Worried about Achilles Tendon rupture recovery

Hi

Thanks for your reply. My Physical Therapy should start soon too. I was seen by a physiotherapist and given some exersices and I doing it. You are right I must be very careful with walking without crutches, won't do it, the pain is still in my system, I wouldn't want to rerupture as easily done!

Good luck to you too and speedy recovery.

My timelines – operation and very conservative recovery. At the moment I am concerned about the my prolonged recovry. I see progress but tendon is very stiff and refuses to go into neutral. I will continue with physio and home exercise.

Apr 11 – Complete Achilles rupture – cast put on

Apr 26 – Invasive Operation to stitch tendon together and cast put on

8 weeks of being in casts (change of casts to reposition foot but foot still wouldn’t go into neutral)

June 23 (week 8 after op) – Remove cast and change into heavy boot (1 wedge and 1 heal slab) + crutches

July 4 (week 10 after op) – start physio and removed 1 wedge

July 11 (week 11 after op) – physio, foot is still not fully in neutral

Jul 21 – (week 12 after op) – check up with the surgeon (after 1 month of being in a boot). To clarify the course of next actions e.g. can I come out of the boot into trainer with wedges and apply more weight

Hi Emma, I was wondering why didn't they operate on 11 April and waited 2 weeks? Is it because they weren't happy with the healing process or you were on the waiting list?! I saw the physio today, I am not happy at all, didn't seem to have any confidence in what she was saying! I may seek a private physiotherapist. My foot goes as far as nearlly 90 degree but she said that needs to see more degree than that! Basically I can put my foot down flat on the floor. In 2 weeks time she will consider putting on the weight bearing heavy boot on, then I can walk without the crutches. 

I had my accident on Apr 11 but didn’t realise it was so serious.

3 days after accident, I called my GP and attended Urgent Care Centre at hospital on that day. The doctor diagnoses complete rupture + need scan + need ortho appointment. So my orthopaedics appointment was Apr 21 + earliest operation date was Apr 26. The operation date had nothing to do with the state of the tendon – it was purely the wait time.

My gap was 2.7cm and hence they pushed for operation. It was on threshold that non op method – wouldn’t work well in my case.

My experience of the NHS physio - they have no notes from the surgeon on the recovery plan – so there is an absolute disconnect. Also the surgeon gave me little indication of the end to end recovery time frame other than 8 weeks in cast, then into boot (1 month) before next check-up. I showed the physio letters from the surgeon to my GP to brief him of my case at 1st physio session. The guy was diligent enough but it is a real challenge for him too – as he is expecting an outline plan from the surgeon – so this is extremely conservative.

My experience of private physio - In the week that I was waiting for NHS physio – I went to see private physio (as I couldn’t afford to lose one week in healing and getting next actions). He challenged me and safely to progress the recovery. I feel more knowledgeable about my situation and next actions / goals.

Risk of re rerupture – both nhs and private physio warn me of risk of re rupture. Their advice is to do little and often to mobilise the tendon. Watch out for bad pain and avoid harsh movements that give bad pain.

In my case, the surgeon targeted my foot to be neutral 9/16/23 June – actually as each week progressed I am still not 100% neutral – a few degrees away now. Hope this helps, I ll be really interested on updates with your recovery…

In your case, its great that you are near neutral and have plan to be put into boot for walking with crutches. Clearly I am no medical expert – but you say you are walking – please be very care to avoid re rupture… If you feel lack of confidence in your current physio – then it can do no harm to have 2nd opinion – it ll put your mind to ease – which I m sure will help with recovery anyways.

Thank goodness for patient community – I ve learnt a lot from people’s experiences.

Hi again, yes this forum is great, lots of help from the people who are in similar situation. How could you bare that pain for 3 days?! It must've been very difficult time. When mine snapped, I thought someone shot me! and the pain, was unimaginiable, was take by ambulance to ED. I actually tried to push for surgery, but they wouldn'd do it, and reason for that was, apparently both end of the tendon was reaching in the toe down position. It is very frustrating period as you know, but what can we do! Have to give it a time to heal hoping won't need surgery later (in my case). I will seek second opinion.  I have stopped walking without crutches, too risky! 

I wish you and the others speedy recovery. 

I ruptured my achilles tendon 6 weeks ago and am being treated non surgically with an aircast boot in the NHS. My experience in the NHS so far has not been at all good. I am even more concerned about when it comes to having to have physio in 2 weeks time (at 8 week mark) as I am worried I may land up with a not so good physio and it appears it is vital to have a good physio to get good progress. I am thinking of therefore using the NHS physio as well as getting my own private physio. Do you know how much private physio costs? Also when you started having physio how often did you have to see the physio and how often do you see the physio now? Thanks in advance.

At week 8 after operation - my nhs surgeon gave me go ahead and put me in the queue for nhs physio. In my case the healing was already very slow - I.e foot did not reach neutral position as expected by the surgeon. So at week 9 I booked private physio as I had no idea the queue time for nhs physio.

At week 10 I got my nhs physio and also continued private physio. I have continued this blend...

This is my week 12 - nhs surgeon says I'm healing very slow, I was hoping to discharge you but we will see you in a months time.

There is no communications between nhs surgeon and nhs physio - physio needs guidance on the overall recovery plan.

I was so pleased to start private physio - he helped and pushed me more but safely.

Physio prices vary depending on location so I suggest you ask local gyms or friends for recommendactions and then look up prices.

Let me know if you have other questions. I learnt a lot through this community so I'm happy to share my learnings.

Hi Stephen. I was just wondering what you mean by a rerupture on a 4cm gap. Do you mean there was a gap 4cm and it reruptured. Surely having a gap of 4cm means it's ruptured already. Are you meaning the gap was 4cm, it healed ie. 0cm and then reruptured. I am very interested as I am also worried about rerupture. Thanks in  advance.

It took a good 12 weeks for my calf muscle and tendon to work togther properly for the thompson/simmonds test (squeeze calf/foot move). The message here is be patient - it is unfortunate but frustrating.  My consultant stated the calf and tendon only fully repair after 3 month and in the 10-14 week period (when you should be out of boot) is the "danger time".  You should not be out of boot before then as any significant pressure on the tendon could damage the new tissue and cause a more lengthy recovery period.  I had a very frustrating summer last year, in a boot, not being mobile, but recovery is still a long process as my calf muscle on left leg is still undersize vs the right calf and only exercises over the next months / years will get it back.

Keep the faith...

I would love to be connected with you friend from facebook, I need advice and encouragement.