norm and ryanb 4) Pain is never a clear diagnostic for an ATR or a rerupture, since our pain experiences with ATRs are all over the block, ranging from I cant believe there was no pain to I cant believe how much pain there was. As they put a new cast on I immediately felt the constriction and started to feel hot (flushed). I was able to do this without discomfort though I could tell that I was weak. Im so down right now. Yeah you are right. Im not sure in your case that going FWB was that stressful to your AT. The old slow conservative non-surgical treatment did NOT work well, with excessive re-rupture rates. I am walkingon it very lightly and mri prob today. Only started turning the corner at around six months post. If your calf muscle cant relax enough to stretch out while youre knocked out for surgery, Im not sure when it will. Im so confused and frustrated now. Maybe its just the one surgeon, maybe he doesnt do many ATs, whatever. The Dr said they will have to harvest a tendon tissue and weave it in to the Achilles tendon. My pain is much better, but I still have trouble with swelling and the foor turning black and blue. Increased my PR from last sessions 12 to this time getting 32 consecutive catches. The sharp pain usually settles quickly, although there may be some aching at the back of the lower leg. This blog is definitely helping with the feelings of frustration and isolation Ive been experiencing. After both conservative and surgical therapy, follow-up treatment lasting several months is necessary. My advice: Make sure you dont get sucked into other things and worries while you are recovering. My doc ?? Was wondering about some sort of light(er) weight padded splint that could Velcro on for sleeping? Even the sidewalk can have surprises, so I just want to be sure. the hard cast was removed after a week and replaced with a boot, and i began light therapy. Brian, Good picture. [Acute achilles tendon rupture : State of the art]. Fiberglass CASTS are pretty waterproof, too, but youd never dry out the inside if you went in the water with it. They create and support wound healing. i think his case is a bit different, MRI confirmed re-rupture. Just think about it. I do recommend swimming as a great rehab activity- my ankle and Achilles always felt better after the swim sessions. It may be mild and get better or worse over. Tenex works by getting rid of binding scar tissue that causes a lot of tendon pain and it does it without major, invasive surgery. Hours later it hadnt dropped much and eventually they got around to taking the cast off to check the wound which was fine. Gravity, who would have thought. The first tear was where my tendon attaches to the muscle. 8 weeks casting. If youre still ruptured, are they planning to go non op? Good luck everyone and be warned, you can rerupture more than once and you can rerupture when in a cast/bootif anyone has any questions about my experiences or treatment let me know and I am happy to go into more detail if it would be helpful or interesting for anyone. My question to you is at what point can you submerse your foot and perhaps swim? (Our ATs dont usually feel like weve been kicked for nothing, unless weve been kicked!) As you said its important to confirm my state and what should be the treatment. Im pretty sure a thompson test wont work two weeks post op either.so how do you tell if you re-ruptuerd? It is best to consider all options for ruptured Achilles tendon treatment. If its a full tear and youre young and athletic and you want that strength back, usually its my understanding that most people want to get that fixed. I started riding a stationary bike just to move my legs even when I was still using the boot. And a couple of answers for leotig from a guy on the Internet: Conservative following UWO? There is a longer post from me above but heres a quick summary - complete rupture of left achilles tendon in mid September, surgery to repair two days later, re-ruptured following 12 weeks of cast, boot, physio and surgeon decided to treat rerupture conservatively. I can already easily do ~40 two legged heel raises but need to be able to do single legged heel raises (havent tried one yet) before I think about running again. Aquinis cast for 4 weeks moved yo almost nuetral and the pop tripped over crutch Oh I wanted to cry well I did. FOIA As posted a few days ago, my achilles rupture is different from a normal rupture. The doctors and surgeon had never seen anything like it. Here youre obviously not talking about just losing one point in a game, so a good-sized safety margin seems rational to most of us. North South vs East west is the way I understood it. Both Achilles have been repaired surgically (highly recommended if you are relatively young and were active) and both feel structurally very strong. Do you guys think I re ruptured it? That is to say. Causes of Calf Pain and Treatment Options, Foot Pain Causes, Treatment, and When to Seek Help, Cortisone shots are also associated with Achilles tears, The ruptured Achilles tendon: a current overview from biology of rupture to treatment, Tendon Injury and Fluoroquinolone Use: A Systematic Review, The Risk of Achilles Tendon Rupture in the Patients with Achilles Tendinopathy: Healthcare Database Analysis in the United States, Diagnosis and Treatment of Acute Achilles Tendon Rupture, Fluoroquinolones and risk of Achilles tendon disorders: case-control study. I knew it