The safest way to rest your foot on the floor is by having your heel touch the floor while your toes point upwards, at an approximately 45 degree angle to the floor. This way you minimize the contact area. I would not advice to lay your foot flat on the floor, as this tends to increase the contact area and makes the weight of your leg press against the bottom of your foot (technically, weight bearing).
Most likely, you will be required to be NWB for a period between 3 to 10 weeks, depending of the nature of your injury and how aggressive the rehabilitation protocol used by your doctor is.
During the NWB period, It is very unlikely that you will not face at least a minor incident that may cause you to involuntarily put some weight on the injured leg. In my case, there were three of those instances:
The first one occurred 2 weeks post-op, getting out of my car. I had stepped down and had put my hand over the back door, which was open, to keep my balance. My wife closed the door without noticing that my hand was there, so instinctively I removed my hand, lost my balance and stepped on my bad foot. Fortunately, nothing happened.
The second incident occurred at 4 weeks post op. It was raining and my right crutch slipped, making me step hard on the floor with my right foot to prevent falling. Other than a tingling feeling, like needles sticking in my lower leg (probably a reaction of the dormant muscles to the sudden pressure) nothing bad happened.
The third time, it happened at 6 weeks post op. My crutch got stuck while I was stepping out of a train and I had to step really, really hard with my bad foot to avoid falling flat on my face. The pain was severe, like needles again, but lasted only a few seconds. Back home I removed my CAM walker (boot) to check the tendon, and it was working normally.
My conclusion is that even though you may take every precaution not to step on your bad foot, there will always be one or two instances in which something will happen that will make you bear some weight. However, the good news is that the boot though (and certainly a cast too) keeps your foot in a position that doesn’t allow putting undue stress on the tendon, so as long as you are wearing it you should be well protected against any such minor incident.
33 comments:
Very interesting...so you had to take a train? Was this a daily thing? I usually take a train to work and back every day but am working from home now. I'm fairly concerned that taking the train will be difficult and frightening. Any thoughts on this subject would be greatly appreciated! :)
I'm two weeks post-surgery and returned to work this week. I am using local transit (SF Bay Area BART) to travel using a turning leg caddy http://www.eastsidelegup.com/ that I rented from a medical supply place for $80 a month. Its working out ok and I'm happy to be making progress, getting out, and interacting with lots of "interested" people who want to chat with me about the process and scooter. :)
I am going on two weeks post op, I bought a wheelchair, use the crutches to get up and wheelchair to get around..
I used a wheelchair for the first 4 weeks which was very necessary. Once my cast was removed, I was placed with a walking cast which I could take on and off. It took a bit to get used too. I had shocks in my heel and some pain in the surgery area, felt hot but when I got tired I took it off and applied a gel ice pack with cloth and rested. The 1st day with walking boot I left the hospital with it and told my husband to take me to the mall shopping. I had great intentions but one hour later had to get home to rest...felt pretty dizzy! At 7 wks all my wedges are removed and I'm walking with crutches in bare feet or with my shoe. I can't go too far without my crutches and I do get swelling but the pain in my heel is gone, I don't get the electric shocks that I used to get which is great! Once the surgery scar heals and your doctor ok's it, don't be afraid to apply vit e and rub the area firmly to loosen up the tendon..it's a bit uncomfortable at first but then it feels better. I'm even thinking of taking a rolling pin and moving it up and down that area but only light pressure now and gradually put more pressure to massage the area. My first day standing by myself with no crutches was an amazing day...I felt so liberated! All I did was stand but with more confidence I took my first step and there's no stopping now..next week it will be 8 wks since surgery of a complete rupture!
I too had three falls, none of them did I put as much pressure on my leg as you did. I am glad to hear others do the same, I think it is inevitable. I recommend the Turning Leg caddy, as opposed to crutches. Much easier to use in my opinion, even just going to the bathroom in the middle of the night is much easier. I am going on week week 7, my Doc let me start walking only in "the boot" at week 5, after a week I am feeling pretty good, almost don't need the scooter at all.
Great site. I am 41, a guy who ran 20 miles/week and lifted weights 3 days a week before the "DAY". On 2/21/09, I ruptured my tendon doing - what else? - basketball at the local YMCA, despite knowing the risks to aging athletes young in mind and old in tendon....
Had surgey on the 27th in Orlando FL. In a cast. My DR seems young, and hence conservative (NWB for 4 weeks, cast for 4, followed by boot). My brother in law, a DR, is very experienced with this injury (but living in VA and hence not a real choice)and more aggressive, but told me to follow my doc's protocols, which I will do.
