Just ruptured my Achilles tendon

Bones, joints and muscles
1

I ruptured my Achilles tendon on 1.2.16 while on vacation in fl.  I live in ga.  after some quick research we drove home yesterday on the 4th. And have an appointment with an 

Orth. Dr. on the 7th....  

I am 63 and was in excellent shape.  Was trying a new sport (pickle ball)

and was more worried about my knee than anything.  After about 1 hr

felt great then I thought someone hit me from behind with a baseball bat.

When I turned around and there was no one there I was actually quite surprised.  

 After doing some research it seems a lot of new

studies shows that non surgical is just as effective as surgical as long

as you have the proper PT.  Will be interested in what the Ortho. Dr, says.

He was highly recommended by the PT I used before who told be he is

the best foot and ankle dr. in Atlanta and that he has done a lot of research in this area.  He is a Emory dr.  will see.

any way right after I hurt my leg went immediately to Clinic and they said

to call an ortho. immediately which meant Monday since I got hurt on a 

sat.  was real depressing.  Looks like a long road ahead.  Will read up on

Some of the posts and see if I can get anymore good info.

2

Tendon injury seems a very variable injury, so hope you have a smooth return . I'm 66 (uk) and had conservative treatment for a partial rupture about 15 months ago. Not into sports but did a lot of walking. The tendon is fine now, but the calf muscle is still weakso its messing with my walking; no strength so its putting stress on my leg and hips; little walking means i've puit on weight over the last year and thats not helping the knees. I guess beware of loosing condition over the period of immobilisation.. but I'm not sure how you can do that! I'm planning to contact the physio I had during recovery to see what they advise.

3

Hi,

Did a full rupture of my achillies tendon 7 weeks ago.  In UK it seems that the opinion unless you are a very active sportsman the best way forward is the none operation way, conservative treatment.  So far had no pain or anything after 4 weeks of not putting any weight on it and 3 weeks of walking on it with the boot.

The biggest nuisances are:

A) the 4 weeks of having to use crutches,  used a office chair with wheels on a      home.

B) Not being able to drive as did in the right leg

C) Having to sleep with the boot on.

D) Foot gets very sweaty in boot but doctor says can keep out of boot when resting as long as leave foot pointing down

Best advice so far:

 a)  Wash leg in salt water

b)  Use a foot spa

c) Go for walks when out of boot in the sea.

Good Luck

 

4

thaks for reply was worried about walking as I love that too.

Heard from a lot of people about the weaker calf muscle and will ask

my PT down the road about it and will be interested to hear what yours says.

I am going to try to stay away from the confort food and alchol. they 

were not a problem when I exercised but I want to try to advoid 

gaining weight. easily said but we will see

5

I could be wrong but it seems In US surgery seems to be the number one choice despite the recent studies.  My PT said that he has had success with both surgery and non surgical.  Will see what the Ortho.

dr. said tomorrow.

yes crutches are not good.  It is scary going in public plalces never know what you are going to run into.  On he way to fl (beore I was hurt). I rebember going the the bathroom after they just washed the floor and sliding around.  No way I could of made it with crutches.

Guess I will experience the boot soon thanks for that advice.

Not being able to drive stinks at least I am retired and my wife

just works part time.  Did the Dr. give u and idea of how long after

you started treatment you would be able to drive?  

good luck

6

Hi,

The doctor is suggesting in week 12, but I am not too hopeful.

I only went out occasionally with crutches as so dodgy in the wet.

Thanks

Laurence

7

I was driveing an automatic (left foot in a boot) after about 5 weeks, manual after about 12. On the plus side, our supermarket lets you use a battery buggy, and I had great fun seeing how fast I could go up the isles and do handbrake turns at the end!

 

8

I found a plastic bag thing over the boot let me shower regularly without getting the boot wet. (Google "Limbo foot protector"wink. I did get the sock wet inadvertantly and ended up with a very unplesaant foot!

I also used "Hibiscrub" to wash.. on the bed on a towel and get the boot off for a good scratch and wash! Be carful to keep the toes tipped down

9

Hi Steve. Similar to some of the others I have a full rupture, 3 weeks in and in a boot with no surgery. There have been some good studies in the UK that suggest non surgery gives equally good results, google Richard Wallace or Exeter Hospital. I have been told to not to expect to drive for around 8-9 weeks (right leg)  so am on crutches when I'm out of the house, at work etc but at home I have hired a knee scooter which is fantastic. It allows me to carry stuff much more easily, even things like a cup of coffee because it runs smoothly. I'm sure you would be able to get them in the US as well

I could use it outside as well but I don't mind crutches now I've got used to them, put some pipe lagging on the handles to ease the early hand pain! I'm pretty nimble on them now and can get up and down the stairs at work pretty quickly now. (I'm 53 so not a spring chicken!) I find the rubber bases stick to wet surfaces reasonably well as long as I take smaller steps. good luck with your recovery.