had gone right away and the skin also tore, perpendicular to my surgery scar. First time I did push-ups in over 3 months. In between my injury and surgery (10 days approx) I was given the boot from one of my med school friends to move around. Good luck. but it seems like i can move the foot still. I was all showered and changed into my street clothes, and VERY much looking forward to getting home.). Also, start physio the day you get your cast off. Where did you primarily have your swelling? An operation was performed on May 10. Tendon damage is a common cause of chronic pain for athletes and non-athletes alike. Do you still have your splint to wear part time? I even slept in that shit to AVOID accidentally waking up and stepping on my foot. He said when I am in bed at night to lightly rotate ankle, point toes if I can, slightly raise them, move toes. For the past 4 months Ive dreaded this section of the blog. Hi everyone! I also wish HarleyLady the best of luck and my warmest sympathy! Is this swelling normal at this stage, right after getting the cast off? Also, does anyone know if the small pop i might of felt, could that have been scare tissue vs the AT? When I got the boot after that iteration I did not take it off at night for donkey years (weeks) as I was totally terrified of doing it again. My aerobic endurance still has a little work, but have ramped it up now to about 4 miles at a good pace (twice a week, plus one bike ride) and am finally feeling like my old self again! I would not wish this off on my worst enemy! Its hard to talk to anyone about this since I dont know anyone who has gone through it other than me. Same with an ultra sound. So thats why im skeptical and thats why I asked all those questions. One thing I would add is that I feel several times, but every time I had on a hard cast walking boot that probabyl saved me from re-injuring myself. A few cases here, some apparently successful including scott and some others whose names I forget. I fear the worst (re-rupture) however I did not feel a pop or extreme pain like the first time and again I am still progressing as far as capability but the pain will not go away. I am afraid of wearing her out. Going the opposite direction (non-op, then op) is more common. Similar to Norms advice to rcastelda, you should at least try a boot and the UWO protocol this time around. There could be some scar tissue around the wound or the tendon. My consultant reckons at this rate I will be back playing football around Christmas time. I tried to get him to give me a few days to get my ducks in a row for surgery, but he said no, tomorrow is the day. I would also like to say that I am no medic nor orthopaedic surgeon and the above advice is purely from what I have read on the internet. Im not into non-op, Im into evidence, and there isnt any on non-op treatment of re-ruptures, AFAICS. The whole Achilles area is now sore and tender when touched, If you can find a way to work up a sweat without scaring your leg, or even working out without a sweat, you may find that the whole world seems a bit brighter. Best of luck to all! I dont know if lucky is the right word when you have an atr. Also, I have shared your web site in my social networks! Monday morning, doc says that we gotta start over again. Dr says I need reconstruction surgery after they close soft tissue. The purpose of this study was to compare outcomes of different minimally invasive techniques for reconstruction of Achilles tendon re-ruptures. I am living downstairs for now, and will continue to do so after she leaves. An Achilles tendon rupture can be partial or complete. Postive thoughts, positive thoughts. PS he also said i would have had to slipped hard to have ripped my sutures. I suspect it was from the scar tissue build up from the repair. Felt like I got kicked again. Lots of answers and advice can be brilliant or stupid-crazy, depending on how far along the patient is in healing, so that Timeline Widget (on your own blog) can really help you get smart advice and avoid the other kind. The tendon re-ruptured after 3 days. All the surrounding muscles are weak and there just isnt a lot of support. I sure wish you luck, Mike! Post surgical infection is one of the big complications to worry about, and my doctor wanted me to be very conservative with the incision - making sure it was completely healed, before getting into the pool. It makes a world of difference to be able to get home at the end of the day, take the boot off and just sit in a chair with the leg propped up. I now know Im allergic to certain kinds of sutures. - one week after surgery, was finally feeling good, but crutch slipped on a wet floor and I landed hard on my foot Hi I was just wondering, how do you know if you have re-ruptured your achilles tendon after surgery. I am terrified of getting hurt again, I was so tense during PT today, that tonight I hurt all over. The back f the heel still hurts and there is still swelling As for meI have continued my story on the newbie side (http://achillesblog.com/just-ruptured-your-achilles). Great job at Pan-Am Physio in WPG. I am able to do sitting heel raises - abt 1/2 inch. Great to hear your story. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Your calf will atrophy whatever.after 4 weeks it will be nothing, youll probably get your cast off at 6 weeks and then try and start strengthening it with seated calf raises(I started a little after 4 weeks because I had a removeable cast by then). Gary - so sorry to hear about your re-reputure! I was doing great after surgery for 4 days then I woke up one night feeling hot like a fever and then cold. I am not one to find fault or reason so keeping a attitude of it is what it is and dealng with it. It is so good to hear that you are back on your feet after 6 months, Brian. However, the Thompson test (calf squeezing test) would most probably confirm a re-rupture or not. He said I had to go the non-op route. i also often and repeatedly said i feel as if this is not connected Push-ups and sit-ups are a couple things they will test him at basic training so he will be ready. I am probably at least another few weeks away from trying a broad jump, but I just turned 44! Brian. I have an appointment to see my surgeon tomorrow (9 days after ER visit). I found myself wanting to do more on my own including showering. - went to get it reassessed, they determined through ultrasound that at rest the tendon was still aligned (this is good), but when stressed a bit it separated (not ideal). The most notable symptom is a loud pop accompanied by sharp pain. Two people in the last few years even tore both ATs at the SAME TIME!! On Friday at PT, just over 9 weeks post-op, I increased the leg press up to 310 sets of 300 lbs and it felt great! Most pain in the Achilles tendon may be classified as tendinosis because this pain is related to tendon degeneration rather than inflammation. To keep blood flowing and warmth to the area during the day. The unassisted plantarflexion was still only 42 degrees on the injured side compared to 50 degrees on uninjured side. The last two Dr. are working together on my care and I have confidence they know what they are doing. They say that it is better for lessening calf atrophy, but it doesnt provide as much protection. Others have had it done same day. When I see other blogs, people seem to be well past me, as I stil have lots of pain and swelling when I do too much and cant even think about running and Im at 8 months form initial tear, but I forget that Im not really that far because of the retear. Ive got some ideas for your blog you might be interested in hearing. Good luck! F&CK! I followed Drs orders to the letter and it still gave way. Reinforcing and grafting seem eminently logical, either in providing a stronger FINAL product, or in providing a srtonger INITIAL product and therefore a quicker or safer recovery. After my initial rupture on left, I always felt a lot of tightness after casting and huge ball of swelling during healing above heal. Had surgery yesterday, 6/26, and the procedure on this Achilles is different then the other one 7 years ago. Had bit of a bad day yesterday with the why me syndrome. I didnt do this often, mainly around home (small 1br apartment). Heat exhaustion occurs when the body loses excess water and salt. Really kicked my butt. 4. played my first mahjong game since surgery. Curr Rev Musculoskelet Med. And sounds like we are on identical track. Also reconfirmed that the tendon has severe chronic tendonosis. Does that make a case for no surgery again. Hes still happy, but thats no guarantee (and there arent any!). I got to my shower on crutches while I was NWB and PWB, then stepped inside and sat down, rested the crutches outside the shower, took off the boot and rested it outside. Healthline Media does not provide medical advice, diagnosis, or treatment. Need some feed back. There is some debate as to whether a partial rupture can be mistaken as Achilles tendinopathy or tendinitis, which involves inflammation and microtears on the Achilles tendon. BTW, when I said Neither were excruciating pain, just a general throb. Additionally, a snap or "pop" may be heard as the tendon breaks. It helps me to remember that were still vulnerable even though we feel much better. Many surgeons advocate early operative repair of the ruptured Achilles tendon, citing decreased re-rupture rates and improved functional outcome. He think it is probably a partial torn and recommended conservative approach and put me in a boot. Anyway, just thought those of you in the frustrating earlier stages of this nasty injury would like hear that even a 44 year old fully recovers within 6 months after a rupture, re-rupture, and two surgeries! For those who are just reading this without any of my previous posts, I slipped while in my cam walker. Apparently studies have shown, younger people have a higher chance of re-rupture, because they are simply more active and have a higher chance of putting the tendon through unnecessary stress during rehab. WOW! As someone just 10 weeks into their 1st (and, hopefully, only) ATR recovery, I go back and forth about whether I should go back to the activity that brought me heretennis. Stuart, did you mean PLANTARflex not dorsi? All I want for Christmas is my two good tendons You dont want to hear me actually sing. I just stumbled upon your blog and wanted to say that Ive actually favored studying your blog posts. Cease all stretching activities for five days, but try to walk greater distances. He put a cast on it. Your leg and situation are obviously not straight-forward at all, so its all judgment and expertise and logic (none of which have distinguished themselves whenever weve tested them with evidence!) I wear my compression socks 24 hours a day. Pain was horrible, I could definitely feel a rip. But no