Comments on Achilles Tendon Rupture Blog: Weeks 13 to 20: Physical Therapy and Ditching the ...

I am now 6 1/2 months out and getting better slowl...

2011-10-29T13:10:55.918-04:00

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.

Protocol for this type of injury has changed and d...

2011-10-10T15:11:20.025-04:00

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.

Today is the 3 month mark since my injury and appr...

2011-07-27T16:47:38.685-04:00

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.

I'm just shy of the 5 month mark since I ruptu...

2011-07-26T10:01:36.325-04:00

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.

Yesterday I got the OK to ditch the boot! Two shoe...

2011-07-10T01:30:25.815-04:00

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.

i have limited insurance which pretty much covered...

2011-07-05T13:47:48.671-04:00

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

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

2011-07-01T18:33:15.267-04:00

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.

anybody know how much PT is gonna cost? with insur...

2011-06-28T04:34:47.066-04:00

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

Thanks Rob for your suggestions. My wife is leavi...

2011-06-26T11:40:30.643-04:00

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.

Kai, Tough situation for you having to deal with t...

2011-06-25T22:58:37.089-04:00

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!

I also want to mention that I rented a knee scoote...

2011-06-24T14:26:22.601-04:00

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.

I am a 61 year old male and had my ATR on my left ...

2011-06-24T09:17:51.960-04:00

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.

Proprioception is your body's sense of where i...

2011-06-14T00:55:40.165-04:00

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.
Physical Therapy Supplies

I,ve found you blog most uplifting. I reptured my ...

2011-05-08T15:51:18.700-04:00

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.

Hi.. I ruptured my achilles tendon playing basketb...

2011-04-27T23:31:58.846-04:00

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.

I am 32 and completely tore my left achilles on 18...

2011-02-03T19:35:29.865-05:00

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!

I tore my achilles playing indoor soccer. I'm...

2011-01-17T16:33:28.564-05:00

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.

Just got the cast off last week and into an air ca...

2010-10-09T05:53:30.892-04:00

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.

Hi folks, I ruptured my left achilles on 23rd feb ...

2010-09-23T15:05:58.207-04:00

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.

Well here is a new twist. I was in Niagra Falls ca...

2010-08-27T16:12:19.926-04:00

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?

(Part 4 from Steve) I'm now walking without a ...

2010-08-09T11:07:18.544-04:00

(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

(Steve-Part3) Today it is around 75-80%. But, th...

2010-08-09T11:06:04.373-04:00

(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

(Steve-Part 2)I mobilized my leg through my ankle ...

2010-08-09T11:03:37.139-04:00

(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

I've been following this blog since 2 weeks po...

2010-08-09T11:00:32.821-04:00

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

I wish I found this Blog earlier. I am now in my ...

2010-06-21T20:24:52.643-04:00

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