Achilles rupture - some pain during healing

Hello JW,

sorry to hear about your injury.  Since you have been through this before, you will have some good insight about the healing process and what to expect

I am about 7 months post-injury and had a complete rupture followed by minimally invasive surgery. During the early stages I found that an ice wrap for about 20 minutes a few times a day really helped with swelling and all the associated discomfort. Pretty close to recovered at this point, although still a little stiffness, weakness in the calf muscle, and minor numbness in heel. 

Best wishes for a speedy and complete recovery, and a return to badminton. 

Hi Rob9700, thanks for your good wishes and the ice pack suggestion - I'll definitely try it. This time feels completely different, though - with the partial tear l wasn't put in a cast or boot at all, I was just on crutches for three weeks, gradually going back to weight-bearing. I had some private physio too which definitely helped.

I'm not sure when I'll be able to start physio this time, as I'm no weight-bearing for 11 weeks, so it's going to be a much tougher and longer recovery. I dread to think how those first steps will feel!

Very sadly, after about 25 years of playing, I've already decided not to return to badminton, as I can't risk it happening again. I think swimming will be my new friend (eventually!)

I'm pleased to hear things have progressed well for you.

Hi JW,

I have had a fantastic recovery since the time I had a full rupture in Aug 2016 while playing tennis until this day. I am 58 years and I went through surgery and now am nearly 95% recovered. Went through the same standard process. First injury 16th Aug, actual diagnosis of tendon rupture only after 10 days, then MRI and finally surgery on 16th Sept, On Cast for 10 days and then Boot (no weight bearing), Stitches removed at end of 3rd week, No weight bearing with Boot on till end of 5th week, at end of 5th week Full weight bearing with Boot (could drive now) and also start Physio. The healing process was pretty good and what helped me in the healing was - lots of ice pack at least 5 to 6 times a day and my meditation sessions at home (at least 20 mins each for 3 times a day) that let me totally relax.

Once I was weight bearing the Physio trainer was amazingly helpful and I did 3 times a week for first 3 weeks and then another 2 weeks. My calf muscles had never been so firm and strong as it is today. I am now able to do full heel raise on one the injured leg.

So, I believe this first needs a good healing (lot of ice packs, relaxation, meditations..) for first 4 to 5 weeks and then after good PT sessions. Even this day at end of 7th month, I do my PT seesion at home/work (20 to 25 mins)each x 3 each day. I started playing TT and look forward to start playing tennis by 9th month.

Do not lose hope, you can surely recover almost full.

Wow, gopal1959, it's great to hear of your excellent recovery!

I've not had surgery, as the consultant didn't deem it necessary for me - she said they only do it for elite atheletes or if it hasnt been diagnosed quickly - so I'm not sure if my recovery will be as good/the same as yours. I'm also not sure what physio is available here in Norfolk on the NHS, but I will be investigating once I've got the boot on.

In the meantime I'm doing what I can to keep my knee and hips moving and strong on my injured leg.

Hi jonathan28999, were you not told to weight-bear while wearing the boot? My instructions from the (very experienced) guy who removed my cast on Monday and fitted my boot were as follows: Weeks 1-2 three wedges, just touch-bearing, resting the boot on the floor. Weeks 3-4 two wedges, up to 50% weight-bearing as pain permits. Weeks 5-6 one wedge, more and more weight bearing, maybe just one crutch. Week 7 no wedges, aiming for full weight-bearing, maybe no crutches.

I have to wear the boot 24/7 but can remove it for washing and later on when resting. Then back to see the consultant to find out if it's all okay and whether I need physio Or any further treatment.

I wasn't told not to weight bear. I had a cast with no weight bearing for 4 weeks, then the boot and they said I could walk on it?!! With crutches, but I could walk. I have been down to final low wedge thing for the last two weeks. I was in the boot 24/7 for about 3 weeks then I could take it off at night from then on (the last 2 weeks). I'm just concerned about being told to try and walk as I'm frightened it will give way on me.

Ah, so sounds similar procedure to me then, except you were walking on it in the boot from the start? How has that been for you? I TOTALLY understand the scariness of weight bearing and what might happen. I'm scared of putting the first bit of weight on mine in a week or so. I think all we can do is trust that the doctors know what they're doing and follow their advice.

