through the entire rehab. I was walking in my shoes unassisted at 3-4 weeks postop, and could hold my weight up on the toes of my injured foot by 8-9 weeks postop. By three months postop, I could do anything I wanted, excluding only high impact activities.
I'm no prime physical specimen, 53 years old, overweight, troubled with osteoarthritis, and not in particularly good shape.
I don't think the usual slow recovery is necessary for most people, but it is forced on many when casts are kept on for weeks. I hope that can change.
I hear ya Doug. I think I might have given the wrong impression. I surely didn't mean to imply that all the strengthening stuff should be downplayed. I have a friend who's philosophy was more like yours. He was back playing league sports after a full ATR in 4 months which is almost unheard of. I was pushing myself pretty hard, often times through pain and doing some extra things in addition to my PT. I'm thinking I was on the right track but was just pushing it too hard while under emphasizing stretching. There's really no reason both can't be a priority. I think it's worth noting too that everybody's situation is different. There are many factors that come into play when it comes to recovery time. I'm glad your recovery went well and I was hoping mine did the same. I'll be happy if I can still hit that 8-9 month mark.
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