Achilles rupture - some pain during healing

Yeah I had some of that, but I think they pushed me too far too soon in physio and it was never right after that, and then it's just been a matter of it was going to go at some point and unfortunately I did on the stairs two weeks ago by the look of it. Although I do wonder whether it was ever fully healed as it was never ever checked properly.

I wish you all the very best for tomorrow, Jonathan. I'm guessing it was a combination of the physio (that bloomin trampoline they had you on!) then your trip on the stairs when it was already weakened. Hope it goes well, let us know when you can.

Many thanks. I am just sitting in hospital waiting to be called for operation. Hopefully get it sorted this time.

I imagine you are home. Always nice to get out of hospital.

How are you feeling ?

I hope your healing goes more smoothly now, Jonathan. You have had a very tought time of it. I worry that I will do something to harm myself as well.

I did not have any pain or discomfort when in my boot, but since then, I have constant heel pain and after doing my stretching exercises I also have ankle aches.  My PT advises it is normal, but to watch the pain level and if it goes higher than a 5/10, then to rest with leg elevated.  No pain when resting though, which indicates to me that it is using the muscles that causes the pain. I just hope I am not overdoing it.

Hi sandy,

I have been reading your post with interest. I am roughly at the same point as you in my recovery doing roughly the same exercises.

I think you are right in the fact that we are basically teaching the calf and ankle to start to work together again. I am constantly having to think as I am walking to roll my foot as I should be but find I skip back to walking through my hips.

I currently have little power on the front of my foot and the one area that I have a bad vibe about is coming down the stairs. I tried to normally come down and there was instant pain in the area I think the rupture occurred. My PT can't actually locate the area of rupture which is unusual.

I am heel raising twice a day, calf stretching for 30 seconds as well as using the green band. I am still finding the ankle area very stiff and still slightly swollen. Is this something you are still experiencing??

Thanks

Gavin

Physio again on Friday in

Hi Gavjones

Yes, very much so.  Coming down the stairs properly is just not working at this point.  I am constantly using my good foot as a reference to see which area I need to work on in bad foot.  The toe-to-wall and bend knee to touch wall is a great exercise, but also very difficult.  I can now just manager to move my toe back from the wall one inch and can bend knee and just touch the wall.  Using my good foot as a guide, I should be able to have my toe 6 inches away from wall and be able to bend and touch knee to wall.  So that is my goal.  I think this exercise will go a long way to using the stairs properly. But flexibility is one part. The other part is having the strength return to my toes/ball of foot. So toe scrunches and balancing on bad leg I hope will belp that. I try to do my stretches throughout the day.  Ie, each time I get up, I do a round of toe/wall knee bends. Each time I sit down I use one of my bands for a round of toe pointing and heel flexing. I do two 5 minute walks a day. Go to my sister's place, sit for a bit, walk home. I find any longer than that and I am back to favouring the bad foot.

I find that my heel aches, like a toothache, every day. Do you? I think it is because when I am up on my feet, I am on my heel on my bad foot. But I sure wish it wasn't such a pain in my ___! 

I also find that my ankle pains easily.

I am hopefully going to see Dr. next week to check that all is as it should be.

How long have you been out of the boot now Sandy?

May 7th was week 6 post injury. Tried coming out of boot. Did not feel that there was any strength in my foot at all. I took it off against my PTs advice. My PT was away on vacation and had advised me to stay in boot til she returned and we had a physio session. So, after two days of using crutches I put my boot back on. 

May 18-23 I took boot off when at home, mostly resting. If going for a walk or out for shopping, etc. I put boot back on.

May 23 - Week 8+2days - saw PT and removed boot for good.

So, out of boot now for 3 weeks, 3 days.

So was the original plan to be out of the boot 6 weeks after the operation then?

I'm wary of PT after last time. Think I need to trust my own judgement more this time rather than just what they say.

Hi,

How is the leg feeling ?

I fully expect to be out of the boot at 6 weeks. I can see that my calf muscle is gone, but am more working on range of motion. Finding the pool excellent.

My last physio (at 4 weeks) had me standing up out of boot and doing very gentle stretching.  My feeling is that after 6 weeks some strengthening can start, but until then it is stretching and range of motion stuff. 

Neil.

 

I did not have surgery.

My PT originally advised 6 weeks minimum in boot and then take stock. However, because she was on vacation week 6 to 8, she advised me to stay in boot until she returned.

And yes!! Rely on your judgement. Know one knows better than you just how the foot is feeling and what it can take. I am blessed with a brain that when my PT says do this (whatever) and my foot acts like a statue and does not cooperate, I have learned that is my brain telling me that it is too soon to do what she says. I tell her and she has been great by shifting her request to something my foot will allow me to do. Don't think that by listening to my internal thoughts that I am not progressing. I always make little goals and work at them until I can do them. My PT has advised that I have progressed far enough that she only needs to see me once a week. We set some goals as to what she thinks I should be able to do next Tuesday, and (lol) I am still working on them.

Hang in there. Listen to your body. And maybe stay away from trampolines. Wasn't that your first physio, if I remember?

Wow well that's very different. My

Physio was a group session every two weeks with a set of people with various injuries from sprained ankle to broken bones. Yet we all did the same exercises. I wasn't impressed.

Thank you. Glad you are coming along well and things are looking up for you.

Hi Neil

Leg doesn't feel too bad thanks. It was uncomfortable and a little tender first couple of days, but feels ok, so I dramatically reduced use of pain killers already.

Your story gives me hope that there is light at the end of this tunnel. Think it's just hard when it's a second time.

As soon as I am out of the boot I will be heading to the pool like you say.

Hi Jonathan,

Wednesday next week will be 5 weeks for me. I thought that I would be able to build a little muscle in the pool, but I still have a matchstick calf.

It has been excellent for range of motion though.  I am not taking any chances with over strecthing or doing things too fast. Staying in a relatively comfortable zone of 5to7 out of 10 for most things.

I had a posterior ligament replacement op in left knee about 20 years ago, and it also took about 5-6 months before it settled down. I was able to ski and ran a half marathon after that. And that was with minimal physio. SO time and patience heals most things. 

I think getting into the boot (after 2 weeks) makes a mega difference.

Neil. 

Your physio sessions sound insane

Yeah tell me about it. Every specialist or other PT I have spoken to since has been really shocked by the treatment I received.

You are similar to me then, I had ACL done on my other knee 4 years ago. As a result I am a bit worried about all this weight going through it whilst on crutches, but just need to cross my fingers and hope for the best.

So almost a week for you today.  How's the pain level ?

I have found the pool to be fantastic. Was doing my stretches in water, as well as gentle kicking.  I started trying to stand only on injured leg today. Quite difficult intially, but you get your balance. You also feel your toes working, and you land up stretching nicely in all directions. 

My feeling regarding physio and rehab is that anything that hurts you is no good. Recovery should not hurt at all.  If something is brusing or swelling its no good. Its your body trying to protect itself.

I mentioned your "ankle class" to my physio and he was shocked that they'd suggest you do any of that so early on. He used to work for the NHS in the 80s and apparently they used to do mixed classes back then to save money, but it was ridiculous because one size does NOT fit all. He couldn't believe they still did it in some areas.