surgery required as my leg feels strong and I have no pain. Tendon rupture typically occurs with sudden forced plantarflexion, or less commonly with violent dorsiflexion of a plantarflexed foot. Yup, that sounds like the traditional (old-fashioned) conservative treatment, with the ~15% re-rupture rate, rather than the new aggressive non-operative rehab protocol like the UWO protocol, with the ~2-3% re-rupture rate! However, I found riding a bike (either stationary or outside) has helped tremendously and can now ride 60-90 minutes a few times per week. Obviously I am hopeful that this is just natural healing and its going well, but my great fear is that I have re-ruptured and everything feels loose because it has detached again. If it is the worst case then it might be better to find a more progressive consultant. Also, was there a dent in the tendon after the initial rupture, but hardly any dent after the re-rupture unless your sock line is over it for a while? She had surgery, etc., and didnt compete at all in 2011. Hi.thesingularity.. Just take the boot off, and feel around back there. What are the signs and symptoms of an Achilles tendon rupture? It was for brief second then went away. Story so far - tore my achilles playing basketball, pushing off to sprint. But I wanted to saykeep your head up and if a silly bball loving fool like me can get thru this twice with no help, I have a feeling you will be in much much better shape and condition than me with all those supporting you and giving you best advice possible. An official website of the United States government. Luckily no red stop signs on my way there. thanks for the prompt respond norm, in my country all the top doctors works in private hosiptals, I am too broke to go private so I did it in a public hospital, which is another reason why I m afraid they messed it up, I read alot of stuff about ATR, the boots and stuff but they dont have it here, 6 weeks on cast then both feet on the ground is what they suggested(i might not have my re rupture if i m on boot) but forget about the past, i look forward to have a pain free healthy life again. Achilles Tendon Rupture. When our hands are busy with crutches, we are in the same boat as four-legged animals, and we find it frustrating, dont we? I believe it is a partial re-rupture because I can move my foot. Following rerupture, what was your strength like? Nothing. Although it's possible to have no signs or symptoms with an Achilles tendon rupture, most people have: The feeling of having been kicked in the calf Pain, possibly severe, and swelling near the heel An inability to bend the foot downward or "push off" the injured leg when walking An inability to stand on the toes on the injured leg kb60, its widely believed by logical people that surgery is especially indicated for large gaps, and non-op works better with small gaps than big ones. In any case, I can basically salute to all details. Spend your time wisely, set some weekly goals (read a book or two a week). Between the frozen food and the take-outs, I am okay. Other common symptoms include swelling and . I am planning an overseas trip in 2 weeks, and things are definitely looking up. Worst part is now Im losing my job and with that my health insurance. I ruptured in Jan had surgery, then started having problems in April when I slipped and felt something tear. I went to see PT 5 days ago all she suggested was to do more streching as my tendon is still stiff, nothing more, but I do have an appointment w/ a specialist tomorrow and i ll see what he has to say, as for the attachment u mentioned, I do feel pain when i touch the attachment but i dont have any pain on the cut itself, hopefully it will leave me soon, will keep you guys posted, take care! Patients may hear a 'pop' or a 'snap,' and will almost always say they feel as though they have been kicked in the heel (even though no one has kicked them). Its a by no means ending circle. I have little or no pain at this point. I cant recall hearing that anybody had demonstrably done it though I suspect that some of the re-ruptures from slips and falls in casts were caused by the calf pulling hard in reflex, rather than the fall itself. What to do this time? My Ortho surgeon gave me both alternatives, surgical and self healing. FML. There is no shower downstairs. Last weekend at just over 8 weeks post-op I rode my mountain bike over 5 miles on the flat road at ~20mph in top gear. I drove myself to emergency but they were pretty useless. Ive never seen a scrap of evidence that indicates that being overly conservative and staying immobilized for longer is actually safer from re-ruptures, than following a good and tested and relatively fast protocol. And when normofthenorth chooses surgery for an ATR, its GOT to be worth at least a COUPLE of votes! Not sure what to do: Do I listen to my surgeon and go for another surgery? 