Achilles rupture - some pain during healing

Hi Sandy

I am also 10 weeks. Limp and fluid/swelling round the ankle. Not really any pain any more just really stiff feeling.

Your pain sounds like it might be the physio pushing you a bit to hard. My physio said my exercises should be uncomfortable but not painful. Doing more and causing pain will heal in the same time as doing less and not getting to painful. That's my physio opinion anyway and I'm sure they all have their own ideas.

If you are struggling maybe go back to non weight bearing stretches. That's where I am at the moment. All the stretches have the same goal to slowly stretch back the Achilles tendon. So as long as it is stretching a bit each day it will get back to where it needs to be. As I'm sure all will agree it's s time consuming process and we all want the recovery to be as quick as possible. Put maybe don't try and push to hard.

Hope the pain eases soon.

Sorry to hear all of that Sandy. I'm with Davie in thinking that it soulds like your physio is pushing you too hard. Pulling, aching, and some soreness is to be expected, but real pain is definitely an indication that it's too much. I know we all have to put our trust in the professions, but we also have to listen to our bodies.

It's good that we can all chat about it here and get each other's feedback. Do keep us posted once you've seen your PT. 

Having read others' progress, and from doing research, I'm concerned that I haven't been doing enough stretching and ROM exercises (I've not really done any apart from simply moving my ankle up and down and wiggling my toes) but on the other hand I've done exactly as I've been told. I can only hope that my first physio appointment isn't delayed too long, then I can find out more.

After 2 weeks I had my 1st PT session. 5 excercises while lying

down with straight leg, maybe supported by pillow. The range of motion is very important in the recovery, as it will help you walk properly later on.

1) Point  toes down and then lift them up 

2) Do a windscreeen wiper action with your foot

3) Circles with your foot (both directions). Just stay within a comfortable range of motion

4) Push injured foot against good one for a count of 15seconds 

5) Had elastic stretch band, and with it wrapped around injured leg, hold a static resistance.

Finish off with a light foot massage if possible.

I was driving after 2.5 weeks (nobody to help me, except my dad and his driving is traumatic for both of us . He's 87 !). Left leg and manual vechile (very soft clutch), but in my aircast it all feels fine.

Hoping for some additional strength building excercises at PT tommorow.

Thanks, Neil, that's really helpful.

The first two I've started doing gently the last week or so, but sitting up. I'll definitely add in 3 and maybe 4, but I've been told no passive stretches, so the elastic band is a no-go for now. It's hard to know - without a professional on hand - how far to push it, so I'll be careful, but at least I'll feel as though I'm doing something to help start the recovery.

No driving for me until I feel confident, but luckily I have my husband and parents on hand as taxi drivers. (Aww, your dad, bless!) 

The other thing I'm slightly concerned about is that my leg and ankle are feeling rather cold, so I'm having to keep rubbing it to try and get the circulation going. I hope it's just a temporary thing.

Just back from physio today. For me it's 3 weeks post operation. Stitches out, and leg feels fine. Added a rubber band stretch with toes down. Band around upper part of foot and toes. Pull ends with hands. Also two weird ankle stretches, that feel kind of strange. Can't really describe them.

Was also on exercise bike at physio. Boot off, with heel on peddle, no resistance. Can do as much of that as I want, and it felt great.

Re you cold musle and foot. One thing I find brilliant for relaxing the muscles (and warming them up) is my infrared Lamp. 15 minutes on each side of the ankle (boot off), and 10 minutes on the achilles,  feels pleasantly warm, and gets the blood flowing through the trauma area. It's very realxing as well.

Physio said I can get in aerobics pool after next weeks physio. No kicking, but he said I would be able to walk in waist high water.

Glad all's well after your physio, Neil. I was still in a cast at three weeks, so it's amazing that you're making such a swift recovery, though appreciate you had surgery and I didn't. 

The infrared lamp sounds like it could be of real use to me (and probably my hubby too, who has sciatica!) I think you said it's a Phillips one, but which one is it? I've found the InfraPhil HP3616 150 W on Amazon that's got very good reviews. Thanks.

Hello,

I have an old philips infraphil. The bulb has blown a few times. Has a white infrasatin bulb, 250w 240V made in Hungary.  It is very similar to the HP3616 .For muscle aches and pains I don't think there is anything better. It dilates the veins and helps the blood flow through the affected area.    For 39 quid I don't think you can go wrong.

I did have some feeling of cold in my foot early on. Not now.  I think it is normal and should subside. If it doesnt, I would mention it to your PT.

I also walk a bit daily, but PT advised that if walking led me to limping more, than to take a break. Better to walk a bit without limp, then to walk more or faster and limp, as limping is not good for the muscle memory that I am trying to develop. I see her point and find that I am now sitting more when I am tired.

Hi JW ,

I know you can't undo your past 8 weeks 're surgery / non surgery.

But I would say to a person who has just suffered an achilles rupture ,

that the surgical approach seems more satisfactory.The non

surgical seems to be endless non weight bearing initially.

It's really interesting to see the different recovery times

for the achilles rupture. The biggest change for me was

getting out of non weight bearing cast into boot after 2 weeks.

Mentally it feels really good, and you feel more proactive in

your recovery.

Did you purchase the lamp ? If so I really hope it speeds your recovery and eases your discomfort.

All the best,

Neil.

To me this exercise sounds pretty hectic.

Seems a little bit too much too soon.

