Sunday, July 1, 2007

Weeks 13 to 20: Physical Therapy and Ditching the Boot

Immediately after week 12, I started physical therapy, which I continued for 27 more sessions (three times per week, one hour each time). The first day was the hardest, as I was instructed to remove the boot and take my first steps without it in more than three months. Needless to say, I limped considerably, with a flat footed gait, as if I still had the boot on.

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:


20050 Band-B Theraband 6yd Roll Bl

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):

ProStretch


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:

23305 Theraband Stability Trainer Firm, Green


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.

92 comments:

Anonymous said...

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

Anonymous said...

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

Resource Box: said...

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.

Anonymous said...

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

Kevin Godsey said...

Great information Thanks!
Im in week two after surgery and your story and information as really helped.

kevin
corpus Christi

Resource Box: said...

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.

Matt said...

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

fieldhockeyguy said...

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?

Anonymous said...

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.

Weekend Warrior said...

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.

Anonymous said...

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.

Anonymous said...

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

Anonymous said...

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

Anonymous said...

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!

Anonymous said...

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.

Anonymous said...

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.

Shazzy said...

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.

Exley said...
This comment has been removed by the author.
Anonymous said...

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

Anonymous said...

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!!!

Anonymous said...

Week 14 on ditching the boot for me too! Sore in the mornings still though but by mid-day it works itself out.

Anonymous said...

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!

Anonymous said...

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.

Anonymous said...

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!

Anonymous said...

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.

Paul R said...

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/

Catherine in BC Canada said...

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.

Anonymous said...

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

Paul R said...

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

Anonymous said...

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

Anonymous said...

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.

Anonymous said...

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!!!!!

Anonymous said...

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

Ron said...

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

Anonymous said...

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.

Ken said...

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

Ken said...

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 said...

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

Anonymous said...

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

Doug said...

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.

Peyton said...

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!

Peregrina said...

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!

Anonymous said...

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....

JonB said...

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.

Anonymous said...

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

Anonymous said...

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?

Anonymous said...

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!

Terri said...

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.

Doug said...

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

Anonymous said...

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.

Anonymous said...

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

Chandana said...

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

Anonymous said...

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

Anonymous said...

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

Anonymous said...

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

wyman said...

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

bacrawford0908@yahoo.com said...

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.

Anonymous said...

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.

Jimmy said...

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.

Doug said...

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.

Jimmy said...

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.

Dave Hawkins said...

Fully ruptured my right achilles 7th Jan 2010 playing squash. In a permanant cast for 6 weeks before going into a boot. Ditched the crutches after 4 days in the boot. Currently in week 11, have been using the boot only for walks over 50m. Doing calf raises, stationary bike, walking with a normal gait after purchasing some asics trabuco shoes and getting heel lifts from the physio (6mm). Physio may or may not be evil, can't actually see horns and forked tail, but assume their existence none the less. From all accounts, I am doing better than average, and I was wondering if it is just luck or some other factor? I am 172 cm short, 80kg, 33 years old male caucasion Australian, not overly fit but played squash and golf regularly after being reasonably inactive from age 24 to 31. Injury was operated on 27hrs after rupture. Incidentally, the scar is barely visible now, even though it was approx 14cm long at time of incision.

mayor of simpleton said...

I ruptured my achilles while warming up as not to injure my hamstring. A bit of irony. For me this was a major pain, as I was about to switch sports from cycling (23 years in competition / 4 years as a professional) to my 'childhood sport' of baseball.

When I tore the achilles I did not really recognize it at first. My ankle hit a closet door as I slipped and I thought that I had a deep bruse. I continued to practice without running. Two weeks pasted without realizing it was torn. It did not swell nor did it hurt all that much. I did not even take any pain killers or anti-flams for it. Just ice. I had seen two doctors and two therapists. As I could still 'walk', no one deemed it necessary to do a Thompson Test. After the diagnosis of a total tear, I was operated on the next day. The two week delay was not a benefit, but I had to deal with it.