Yeah from week four in the boot.Weight bearing was ok to be honest. A little strange to begin with, but it's felt ok on the whole. The whole thing is quite scary when you are left in limbo really in terms of recovery. It seems a case of fingers crossed and hope for the best. Really ready to get a bit of independence back to be honest. How have you found it?

That's surprising about weight bearing from week four, though I guess all NHS Trusts are different, as are the doctors. From the research I've done every bit of advice is different, so no-one's entirely sure! I'm with you on wanting independence - I've still got a way to go before I'm at that stage. The whole thing is scary and I don't suppose I'll ever feel 100% confident on it again.

I've found the boot really heavy and cumbersome to lug around (even though I'm fit and fairly strong), especially as I'm not supposed to put any weight on it yet. I'm glad to hear it's been okay for you on that front; that's reassuring.

Sounds as though as long as the weight-bearing has been okay you should be fine on Monday. Please do keep me posted with your progress. Good luck with it.

Hi Betsy,

Sorry to hear about your injury. Pain at incision is not too uncommon, judging by posts to this site. BUT, although unlikely, could be symptom of infection, especially if accompanied by redness, warmth, discharge at the surgical site. Probably best to check with doc if you are concerned.

Burning and shooters along outside of foot and last two toes likely associated with some irritation to sural nerve. If that is the case, the good news is that will improve, albeit very slowly. I am 8 months post op and experienced the shooters for quite a while. They woke me up. Best treatment is ice wrap and elevation a few times a day. It won't stop altogether, but it gave me some relief until the frequency and intensity of the subsided completely. I no longer have pain, but still have a touch of numbness even now that is occasionally mildly annoying. This, too, seems to be improving slowly.

Hang in there. Recovery is pretty slow and frustrating, especially first few weeks. Gets better when you can get some mobility back. Best wishes for a full and speedy recovery.

Must be a relief, albeit a very strange one, not to have to lug the boot around any more. I think doctors sometimes forget that, although they see these injuries every day and it's routine for them, it is completely abnormal and scary for us as patients. I can imagine your leg does feel very wobbly, but all you can do is listen to your body and take things slowly.

I undid my boot for the first time today, but didn't dare take my leg out completely for fear of flinching, or twisting it, or damaging my ankle. I'll have to pluck up the courage by next week, as I've got to take the first wedge out :-/

Please keep us posted on your progress.

You should be ok to take it out as long as you are sitting with it raised and fairly immobile. I did this most nights to just give it a bit of air and try to wiggle my toes a little.

Yeah they are a bit blasse about it which as you is say is probably because they see it evry day but very scary for us.

Stairs are really hard going and slow at moment. Not willing to risk them without crutch yet.

My boot's quite big, so I can easily wiggle my toes while I'm wearing it, but it'll be nice to get some air around it. I'll pluck up the courage soon - it just seems daunting when it's been tucked away safely for so long!

You'll get there with the stairs, but take your time and don't put pressure on yourself to do too much too soon.

Are you experiencing any pain now, or is your ankle just stiff?

It's a bit stiff, but not so much sore. The pain is in my foot around the outside by my toes weirdly. Not a lot of pain in the Achilles at all to be honest.

Strange about the toe pain, but otherwise really good news! Hope it continues to loosen up and stretch back out again.

Thanks!

Keep me posted on your progress. Would love to find out how you get on. Hopefully all will be good

Will do, and thanks.

By the way, did you still have bruising after several weeks? I actually managed to pluck up the courage to lift my leg out of the boot this evening and noticed I've still got a fair bit around my heel. I'm hoping it's normal, even after nearly six weeks :-/

I've got another question, as well as about the bruising... I took my boot off briefly and noticed that around the Achilles area there's quite a lump and an indentation - did you have this? I hope it's just a knot where it's healed and It will stretch back out as my Achilles stretches back out, but I'm a bit concerned about it. I'll give the hospital a call tomorrow, but it'd be good to know if anyone else has experienced this while undergoing conservative treatment. Thanks.

Firstly, bruising...yeah I do have a slight discolouring there. Not full on bruising like it was, but definite purplish colouring there.

The indentation...yes also, I did have this and it really concerned me tbh, but apparently totally normal. It is, as you say, just the achilles needing stretching out. It heals wider and shorter due to the position of the foot whilst healing, so the game when you get boot off is to stretch it out and get some length back in it. Hope this helps.