10

 

 

I went to the orthopedic dr. Thursday 1.7.16 five days after the accident.  Saw the sports medicine guy 1st. (not sure his background, was an assistant to Ortho. Dr)

Said swelling was not that bad (I religiously kept my foot elevated and iced since the accident).  He did the Thompson test and said I had a little movement.  He also said that the rupture did not look as bad as a lot of people who came in.   Not sure exactly what he meant but any good news was music to my ears.

I still had no pain at all.   

Then the Ortho. Dr. came in.  He did the Thompson test and said it was a complete rupture. (Wife said he did the test higher on my calf).  He also felt all around my tendon and foot.  I was in a state of high anxiety waiting for excruciating pain, but it never came, just mild soreness.  I was amazed.

 He recommended surgery and stressed that re rupture was more likely without surgery.  I decided from what I read and what activities I plan to do and possible negative effects of surgery that I wanted a non surgical solution.  I also read with the proper PT , in the long run there is no difference between non surgical and surgical as far as re rupturing the tendon.   

So they fitted me with a boot and made an appointment for 4 wks. On

Feb. 4th, 2016.

 

 

In the US , from my limited experience,  it seems like surgery is still the first choice while in Canada and UK it is the opposite.   I know 2 Physical Therapists.   One said that most people he sees had surgery but he has had successful rehabilitation with both surgery and non surgery patients.  The other PT said his patients were close to 100% Surgery.

 

The Method my Ortho Dr. will use for my rehabilitation is based on:

Accelerated Rehabilitation Program For Non -Operative Treatment of Achilles Tendon Ruptures adapted from:

Willits K, Amendola A, Bryant D, Mohtadi NG, Giffln JR, Fowler P, Kean CO,Kirkley A, Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am. 2010 Dec

 

Other notes:

 

1)    After 2 wks. Can stand with crutches and put 5% weight on foot then gradually add more.  Can add more weight slowly as tolerated. Should be interesting since I yet to have any pain  (no complaints on this no pain)

2)    After week 4 start PT.  I can also do one legged aerobic exercise on the stationary bike and the exercise the PT give me.

3)    Drive at 8 wks.- sounds optimistic to me based on what I read.

4)    At 8-12 weeks there is a warning in capital letters about this being a time where re ruptures can occur.

 (The above timeline goes on about future goals or timelines until 6 months when I can return to normal sporting actives)

 

This is scary. (wk. 8-12)

** Ensure patient understands that tendon is still very vulnerable and patients need to be diligent with activities of ADL and exercises. Any sudden loading of the Achilles (eg Trip. Step up stairs etc.) may result in a re rupture**

So far I have been keeping a mostly positive attitude. When the injury occurred and I left the ER Clinic I just broke down and cried.  Also did this a few times since, but I am pretty much focusing on the future when I can sit on a beach or maybe just go for a walk.   

I am (was) very active so this has been a major adjustment.  I think I cut my calories by 60% since I’m a couch potato and alcohol been zero so far.

I am determined not to put on any weight.

 

The other thing is I am retired and my wife works part time so I am lucky that I have someone else who is here and has the time to help She’s been great. Cannot imagine living alone and dealing with a seriour tendon injury.

 

I will try to keep this updated with any mile stones, changes , or progress reports so maybe someone can learn from my experience as I have greatly learned from the people on this site

11

Hi,

I am in week 7 in the  boot.  As yet PT starts next week and had now advice yet on exercising apart from walking around as much as you want.  I am concerned that is is not brilliant.  Will see what the PT sats.

12

Retired too, and in Uk. I was told they'd prefer the conservative route mainly for the risk of post op infections, and there was alwasys the option of surgury if that didnt work. Seems to have worked anyway. Apart from the minute or so lying on the floor ouching immmiately after the rupture no pain at all; in fact a relief as I'd had bad tendonitis in the months before. At over a year after being released from the PT I'm trying to push back to normal use; I don't do 'exercise' but prefer walking and the gym; I've started to re-address the toe lift stengthening exercises; I think they are more important than I realised.