I found I definitely had some aches and pains in other areas as a direct result of being in the boot.

A little knee ache, and some weird leg spasms before climbing out of bed.

The pool has def helped me, but I prob only started at 3 and 1/2 weeks post op.

It definitely sounds like you are on the mend. I like the fact that your pain has diminished, which says things are settling down .

Pains been ok. Was painful first few days, but settled down quite quickly. Every now and again I'll get a weird throbbing in it, but then it'll pass again.

What's the wound/scar like on yours now?

I agree, how can my recovert be the same as someone who broke a bone in their foot etc?

Cost sitting sounds about right at the moment though doesn't it?

I'm dreading it when I'm at that point again. I paid for private sessions last time if you remember, but it's the cost of doing that all over again.

Glad to hear that the pain is going. Will be interesting to see if you have any swelling or bruising when that cast cones off next week.

I wanted to attach a pic of scar, but it only gives me that option using a desktop and not mini tablet.

Most of my scar has healed pretty quickly (will attach tomorrow).

're the throbbing. In my 1st 2 weeks, I would also have that if I over did the time with leg down using crutches.

Would feel the blood rushing to my toes. Elevation solved that problem.

My physio is of the belief that it takes at least 6 weeks for the 'bond' or rejoin of the achilles to form properly after surgery.

After that period they will start me doing strengthening exercises.

I asked how long it would be before I could get on tennis court again.

He said that they will do certain muscle strength tests (in a few months),

and they would give me the go ahead if I passed them.

But my feeling is prob another 3 to 4 months minimum. Not going to rush it at all so we''ll see...

Thanks. Intrigued by the scar, as when you google it, you get the worst case scenario pictures and as I have no idea what mine looks like as yet, just wondered. What sort of length is your scar?

I was determined I would play football again, but I'm now wondering whether it is time to leave it be after this.

I think you'll be best to go private again, or they might send you back to that class if that's all that's available in your area. I know how expensive it gets, but your health is priceless.

I'm going private too - third session this Thursday - but I don't feel that I'm making much progress, I still can't get my ankle beyond 90 degrees (and even 90 degrees pulls a lot). It's such a long haul.

My scar must be 3 inches, but most almost of it has healed. Maybe 1 inch of it is lagging behind in recovery. Feels fine, but if I massage it directly I get pins and needles in foot. I don't feel it at all.

When I started swimming, I used to dry off and give it a coating of dermadine, and a plaster .

Neil that's great. Not too bad at all that scar. I'll keep my fingers crossed that is how mine looks. Some of the ones on the internet are horrendous.

I looked for the Dermadine you recommended. It doesn't look like it is sold in the U.K.

I know. I do agree, just worried about cost spiralling. I might be able to get some sessions through occupational health as I am a teacher and they will want to make sure I am fully fit.

I wish I had just gone for physio every two weeks.

Realistically they could have just given me the exercises to do at every week.

(after 2 weeks in cast) range of motion exercise

Wedge out of boot

Week 3 start stationary bike, no resistance heel forward

Continue range of motion stretches

Very gentle in pool, sit on floater and do gentle leg movement

Weight bearing in boot and another Wedge out of boot

Week 4 continue doing week 3

Try and stand on injured leg in pool

Walking in pool

Week 5 I'll pay and see tomorrow.

Just stay within the limits and listen to the body. No pushing anything for 6 weeks,

And no pain while you are rehabbing.

I totally understand about the costs, it is a worry. Hopefully you'll be able to get some through work - they should help support you, especially after you've shown your committment of working through it previously.

I got four sessions paid for by the FSB, of which I'm a member, but after that I'll have to pay and it's £35 a go, so although he's not as expensive as some physios, we're taking my rehab very slowly (my choice as well as his) so it's likely to be a lot of thirty-five pounds!

Been cycling at level 3 with sock and shoe on. Foot toward on peddle, not in foot strap.

Done 30 minutes and everything feels 100%.

Things get a lot better after 2 weeks. Hang in there, there is light at end of tunnel

Thank you both for your support and advice.

It has helped a lot. Your experiences, coupled with my own, will give me a much better feel for where I am going and should and shouldn't be doing this time around.

I spoke to the headteacher from my school yesterday and his neighbour ruptured one Achilles last year playing football. Went back the other week and the other one went. Absolute nightmare.

This is what concerns me about returning to sport again.

'll definitely play tennis again. Mine is just a stupid story. Had a break in in our house last year and of

all things stolen - my tennis shoes. So I played in light cross trainers with a flat sole and no achilles cushioning.

My stupidity

It's good to have everyone here supporting each other :-)

It's a very worrying thought and one that'll stay with all of us for the rest of our lives, I imagine. I probably said before that I ruptured my right one about 10 years ago. (I think it was a full, or near-full rupture - I had exactly the same symptoms/sounds/sensations - but didn't go through all that I have this time with the cast/boot, so who knows?!). But it was my left one that went this time and I would've thought that, in that situation, if either of them was going to go it would've been my right one again.

I'm planning to change my outlook on sports - I won't be playing badminton again and I doubt I'll go running - but instead I'm going to get back into swimming (once I'm confident enough on both feet - I haven't even had a shower yet, as I'm still scared of slipping) and I'm hoping to take up yoga in time, as it's something I've always wanted to do. 

Yeah I think swimming and cycling may become my new best friends. I too though like Neil possibly played a part in my own problems here. I didn't warm up before football as the person giving me a lift was late, I also normally tape my ankles before playing as they aren't the strongest, but...alas, this time I forgot!

Little things like these may have made all the difference. I am also going to spend out on decent running trainers when I eventually reach the point of attempting a run again. No more bargain trainers for sport for me.

I think that's the way to look at it - making a change of direction, rather than giving up completely. 

I think I caused mine too... I'd planned to go for a run the day before the badminton match, but it was raining, so instead I decided to run up and down the stairs LOTS of times, and I was barefoot (stupid!). The next day my calves were both really tight, and I'm sure that's what did it. It was strange, though, as I'd warmed up and stretched properly before the match and it was the last game of the night, rather than early on. 

Just climbed out of the pool now. 1 hour 15 minutes . I feel great.

I fully expect to walk without a limp by week 6. Standing on injured foot in water

feels amazing.

You get the trust and balance back, while having almost no

chance of injuring yourself again.

Hey Jonathan good to hear your op went well and your on the mend. Think healing is a bit quicker post op so hopefully your set back didn't cost you to much time. Glad everyone seems to be doing well.

Was reading about people's experience of physio and thought I would chip in. I seen an NHS physio just prior to getting my boot off at 10 weeks. Was told to go back at 12 weeks which was yesterday. I went in expecting everything to ramp up as everyone keeps stressing the importance of physio and the hard work needed.

So my 12 week physio appointment went something like this. Oh you look like you are walking pretty well. That's good for this stage. Here is 2 calf stretches to do and do straight and bent leg calf raises against a wall. He demonstrated then got me to do them. Then said come back in 12 weeks and we can start the bouncy stuff. Well done David. Looking great see ya.pat on the back. This fun experience lasted less than 10 minutes.

!!!!!