My issue: I don't want to rot until I get the cast off. When can I work out the other parts of my body? What did your Drs let you do??? I'm kinda like a race horse - if I can't go to the gym and move, I should be put down and
euthanized.
hi, I need info fast. My Dad is due for surgery on Friday 3-6-09. I am trying to get him in a rehab. he is 82, can't do general anithesia and not they are saying no spinal either. Will find out tomorrow if they will do the surgery. I work, he is 82 with COPD and uses a walker, not too stable. I need help and info fast. I thought not to do the surgery at his age and with diabetes. help please kathyhanley@bellsouth.net
I am an anesthesiologist. As far as non-general anesthesia options for this surgery: 1) spinal 2) nerve block(s) 3) combo of the two.
1) The spinal causes the most complete anesthesia, but it paralyzes you (and your bladder) from the rib cage down. Not a bad choice, but be wary of the urination issue.
2) nerve block(s) with a popliteal or sciatic block and some local anesthesia, the surgery should be manageable, but break through pain is likely. With a sciatic or popliteal block and a femoral block, the pain of the surgery is nonexistent - but a tourniquet may be used and that gets uncomfortable after a while. Sedation is usually needed.
3) a light spinal with a sciatic or popliteal block may be the best combo.
remember this is usually done with the patient n his/her belly and any issues with this position need to be discussed.
Ruptured my Achilles a week ago playing one-on-one with my twelve year old nephew. Heard the "pop" and knew it wasn't good. Had the operation to repair it three days later. I am sitting at home on the couch with my leg elevated. It felt so good to take the bandages and splint off. I even tried moving my foot and applying light pressure which wasn't that bad. The hydrocodone was great for the first three days following the surgery, but has now made me constipated. First BM was not a lot of fun.
Hi,
I'm 6 days post-op and just about an hour ago, was reaching for something and came back to put my knee on my roll-about scooter, but missed it and fell over to the side. In the process of falling, I put quite a bit of weight on my injured foot. I'm really afraid that I may have reruptured the tendons, especially since it's only been less than a week since the surgery. Has anyone ever reinjured or reruptured their tendons during the recovery phase? If so, what happened? Did you go into the doc office each time to see if whatever you did casued a rerupture? Basically, how do you know if the incident where you accidentally put weight on the foot was serious or not? Did you go see the doc each time? Has anyone ever had to go through another surgery to fix the rerupture? I'm so scared that my fall caused the tendons to pull apart again. I'm going in to see my orthopedic surgeon in 3 hrs. How do they even determine if you've reruptured it? Do they need another MRI? Would definitely appreciate hearing what others have gone through and how you've dealt with these situations.
The surgeon set my foot so that it is pointed.
I'm unable to actually put only my heel on the ground.
It's very frustrating as for the last 4 days, my leg has been on a straight angle so my leg can sit somewhere comfortable.
Freaked out -
Had my 1st surgery on 6/28/10. 2nd day post op, I fell on way to bathroom in middle of night and fell on to cast hard. Did not call the doctor; but when I went to post op on 10th day, found out I had broken up the incision and my tendor was sticking out. Was back in surgery again the next day where they discovered I had also ruptured the tendon. Am now 2 weeks out from 2nd surgery and doing well. Definitely have it checked out sooner than later.
Vicki - thanks for sharing your story. I can't imagine your experience of seeing your tendon sticking out. Hope you're recovering well now. Luckily for me, my fall didn't cause any harm, as least that's what my doc tells me. I won't have complete peace of mind until I'm walking on the foot again. I did go into the doc's office the same day of my fall and they opened up my splint and checked the wound site to make sure there was no active bleeding. I'm at 3.5 weeks post-op now, and looks like I'm on the aggressive schedule. I just got my cast removed yesterday after having it on for only 2 weeks (10 days in splint right after surgery, and 2 weeks in cast), and am now in a CAM walking boot with heel inserts. It's like wearing 4 inch heels, but in a snow board like boot. It's more awkward and bigger than a snowboard boot. One insert will be remove each week, until my foot is back to normal position. I'm starting physical therapy today and my doc said I can start putting weight on my foot, as much as I can bear. It's amazing to me the difference in the recovery protocol mentioned on this blog. My doc said in the latest study published in some journal, the consensus among orthopedic surgeons who treat this particular injury is the sooner you start moving the foot, the better. Anyway, just thought I'd share. -FreakedOut aka Hoa L.