Definitely helps, thanks very much. Reassuring to know that it's all a normal part if the healing procedure. First wedge out tomorrow for me :-)

I think it is common. I had purplish bruising and swelling around the Anke for quite a while. Also had some similar indentations and a little bump around the incision (which was lateral, that, across the Achilles in my case). Also some swelling which subsided slowly. Color is gone, discontinuities less profound but not gone. My doc said the Achilles' tendon on the injured side would remain somewhat thicker than the other for the long term. So far, he's right.

Yeah I think from what I heard too that this is definitely the case. I watched a video and the physiotherapist in it said that the Achilles may be visibly thicker for good. I have been doing my stretches but so far not much more mobility. Presume it's a long term game.

Thanks, Jonathan and Rob, it's really good to be able to chat about it all and reassuring to hear your stories.

I've taken the first wedge out of mine this morning and I'm amazed how different it feels! My toes have been kind of 'dangling' (not actually dangling!) with the three wedges, as though if I'd put any weight on it, it would've been on my heel only, but now I'm on two it feels like the complete sole of my foot, including my toes, are nicely on the insole of my boot.

Looking forward to hearing more of your progress.

Feels very weird for a while. I think once you are able to move around more the progress will be faster. Still slow and frustrating but faster. I am still working on getting back the strength in foot and calf muscles. At 68 my recovery times are so much slower than when I was 30. I think we need to just hang in there, stick with the PT program, and take it one day at a time. 

I am around 6 weeks post surgery for complete rupture. I still have major bruising around my heel. When I walk far in my boot the bruising gets worse. Best of luck with your recovery.

Hi there.  I have been in a boot, with three wedges, for 10 days following 5 days in a cast. I  have just started weight bearing and know exactly what you mean about toes dangling.  I am size 6 (39) and it's occurred to me that if I had bigger feet the ball of my foot might be able to touch the bottom of the boot and that way I could spread the weight evenlyand keep the achilles relatively short.  I am concerned that just putting weight on my heel is actually worse for the (so-called) mending achilles than pressure spread across the foot which would help to keep the foot in the pronated position.

Did you ever mention your concerns to a medic?  I was toying with looking on the internet for wedges specific to foot size.  (It cannot be the case that one size wedge suits all size feet equally well.).

Hi lyndall04191, sorry to hear you've had this injury too. I'm guessing you had an op on yours as you only had five days in a cast? I'm on the conservative route and was in a cast for four weeks, then the boot for seven, and I'm now nearly six months in. I'm a size 6 shoe too and I agree that with longer feet the ball would more likely sit on the bottom of the boot. I've no idea if they make any different size wedges, though, and never enquired. My foot could move up and down within the boot a little bit as it was quite big on me, and my toes would lift up, stretching the Achilles slightly, but 'touch wood' it doesn't seem to have had any negative effects. At that stage, with three wedges, I wasn't allowed to put any weight on mine, only rest it on the ground. Once I got down to two wedges and could feel my whole foot on the sole of the boot I started to carefully put some weight through it whilst still using my crutches. Hope that helps and you make a good recovery. Feel free to ask any other questions.

Thanks JW.  What a long haul it is for everyone.  Actually I haven't had the op and have read somewhere that the sooner you are weight bearing the better.  What's clear is that everyone seems to have completely different treatment regimes.  I have no clue if the achilles is actually mending and never had an ultrasound to check it was only a 90% rupture.  Everytime I go to the fracture clinic I get a different doctor etc etc. The only pain I have is in my LHS of my calf which only kicked in at 2 weeks post rupture!  Hey ho - I dare say I'll get there in the end.

It's very much a postcode lottery on the treatment you get, and everywhere and everyone seems to have different opinions and methods. My hospital were very conservative (I only saw them three times - once initially, once to have the cast off and boot on, and then again to have the boot off - I had no scans at all and there's been no follow-up or support. I see an NHS physio once a month, but, even now, is reluctant to really get me moving! He just likes to talk at me! I've been doing a lot of stretching and strengthening on my own and I'm now at a stage where I can walk two or three miles without limping, and can do mini single calf raises on my bad leg. I follow someone on Instagram who's in Australia and non-op, she's about five months in and *just* starting to jog! She's under an ex-All Blacks physio and they had her stretching and weight bearing from a very early stage too. Pretty inspirational stuff.