What I took from it was if you live in an area in the UK where the nhs physio is good and providing you what you need then great. If not go private. I have been seeing a private physio who is great. He is tailoring my rehab to me and the goals I have of returning to a reasonable level of sport. Certainly running, cycling, circuits but think I will knock the football on the head. He feels I am ahead of the game and steeping things up a bit quicker. yip the cost of it ain't great but the way I look at it is if it gets you back to where you need to be then it's money well spent.

All the best everyone.

Good to hear your progress Davie, I was wondering how you were getting on. Your NHS physo appointment would be almost laughable if this wasn't such a serious injury. 12 weeks until you go back?!

I've got my third private physio appointment on Thursday (and my second NHS one next Tuesday). Interestingly, the private one's got another client who ruptured his achilles playing football about the same time as I did mine. Apparently he's ahead of me on his recovery, as he's walking more 'normally' and with more rhythym than I can manage. The front of my calf is really tight and seems to be holding me back. I still can't get my foot beyond 90 degrees. I really want to make better progress, but both the physio and I are of the opinion that taking it slowly is fine for me, however he is going to try and get more movement in my foot this week. I'm so scared of any pain and of doing too much though! 

In South Africa it's like a sausage factory. I go for physio (at least 5 physios working there), and there are at least 2 people with achilles injuries, in at any time. Serving # 24 at the meat counter !

I can't complain though. I get my same physio person every week, with his vice like  hands.  But he seems to work a lot on ankles and achilles , and I trust him.

Regarding recovery, I think everyone and every injury is different, and you really have to compare yourself only to you. You are the best judge of what is happening in your recovery process. 

 

I looked up dermadine and the equivalent is pividone-iodine.

I think at boots you can get it , it's called betadine ointment.

I was putting that on scar after every pool session, with a fresh plaster covering.

We're you in the boot before ?

Was it weight bearing ?

Hello all,

I have been constant discomfort in tendon area and pain in bottom of heel. Saw my PT and she has taped the outer ankle area to stabilze the ankle there. Thinks that I may have done more than rupture my Achilles Tendon. Perhaps a ligament that crosses from outside of ankle over front of foot. I actually have thought that since the beginning as this area always suffered pain and discomfort separately from my tendon. PT also recommended that we take a 2 week break, although she wants to see me next Tuesday, as planned.  Also sending a progress report to my Dr. with a recommendation for a follow-up ultrasound. I have appt with Dr., but do not see him until the 30th. So today, no walking or very much standing. Have stretched, but nothing else. PT advised that slowing down for 2 weeks will not have negative impact on long term recovery, so taking her advice. Heel pain down considerably; back of ankle in tendon area is uncomfortable, but 1 or 2 out 10. So, not bad, I think.  I am very frustrated.

Yeah 5 weeks in the boot last time and weight bearing on the boot. Were you weight bearing in the boot straight away?

Hi Sandy.

If you have also damaged a ligament, what does this mean? If this is the case, will it heal itself?

Morning,

Yes I was weight bearing straight away in boot. Was able to put garbage bag over and tape it and have a lengthy shower at that stage, which certainly made me feel better.

After 4th week the physio said i could sleep without the boot.

Def overdid the activities yesterday. Both calves feel tired and slightly stiff today. 40 min on bike and over hour in pool was too much.

Have physio at 9.30 . Hopefully last wedge out of boot, and an all clear. Gonna take a rest day today with stretching and massage.

Hello,

I am curious as to how your injury ocurred?

Were you wearing shoes at the time ?

When you got the injury did your heel hurt or just the achilles ?

Hopefully it's something minor, like a muscle spasm, or perhaps a little bruising from favouring your heel.

Neil.

Hey JW sounds as if you are right on track with recovery. Good your physio isn't pushing u to hard. As Neil says everyone's injuries and recoveries are different. Don't be disheartened to here people are a bit ahead as in the long run you will still get to the same point.

I have still got a bit fluid round my ankle and it swells up when I am up on it a lot. Still elevating and icing. My physio has been working hard to massage the fluid up my leg and last time was bloody agony. He was firmly massaging up my Achilles while I swore a few times and he laughed. It did seem to work though.

Has anyone else still had the fluid swelling at 12 weeks? I guess it's normal.

Thanks.

Morning Davie, thanks, I'm glad he's not pushing me too hard, but on the other hand I would like to feel I'm making good progress. I know I am, but it's sooo slow, I have to look very carefully to see the subtle changes!

I went out for a short walk on Monday morning along a quay and back (I live near the coast) and I managed most of the way there, but still needed my crutches on the way back as my ankle was sore. It's the most I've done, but it was lovely getting out in the sun! That afternoon and evening it was quite sore, and I had a bit of swelling (though not that much and more at the top of my foot than around my ankle) so elevated and iced it. I think it's to be expected, as our muscles and joints just aren't working normally. Same with my leg and foot that still go quite dark/reddish when ever I'm standing. Does yours do that? 

When I had the boot off, the hospital gave me wedges to put in my shoes, but I think they were holding me back from getting to 90 degrees, so I took them out yesterday. Now I need to progress with that. Baby steps - literally! It's so hot wearing shoes all the time too, so it's a relief to "walk" around the house barefoot. 

Hi

Just reading your last post. I have noticed that whenever I am up on my crutches my toes go a kind of purple or red. Is this normal??

Didn't really notice this happening last time. I get the same feeling that Neil had of blood rushing down to my toes when on my feet, but hadn't noticed the colour change before.

Jonathan,

I had that as well. Toes go that color and the foot felt like a lollipop. As soon as you get back elevated it goes away.

Had last wedge out of boot today at physio. All looks good. Two exercises to add. One leaning against a rail, standing on both feet out of boot. Hold on to rail and lift good foot off ground. Try and stand on bad leg, and let go of rail.

Other was a step exercise. Out of boot, stand with both legs on step. Then move good leg to step below and step up. Again start by holding rail and mve to doing this without holding.

When I was in the cast my toes would turn purple whenever I stood up, and I could feel the blood rush and my ankle swelling too. It'd be like that until I sat down and put my leg up. 

These exercise sound perfect. They would have been great for me first time around. I'll remember these when I get to that point.

Can I just ask, with your swimming...how were you getting into and out of the pool with your boot on? Were you walking to poolside in it and then taking off or were you leaving it at changing room?

Thanks JW. Did this stop once you got into your boot? It's a very unusual feeling and one I didn't have first time around like I say.

My ankle would still swell a bit in the boot, but I think it wasn't noticable as there was more room for expansion compared with the rigid cast. My toes would still turn reddish when I was in the boot - they still do now sometimes, but there's no accompanying blood rush or swelling sensation. Keep wiggling them! 

Just tried the step one and it's good! I can really feel my muscles working, yet it doesn't pull on my ankle. Thanks for that, Neil! 

I am kind of lucky in that I can go to the gym when it is quiet. So nobody gonna slash on my boot, towel etc. I would walk in the boot to the pool and take it off there. Getting in was no problem, but out was a trickier one. Could'nt use the steps, but the corners of the pool have a rails, and I was able to haul myself out (facing away from the pool and doing a pushdown on the corner rails), and then skoot over to my boot.

Quite strange but my standing on one foot in the pool has definitely helped with the 1st exercise I got today.

Re the swelling toes. For me it went away completely at about day 12. Once I was in the boot it was banished.