I had an open cast for a 13 days and then a solid cast for another 7 days. 20 days after the operation, I received a 'scotchcast' an a 'overshoe' (no crutches and sort of walking). It was recomended that I place partial weight on the leg and walk sort of like 'Frankenstein'. This 'monsterwalk' irritated my knee and the front of the hip on my good leg. I concluded to place an elevation in the heel, about 2cms. (a combination of a bit of cardboard and two gel heel cups) This has resulted in a bit of a more normal gait.

Before I forget to mention it, I have used an 'electro muscle stimuli machine' (a MyoMax4 Plus from Cefar) to give light muscle stimuli to the calf muscle in the cast. My hope is to keep a bit of the muscle memory and tone.

*(I used this during a period where I had to have a 12 day 'spinal tap' and only laid on my back for the 12 days. After this period of non-activity, I was able to walk within the first 45 minutes of being able to 'get up'.)

I have been using this 'stimuli' on average 2 to 4 hours a day for the past 3 weeks.

Currently I have been able to walk on this 'scotchcast' without any pain in the achilles. The only problem is when the cast 'cuts' into the top of my foot.

This cast will be removed this coming week. In total, this means the 'scotchcast' is gone 6 weeks after the operation. I was only 3 days in the hospital and another 11 days on crutches.

From what I understand I am a good bit ahead of the plan. I am not sure how much my physical condition prior to the injury has played a role, but I cannot help but feel that the 'electro muscle stimuli' has made a major difference. This may not be for everyone, but perhaps there are those who can benefit from this idea. I'll post what the result is when the 'scotchcast' is removed.

Injury: 17.02.10
Diagnosis: 04.03.10
Operation: 05.03.10
Out of Hospital/crutches: 07.03.10
'Whiteplastercast': 18.03.10
'Scotchcast'/weightbearing: 25.03.10
'Scotchcast' removal: 14.04.10

I have no idea what comes next, but I am very optimistic.

Cheers!

Greg (Austria)

Anonymous said...

I've got 14 weeks after AT surgery. I still need the boot for outside walking. For inside I use my regular shoes with elevated hill. Also I would highly recomended some special strip ACE around the ankle. It gives you some stabilty and safety feeling when you are walking. I purhched it regular Wallgreen. Does anbody know about ultrosound machine for muscle stimulse?
Bob

Anonymous said...

Hello

I am 4 weeks post op,never thought I would get here. I was playing kick ball at a company function on 3/19/10 and ran to first base and heard a loud pop! It didnt hurt much but we iced it and 2 days later I was at Centra Care. You could see the space where my achilles should be on the back of my right ankle so I knew and did not need the dr to tell me that it was not a sprained ankle....They put me in a boot and since it was workmans comp I have had to go to a foot dr and then get an mri and so on. Finally on 4/14/10 I had surgery. I was pretty scared since I have never had to have any type of surgery. Well I had general, woke up with a fiber glass cast on. The pain was excruciating for the first 3 days. I wanted to get back to work right away since I work on commission but working half days was not working. So they sent me home to recover for 6 weeks!!! Of course Everyone says to get an attorney to make sure I am being treated right? I love my job and don't really want to mess anything up. Has anyone else gone through this workers comp? I'm going nuts being home...A week after surgery the cast came off and then another one was put back on and then the following week stitches out and now I'm in boot. I live on the 3rd floor so its been fun getting up. We finally bought knee pads and my boyfriend puts towels on the steps and I climb up. I also have a wheelchair since its been NWB for 4wks. On 5/10/10 my Dr said I can start putting a little weight on my foot!!! yeah, we also bought a stationary bike so I have been doing a mile a day. I start PT this friday, a little scared hope it doesn't hurt too much. Still take meds when I need them and ice my ankle everyday. I am so glad we have this blog. There have been somedays when I just wanted to scream!! I cannot wait to walk again normally. This injury gives you a new appreciation for life and your legs. I know I am lucky because I will walk again and now I know how it feels to dependent on another adult for everything. My boyfriend has been great and has put up with all my moods:) I wish everyone a speedy recovery...God Bless

William D said...

