Post rupture rehabilitation at private clinics

Bones, joints and muscles
1

I've ruptured my Achilles and have read so many articles and looked at these private ankle clinics. The treatment at these clinics seem to differ somewhat to the NHS, where they stick you in a cast for up to 10 weeks, which does repair the tendon but because of the immobilisation period you suffer because of it. Compared to these private clinics where they get you to partially weight bear after 2 weeks and FWB after 4 weeks. I've read recent white papers and this seems to a newer cutting edge method, but the NHS don't really seem to follow it.

My question to the forum  is has anyone been through this process and how did they find it.

2

Hi Mike, I ruptured my achilles in May and I can honstly say that the NHS treatment was brilliant. The consultant talked me through all the options, including op or not, pot or not and I had a moon boot thing. Was part wb in 2 and a half weeks and full in 4. I am now 3 and a half months since the accident and I am having physio. Walking almost normallly in sandals and doing strectching and resistance work. Can lift from toes on both feel but not on the bad foot alone yet. In all, the surgeon was amazing and I couldn't fault him.

3

Wow that is impressive, which nhs hospital was it?

4

Hello Mike,

My experience of the NHS was poor i.e. overly conservative rehab plan.  I saw a surgeon at West Middlesex Hospital and typically each check-up was a different person in the ortho team. Also the NHS physio does not have access to the surgeon or the surgeon’s medial notes.

 

Cast for 8 weeks (with reapplications of cast during this period) .

When I came out of the cast, I was put into a moon boot (heel wedge and extra wedge - since my foot was still unable to reach neutral position). Also at this appointment, he placed the request to NHS physio to start give my physio therapy. He said that he ll see me in 4 weeks time.

When I saw him 4 weeks later, he said I should have loss the boot earlier - i.e. go full weight bearing in trainers.

I am now week 17 after operation for full rupture

- limping in trainers, no crutch. I take the crutch for longer journeys, just in case I need some support or pain gets too much

- walking down the stairs with 2 feet per step (I step down with bad foot, place good foot next to it, then step down with bad foot...). This is due to the limited range of motion in the bad foot, although I hope in time, I ll be able to walk down stairs in a normal manner

- stiffness of the tendon e.g. after sitting down for 30 mins need to warm up tendon before I can limp/walk

- unable to do single heel raise on bad foot - but I am working on this as much as possible

- severe loss of muscle / flesh on the bad leg - some loss of muscle is to be expected but being stuck in cast/boot for such a long time made is significantly worst

I m determined to exercise as much as I can to reach a better state. I know healing depends on each person such as age, fitness before injury and activeness but really in my case being stuck in cast & boot for so long didnt help.

5

8 weeks in a cast is quite a long time but the 3x3 protocol the nhs uses is a fair but in a cast. You must have lost a lot of muscle during that period.

6

Hi Mike - Yes I have lost a lot of muscle. Orginally it was very distressing but now I m goal is to get back walking normally, going downstairs, jog  / run etc. I ll work on aesthetics later but also accept that one leg is always going to be much thinner than the other...Good luck with your rehab...

7

NHS for me, at CHeltenham. 2 years ago now, but straight in a moon boot NWB for 5 weeks, and gradual return to normal. Muscle loss was my problem, but I am 66 :-) . Walking is fine, but it still feels a bit weak

8

Hi it's a terrible injury to have. I'm 3 and half weeks post injury and operation. I will be 4 weeks in a cast when getting it off. Then I will go into a boot with heel risers which with a riser being taken out each week. This will bring me up to week 8 before I'll be able to put any weight on it.

Wishing you well on your recovery. I missing the driving terrible

9

My NHS experience has been not too bad. I ruptured mine on the 20th of July and straight to cast for 4 weeks, then on the moon boot now since Monday. Partly WB with 2 crutches and 3 wedges which I need to remove 1 every 2 weeks. My first one will come off a week on Monday then 2 weeks after that for the next one.

They then gave me an appointment for the 20th of October (next available time), before I can start physio, which I wasn't too happy about so I decided to contact my private health care (I wish I had gone with them in the first place). I had my private physio yesterday, the best feeling ever and I will continue to have one every week and hopefully by the time I go back for my appointment on the 20th of October I won't need NHS anymore.

10

I suffered a partial rupture 5 weeks ago.

NHS conservative treatment

A&E gave me a cast, had it for 10 days

Ortho clinic gave another cast for a further 2 weeks

Next appointment they gave me a CAM boot and said I can bear as much weight as I want as long as im not in pain

I've had it for 2 weeks, I get to remove a heel insert tomorrow, my next appointment is another 2 weeks away.

I remove the outer boot to sleep in and do a few ankle mobiliastion movements each day.

Initially they told me 3x3 weeks in plaster, they only changed their mind when they assessed the injury further and realised where the rupture was in the tendon.

All the reading and research points to NHS treatment being a total lottery unfortunately.

11

Hi Mike,

I have no idea what NHS is, but I ruptured my Achilles on May 7th and went with a no weight bearing, immobilized in a cast for 8 weeks (change cast every 2 weeks) and then was in a moon boot with a wedge and was supposed to be partial weight bearing for 4 weeks, but was full weight bearing in the boot after 1 week, and then out of the moon boot and into heel raise shoes by the time I went back after 4 weeks. I'm now 15 and a half weeks and in flat shoes, jogging and able to go up onto the rise on my right foot alone (my bad foot) and this was without any operation aswell.

Hope this helps

12

Oh, and I had a full rupture as well, 7mm gap