Feel flat today. Mentally, physically  and emotionally drained. Otherwise I feel like a million bucks 

sounds totally wrong. Managed to get out facing the pool, in corner with back to the sides. Also no slash, just splash !

I really like it as well. I feel like I am working the calf, and as you say, it's  putting no strain on the ankle. He said start slowly with it and work up to 3 sets of 20 3 times a day.  For me the number will differ for everyone. I reckon do what feels good, and stay out of the red zone.

At the sports rehab center here, there are two orthopeadic surgeons that specialise in ankle injuries. My physio said they were each doing 2 achilles rupture surgery's that morning. I feel like I am in very good hands here

I certainly hope so. I think PT and I are just being cautious. But I won't know until I see Dr and hopefully get that second ultrasound. If I did do damage there as well, then I think, like everything else with ankles, it just takes time.

But I am glad I took a break. Yesterday was first full day of lazing around, very little standing and walking and only to get from one room in the house to the other.  Some stretching, but only to the point of feeling a pull. Woke up this morning with no heel pain. YAY! Then did some stretches and tried to raise up on to toes.  Heel hurts now, so resting it.

Here is photo of my back deck. I was standing in front of this little greenhouse fixing the plastic. I couldn't reach the back of the plastic, so I stepped around to the side of it. Totally forgot there were steps there and actually stepped into mid air. I tried to catch myself by turning around and thinking I could run down the steps, but my body was already almost horizontal and only my left foot managed to step onto the first step. Then I went flying, heard a pop or snap sound in my head from my ankle. Found myself flat on my stomach with my foot instinctively raised in the air. Yes, was wearing shoes. I actually do not remember any pain, or more accurately I remember feeling no pain.  When I finally worked up the courage to roll over I was so thankful that my ankle was not at an odd angle. Thought I had broken it clear through and would see my bones sticking out of my leg. LOL. I am glad that did not occur. I put my foot down and I must have felt pain, because I knew instantly that I had nothing there in regards to muscle or strength. And that is my sad little story. Total human incompetance.

I don't think I have done any further damage, but I am thinking I was pushing things too hard.

And now, twenty minutes after sitting down at the computer upstairs, my heel pain has settled down.  Time to go downstairs and get my first cup of coffee for the day.

Have you had a lot of massage on your foot ?  Maybe the muscles are just in a spasm. I don't think you have bruised your heel because you were wearing shoes. Have you tried doing exercise in the pool ?

Chilled out for a couple of hours and feel much better. Been doing the step exercise and walking around in the house with boot off.  Was not sure what to expect 1st day walking again. But I have no pain, and no swelling and walking around feels pretty easy.  Really happy with progress so far. I feel that I will be walking normally by end of next week

in 4 and a bit weeks time you are also going to be walking !

So are you walking without a limp?

My PT massages during our sessions, but they are down to once a week now. I massage the foot as well, but it seems more effective when someone else does it.

I live in a resort village with hot springs. However, to go their public access is $10 each visit. Too expensive for me. No other pools close by. However, my sister has a swim spa pool. They are almost finished redoing their back yard, so I think next week I can start with daily dips and exercises.

It really does feel like a bruise on bottom of heel. And also behind heel it feels like a blister when I wear shoes. But there is no blister there. It is just the pressure of the shoe on my foot. Last few days have avoided shoes and walking around in foam-padded flip flops.

Sorry about the picture. It was upside right when I loaded it.

Sometimes when you walk barefoot and your feet are not used to it, you bruise the heel, or hurt yourself  without really knowing it. The pool has been amazing for me, and I am sure it's really going to help you.

I have a little limp, but the stepping exercise seems to be stretching the calf, and building strength. When I walked at physio, he wanted me to have good form. Ie. walk normally, and put pressure on your big toe. I'm almost certain that after another 6 days of steeping, stretching and pool my limp will be gone.

My physio wants me to walk as naturally as possible too, but I've just not got the flexibility in my ankle to do it yet, so I'm still lifting through my hip and that hurts.

I think do the range of motion exercises.

Circles with your ankle clockwise and counterclockwise.

Point toes forward and then try and curl them up and stretch achilles.

Windscreen wipers left and right 

 

I've been doing all of those a few times each day, and working with the resistance band. Maybe I should be pushing the stretches harder, but I'm reluctant to for obvious reasons. 

I don't think you need to overdo anything. Stay in a zone of no pain with the stretching. So what if it takes a little longer, as long as you are getting better and making progress

You're right. Thanks :-) 

I think having the boot instead of the cast probably helps the initial flexibility, because you can massage and stretch far more often, and earlier

If you are in the cast for 8 weeks,  the total ankle immobilisation will definitely require more work to get range of motion back.

  

I agree. I was in the cast for four weeks, but was then told strictly no physio while I was in the boot (for a further seven weeks) so didn't dare do anything - I didn't even take it off for the first couple of weeks, and then only to wipe over my leg and foot) so my ankle was immobile. 

It seems a very long time in cast and boot. 11. Weeks on total.

Again, it's really interesting finding out how everyone's treatment differs. How can the treatment for one injury vary so much.

The whole think looks like a trade off between surgery and non surgery.

The surgical route is quicker, because it is 2 weeks in soft cast and then 4 weeks in boot.

Your total immobilization is only 2 weeks, but you will get the red toes and blood rush.

The advantage is that if you a partial weight bearing in boot you only have to undo 2 weeks of immobilisation.

You can also start stretching and Rom exercises, because unlike the non surgery, your achilles is reattached.

You also only have 2 weeks of muscle loss, instead of approx 8.

The non surgical is a slower process because you can't risk any stretching, because the achilles is not rejoined yet.

So you prob need 8 weeks immobilisation before scar tissue and collegen bridges the gap.

Hi JW11.  I think part of increasing flexibility so that you don't limp is in your leg's ability to bend at the knee. At least it was for me. I found that when I was walking that my leg did not bend at the knee, and that forced me to continue to limp.  I have concentrated on bending my knee when doing a rocking motion - put good foot forward as if to walk, but stop and rock from heel to toe on bad foot (which is behind good foot). I noticed that while I could rock back and forth, my knee stayed straight. When I switched positions, so that I was rocking on my good foot, I noticed that my knee bent naturally. So I have been concentrating on rocking and bending my knee. This does not feel natural yet, I have to keep thinking to do it.  But I have noticed that I am limping a lot less when I walk. I am still not walking as fast as I used to, but that will come in time.

Thanks Sandy. Mine's more that I can't bend much at my ankle, so I've been lifting my hip in order to take the step. However, that's slowly improving, thankfully.

I've been to my physio this afternoon and had the tens machine and more massage. Also got some new exercises to help me progress... 

At my first session, I had to put my weight on my bad foot and step forward and back with my good one. Now, as I step forward with my good one I have to try to push off with my toes. Same goes for when I'm walking - push off with my toes.

Another one is to put my good foot just in front of my bad one then, keeping my bad knee straight, bend my good knee forwards, so that I get a stretch in my whole calf and through my Achilles. (Apparently this is good as it stretches the whole section from the back of the knee to the ankle, rather than just putting pressure on stretching the Achilles.) He says the aim is to feel that stretch but not push beyond it. Once that gets easier, to then do it with my good foot a bit further in front, and so on.