Thanks for this post and all this info. I am starting week 11 post op and I was really concerned about the fact that I still wasn't in physical therapy of any kind yet. But seeing your post I am thinking he is going to make me wait until after week 12 to start

Anonymous said...

Hello
Looking for some feed back. I rupture my AT March 6,2010 and had surgery. After surgery I spent 10 days in post surgery cast and then 12 days in cast. Got to take off the great boot 2 weeks ago and now have problems with my heel. My Dr. now wants tp put me back into a cast. My PT say that's bad, she pushs me hard as I can go but the heel is slow me down.
Thanks
Marcus

Kathy said...

I wish I found this Blog earlier. I am now in my 10th week post-op. Now in boot for past two weeks getting very antsy and want to get back to work. Started PT only once a week but do stretches alot at home. And RICE. I have a very conservative doctor. PT states tendons have healed. Need to get back to work in 2 weeks to keep job any advice on to speed therapy and recovery. I can swim, but need exercises to strengthen. The most frustrating recovery. Kathy - Ohio

Anonymous said...

I've been following this blog since 2 weeks post injury. I ruptured my tendon back in late March during a badminton training program in Malaysia. It happened during a typical cause; a deceleration force or eccentric movement as I was running back for an overhead clear. Pop and I was down. Indeed it felt like someone kicked me and I even looked around. Instant pain, but subsided after that. Total rupture, but I was given a choice of cut or no cut. The doctor was great and was trained in the U.S. He gave me research papers on the pros and cons of both choices. I thought there was only one choice, but this was an easy choice. I took the non-surgical route. Though I am 58 yrs old, I am in great shape. I'm also a Kinesiologist, exercise specialist and personal trainer. I heal quickly and wanted to prove that I knew enough to go it alone. I was fitted with a temporary support cast (just keeps the ankle from flexing) for my flight back home (Japan). I did use crutches, but often slithered on the bad foot. I bought a fitted supportor that cost over $1,000, but never used it. The research indicated that early rehab would be important, but aggressive rehab could cause a re-rupture (8-10 weeks out was common). Upon my return after another 4 days in Malaysia, I continued my research and found a couple from Canada and Finland that indicated that non-surgical approach was just as good as surgical repair. I became very hopeful. Knowing this and my knowledge of training protocols, massage, foam roller work, band work; I proceeded with my own rehab. To this day (8/9/2010) I haven't seen a doctor or a physical therapist. I mobilized my leg through my ankle with Range of Motion (ROM) work, always being aware of the joint limiits. I ordered a boot online and it arrived about 10 days later. This relieved me of the crutches and I was mobile again. I only used this boot for another 10 days. So, it was into my 4th week that I just used specialized ankle support. I was able to stand normally by this time. Research stated that the tendon is mostly healed by the 3rd week, but I let flexibility and strength be the judge. Big limp, but walking up stairs was the most dangerous to control where to place the foot. You cannot allow your heal to drop. Not enough strength to hold your body weight. I was able to walk up stairs normally just two weeks ago or in week 18. It felt really good to be able to do that. This week I'm finally able to walk down stairs normally as flexibility has returned. (Part 1) see the next entry Steve

Anonymous said...