12 weeks locked up is very old school. I also asked him about the surgery. Cant really see whats going on with the cast on, so any thoughts would be apprecaited! Deeleft, I usually encourage everybody to start a blog, but your story is obviously more involved and interesting than most, so do so if you are tempted starting with the email outlined on the Main Page. My first rupture was also from the bone. This means the Achilles tendon has not completely separated from the heel or has not completely torn apart. Its not as painful as the first surgery which is excellent. I spent about a week in bed with my leg up on bolsters and pillows, as I recall. If its a full tear it might be a different story. Nuisance for sure, but (a) it may save you some grief later, and (b) its way less nuisance than letting your Doc re-open your AT to have a look-see! I would like to do some hiking this summer and am optimistic that I should be able to do that. and probably tore the sheath (paratenon) about two inches above the repaired completely ruptured tendon. The average ATRS was 86 (range 79-92), and the average number of single-legged heel lifts was 33 (range 11-48). Supposedly the swelling is going up after injury for about 4 days. My decision was based on the fact (fact as best I can tell) that some reinforcement could not hurt my chances and letting my body bring some blood and healing nutrients to the tendon by way of the surgery. No returning to work for several more weeks, wanted me back in Aqua therapy asap. I wouldnt call it Brians plan, I simply suggested that he should *at least* try the UWO protocol as opposed to nothing at all. After 7 weeks in a splint/cast/boot, I went to 2 shoes against my doctors advice. Normofthenorth, Dr. did do a Thompson test, and it did show that it is not a complete rupture very close, but I still did have some movement, which he was pleased with. When all this started I purchased a Portable ultrasound to use on my calf and ankle to stimulate blood flow twice a day for 5 minutes. I had surgery for my torn achilles about 2 weeks ago. I also used it in the beginning when first started having problems. The dr. said that hes never seen a rerupture with the surgery option, so Im feeling pretty comfortable this time around. Anyway, your job now is to recover as well and as fast as possible without any more setbacks! Therefore the question is: what is the chance for someone (from the general population) who may epxerience ATR sometime during his/her lifetime? Heather, theres no way to tell a rerupture from a scare over the Internet. He treated ~945 primary ATRs non-op and had a rerupture rate <3% and a 100% Return to Sports, and he successfully treated ALL of his reruptures non-op, with NO subsequent reruptures. Still no heel raises, running or jumps yet but should be back by September. Norm seems to know a lot about the pros and cons (as many of you do, however, just started reading the blog today). A partial or complete rupture of the Achilles tendon is an injury that requires prompt medical attention. Start a blog of your own if you can, to make it easier for us. He cited the physical presence of my intact achilles tendon and the tension I experienced when he moved my foot in his assessment. Anybody been through something similiar? Interesting to find an OS who believes in non-op treatment of reruptures. So Im guessing nobodys got a solid answer, just everybodys anecdotal stories (which we humans all seem to over-value and over-generalizes). Im already upset from hearing that I have to go for surgery again, and now my employers are being huge asses about this. She kindly explained that because woman have more flexible joints, it is very uncommon for them to have a full rupture. Basically I got form him that I could have a some what normal life. On Saturday night Feb 13th I was ready to go to bed, my boot was off and I got the fright of my life when a massive cockroach flew onto me and I jumped upright onto my injured leg. I chose the non-op route following the posts here and the research from the UWO study. Although it's possible to have no signs or symptoms with an Achilles tendon rupture, most people have: The feeling of having been kicked in the calf Pain, possibly severe, and swelling near the heel An inability to bend the foot downward or "push off" the injured leg when walking An inability to stand on the toes on the injured leg The classic sign of a ruptured Achilles tendon is feeling (and sometimes hearing) a pop or snap at the back of your ankle. I have now ruptured both my Achilles tendons over the years and am currently recovering form my latest rupture to my left leg. At week 16 the physio pushed me too hard and I believe I have a partial tear. If you did hear a pop then you may have re-ruptured. My initial surgery was May 24 - following a flying glass accident. Annoyingly and sooooooo frustratingly Ive joined the re-rupture clan! Therapy later would involve ultrasound among other things. It was painful and started bleeding for about 5 minutes! Had an ultrasound on what I thought was a re-rupture. My question is : Is it possible to re-rupture your tendon by pushing to hard inside the cast? I also rented another knee scooter to be used exclusively at work. Alex, most people find that getting sliced open and stitched together hurts a lot, and that the pain goes away as it all heals. Today I was walking down the hall and tripped, heard a loud rip and excruciating pain. hey guys, havent update for a while, the reason being, i was in the hospital again, this time for an infection, its kinda odd as I had my re rupture dated way back on june 2nd, i discovered the infection on aug 12 and had surgery on aug 14 to remove the pus, was on antibiotic for the past 4 weeks, just as things cant get worse, i now have plantar fasciitis, its really frustrating, everytime i think i can finally do some rehab excercise i have to stop, sigh. After a couple of months here, Ive had the impression that most