Hi JW,

Had my usual hr in the pool, with some cycling but still struggling to get rid of the calf and achilles stiffness. Just watching TV and have been massaging achilles and calf for abut 40 minutes (using bio oil). Amazing difference and really good release . I am almost walking without a limp after the massage. I think its time for your hubbie to turn into the masseuse.

My sister's pool/spa is ready to go, so tomorrow we start exercising.  Hoping for an hour.  I have never heard of bio oil, but will search that out.  I massage just by rubbing - no oil, altho sometimes use hand lotion.

Haha, Neil, that's made me chuckle. My hubby's been a star and I couldn't have managed without him, but there's no way he'd massage my ankle for 40 mins! I think I'll stick with lamp > massage > stretches.

Maybe you have to start him on 10 minutes and work from there. Exchange dinner from massage  You need to do a joint stretching session. Your achilles and his sciatica. It's funny, but we only stretch when we are hurting, and hardly ever as preventitive maintenance.

for massage

Even 10 minutes would be out of the question, and trying to get him to stretch is even less likely! You're absolutely right about how we only stretch when we're hurting. The only time I would normally stretch was before playing badminton (but not after), and after running (but not before). I wouldn't normally stretch on a daily basis just for stretching's sake.

Off to the gym for stretching and pool workout. Feel that things are not progressing as fast I would like (which is I know ... ridiculous  Wed is 6 weeks post op). Would just to find the perfect exercise to wipe out the tight calf, but maybe it does not exist.

It doesn't exist, or this recovery wouldn't take so very long. Don't push too hard.

You are right, just gotta grow some patience. 

Looking at an anatomy diagram, I can safely say the muscle group that is tight for me is the soleus and the digitorum longus (the Doc is in house ). These are the muscles on either side of the achilles low down in the leg.

I have done an internet sarch and it's bent knee stretches that target this area. A really good one is the .................................

seated calf raise 

The beauty of a calf raise is that as you do it you are shortening your achilles, so you are not going to rerupture anything.  Also quite easy to do while sitting at computer.

I'm saying nothing! 

Went into sister's spa/pool today. Found it a good way to stretch without body weight as a hindance. But found that I still cannot stand on bad foot and raise onto toes, even with water eliminating 75% of my body weight. Found that if I hang onto side of pool, chest deep in water, lift good leg and stand on bad one, then bend knee and put a lot of support in my hands and arms that are hanging onto the side of the pool - then i can raise onto toes. For a few moments. Only tried that a few times.  Turned on the jets, put on her harness and swam by only kicking feet.  Could feel bad foot stretch, but no pain, so that was good. Also good excercise is balancing in the water on bad foot. The weightlessness means no heel pain, and the buoyancy of the water means increased concentration required to stay balanced on the one foot. Later, when out of the pool I found i could actually balance on bad foot almost 24 seconds - 14 seconds faster than I could before.  So I liked that too.

My husband is a god send in many ways, but massaging my foot so far is not one of them.  At end of my workout in pool just sat there with the jets pulsing over all areas of my foot - that was the best. Great massage.

Nice one,

I like to sit on a floater tube and gently kick both legs (knee bend) just to warm up for 10 minutes). Standing on bad leg, and doing all the ROM stretches. I find that you get a few aches and pains in knees an other areas as you cmpensate for the boot, or injury.

I am almost walking no limp. Can go up stairs easily 

I can go upstairs easily now. Have been practicing without holding handrails for last couple of days to improve my overall balance. Going down not so easy. Although I can now go down alternating each foot (prior to that it was always bad foot first), it is not easy. I hold on to the railing for balance and I am going down sideways, like a crab. I know it depends on the height of the risers in stairs, as well as individual height. I am 5'3", so quite short. I think stairs are industry standard. My sister had a bad sprain to her ankle, and tore some ligaments thirty some odd years ago. She did not rest or recover properly. To this day she walks with a limp and always goes down stairs bad foot first. She is such a lesson to me to do things right. I will not be that person who limps and cannot do stairs properly.

I am also OK going up but down is tricky. Been doing hundreds of seated toe raises will goofing around here and definitely helps

I am about to plunk myself down in front of my TV, so toe raises it will be.

Hi Jonathan,

Have'nt heard from you for a while. When does your cast come off ? I think Tuesday ... Hang in there because the worst is over after that.

I really did'nt know what to expect re recovery, but luckily for me mine has gone really well. I am almost walking without a limp (prob 90% there), and am doing everything I did before my injury (I am 5 weeks and 3 days post op), execpt active sports.

I don't feel any pain at the join/injury/scar/achilles at all. I have no swelling or bruising or discomfort. I really put some effort into rehab, having been in the gym 20 days in the last 21.

If you have any questions or need any advice don't hesitate to ask. Stay positive, and your rate of recovery will surprise you.  

All the best ,

Neil.

I too can get up stairs alternating my feet now, although I still need to hold on, but there's no way I can get down them in the same way and have to go one at a time leading with my bad leg. My ankle's still not gone beyond 90 degrees, so I just don't have the bend there to get the action needed. But I'm working on it!

BTW Neil, I bought some Bio Oil and I'm really liking it for massage, feels good. Bloomin' expensive though!

Hi Neil

Thanks for asking.

Yeah I'm ok, going a little stir crazy in the house. No clinic on Tuesday so they are seeing me Monday. No idea what to expect. Little concerned as when I rang about appointment, they didn't have on their system that I had been in for surgery 🤔.

Hopefully though, it being a day early shouldn't affect going into the boot. I remember last time, that it made it far easier to get around and get sorted etc.

Really hoping my recovery is a bit smoother this time. Even a fraction of how yours has gone would be great. Can't wait to get active again.

Here its about 5 pounds for 60 ml. I find it goes a long way.  I have used about half the bottle in about 10 days. Thought I had done myself some damage, but I think it was just tight muscles relaxing. I can do toe raises while seated so should be ok.  My calf feels fine but the muscles on either side of my ankle are just knotted

One day earlier sure feels better than a day late.

Where you weight bearing in boot last time, straight away ? 

This time I am pretty sure you will be able to remove boot and do ROM stretches, and give foot/calf  massage. Makes a big difference, beacuse at 6 weeks post op, the join of the achilles is healed but getting the tightness out of  the muscles is the problem.

Good luck Monday.

I am finally getting some flexibility so going downstairs is easier, but still not there. Today I was at the beach for dragon boat fesitval (Sasquatch Days), so did some walking.  I have been avoiding walking for last few days as my heel was really sore. So, heel is fine, but pain in Achilles area at back of foot has me bothered.  As for walking, limp is a lot less, so Yay!! I am off for a wine tour in the Okanagan area of BC.  Hopefully this distraction will take my mind off me for a while.

Good luck on Monday Jonathan.

What happened to make you think you'd done some damage?

Pleased to hear you're not limping as much now. My limp is worse first thing in the morning and in the evenings, but during the day it's not *too* bad. At last my hip has squared up, so that's less painful now. I'm now planning to get a bit of a walk in down the road each day, rather than just laps up and down the hallway!

Yes, good luck for Monday, Jonathan, let us know how you get on.

