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Achilles rupture close to the calf - any advice?

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chris13067
chris13067

Hi all. I ruptured my achilles tendon on 16th December (playing squash) and was expecting to undergo surgery but the consultant has advised against it due to the close proximity to the calf muscle, says it would be like stitching cooked spaghetti. I had a half-cast for the first week and since have had a "boot" which is still non weight bearing at the moment. The position of my rupture weems to be quite rare and I haven't seen anyone recalling details of a similar injury. I am booked for my next appointment on 11th Jan when I should start the partial weight bearing/wedge removal process. I have heard I may get a better blood supply to this part of the don't know tendon which is encouraging but I don't know if that will result in a shorter recovery period? The worst part for me so far is not being active and not being able to drive, it's my right leg and I drive an manual. I can't bear the thought of relying on lifts for another 10 weeks! If anyone else has suffered a "higher" rupture and has any experiences to share it would be much appreciated.biggrin

Oh, I'm 53 by the way but was very active prior to the injury, running and cycling/mountain biking especially. I'd only just started playing squash again a couple of weeks before the injury after a 5 year lay off.  I used to play quite a lot and never suffered any injuries.

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  • tim50stroud
    tim50stroud chris13067

    Posted

    Can only express my sympathy at you injury; this is another variation of the injury I've not heard of; mine was a partial rupture of the left tendon. it makes sence that there will be a better blood flow higher up the leg. I went straight into a boot and found exercise and movement seemed to help getting mobility back. My biggest issue was/is the calf muscle which is still weak, 15 months after the injury. Means I don't walk quite right and that throws stress on the upper leg and hip joints and gets painful quickly. I'm 66. Good luck and a better new year!

     

    • chris13067
      chris13067 tim50stroud

      Posted

      Hi Tim, thanks for the comment. I'm really worried about the long term effects, I really want to get back to my hobbies asap but know I have to be patient to get the best possible outcome! Mine was a total rupture and an ultrasound showed a 2.2 cm gap but the consultant still thought surgery wasn't necessary or advisable in view of where the rupture was. Thanks for the wishes for this year, I hope you get your issues sorted as well!
    • tim50stroud
      tim50stroud chris13067

      Posted

      I remember feeling the gap in my tendon; engineer's curioisty; and I was amazed that it all closed up quite happily. Exercise as much as you can; I rotated the ankle while foot up watching tv, & used bungee cords to push against. I'd have thought a right foot would be quicker to get back to driving; no clutch and brake issues?   Definately a question ask.

       

    • chris13067
      chris13067 tim50stroud

      Posted

      I fully intend exercising as much as I can as soon as I can! Do you brake with your left foot??!! Last time I drove I used my right foot for accelerating/braking! The boot makes that pretty much impossible and an automatic would still be illegal and is only possible if you have a permanent disability and take a test to prove you can do it "wrong footed". the gap was a worry for me, I was convinced it would need surgery or manipulation of some kind. I'm hoping the consultant made the right call!
  • peterrobson145
    peterrobson145 chris13067

    Posted

    Hi Chris

    I had a complete rupture on 22/12, i've just had my cast removed and put in a walking boot yesterday, I was given 5 wedges and start physio on Monday and remove on wedge for the next four weeks

    A couple of things to ask your consultant as i'm finding,  can you remove the boot for bed as i was told yes, but it seems to be uncomfortable to sleep without boot, Walking with boot, should you be usine both crutches or one. Can they suggest anything for levelling up your other leg while in the boot, as it hard to balance on non injured leg.

    good luck, with recovery.

    • chris13067
      chris13067 peterrobson145

      Posted

      Hi Peter

      Thanks for the response and for sharing your experiences so far, sorry you have suffered a similar injury! It seems that you are on a more accelerated rehab than mine, did you have surgery?