Ruptured my tendon June 28 and didn't figure out there was a real problem for 2+ weeks. Had the surgery, spent 3 weeks in soft and hard cast and asked to graduate to the boot. Fell in the doctors parking lot with the sleeping spint on my foot and reruptred it. Had it repaired again Aug 9 and today fell hard on it again. I'll find out tomorrow if I ruptured it again. Anyone done it three times?
To Hoa L Becoming weight bearing sooner is state of the art providing caution is used.. no bag racing at the county fair... Is your weight bearing done in the boot or out??? Is your surgeon highly experienced ie performs lots of these surgeries perhaps at a teaching hospital Interested in knowing more
I'm entering the 4th week and the main problem is the severe numbness and sometimes a burning and tingling sensation on the outside of my bad leg. I know some of the doctors said this is normal , but some said that i must be aware of blood clots and nerve damage. So, any of u experience this? How long until it fully subsides? Its really annoying especially in the night. Thanks.
Giovanni
Responding to anonymous' question above: My weight bearing was done in the boot as soon as I started wearing the boot. Surgeon basically said your body will tell you if you're overdoing it. If you're in too much pain, ease off it. If not, go as far as you can bare. The boot protects the ankle, so you can't overextend the tendon. My surgeon works out of a private orthopedic office and specializes in tendon repairs. As for my latest update: I'm 8 weeks post-op now, 4 wks since I've had the boot. I just started seeing a new physical therapist in different office 2 days ago, and boy, is he different from the first one I was seeing. The first PT was very gentle, mainly giving me stretches and exercises to strengthen the muscles around my ankle and hip. Probably because I was still early in my recovery. This second PT actually had me take off my boot and I stood on my bare feet for the first time since my injury! And I walked around the PT office without the boot! I was so excited. He really worked my ankle, massaging and kneading it to break down the scar tissue. It was painful, but the good type of pain, like when you get a really good deep tissue massage. So just 2 months after surgery, I'm walking on my feet again. I'm taking it slow, mainly walking in the house without the boot. I'm really quite surprised at how fast my recovery has been, compared to others. But I guess it just goes to show how everyone is different, and every doctor/PT is different. Some are more aggressive then others in their protocol.
I have also joined the ranks on August 28, 2010 on St Augustine Beach in Florida 721 miles from my home in Virginia. I was taking my last run skimboarding, turned 50 in July, bench 300 pounds and rep 225 at least 14 on a good day so when I heard the bang, the hit, and nobody there I knew it was trouble. Flagler Hospital put a full leg cast on which I wore for 3 days, a real experience having never wore a cast of any kind or size. Things got way better in Virginia where I opted to have work done, they took off cast and booted me until I could have MRI which was following week, then another Doctor Appt next day surgery open as it was 18 days since injury. My tendon was 100% in 2 pieces and blown up. I came out of surgery after 1 hour and 20 min, with cast pointing toes down. Today was day 9 post op cast was removed after 7, boot on and today was also first PT session. I have already stood on my 2 legs without crutches and use boot to drive at home elevate it on desk. My incision is about 6 inches and will almost be invisible when healed all I have on now is 6 steri strips with dissolvable sutures, no staples. If you want to fast track and get your life back sooner than later please contact Orthopedic Speciality Clinic Fredericksburg Virginia, you wont and I will never regret having the best doctor out there to do these repairs. Dr. Erik Krushinski MD. I played college football as a defensive back, motorcross, backmountain skiing, and with his expertise and techniques will be at it again soon. Also I am taking via injection vitamin c, as well as Bcomplex, and B 12. You need massive doses of C to repair the collegen in the tendon and the B vitamins help also. Google Basic Science Study of Vitamin C and Achilles Tendon healing in Rats.
Just a follow up on progress 4 days after cast was removed I tried walking in flip flop to go to dinner, was slow going not too much pain, past week had second PT session tried several pairs of shoes at house to see what felt comfortable. Used some Asics with shocks in heel walked entire day at house , ditched crutches, and walking boot, PT therapists could not believe all swelling and bruising was gone, and how much I could do range of motion, they had me go from the gym at office to a back room to pick up marbles I simply walked there much to the staffs dismay. This past weekend I put on my adidas sneakers and drove 200 miles to my sons college, once there up 4 flights of stairs, and then a campus walk which was about 1.5 miles, today I drove back another 200 and upon returning put my Freezie wrap on and then Inferno Wrap for heat , am doing ultrasound now, I purchased these products at Mendmeshop.com they are great devices. So in conclusion I had surgery 2.5 weeks ago for 1 hour and 20 minutes because my achilles tendon was ruptured for over 2 weeks 100%, I am now Weight Bearing, walking, climbing up and down stairs, driving, and even pushed my foot into my alpine ski boot with very little discomfort. If you have had a rupture and want to ask any questions or advice please contact me . dlhunzi@comcast.net
Hello
I am very grateful for this blog and resultant comments. Whilst this is very frustrating, it is comforting to know so many have been through the same and emerged (eventully).