ATRs described were full ruptures, the biggest difference being in the protocols used. It really is as you say a kick in the head as well as the leg, reassuring to know that its kind of normal. I had hardly improved almost a year and a half later when I finally got to a doctor who diagnosed a re-rupture within about 2 minutes. Thanks for all the info! If you find that your Achilles Tendon is still swelling 3 months post op. Naturally, I wanted to use my foot to brace and then there is was again - slight pop. Good luck, and keep us posted. Whilst performing the stretches this morning, I felt some tearing, I immediately contacted my consultant who informed me it was more than likely just scar tissue separating from the tendon, but to be on the safe side. I have my bedroom and bath upstairs. I think its important to confirm wether or not you have re-ruptured before deciding on treatment protocol. Does anyone know if waiting for the surgery is detrimental? The Achilles tendon is the body's single strongest tendon. Sounds like youre almost back in the game! It made rehab this second time around, dare I say, enjoyable. My Dr. had left practice the end of May, due to family issues. THought you might like to see this evidence based discussion. To be fair, physio was going well and I was gaining strength and range of motion each day. Leaving you without some protection option (splint, boot, something) is certainly odd, too. This article is based on an episode of the Dr. Jay Show broadcast on AM1560TheGame in Houston, TX. My first day out of the cast and in a boot I re-ruptured and my tendon recoiled up my calf. Mind you, ALL of this is about treatment outcomes for PRIMARY ruptures, not re-ruptures like you. To be honest, i have not stopped thinking about your story and definitely have tried to be more careful myself even now. It might work, or not, hard to know. Deeleft, I agree completely with your I feel exactly as though I have had surgery but only to set up good conditions for non-op healing. The puzzles are still multiple, though: (1) Theres precious little evidence on non-op treatment of single reruptures treated promptly, and none on 3rd-time-rounders. Then it started burning and pain was shooting up my leg. Almost took the stiches out yesterday because it looked so good. Many dont understand. My advice to anyone researching a fall or potential rerupture is to reach out to your doctor and avoid wasting too much mental energy worrying. I thought Id contribute/vent to the blog. Ruptured my right achilles in April on a basketball court. (Hopefully tomorrow). Keep your chin up. The rupture sound is often characterized by a snap at the back of the heel. Maybe they are? I wish we could of all met in a different blog like People who can jump freakishly high Content is reviewed before publication and upon substantial updates. That trauma is what creates the bodys rush of healing and reconstruction. Told me that I need to wear the boot for 4 months and continue my PT. I am in pain. It connects your calf muscles to your heel bone. Some really wonderful work on behalf of the owner of this web site , absolutely outstanding subject material . really need help with some questions. I didnt ask how many degrees dorsiflexion, but both feet definitely look like at least 15 degrees. I Tore my Achilles just recently, and have documented the whole process because there is so little out there that really gets into the day to day of it all. Its caused by severe stretching of the Achilles tendon usually beyond its normal capacity which results in the tendon rupturing or separating from the heel. I do have a noticeable amount of swelling in my foot and ankle areas, even a little bit more than 2 weeks post-op right before the cast. What a living HELL.FML and all that bad stuffHere we go all over again. I wanna know, do I need longer recovery time then the first surgery. The prognosis for a torn Achilles tendon is very good with professional care. Your confidence will increase as you do more. I didnt say anything to you until now because your description sounded too much like when I re-ruptured at 6 days post-op. But there was a 3 cm horizontal tear and they decided to send me back to the OR for debridement and resuture. Good to hear you would choose the same routine I am doing! But it seems to be false! The best study on non-op rehab, with the best results, used boots and no casts. He also said I should starting easing to get rid of the boots in a few weeks. But youre right it might be a partial retear, so I am getting my crutches back and planning to take it easy and will call the doc in the morning. I didnt hear a pop or feel the kick sensation, but I definitely felt stitches popping. The only change to the protocol was that my surgeon decided that as a result of the fall I have earned myself and extra week in the cast, three instead of two. I had surgery for a full rupture on 11/28/12. Im not sure what sort of boot you have but if its like mine with a washable inner then it may get a bit woofy until you can get it washed. One Sat morning, 6 weeks after surgery, I was vast asleep when the door bell rang. Still have a bit of pain and a bruise at rerupture (on one side of leg). As a result he decided that the tendon had not reruptured and that I should be put in a cast as per the original protocol at 30* plantar flexion. I will be by myself. Does fwb out of the boot mean that you werent FWB