      I did my injury on the 16/12, was in a half cast until 21/12 when the decision to not have surgery was taken when I was put in the boot. I am completely non weight bearing until next Tuesday when they take the first wedge out (I think I have 4) and allow some weight bearing with the aid of crutches and then it's a further appointment every 2 weeks for each of the other wedges to be removed. Is yours close to the calf as well? I'm not expecting any physio until the boot comes off after 8 weeks and have been told to sleep in the boot which is a nightmare.  I would be very nervous trying to sleep without it though, I move about in my sleep quite a bit.

      Interesting to see the differences in treatment, where do you live, are you in the UK?

    • peterrobson145
      peterrobson145 chris13067

      Posted

      Hi Chris

      Sorry in the delay, no I didn't have surgery. My injury is the same as yours near the calf,

      I had two weeks non weight bearing in cast, now walking boot with five wedges, one due out each week. I tried one night sleeping with boot off and found it a bit too sore, so im sleeping with back on.

      The Physio starting today.

      I live in South Tyneside.

    • chris13067
      chris13067 peterrobson145

      Posted

      Hi Peter

      Thanks for the update, you are definitely further ahead than me. I had the first of 4 wedges removed this morning and have been told to only partiallly weight bear and still use the crutches. I'm away when my next appointment was due in 2 weeks so she showed me what to do today to remove the next wedge so my next appointment won't now be for 4 weeks and she said then I would start physio to get me walking without the last wedge. I have already got a referral to a decent sports physio and am debating when to make my first appointment with them so would be really interested to know what physio you are doing so early? was your's a complete or partial rupture? thanks again for sharing your experiences so far!

    • peterrobson145
      peterrobson145 chris13067

      Posted

      Hi Chris

      Physio told me not much they could do at the moment, although he has given me gentle exercise todo, basically flexation up/ down/ left and right. Also I ask if I could go to the gym, which I'm allowed to do strength work on my upper body and allowed leg work on good leg, as well as handbike for cardio.

      I will see him in four week after next appointment with consultant.

      He did give me the protocol there following SMART ( Swansea Morrison Achilles Rupture Tendon)

      I have read it and it's helpful, Chris how big was your tear.

    • chris13067
      chris13067 peterrobson145

      Posted

      Thanks Peter, I will google that and have a read. Mine wasn't a tear it was a complete rupture with a gap of 2.2 cms. Maybe that's why you may be further ahead than me if yours was a tear? I'm just using my crutches for exercise at the moment, up and down stairs at work around 10 times a day does it for me!
  • chris13067
    chris13067

    Posted

    I just thought I'd give a bit of an update, I'm now 5.5 weeks since my rupture and I've been in the boot for nearly 5 weeks. I feel like it's healing well and I'm doing some mild flex/rotation exercises when my boot is off, generally weekends and evenings. I'm being very careful not to overdo the stretches but feel like I've gained some movement and strength back already. I'm walking around on the boot quite a bit although I was told to be only partial weight bearing. They also said that I won't do any harm as long as I don't get any pain and at the moment I don't get pain walking around so think I;m ok doing what I'm doing. I can actually now move around with no boot as long as I keep my bad foot forward. I can stand up straight with both feet together (being careful not to put weight when in this position) I got on my scales yesterday and was pleasantly surprised to see I had only put a couple of pounds on, even being inactive over Christmas! My calf is noticably smaller though so probably another pound or so lost in that area! I'm thinking of losing the scooter soon as I'm using it less and less but I did get an "even up" shoe balancer which makes walking around MUCH easier and I would heartily recommend this for anyone walking with an aircast boot. I will be down to 2 wedges on Tuesday so all good so far.

    Good luck to all my fellow sufferers and I hope you are progressing well!!