I am 26 and ruptured it last week playing squash. I had surgery on Thursday 3 Feb and I'm currently in a back slab, leg elevated and on lots of painkillers.
I am due to see the consultant 1 week on wednesday but i just slipped on some water and put weight on my foot/ankle. It was only for 1 second but it hurt like you wouldnt believe. I am terrified that I've done some damage (re-rupture, open the wound etc.) but being totally honest, now the pain has subsided it feels no different to before I put weight on it.
Having read the comments here it would seem I am not the first to accidentally put some weight on it during the NWB period. If this happened to anyone else I would love to hear from you.
lesson learnt!!! Rest only for me now
I actually got surgery done on Friday 2/4, for a complete rupture after waiting 3.5 weeks. Im 30, physically fit and never had an injury like this before, first surgery of any kind. After reading exactly what i did and the recovery process I kind of wish I broke my leg bone itself instead. I also read that this happened to David Beckham. A couple of doctors at my gym told me to do research on HGH, and how it helps the healing process. After doing research it says Human growth hormone speeds up tendon healing time up to 400% faster. Not sure if any of you folks heard similar information from your doctors about that, but any info would be appreciated.
To the idiot that said this:
Ruptured my tendon June 28 and didn't figure out there was a real problem for 2+ weeks.
Are you trying to impress strangers on the internet? If you ruptured your achilles tendon like the rest of us on here you would actually know that your toes point down towards the ground when you pick up your leg when your achilles is torn through. I made it three steps after my achilles ruptured but there isn't a person on the planet that could rupture an achilles tendon and not know it. Jacked up on crank? You'd still have to consciously alter the way you walked or you'd trip over your own toes as your foot moved forward.
You might as well just say that you rupture your AT and duct taped it back together and finished the basketball game and were back to 100% the next day.
8/15/10 blogger - did you rupture it a 3rd time? I lost my balance e wks after surgery and while I had my boot off; slammed my foot flat onto the floor w/my full weight. I am now panicked about having ruined the FHL tendon transfer. My doctor was not in the next day so am waiting over the weekend to talk w/him. Any one know how to test to see if the transfer was damaged?
I'm 19(seem to be one of the youngest to do it) and 3 weeks ago ruptured mine playing soccer.. was operated on a week later and was put in a boot before and after the operation! got the stitches out yesterday and have been told to wean myself off the crutches over the next 4 weeks and FWB (in the boot) as soon as i can...Sick of my life already ha!
Danielle
Great blog. Thank you to all who have posted. "Joined the ranks" as they say the day I signed a contract for a soccer team. I tell my story as it was nice to read others. Had surgery the next day, was in a cast for two weeks, and now have a boot. Took a few hours to get to 90 degrees to get into the boot. At 17 days now I am comfortable with the boot on and can walk with it without any pain. I spend the days icing, elevating, doing light stretches constantly. The difference between swelling in just the last few days is a major difference. I am not entirely sure how much weight bearing I should do. But have gone through knee, and shoulder surgery as well, not mention countless injuries so I am just kind of doing what I think my body says is okay. I think for those who have not had previous injuries, and long rehabs, it may be most difficult to tell what your body is telling you and a more conservative route is best. On the other hand, I think my problem is that I am likely over confident and also tolerant to pain -- which can lead to over doing it (hence how i got injured!) and being too aggressive in the rehab. Seems a good recovery has to strike the balance. Anyway, so far so good and I will post again in a few weeks.
Just wanted to update progress. I am at about 5 or 6 weeks now since surgery and pretty much out of my boot for walking. Been doing rehab three times a week with a trainer and on my own constantly all day long. Everyday is better and better and walking at a normal pace without the boot I only have a slight limp. Driving is now easy which is nice. I use the boot for protection when doing total leg exercises to try to build up muscles in my leg that have shrunken. I have a regiment of stretches and non-weight bearing strengthening exercises to do out of the boot everyday. Pain is nonexistent, but I do have some swelling at night which I relieve with ice, ace wraps, and sleeping with my leg up. So anyway -- if your surgeon is okay with it you can make progress relatively quickly. I am fully aware tissue just takes time to heal, so being this aggressive increases the risk of re-injury. That said, if you are younger, were in excellent shape before hand, and are careful and listen to your body, you can go as fast as your body and surgeon will let you on the rehab. Good luck to all with this injury!