It was very strange. I started doing a lot of seated calf raises and felt ok. Then I got a strange tingling in the achilles, and my calf muscle felt kind of odd. So I just rested it yesterday.

But I know that you can't do any kind of calf raise with a ruptured achilles (seated  or otherwise). So I am able to do those and the sensation has gone away. Did an hour on exercise bike the morning, at level 8 with no pain, so I reckon I am OK. Still no real sign of any calf muscle, and I cannot balance on injured leg. Steps up and down no problem though. 

At my last physio session, they showed me how to do a standing calf raise. You do a standing calf raise with both legs, and then relax the good one while taking the strain on the injured one, letting it return to flat position.

Ridiculous Winter weather here continues. Mid Winter and it must be 16% pure sunshine here. Trump and his climate change ignorance should alarm every one of us  

Sounds like it was just your body telling you to ease back a smidge. I'm doing those standing calf raises too. Well, I say 'doing, but what I actually mean is putting most of my weight through my good leg and slowly trying to put more across to my bad, but it's not quite happening yet. I can feel some movement in my calf muscle where there was none, so that's promising, but I'm not expecting it to greatly increase in size for some time.

Thanks for your well wishes guys. Quite nervous about tomorrow following all the hiccups last time around. Hoping all is well and hoping to get into the boot.

I was weight bearing on the boot last time yeah. With crutches until the last few days last time around. Atleast with boot you can take it off and get clean properly which will be a relief.

Don't worry,

I have a feeling you will come back from the appointment with stitches in, partial weight bearing in boot on crutches. You will prob start your stretching and massage.

Good luck

Well they seem to be treating this completely differently. So they have tried to push my foot as close to normal as they can till I felt it pull and then cast it again for another two week. So frustrating. They said I can weight bear on it, but I can't as my foot isn't flat.

Was also told that as this was the second time, that any explosive sport is unlikely again. I'm 34. So frustrating

Wow, so u are in a cast again for 2 weeks, but you can put some weight on it while on your crutches ?

Don't listen to their crap regarding explosive sport. I am 53 and I will be on the tennis court in another 8 weeks (easily). I am not gong to make it to WImbledon, but I plan on being relatively active. Your body, at 34 has to be faster at recovery than mine ( I am middle aged, and you are a young man).  

Once your achilles is stitched and rejoined it takes 6 weeks for the collegen and scar tissue to grow, heal and bond. Thats it !

Then it is relatively strong, an it will require exercise to strength/stretch  calf/ankle  etc. My feeling is that they are being over cautious because of your rerupture.

Did they explain why you could'nt just go in the boot ?

They just said that they want my foot set in a near flat position for two weeks before going in the boot.

Not sure I understand this as surely the gradual decline in the boot is easier. The problem is, my foot isn't flat as it wouldn't stretch very far yet as you would imagine. So I actually can't put weight through it at all as my foot won't go flat to the floor.

They have tried to sign me off work for 4 months too. I told them this was not possible. Is it just me or does 4 months off seem a little extreme.

To me that sounds crazy. The foot should be set so that the achilles is shortened and heel/toes are pointing down. ie. in boot with 3 wedges to lift heel and take pressure off achilles. Each week a wedge is removed which brings a little more pressure onto the heel. That's standard stuff.

I have never heard of this. When they took cast off could you point your toes downwards ?

To be honest. I was struggling to move it myself full stop. Think after two bouts of this my strength to move my foot using Achilles was very minimal full stop!

I know, I did question it, but he said that because it is surgically attached it can take the stretching. Do you think I should seek a second opinion? Not sure who I would seek further assurances from thought to be completely honest.

I reckon they're being over-cautious because of the re-rupture. They probably think because you've been injured so long now that you'll be impatient and do too much in the boot, so they're preventing that by putting you back in a cast. Personally, I think 3-4 months off work is reasonable for recovery.

are u in another cast similar to what you had ?

did they take the stitches out ?

are you able to half step on the foot using crutches ?

It's a full cast from my toes to just below my knee.

Stitches were dissolvable ones so they were gone already.

Wound didn't look too bad to be fair.

How do I attach a photo to these posts.

It just to be overkill. I think being in the boot would have given you a chance to start stretching/massage earlier. to attach i think you need to choose last box n right above reply area.

Really?? I feel like that's a very long time. That's until October! As a teacher that would be a complete nightmare.

Man I am sorry for your troubles. I am surprised that they didn't put you in boot.  To me it just does not seem right. Where was your scar, or plaster over scar when they cut off the first cast ? Surely it has to be better for your foot ...

It is a long time and I totally appreciate that it's tough, whatever the job, but better to take some time out than do any further, potentially long-term, damage. If you're fine before that time's up then you can always go back early.

I am surprised about not going in the boot too. That's fully what I expected. I may ring my gp tomorrow and discuss what options I have. Scar is in normal place. It has healed fairly well, but now it's covered again with the plaster. I would have thought it would have been better for my foot too. Can I just ask, when they had yo doing rom stuff at physio, how much were they stretching your Achilles?

My 3 original ROm exercises were

While sitting on bed/couch.

1) point toes down (ie foot downwards). Realistically you can go as hard as you like here, because you are not stressing your achilles.

2) Windscreen wipers with foot. Left right left right.

3) Small circles with foot, clockwise and visa versa, stay in comfortt zone with that one.

I did those for week 2 until  week 3

1st one and bring toes up, but dont overdo upwards

My foot was down in boot, with three wedges. They did no active stretching of my achilles

That's the bit that worries me. They seemed to have no concern stretching my Achilles at all

took cast off. massaged my foot, and showed me the stretches

Look, I am far from being a doctor but it does seem strange .

They would need to give me a very solid reason as to why I

would be in another cast instead of a boot with wedges.

Both the boot and the cast will immobilise your ankle,

so what is being gained by being in cast ?

Because the downside is that you only start your Rom

stretching and muscle massage in another 2 weeks.

There may have been some complication in your surgery because 3 hours is a pong op.

No they seemed happy with the op. Strange isn't it?

I am going to my GP this morning to see what they say and recommend I can do and see if they give me any options to switch hospital etc.

Just don't feel confident at all in my treatment at this hospital.

I would definitely be looking to move. Once you have lost confidence it won't come back. Your whole recovery and mindset will be clouded with doubt, and it is a negative you don't need.

Surgery and non-surgery recovery is different. The big advantage of the surgery is that your achilles is already joined. You are not waiting weeks for the body to bridge the gap between the  ends.

With your foot in the boot, on 3 wedges it is not going to rerupture. No way ! It is as immobile as being in a cast. But you do get your ROM started (2 weeks earlier). The recovery from operation on normal snap in achilles is pretty standard.

Everything I have read seems to suggest early weight bearing in cast is beneficial.  You have no pain, just stiffness in the leg ?

 

If you do change hospitals, I would ask them to remove the existing cast, and try your boot with  the 3 wedges. You can try it there and then. If it really proves uncomfortable and hurts (unlikely), then remove the boot and have them recast the injury. 15 minute exercise that could potentially take 2 weeks off your recovery, and make a big dfference.

The only possible issue is how long transferring to another hospital may take. If it's a few weeks then I'm stuck in limbo a bit.

Your cast is now a hard plaster cast ?