13

Hi steve, we seem to have a lot in common. I also ruptured my achilles on the same day playing pickleball. Unbelievable. ... I live in California and my ortho has decided on the non-surgery plan. After doing some research I thought it was the best decision. I have been in a splint since the 3rd and will be in a boot starting Wednesday. I'm trying to do as much research as possible but it's so frightening looking at how long and difficult this journey will be. Hopefully we can help each other along the way. I'm almost 58.

14

Wow!   Amazing but at the same time I am so sorry to hear.  That was my first time playing pickle ball and I loved it. I was playing for over 1 hr when it happened.  My ortho was big on surgery, but by the time I saw him I decided to try non –surgery.   The protocol that he uses for non surgery has the same rate of re ruptures as surgery with out the complications.   

There is no way to find out ahead of time to find out the Ortho. Drs. That prefers non surgery over the knife.

If you Google the following you will get the system Surgeon uses for recovery.

Accelerated Rehabilitation Program For Non –Operative Treatment of Achilles Tendon Ruptures1. May also be used for Operative Treatment of Achilles Tendon Ruptures July 2013 Updated Version Prepared and Modified by: Daniela Rubinger, BScPT, Citadel Physiotherapy Mark Glazebrook MSc. PhD MD FRCS(C)

Only difference so far from the Accelerated Rehabilitation Program and what I am doing  is that  my Ortho. started me with the Berg walking boot instead of the plaster cast and  at 2-4 weeks I only do the weigh bearing starting at 5%  weight  and forget about the other stuff they have you doing at 2-4 wks..  I am going to be real conservative.  Read of a number of people who re ruptured and hopefully I can stay away from that.

So far I have no pain just real stiff when I take it out of the boot.

The hardest part so far is the non activity and being unable to do much. It can be depressing sitting around all day.  I keep busy but physically this coach potato stuff is not for me. 

 Next appoint is 4 weeks on 2.4.16.

Good Luck and hopefully we will both recover quickly!

15

Yes there are more studies that are showing the advantages of non-surgery.  My Orth prefers the knife but I wanted that as a last resort. My rehab. seems a little different time wise but same idea.  Not sure what is best.  I am suppose to put a little weight on it at starting week 3 , but we'll see.

the scooter is great.  Got one on Amazon for a good price.

Dr told me that 8 wks I should be able to drive.  We'll see

Hope your recovery continues to go well

16

Do you take it out of the boot while relaxing? It seems that icing it and gentle massaging would be helpful. Do you have to sleep with it on.

I have very little pain just some tightness in my calf that comes and goes. My foot does feel tingly (like it needs to move).

Have you gotten out of the house? It makes you feel more "normal". I ordered a scooter and that helps a lot.

I agree the most difficult part is the boredom and doing nothing. I hate it.

Let's keep each other updated on our progress. It really helps.

Take care,

Karren

17

The boot only comes off when I shower.  Dr. orders. I think the prevention of re injury is the most import. thing right now.  

Yes I sleep with it on.  I never had a problem sleeping.  It feels weird

like I am wearing cowboy boots and even stranger when I put them under the covers but like I said I go right to sleep.

The worst part is looking at my foot when I do take it out.  To me it looks horrible and depressing.   Im also paranoid about re injuring it.

I have not gotten out of house except to go to Dr.  I have going down the steps and it is cold here (50's) . I have to make a point of getting out there.  I do open the door and breath in the fresh air. 

Steve

18

I wore a plastic bag thing over my boot when I shower, available in Uk if you google "limbo protector". Boot came off when i was lying down on the bed for a good washa nd scratch and change the sock every couple of days, keeping the foot relaxed but keeping the toe down angle. I was surpirsed at how quick the confidense came back though, but I've not run or played any hard sports for years!

19

Hang in there, Steve.  I ruptured mine on Sept 29th, had surgery, and then re-ruptured it on Dec 5th, 2015.  This time around, they chose to do it non-surgically.  I had a much better attitude the second time.  I found a personal trainer who works at my physical therapist's office to do a strength training with me 2-3 times a week until I can engage my lower right leg.  That has helped SO much!  I was actually getting a little depressed on the first round.  I would really encourage you to try to be as active as possible as long as you can stay safe.  We just returned from a 2 week trip to Florida and the Caribbean.  I was on week 3-5 so I was nervous but it all worked out.

Also, I'd highly recommend the vacocast boot.  I had to find it myself and buy it on my own but it has made a world of difference for me. 

 

20

Hi steve,

Just checking in to see how you're doing?

Doesn't it feel like this happened months ago.....