(Steve-Part 2)I mobilized my leg through my ankle with Range of Motion (ROM) work, always being aware of the joint limiits. I ordered a boot online and it arrived about 10 days later. This relieved me of the crutches and I was mobile again. I only used this boot for another 10 days. So, it was into my 4th week that I just used specialized ankle support. I was able to stand normally by this time. Research stated that the tendon is mostly healed by the 3rd week, but I let flexibility and strength be the judge. Big limp, but walking up stairs was the most dangerous to control where to place the foot. You cannot allow your heal to drop. Not enough strength to hold your body weight. I was able to walk up stairs normally just two weeks ago or in week 18. It felt really good to be able to do that. This week I'm finally able to walk down stairs normally as flexibility has returned. I used flat bands to strengthen my calf starting at 25 reps to 50 reps to 2 sets of 50, then lengthening the band and then adding a 2nd band. Progression is quite fast. You just have to do it everyday for 2-3 weeks. During all this time, I continued to walk. This is the best rehab tool for your ankle. The walking motion allows for plantar flexion as you step out. You have to watch out for all the compensatory adjustments the rest of your body does. I felt strain and sometimes a little pain in both knees and sometimes in my hips. You will lose strength in you good leg if you don't do some exercise for it. Single leg squats are great. I am also a spinning instructor and wasn't able to teach on the bike until 2 weeks ago. I got through my hour class, but I wasn't able to stand. I only had around 60% strength back in the injured calf. You can test your calf strength using the leg press machine. Test you good calf for comparison.
(Please see next entry-Steve

Anonymous said...

(Steve-Part3)
Today it is around 75-80%. But, the test I use to guide me to my goal of running again is to be able to do single leg calf raise standing. This is a body weight movement. I can't do it yet, even though I can do press almost 80% on the leg press. I can now do jumps onto a platform and back onto the ground. I won't attempt plyometric jumps yet. I plan to do this next week, just off the ground.
I read a lot of entries with so many people getting into their rehab so late. I know that having a cast on the leg detoriates the muscle a lot. For the first 2 months, I couldn't even contract my bad calf. It felt like there was no neural connection even though I could do band plantar flexions. Now that I'm at 20 weeks, I have very good muscle tone, but at the end of the day, there is still some swelling. I never used ice to control swelling. Every morning, my leg feels normal. Always do flexibility exercises after you wake up and before you try to stand and move about. I also stopped using any supporter after week 10. This allowed me to use my stablilizer muscles while standing or walking. Limit how long you sit. Your leg will swell up in a very short time. Before I forget, I massaged my leg every day. Just use your hands to push and squeeze in every direction. Later I added an electric massager, foam roller and a massage stick. I have all these tools since I use them in my classes and with clients. In the first 4 weeks, I also used a topical heat cream. It felt good, but not sure if it assisted in the healing. I can only assume that it did.
(see final entry) Steve

Anonymous said...

(Part 4 from Steve) I'm now walking without a limp and at my normal speed. The literature said that it would take 6 months for this, so I'm 2 months ahead of schedule. I believe that I'm also past the critical stage that an accidental re-rupture could occur. But, never take a chance. You need to track your progress, make changes in your exercises a week at a time. The only concern I have is to explain why my bad tendon is so thick. It feels 3-4 times thicker than my good tendon. It is also uneven. There are thicker sections. A clue maybe from the last indoor cycling ride I did about 2 weeks ago My tendon felt good and it felt a lot thinner than usual. After a day though, it went back to its usual thickness. I couldn't find any information about this is the literature. Does anyone have a guess?? It is either scar tissue and/or a shortening of the tendon, or maybe there is still inflammation. My goal has been to be normal at 6 months and I have 6 weeks to go. I run bootcamps and I need to be able to run. The true test will be when I get back on the court. Thank you for reading this. I hope this has been helpful for some of you. Be hopeful and stay with your exercises. Don't push into pain, but push yourself. I almost forgot. Improve your diet. Increase your intake of certain key minerals and vitamins. Being a nutritionist, I always eat well, but I took it to another level for this injury. Could this have helped in the healing. I'm sure it did. Go green, and get it through real food, but i supplement every day and I get the full spectrum. If you want to know what I consume, email me at syterada@hotmail.com.
I will add more commentary in 3-4 weeks and definitely at the 6 month mark. I want to be active before Beckam. The best to everyone. Steve

Anonymous said...