in the boot, or am I misreading your tea leaves? The classic symptom of an Achilles Tendon rupture is the inability to rise up on your toes. Hi ring. I wish everyone good health and successful recoveries. The subject of this section of the Show is the chance of re-injury afterachilles tendon surgery. My surgery went good! . Instinctively I put my left leg out placing significant weight on it as I continued to fall onto my back. For now I just need to keep sitting tight and waiting (damn public hospitals! Or, have a friend to the Thompson test apparently, its pretty hard to get a good result on yourself. Athletes can often get back to sports faster, and there is probably a smaller chance of re-rupture of the Achilles tendon. Just a little update from me. There is someone else on this site that re-ruptured going up on their toes at PT, cant remember who right now, but if you search around, you might find them. I feel much better this afternoon as a result. During this time I will start practice walking in a swimming pool which improves rehabilitation. I am too old now to keep doing this to myself lol so if all i can do is walk and do stairs entire summer, ill be truly happy with just that. Ive posted their aggressive and very successful protocol at bit.ly/UWOProtocol . My wife has cooked up a lot of food and put them in the freezer. Here are the signs you may need to see a doctor. Check out his blog for his story. I had been clear for 8 days. This will be on for another 4 weeks and I have to go back for another one. Had surgery again on the 2nd July, where they used a tendon from my big toe (taken from the sole) to help reconstruct the achilles. Some people here have gone non-op after re-ruptures, and I think most of them have done well. This is just one study I found: Anyone any ideas on what I can do? Hey guys, need your expert opinion! This time im sure I have to have surgery. who had surgery then re-ruptured, and was then treated non-op, but that was unusual. This is to prevent swelling only he said. Initially during PT I would feel some soreness but outside of that, I really had not had much pain though the entire ordeal. I will start timeline. Could be bleeding with the new injury? Thanks for the clarification and sorry for any confusion. All I could add is if you are not confident understanding all the scientific information you find in these pages, dont try to make it up yourself. I will keep updating and I appreciate the kind words. Biomed Res Int. This should pass, though its already been a while. Every two weeks we removed the cast and flexed the foot a bit to put some stress on tendon. weight-bearing for a couple of weeks, dont dorsiflex past neutral when youre out of the boot. Appreciating the ability to simply go for walks and thats all. Help. Anyway, just wanted to remind everyone about the danger of getting your stitches wet at all during the first couple weeks. Wonder if someone can update me on their experience of Physio post op. This time want to do everything slow. It is hard to imagine that I will get there, as I await my third surgical procedure. Go USA SOCCER! Not sure what to make of this, but last night (1 week post surgery) I was going to the fridge on crutches when my crutch hit water and slipped from under me. So if it wasnt that bad after the fact, how can I keep from getting so depressed while in the middle of it? I wonder if anyone can relate/advise on my situation? It is so hard. My fear of re-rupture is even greater than before. I found some new Cryo cuffs on eBay for $79 - Im so excited to try it out! Achilles also needed lengthened. Since then, have you had any bad falls, a hard calf cramp, or any other events where you suspect you re-tore it? I found the only reason doctors and physio recommended early weight bearing and more aggressive physio is to get you back to your feet sooner, if you feel this is not really necessary or are afraid of a re-rupture, then take your time to heal. No girlfriend this time, as we had broken up. Your PT should be doing some deep massage of the tendon which will help to break up scar tissue. Do not rush back too quickly. It sounds like some kind of tissue damage but there is no way it can be properly diagnosed here. Looking at more surgery and possible tendon transfer. Do you know on average when people see a negative Thompson test once they start non-srugical treatment? I definitely do not want to go through this again. What was it that you were doing that created the pop on the 14th August? There are certainly pockets of the world most of them in the US where thats still the song thats sung. She is conservative. And, as I look at the clock, the insomnia! It was published as Willets et al in 2010, and the full text is on this site, linked from the page with all the studies listed. It sure seemed to be in pretty good shape prior to the accident. I have two dogs that have to let in and out. At the time it happened (especially when my right foot gave way that night when I was putting on my pajamas), I was almost in tears. X-rays may be performed to evaluate for other conditions including an ankle fracture or ankle arthritis. MRI studies may be indicated for surgical management of chronic injuries. By the time I went in for the MRI last Friday almost all of the swelling had gone and there was hardly any pain at all. The pain was sharper with my re-rupture, but it went away faster than the original