Do you have a swimming pool locally ?

I think doing this in water initially would be much better.

Neil.

There's a lot of recent research that disagrees about surgery and suggests that the conservative route is better... but it does seem to be quite an ongoing debate, and is one that differs from country to country and doctor to doctor, so all we can each do is follow the route given to us. 

I'm going to see a private physio this afternoon (the same one I saw when I paritally ruptured my other Achilles about 10 years ago). The hopsital said that it could be 2-3 weeks before I get an appointment on the NHS, so I want to be pro-active and start making some progress instead of sitting around waiting and not knowing what I should and shouldn't do.

I've ordered the lamp and it's arriving today, so hopefully that'll help - thanks for the advice on that.

The routine since Surgery:

- 3 weeks Cast ( during this time I would do regular meditations ..about 3 to 4 times a day) and lot of Ice packs. No weight bearing.

- 3 to 6 weeks ..Cast removed and Boot on..  still No weight bearing..

- 7th week .. weight bearing and started driving. Started Physio.. The Physio started aggressive and showed much improvements into 2nd week.. All the while Ice packs would continue.

The Physio gave me a target to do heel raise, which I slowly started into the 4th month slowly and now in 8th month I can do a complete heel raise. I still do stretches 3 times daily (20 mins each) toe raise/heel raise on stairs, heel walk and toe walks, and stretch the achilles tendon.

Caution.. early on do it carefully but consistently.. the stretches has to shed the scar tissues...

At end of 9th month (this 16th June) I still feel a little unease, but continuing the stretches makes it better. I play table tennis daily and looking forward to regular tennis games.

Do not lose hope folks, it is going to be hard work, but you will come close to normal surely.

Hi Davie. I'm around 6 weeks post op from a complete rupture. I have also experienced the shooters from the heel down the outer edge of foot to the last 2 toes. However, what's got me most concerned is the bruising. I'm in the boot and when I walk very far, I not only swell substantially, I bruise. My heel is a deep purple and bruising gets worse every time I walk very far. Do you think this bruising is normal? I was 2 weeks in a hard cast post op and now around 4 weeks in air boot.

Hi Kristy. I don't think the bruising is good, especially as you say it gets worse every time you walk far. Maybe you are doing too much? are you in heel wedges? I did not have surgery, so I was only in a boot, not a cast at all. However, my brusing began to fade after about 5 weeks and now 12 weeks post injury I do not have any reoccurance of bruising. Are you in physio? If so, I would discuss it with your PT. If not, then with your Dr. You could be someone who just bruises easily, but should check it out to be sure.

Hi Kirsty.

I was non surgical and when I got my cast off at 8 weeks I still had bruising around the bottom of my foot. Went in a boot for 2 weeks and I was full weight bearing but don't feel it use to bruise up anymore but certainly did swell.

I would say bruising is normal at this stage but maybe get it checked out as you would think the bruiser should be getting better not worse. I ain't a doc but I'm pretty sure it's just your bodies way of healing.

Hope it settles down soon.

Hello Kristy,

I am 5 weeks post op, 2 weeks in soft cast and last 3 weeks in boot. My rupture was also complete, about 2 inches above my heel. I am walking in house without boot, but I have no sweling, brusing or pain.

To me brusing would be ok'ish, but swelling is the body protecting the area/joint from injury so something is not right there.

No physio yet. I don't see or tho again for 2 more weeks. I'm ready for physio. I have substantial pain in heel and the bruising just remains. Im at a frustrated point with it.

Hello all, It has been awhile since anyone has posted their progress. I am hoping all is going well. My progress was going slow, but forward. Managed to do small heel lifts for a few moments.  But recently have been experiencing tendon pain and stiffness in both legs. Not sure where that came from. But find it pretty debilitating.  With PT, I have two things that are being emphasized. One, is doing calf raise, lift good foot and hold stance for 45 seconds (I do hang on to my kitchen counter). Then lower, rest 2 minutes and repeat. Total of 5 times. Repeat entire sequence 2 times per day.  I find it painful in the tendon area, but do feel that is where my progress in lifting on to toes on injured foot is coming from. Having said that, continued tendon pain means that several times I don't repeat the exercise later in the day.  My PT advises this is a specific protocol and that I need to do it. So still struggling with it.  The second PT is with her co-worker who does IMS. I have had two sessions with him. It is not comfortable, but so far no pain from this. And I think it has helped stimulate the muscle that is attached to my middle toes. The numbness I used to feel has dissipated quite a bit.

During this time, I have not done a lot of walking, but last week I took a 1.5 mile walk that took about 45 minutes. Now to my reckoning, that is not overly fast. And although I was feeling it in my tendon by the time I finished, I otherwise felt great. The next day is when I started to feel pain in both tendons and that pain has been consistently there since then. I find it very painful to go down stairs on either foot. I did not go for any more walks until two days ago. Went for 2 1.0 mile walks. Yesterday went for two .5 mile walks. The first time, I found that walking seemed to help loosen up my calves and then tendon pain on my good foot eased up to negligible. The pain in injured foot went down to a 1-2/10. Yesterday was shorter walks, but did not feel good and was in 5/10 pain in both tendons by the end.

Anyone else having any similar setbacks? Any suggestions?  I am still stretching - stair calf raises and lunge stretches. Have not completed the 45 second protocol in two days, but plan to try again shortly today. Yesterday I soaked in hot tub for 30 minutes and that seemed to help for a short time.