Yeah it's a hard plaster cast. Just been to my gp and he has put through an urgent request to transfer hospitals.

I wonder why they would go hard cast.

Any swelling or bruising?

You don't have pain , just stiffness ?

No, no bruising, swelling or pain.

I hate the cast too as can't do anything with this on. Boot was so much easier last time

Then to me it makes zero sense at all. You probably still have the three wedges as well. You are exactly where I was after 2 weeks.

They seemed to be saying that I wouldn't need all of the wedges in the boot or probably just one as my Achilles will already be stretched out a bit from the cast this time. I don't know and I don't feel very confident as I say. When I asked and pushed them on it, all I was getting told was that this is the way they prefer to do it.

You said it as well, the experience of being in boot and weight bearing, is far more comfortable. You can take it off when you like, massage and do stretching. I would tell them it is not acceptable. Surely you as the patient should be given the choice, depending on what is most comfortable for you. Itshould be your  perogative to decide in my opinion. 

Problem is I'm not back for two more weeks. Hopefully the appt from the new hospital will come through before then and I can speed things up a bit.

Well, whatever happens I wish you all the best. That you have no pain or swelling is excellent, and the join of the achilles will take 6 weeks. So you are on the mend. Hopefully, at the new hospital, they will take the cast off and let you wear the boot.

I can't walk properly yet. Never realised what a complicated thing basic walking was. I cancelled my appointment with the physio tommorow. Just can't afford all these expenses at the moment, especially with work and cash flow so uncertain. 

Hi Sandy,

I found that after week 5 post op my best two exercises were seated calf raise, and standing calf raise in water. In the pool, do a both foot calf raise while holding the side of the pool. Try and squeeze the bad calf as hard as you can go. The exercise is shortening the achilles, and is really just working the calf. I found it really loosend up the muscles above the ankle and around the achilles. I have been doing it for about 4 days, and am almost 100% waking. No limp, with just a minimal tightness.

Yeah last time I was a month gone and still wasn't walking properly. It just takes time doesn't it? You sound like you are doing really well. Keep up the good work.

I do understand about the cost though. I still owe for appt from last time around.

I feel that my recovery has plateaued somewhat. Did 'nt exercise today but was in pool 45 minutes. Light kicking walking backwards, raises and standing on one foot. Probably overdid it . Achilles  feels a little tender, with a little swelling.  I think there is a huge difference between doing light exercise and calf raises/strengthening etc.

Do you have a pool at the school ?

Hey Jonathan,

How are things going

Any news regarding hospital transfer ?

How's the achilles feeling ?

Hang in there, the worst part is nearly over.

're my own progression , it is still too early for me to do standing calf raises in pool.

It feels ok, but I get a slight swelling reaction.

I will prob stick to my step excercise and seated toe raises, with some stretching

All the best in your recovery

Hi Neil

I have a hospital appointment at a different hospital this coming Thursday, that will be 3 and a half weeks since the operation. So really hoping I can persuade them to let me go into the boot.

Sorry to hear you think that you progress has plateaued slightly. I think it'll probably come in stages. You have being doing really well by the sound of it.

Did you have some tingling in the Achilles still in a morning or at night still when you were at a similar stage to me?

That sound good. At 3.5 weeks hopefully you will be out of the cast. 

I think I overdid the strength exercise (standing calf raise) yesterday. Had a slight swelling, and foot felt hot. I have decided that if anything adds discomfort (pain, swelling etc) I will cut it out. I reckon you should be able to rehab without side effects. Today I was on exercise bike at gym for 40 minutes, with zero side effects. 

I have no tingling in achilles. When I was massaging the scar/achilles area and I would get a burst of pins and needles (but that was 10 days ago).

I am really close to having no leg stiffness, and when that is gone I'll try the calf raises again. 

If you need the physio exercises they gave me just ask. but 1st see how the foot feels out of the cast (hopefully). I would be aggressive at the new hospital, and insist that I get into the cast.

Yeah fingers crossed the treatment is better and I get the outcomes I am looking for this time. I just couldn't believe that the doctor at the other hospital was so dismissive and clearly didn't want to engage in any kind of conversation with me at all regarding my injury, the operation or my recovery.

It sounds so weird, and realistically is totally unacceptable. I think you will find the recoverty totally different this time, compared to no surgery. The bond/join of your achilles is only 2.5 weeks away from being pretty strong.

I think your physio path will be much better. I think they confused you with someone who had had surgey, when they put you on the trampoline.

they didn't check me at al so wouldn't have had a clue whether I'd had surgery or not.

Anyway...as I say, fingers crossed.

When I described tingling in Achilles earlier; I think it's similar to what you said, it's like a weird pins and needles type feeling.

I mentioned the pins and needles to my physio, and he said it was good. Meant that the scar was healing.

Oh that's reassuring. Where are you up to now is it 7 weeks?

Next week Wed is 7 weeks for me. 

You gotta get that cast off so that you can start stretching and massage. Especially now that you leg has been injured for months.

Tell me about it. I had loads of muscle wastage already in my legs particularly the injured one, so this time it's going to be much worse.

Needs to get moving

3JW11, how are you getting on? Not heard from you in a while.

Hope things are progressing well for you.

Morning Jonathan, I've been popping in and out of here and following your second recovery - I hope you get on well at the new hospital this week.

Thanks for asking, I'm doing okay. I'm now walking more without my crutches, which is great, but still struggling to get my foot beyond 90 degrees, so it's not quite a fluent walk yet. I've managed some short laps around our village over the last couple of weeks, so hoping to continue doing that.

My last private physio session was last week and, being the honest guy that he is, he's said that it's not worth me going every week and paying him to watch me exercise! He's given me loads of guidance and exercises that I can progress with over the coming weeks and has said that any queries to just phone him, then if I feel I need to see him further down the line then he'll be happy for me to go back. 

He's also advised to get into the pool, so I've found a private hydrotherapy one locally that I'm hoping to book very soon. (I've ordered some pool shoes that are meant to help on slippery surfaces!) And I've bought myself an exercise bike, so doing two or three 10 minute sessions on that each day, trying to strengthen my hip and knee. It feels good to get my body moving again. 

So, although very slooooooow, it's feeling fairly positive at the moment. (Although I'm, of course, still very nervous about overdoing things.)

That's great. Where are you up to now in terms of time since injury? Sounds like you are really starting to make some progress.

I'm at 15 weeks now. It's still on my mind the whole time, but I feel that I've now come out of the 'bubble' that I was living in.

My main struggle is getting my ankle past 90 degrees, as well as obviously trying to get my calf muscle firing up. I'm really hoping I might be able to start driving again, maybe by the end of the month if it's all okay and my leg's strong enough.

How are you feeling in yourself? Must be so tough, mentally, going through it all again. 

Well this time the join will be so much stronger. Hopefully into boot on Thursday, and get the ROM stuff going. My physio said at 6 weeks (post surgery) the join is almost 100% (so you are already pretty close).  

I took a break from any strength exercise for 2 days, just doing stretching and walking, and noticed that I had zero swelling. But I am happy. DOing everything I did pre injury except play sport. 

 

Did you have surgery JW or was it conservative method?

Were you still using both crutches or just one?