rupture. But if the evidence shows that going very slowly makes you as likely or MORE likely to re-rupture, then its more an empty slogan than a reasoned argument. He did the squeeze test and ultrasound that confirmed it. Are you in Canada? The next day, I went back to the doctors office and he reluctantly removed the cast and put me in the CAM walker. I was casted today, but it is already driving me nuts, I keep telling myself it is at least worth a shot. I have what is supposedly supposed to be one of the top Orthos in the Atlanta area, but I feel like shes always very rushed. ), and his surgeon decided to treat it NON-operatively(!). Surgery on Jan. 31st, 2015. (Dont know dont know.). Or not. I understand that its hard to diagnose anything over a forum, but I find it really helpful to draw on other bloggers experience. Thats six weeks in total since the operation. Finally, do NOT hesitate to go back to the doctor if you are having any pain at all with the splint or cast!!! This past week was 5+ weeks post op today was 6 weeks. Last I noticed he was happy, and its been a while. Meanwhile, I think it was Brad here (if not, correct me somebody, please) who re-tore his and went for a UWO-like non-op cure. I am trusting less and less into my surgeon. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. Had the open plaster cast for about two weeks, then got my walking brace on Sept. 13, 2011. While watering down the dust when the excavation for my home waterline connection was being filled in, the side support outriggers of the machine that was compressing the dirt stepped on me..in Oct of 08. The pain may be a bit more difficult to diagnose from the comfort of my chair and without more specific details. If I can not find anyone in NJ, I will probably go with him. Any words of wisdom? My tendon was really stiff thou. [my original surgery gave me a DVT which turned int a Pulminary Embolism and so I am on blood thinning medication]. The classic symptom of an Achilles Tendon rupture is the inability to rise up on your toes. But youll be able to care for yourself better and its so much safer once you get rid of the crutches. Best bet is MRI but it can be inconclusive. Have many of you gone the non-sugical route and had success? Kai, I am now fine. Anyway Ill be subscribing to your weblog and I hope you put up once more quickly! Signs and Symptoms. erally enjoyed reading all your shares and Im glad I found this place. When I point my toes way down, I can see the top of the almost-invisible incision puckering, because something is stuck!). to talk him OUT of it! Horrible pain, like I had it when I ruptured my tendon, and straight to E&A. In my case I was lucky I had a follow up appointment with my OS two days later and was told everything was ok, it gave me one heck of a fright though and a reminder if how much care must be given at all times. Worth a phone call. Im really hoping that Ill be able to start back late in the spring. I would not pretend I know how you feel, but I can guess. What sort of protection did you have on your leg? Hope it all goes well for you this time around! You should be able to gently pinch your tendon, gingerly wiggle it side to side a little, and feel that its intact. I will post tomorrow my results and what Ill be looking forward after my MRI results. Yes, the lack of evidence to inform what to do in my situation is a bit worrying although as you say other people do have treatments which are somewhat similar for other tendon issues. 1st 3rd week Visit. Wants me to get active said the more I move the better quicker the healing. They cleaned me up and put on a fresh splint. Additionally, because the function of the Achilles tendon is to enable plantarflexion (bending the foot downward . Im not sure Ive seen proof, but that doesnt mean it doesnt exist. But the newest evidence indicates that its unnecessary. Two days ago, at just under 12-weeks post-op, I tried doing a single legged heel raise after I returned home from PT and just couldnt do it without some assistance from my good leg. That sounds nonsense. Thanks normofthenorth. - Since getting my full cast I found it very difficult to even straighten my leg (finally successful after some slow stretching). In the meantime I kinda feel like I dont get the whole story. They have good experience with ATR and examined me, squeezed whats left of my calf with a positive response - my foot moved - as far as I can tell, as much as before the pop. I am not sure if a rerupture means the exact same place or just another rupture while still healing. what i could not do was stand on my toes and my inner calf was just not responding and I did express my concern as I hit the wall with progress. Anyway I can tell whithout having to go back to the Dr? I know I have a long way to go for recovery, but I feel like I can see the light at the end of the tunnel. Many people describe it as a kick or hit in the calf. Unassisted dorsiflexion is 15 degrees for both feet, with lateral ROM (both to the right and left) also identical. Thinks I ruptured it back in April all the increased activity was causing it to swell and the surgical site was pulling apart. Achilles tendon injuries occur more often throughout sports that involve running, jumping, and sudden starts and stops- such as soccer, basketball and tennis. This has been really interesting to read all the re-ruptures. 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