    • tim50stroud
      tim50stroud chris13067

      Posted

      Sounds good news; have you tried pushing your foot against any tension.... I used bungee cords, starting very gently, gradually increasing over the weeks. I;ve still got a noticable calf weakness, and have an appointment with the NHS physio a week on monday. I did hear a radio prog about how quickly muscle loss occurs on the space station in zero G; muscle loss and regaining the strength has been more an issue than the rupture itself!
    • chris13067
      chris13067 tim50stroud

      Posted

      Hi Tim, sorry I missed this reply! I was thinking about starting using therabands and will probably do so this weekend. I'm rotating my ankle quite freely now and gently flexing my foot back but not past the neutral position. I'm finding it really hard not to keep pushing the boundaries further every day because I feel like I'm really making good progress. I'm moving around FWB in the boot, up and down stairs at work with no pain and little discomfort at all. By the time I get to my next consultant appointment on the 24th I think I will be more than ready to get out of the boot. I think I will start to do some one legged cycling on my turbo trainer just to get some cardio in. I'm not taking it for granted all is rosy though and more than aware a rerupture could easily happen if I don't watch myself! I get a little swelling by the end of a day at work but ice the area when I get home and every morning all the swelling is gone and there is no pain at all. Keeping fingers firmly crossed all is well!
  • chris13067
    chris13067

    Posted

    Another update for the benefit of my fellow ATR sufferers. I had my final appointment at the hospital on Monday morning, with the registrar because the consultant was away. She was happy to confirm I could discard the boot and after a Thompson test and examining the tendon said I appeared to have made a good recovery. I told her I had booked private physio myself through work private care so happily discharged me. I had my first physio earlier this evening and the PT was amazed at the range of movement I had, said "this should be a breeze" which made me feel really positive! In my ankle flexing I have nearly as much as in my good foot, the area I am really lacking in is in trying to stand on tip toe, it feels like someone has super-glued my heel to the floor! He gave me the ok to start doing some light turbo trainer cycling so I came home and did 10 minutes with only mild resistance and with no ill effect. He manipulated the tendon for around 10 minutes which will help to take some of the thickness away from the tendon which seems about 3x the thickness of my other AT. Anyway, I am exactly 10 weeks to the day since injury and I finally feel like I'm getting my life back! So stick with it everybody and good luck with your recoveries! Thanks for all the support and for those that blogged their own stories, many of which I have read and this has helped me massively. I'm not taking it for granted I'm out of the woods by the way, just encouraged at where I am at this stage!
  • chris13067
    chris13067

    Posted

    Another update for the benefit of my fellow ATR sufferers. I had my final appointment at the hospital on Monday morning, with the registrar because the consultant was away. She was happy to confirm I could discard the boot and after a Thompson test and examining the tendon said I appeared to have made a good recovery. I told her I had booked private physio myself through work private care so happily discharged me. I had my first physio earlier this evening and the PT was amazed at the range of movement I had, said "this should be a breeze" which made me feel really positive! In my ankle flexing I have nearly as much as in my good foot, the area I am really lacking in is in trying to stand on tip toe, it feels like someone has super-glued my heel to the floor! He gave me the ok to start doing some light turbo trainer cycling so I came home and did 10 minutes with only mild resistance and with no ill effect. He manipulated the tendon for around 10 minutes which will help to take some of the thickness away from the tendon which seems about 3x the thickness of my other AT. Anyway, I am exactly 10 weeks to the day since injury and I finally feel like I'm getting my life back! So stick with it everybody and good luck with your recoveries! Thanks for all the support and for those that blogged their own stories, many of which I have read and this has helped me massively. I'm not taking it for granted I'm out of the woods by the way, just encouraged at where I am at this stage!
    • tim50stroud
      tim50stroud chris13067

      Posted

      Good news, I hope it continues, though this does sound horribly familiar! For me, this is where the recovery got really slow, getting that calf muscle back into condition again. Maybe I didnt do the exercises as regularly or as thoroughly as I should, and maybe I didnt go to the gym as often as I could, but over a year down the road,I still can't do a toe stand on the bad leg. No pain, but its still making walking uncomfortable for any distance .. I find the discipline of exercise (like dieting) difficult to sustain.. especially after a series of colds and sniffle since xmas.. musch easier to stay indoors and watch tv!  Good luck..keep us informed of progress!!!
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