Well here is a new twist. I was in Niagra Falls camping with the boyscouts we had just disembarked from the maid of the mist and a lady in a wheel chair ran into the back of my leg cut it open and cut the tendon clean through. that was may 30 and hopefully i will get my last cast off monday. just been putting some pressure on with crutches. I am not sure what is up next. this was all interesting reading. i guess it will be some time before i can drive?

Maggie said...

Hi folks,
I ruptured my left achilles on 23rd feb 2010. I had op a week later as did not realise what had happened straightaway, and a few days later had a cast on. I had plaster and crutches for 6 weeks, and then a boot (which was a godsend) for 6 weeks, and then began to walk "normally". Every day is better, although at the moment I have pulled a muscle in my back on the same side, and it is more painful and taking longer to recover due I am sure to my leg and foot still recovering. I did not have too much pain after op, and did get low and lost confidence, which does come back. Hubby has automatic car, which I can drive in comfort, and am hoping to get back to work soon, although the back problem is more painful than the ruptured achilles. I have started (before back problem) to walk with walking poles, which support the knees and rupture and walked 5 miles recently and it was a great achievement. I have also done some walking around wales, nothing too advernturous, but still marvelous. Take care and look after yourselves, things do get better.

Anonymous said...

Just got the cast off last week and into an air cast. Felt good to include this leg into the shower and get to shave it..(Its the little things)..Started physical therapy and keeping up w/ my home excersizes as well. Have to sleep in the air cast for a while longer. I am a 52 yr old female just missing evening walks. I feel numbness around my toe area. Also, they put a cold wrap on my foot at physical therapy and it was almost unbearable. Guess cause it is still so tender after getting the cast off. But I am ready for anything.In time, I hope to be able to get back to life. No, in time, I will get back to what I used to do.I have had depressing days."Oh woe is me" days but since the cast came off after 8 weeks,I knew then I was getting better.Hang in there everyone.

Anonymous said...

I tore my achilles playing indoor soccer. I'm 34 years old, and a school teacher. After surgery, I worked the next day, I was in a hard cast for 2 weeks, walking boot for 6 weeks (I was able to walk without it around the house after 2 weeks with boot), physical therapy started when I got the boot (2 weeks after surgery).

I'm currently 10 weeks post op, and I walk with a slight limp, I still have some tenderness where the incision is, and still having trouble doing heel raises with all my weight on the injured foot. Also, I'm not able to do stairs as I was able to before the injury.

Mel said...

I am 32 and completely tore my left achilles on 18th October 2010. Due to an illness I had, surgery was postponed until 12th November. I was put in a half leg cast for 6 weeks with my toes pointed right down, then gradually the casts were changed to a neutral position. I had 14 casts in total! I was also injecting blood thinners daily to avoid DVT. I was offered a walking boot, but tried it and didn't like it, so I stuck with the casts. I have 3 children under 10, a house with 2 stories, and I work full time. I was able to drive an automatic (as the right leg is used here is Australia) and was able to work as I spend most of the day sitting at a computer. My boss, my family and friends have been amazing, but the frustration was incredible, particularly as many of the blogs I read had people walking after a few weeks. My cast finally came off yesterday, 16 weeks after the injury. I now have a heel raise in my shoe and will wean myself off of the crutches in the next week or so. I think the important thing for everyone to remember is that we're all different, the injuries and can be different also, so the way we recover and the time it takes depends on the surgeon treating you, and your age, activity level, lifestyle, etc. It's the worst injury I've ever had, and I wasn't about to risk doing any further damage by going against my surgeons advice. Today there is only minimal swelling, and a bit of a tight feeling when I walk as everything is stretching out again, but I have no pain. I won't go back to netball as I am now experiencing some tendonitis in the other leg, but I will get back to the gym and hopefully get my fitness and strength back to where it was. I won't be doing anything stupid though, as I never want to put myself or my family through this again. To all of you who have only just begun this journey: hang in there! It seems like a lifetime away, but follow your surgeon's advice and you too will get there! Good luck!

Monty said...