Re CALLING BS
I ruptured my Achilles 5 weeks ago and when I
first did it I didn't realize what I had done either.
Yes it hurt when I first did it but only very briefly
and then it seemed ok, if a bit swollen. I didn't
go to the doctor for a few weeks as I thought it
was just a sprain. I am now in my third week of
plaster and I fell over last night. I spoke to the
doctor's nurse and as the swelling had gone down
she said it should be alright. However if I get a lot
of pain I must go in for an ultrasound. hopefully
Everything will be fine, I do not want to go through
this again.
Tonyer
I was skipping...yes skipping.. and I found out this was one thing I wish I had not done. Surgery was within the 10 days (as recomended) and I was terrified. My doc was great. Day two post op I fell and though oh no! Lucky for me no further damage. I am now three weeks post op and 4 weeks since injury and I am going stir crazy! Week 2 post op started pt and I would say that was the best thing ever for my mental and physical state. Week 6 post op my doc wants me at a o incline inthe cam boot and wants to see me weight bear. Still terrified about reinjury but pt is not only helping the body but helping me adjust my anxious behavior as well. GO PT! : )
I was told by the Surgeon that did the consultation that 2 full days after the surgury were required for rest. The day of the surgury th e actual Surgeon said 2 weeks before going back to work. Any thought about how much rest is required at home before going to a non physical desk job?
Mine was successful, another surgeon has been in since to address another problem and where there was bone on bone in a huge area there isn’t now. NWB meant no weight not even touching the floor with the affected leg. Due to swelling going down enough he allowed to PWB at 4 weeks when he had originally told me 6.
Physical Therapy Supplies
18 Weeks After Blowing My AC, I had Surgery
I had my surgery August 8. I blew my tendon April 2; I did not know. I thought it was a sprain. I went to my regular doc the Monday following the Saturday incident. He thinks I'm a bionic woman and thought it was a sprain. Sent me for an x-ray and mailed me a note saying you're fine. Six weeks later I was still hobbling but playing lots of golf and being as active as a limper could. My friend, a nurse, said go back. I did and they threw me in PT for three weeks. Then the PT suggested a Podiatrist look at it and without a doubt he said you blew that honey. From there it was another three weeks before these folks could get me in for an MRI. Then another two to meet with their surgeon; this is where I woke up and acted like an adult. I reviewed his resume. I had scar tissue now. I found a top flight orthopedic surgeon, a Yale Grad (Yes, I am impressed by resumes.) and I'm now 12 days into recovery. Sugery for me was 3.5 hours folks. I'm told i'm NWB through mid October. There goes my golf season. I did get to play in a tournament before surgery. We were 13 under par and with one guy (our weak link) we were kicking ass on all the old dudes for the first 4 holes. I had to throw that in; sorry. I love golf! Anyway, I am very happy to be on the path to recovery. I have fallen too going to the bathroom at night and it scared the living crap out of me. Thank you all so very much for the info on accidents to be very mindful of. Also, i am going to try those vitamin shots one of you recommended. I have a scotter and my but is so sore. And I'm use to being 5 ft. 2 and 100 lbs. and i feel like a fat slob. how do you work out with this condition please!
Thanks Everyone for the great info!
Viv
I WANTED TO PASS ON SOME POSITIVE NEWS ABOUT THE RECOVERY TIME FROM THE SURGURY ON COMPLETE ACHILLIES SEPARATION. 2 WEEKS NWB WITH CAST FOLLOWED BY 1 WEEK W/ WALKING BOOT, AND NOW WALKING WITHOUT ANY ASSISTANCE. THE TENDON FEELS LIKE IT DID BEFORE THE SURGURY WAS DONE, ACCEPT MY CALF MUSCLE IS NOW RESPONDING TO WEIGHT WHEN PLACED ON THE TOE. I AM STILL LIMPING AND BY NO MEANS 100% BUT I WANTED PEOPLE TO KNOW THIS ISN'T AS BAD AS SOME BLOGS MAKE IT OUT TO BE. THE HUMAN BODY IS AMAZING AND MOSY DOCTORS ARE NOW SUGGESTING NO SURGURY UNLESS THE TEAR HAS CONSIDERABLE SEPARATION.
HAPPY TRAILS!
I think as running is important in athletics o any other games same as yoga has same importance too. Yoga makes our body light as well as it also make our mind cool and helps in performing diligently. So I would like to suggest all runners to practice yoga on a daily basis. Diet means to have a food in a good routine basis to have a good diet and to loose unwanted fat is to eat green vegetables and fruits on a daily routine basis.
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