Hi.. I ruptured my achilles tendon playing basketball back in Jan 2011. Could be from playing too long since it was my 3rd game of the night or not stretching properly or maybe of my low top shoes. But I didn't go to the doc until 15 days after and tried to walk it off.

At my doctor's visit he said he recommended the non surgical treatment. So I was assigned to wear a cast for 4 weeks. Used crutches, showered with a bag, and continued going to school.

After the 4 weeks I went to see the doc again and they took off the cast and assigned me to wear a removable cam walker boot for 6 weeks. It had 3 heel lifts where I had to remove one every two weeks. I wore the shoes every day even when I slept, but took them off when showering.

After 4 weeks wearing cast, and 6 weeks wearing removable boot I had the boot completely flat. At the doctor's visit he said to start walking without the crutches and only use the boot outdoors as it has become optional now. They assigned me self physical therapy exercises to do at home 2-3 times a day.

Now a little over 2 weeks I've let go the crutches, walking without a boot, but still walking with a slight limp. Pain is not bad, and tendon on the left still shows differences in sizes. But you can now start to feel the tendon on that area.

Foot/Ankle still swollen after walking a lot and pain after I wake up in the morning.

Walking long distances I still walk very slowly.

When you guys were recovering and took off the boot or cast did you start wearing hi tops, cross trainers, or what type of shoe did you wear? Did you have pain waking up in the mornings? And how long did the limp last?

So far It's been Since Jan 2011 since the injury.. but I'm pretty patient so I know by the 6th month mark I'll feel much better.

Anonymous said...

I,ve found you blog most uplifting.
I reptured my right achilles back in august 2010 and went straight into cast for 9 weeks(conservative treatment).Then got DVT, so if anyone reading this watch out for calf pain! I started having physio when i came out of my cast and then 3 weeks in, BANG! it snapped again.Nooooooo

I was operated on in Decenber and now i've been out of cast for about 12 weeks.

Still very stiff and weak.

Keeping up the physio.

Physical Therapy Supplies said...

Proprioception is your body's sense of where it is in space. It's more than just balance; it's a combination of balance, coordination, and core strength. Good proprioception is a combination of strength and balance and is what makes you instinctively turn your head and tuck your body when you fall, so that you don't land flat on your face. The stronger your core muscles, the better your balance, and the more likely you are to have good proprioception and avoid injury.
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Kai said...

I am a 61 year old male and had my ATR on my left foot. Surgery was 16 days ago, and went back to the doctor 10 days after surgery to remove the stitches. He put a cast on it. That evening I was very uncomfotable with the cast. I felt it was hot, tight, and suffocating. I could not concentrate on anything else, but kept thinking I could not be in this cast for another two weeks, when I am supposed to go back for the CAM walker. The next day, I went back to the doctor's office and he reluctantly removed the cast and put me in the CAM walker. My wife was not happy about it, but I went against her wishes. On a scale of 1 to 10 for being uncomfortable, a cast is definitely a 10, while the CAM walker is a 5. I don't like the CAM walker either, especially sleeping in it. However, it beats the cast by miles. In addition, the doctor said it is okay for me to loosen up the CAM walker at night, and that helps a lot. I also pointed a fan at my injured foot when I sleep, and it helps.

I wanted to know if there are other folks out there with the same problem on the cast. To me, it was worse than the surgery.

My wife has been great in taking care of me after surgery. However she will be visiting her folks out of the country for three weeks starting next week ( a prior commitment). I will be by myself. My wife has cooked up a lot of food and put them in the freezer. Between the frozen food and the take-outs, I am okay. I am living downstairs for now, and will continue to do so after she leaves. There is no shower downstairs. My wife suggested that I should skip taking showers for the first week after she leaves. Sometime during the second week after she leaves, I would go back to the doctor's office and I think I would then allowed for PWB. She said then I can go upstairs to take showers by myself.
I am thinking using a sponge to clean myself during the first week after she leaves. The other option is is ask a friend nearby to help me with the shower.

Any suggestions would be appreciated.

Best of luck to all.

Kai said...

I also want to mention that I rented a knee scooter. It is 100 times easier and safer than crutches. It costs mer $140 per month, or about $4 per day. To me it is well worth the money.

Rob T said...

Kai,
Tough situation for you having to deal with this alone at least for the next few weeks. My first 6 weeks in the cast was the most difficult for me because of all the swelling I got in my toes not to mention the DVT and PEs I got.

You should sponge bath and perhaps consider asking a neighbor if you can use their bathtub a few times. You could always drive to a friend's place too.

I'd be extremely careful with your stairs though. One false step and you could re-rupture.

Getting the knee scooter was a great idea. I bought mine. Is your's steerable? That knee scooter helped me tremendously.

Best of luck in your recovery!

Kai said...

Thanks Rob for your suggestions.

My wife is leaving tomorrow, and she asked me to do a dry run on the sponge bath yesterday at the kitchen sink. It worked out pretty well. I think I will be doing the sponge bath for the next three weeks instead of taking the risk of going to the upstair bathroom. I hope I won't get too smelly.

I also plan to return to work in two days. I am going to rent another scooter to be used exclusively at work. The scooter is steerable, and I feel more secure than using crutches. At this point, spending some money to buy a better sense of security is not an issue for me.

Best of luck to all.

Anonymous said...

anybody know how much PT is gonna cost? with insurance? without it? ...i plan on going for about a month, and then when it gets stronger i just plan to rehab it myself...anybody else do the same?

dean

Kai said...

It is a little bit more than 3 weeks post-op.

My wife has been gone for four days, and I am getting used to living by myself. I am eating food from the freezer. I get around in the house using the knee scooter. I also rented another knee scooter to be used exclusively at work. I am also getting used to the CAM walker. I am still at the NWB period. I am going back to the doctor next week, and see if he will let me have PWB. I read in some blog that I could ask for a report on the surgery. I think I will do that.

I had my first beer tonight since the surgery. Now it is just a waiting game. This probably will be the loniest 4th I have ever had.

Anonymous said...

i have limited insurance which pretty much covered my surgery and other costs, but i maxed my limit and they won't cover me for the physical therapy....i called to see how much i would have to pay out of pocket and the amount is ridiculous....$115 per 15 minutes! thats around $800 for a days session...there is NO WAY i can afford that for a month

so i think that i will have to go the "do it yourself" route.... anybody else do physical therapy on their own?? if so can you give me advice and pointers..what types of exercises i could do...i am 7 weeks post op and can walk in a boot without crutches.. barely any pain, except for a small small lump where my surgery was...

dean

Rob T said...

Yesterday I got the OK to ditch the boot! Two shoes never felt so good. No PT yet but I was given a few exercises to do at home. Walking very tentatively with a limp but no pain. Just terribly weak. The ability to now plantar flex has helped reduce my foot swelling and erythema. Still elevating foot in bed and using massager on scar.

Anonymous said...

I'm just shy of the 5 month mark since I ruptured my right achilles tendon. I have been cleared to work full duty at my job as a police officer working patrol. This has been a long road to recovery even though it is a lot faster than others. I played in my first organized basketball game since the injury occurred. I ran at about 70% but it felt ok. The pain is still there but it is tolerable. I'm a 52 year old male who was in pretty good shape when the injury occurred. Going to physical therapy asap was a big help. I did alot of working out on my own and took vitamins and supplements. After my workouts,I always had a protein shake(Costco). Dont know if this helps anyone but the best advise I can give is to stay positive.

Anonymous said...

Today is the 3 month mark since my injury and approximately 12 weeks post surgery. My experience has been cumbersome but relatively mild in light of what I have read here.

Personal Info:
Age - 28
Sex - Male
Fitness - Very Good
Achilles Injured - Right

Timeline:
April 27th - Full Achilles Tear
May 3rd - Surgical Tendon Repair
May 17th - Cast Change
June 6th - Cast Change
July 5th - Cast Removal
July 25th - Doctor Visit

My Experience:
I tore my achilles tendon when simultaneously stopping my sprint and elevating for a high football pass. I had surgery 6 days later and was put into a cast with my toes pointed down. I spent the next two weeks working from home and using crutches. At this time my cast was changed and my new cast had a wooden wedge in it allowing my toes to be pointed and my cast to have a flat bottom. After about a week with the new cast, I began to walk without crutches even though my leg was 4 inches longer than my normal leg. I started going back to the gym and could get around very well after a couple of weeks. After wearing this cast for 3 weeks, my cast was changed and a smaller wedge was put into my cast flatting out my foot a litte. I wore this cast for a month and was very active in it. At the 8 week mark, I was finally done with the casts. I needed to use crutches for a few days after getting my cast off, a huge reduction in mobility, then began slowly walking in shoes with a lift (Nike Shox or Cowboy Boots). I've been walking around in these shoes for 3 weeks now. At first I had pain with each step but have progressed to the point that each step doesn't really hurt anymore but you realize you are flexing the tendon / muscle. I really feel that staying as active as you can, using your leg when possible, and not isolating yourself from the world are key to avoiding feeling sorry for yourself and progressing your recovery.

Best of luck to everyone.

Angelkos said...

Protocol for this type of injury has changed and definitely varies by doctor. I'm a 37 year old former rower that keeps in decent shape. I ruptured my Achilles on August 13th 2011. I went in to see the doctor the next day and he scheduled surgery for August 19th. On September 14th, I was scheduled to go to Italy and Switzerland for work for 2.5 weeks then my wife was to meet me in Italy for another 8 days to celebrate our 10th anniversary. I voiced my concern to my doctor about having this affect my trip. He basically said that we would take an aggressive course of action. I was in a short fiberglass cast with my foot pointed down for 10 days. I kept my leg elevated as much as possible. I have to admit, that first week was really tough mentally and physically. After that I went straight to a Cam boot. The first few days I had to use the crutches which had me very concerned because my trip was only 10 days away at this point. Gradually though I was able to put more weight on it until the point where I didn't need crutches any more. I was walking with the boot at 2.5-3 weeks post op. At 5 weeks, I walked all over Milan with the boot. Admittedly, my leg was tired, but probably more from the boot than the injury itself. By the time my wife made it out to meet me at week 6, I felt comfortable enough to ditch the boot and just go with comfortable running shoes. I did put the boot on when lugging our luggage, partly because the boot is so big that it is hard to pack, but it was also a good idea to have the added support. I didn't want to get ahead of myself. We had several days where walked quite a bit. I still had a slight limp and definitely got tired but I felt good. The worst part was probably how sore my heel got as I was probably putting more weight on it than normal. So now its October 10th 2011. I'm at week 7 and I'm walking with normal shoes and have a slight limp. I'm scheduled to see my doctor tomorrow. He will probably advise that I go to physical therapy. I'm not sure how much I really need it at this point, but I do want to continue to heal properly and be able to get back to running as soon as possible. The bottom line is that you know your body and have to listen to it. Luckily I have a doctor who clearly is on the same page as me, but I can't say enough how important it is to keep active during the healing process. Staying in bed for weeks on end does nothing for you physically or mentally. It can even cause more damage than good. Listen to your body and take it easy when it asks you to, but don't be afraid to push forward a little if it feels ok.

Rob T said...

I am now 6 1/2 months out and getting better slowly but surely. Never needed to go to PT but was taught by doc a few stretching and strengthening exercises and later advanced to eccentric exercises using a step-the most important point of emphasis is the lengthening or eccentric contraction (when the Achilles is at maximal stretch). I bought a slant board to help with this and use it daily. Also using therabands to strengthen the foot inverters and everters. Swelling down to a minimum but foot is still a different color tone compared to my normal foot but I think that too is improving. No longer need to elevate leg too. Initially out of the boot I was wearing a TED hose to reduce swelling but have now gone back to regular socks.