I am really hoping that the join is stronger this time. But to be honest it felt strong last time until the physio put me on that trampete thing.

So you think by 6 weeks, it is a case of just getting movement and strength back?

I think it is going to take you longer, simply because it's a rerupture.

But after 3.5 weeks I was allowed to peddle on exercise bike, no resistance, bad heel  forward on peddle. I could get into the pool, as well as  do various stretching routines. It is definitely a different recovery path (surgery vrs non surgery). 

I think it will take you at least 10 days of ROM exercise, stretching and massage to get your foot going again. Expect to be walking (with some limp and tightness) after 6 weeks, but then it kind of flattens out. Time will heal it.

My feeling is that getting strength and real stability will take me at least another 2.5 months. SO I am hoping 4 months to get back on the court and hit some balls.

I was conservative - four weeks in the cast, then seven in the boot. I was mostly using my crutches for the duration, although towards the end I could manage to get around the house without them. 

Hello all, I think my progress has been ok. A bit flat this last couple of weeks. But my PT and I decided i would back off a bit on the walking (which wasn't a great deal to begin with, in my opinion) and the stretching. I found that I was experiencing more and more discomfort (pain?) in Achilles area, bottom of heel, and across the front of the ankle. I can stand on bad foot with foot flat on floor - balancing for 30 seconds+. However, when I stand on toes and try to shift weight to bad foot, get pain in Achilles and do not feel there is anything there for my toes to use as a muscle. Not sure if I am expaining it right.  But when I described it to my PT she had me try while she watched my calf muscles on both legs.  She says that the muscles are quite different on bad foot, perhaps more than just the Achilles was ruptured. She thought perhaps I had also torn my upper calf muscle, as it is still quite atrophied (flat).  Went to Dr for opinion and hopefully another scan to review. He advised that while I may have done damage to my calf muscle, that there is no surgery to repair that kind of damage. Advised me to be more patient and just let time and continued exercise and stretching do its job. He also thought that the planter fascia was inflamed. Gave me a prescription for a gel to rub into the area to help with that. As with the PT, advised that I cut back on stretches and walking.  Very frustrating.  When I do follow their advice, my foot feels better - no pain or discomfort. When I increase stretches and try walking more, it all comes back. 

Yesterday, back in pool (water depth is 4', so up to my chest. Tried bending knees til water at my neck, then lifted good foot up and balanced on bad foot, and then - YES - could raise up onto toes!! Did that a few times to make sure I was not imagining it. Tried standing up a bit taller in water and could still raise on to toes for a few seconds. So that is good, I think. Woke up this morning to a 'charlie horse' (big muscle cramp in upper calf). Ouch!  However, it means the muscle is now starting to do something. 

Hang in there JW and jonathan. My biggest lesson to learn is patience. I also know that age and prior physical fitness play a role too.  I am 63 and my prior fitness routine was going for long walks.  My goal is to get back to that and then to progress even further. Never, ever want this sort of thing to happen again. Neil, I think you are doing great. Your commitment to physio is  amazing. 

Hi Sandy,

One thing that is evident from all of this is that no two cases are the same, which makes it even more surprising that hospitals use a blanket approach to treatment in my area.

All of our experiences are so different. The one thing we all have in common is that we all need patience and time to recover.

Thanks for that Sandy.

I'm at a point where everything feels ok, but have no real strength in injured leg.

Seated calf raise feels fine.

Standing one only with both feet, feels better in water.

Balancing on injured leg in water is excellent.

Cycling, with shoe, normal at level 8 on stationary bike no problem.

I am going to try easy stepping in the gym today, just a basic up and down .

Wednesday will be 7 weeks post op.

Will go for physio at week 10 for inspection and 10 point check (oil change)

Hi Sandy, sounds like it's your body telling you to ease back if you're getting pain when you stretch and walk too much. It's funny that we all tell each other to ease back and take our time, but each of us individually wants to push things harder for ourselves!

I totally get what you're saying about standing on your toes and shifting your weight onto your bad leg - I'm the same, there's just nothing 'there' when I try to put my weight onto my bad foot.

I'm going swimming on Thursday (in a small hydrotherapy pool, 4' water depth) so I'm looking forward to trying all my exercises in there. My physio said that I need to get my calf muscle really firing in order to make good progress, but of course that's easier said than done!  

I'm following someone on Instagram who's doing brilliantly with the conservative route. She's in NZ and her Dr/physio used to look after the All Blacks! She's about three months in and can already stand with her bad foot a couple of inches away from the wall and bend her knee to touch the wall! She's really positive and such an inspiration. But it really does highlight how different we all are. 

I thought I would just have a light session in the gym today, but can't help myself.

Had session on exercise bike. I find that I am over working good leg, so was trying to isolate the bad one.

Was peddling only with bad leg for 1 minute out of every 3.

Then decided to give it a full go. Got my heart rate to 165 which is probably max for me, on level 11.

No pain, all feels good. Standing calf raises still causing some swelling, and a 1 footed bad leg calf raise impossible.

Great to finally get a workout sweat on

This sounds good Neil. Hope I can get to a similar point. Any limping still?

I'm at the new hospital this afternoon. Quite anxious, but fingers crossed for better treatment.

Good luck with the new hospital. Hopefully you come back home in the boot, and can start your active physio. I think dealing with fresh people, with a clean start will be really good for you mental wellbeing.

I have a tiny limp now. Am getting more comfortable doing standing calf raises (both feet, and then trying to take pressure on bad leg). I can see that the calf raise really works the soleus (muscle low on either side of the ankle), which gives your leg stability.

Also doing the step exercise where you stand on a step and step up and down with your good leg. I am now stepping down and back up, 2 steps instead of one. 

Gonna have a nice session on bike at gym. Try and do 1 minute of every 4 just using bad leg, but push it quite hard (level 12 or more) for each of those minutes. Good way to spend an hour and a half.

Boot is on. They were happy with join and scar. They have referred me to pt too. Doctor spent about half hour just discussing injury, my case notes etc. Really really a lot better treatment than before. Feel more positive than I did now.

He has told me that I need to get to pt sooner rather than later as my calf has wasted completely away as it's been inactive since February. But that's to be expected.

Hey, that is excellent news.

I imagine you are already weight bearing on crutches.

You prob didn't get your Rom exercises yet,

but you could prob start with 3 simple ones and some massage.

Toes pointed forward and then heel stretched back with toes up.

Wind screen wipers left and right.

Comfortable circles with foot, anti and clockwise.

Nothing must add discomfort at this stage.

Do you have a pool available?

Great news J!! It sounds like your new hospital/doctor is more in line with what the rest of us have received, in the way of advice and getting to PT.

Your calf will be jelly for awhile, but I think you are finally on the right track.

The cream Dr. prescribed appears to being doing its job in decreasing inflamation, as pain has greatly subsided. Back to doing my calf stretches several times a day. Went for 2 short walks. All Good.  Put my back out, so not able to climb into pool today, but hopefully tomorrow.  Seeing PT today and hope she give ok to start up again with standing calf raises.

 

Hi

Thanks. Much happier. Atleast I can move about a bit more freely now and can weight bear.

As for range of motion, do you think I should start them now or wait until I see the PT first?

Sandy, putting your back out isn't good. How bad is it? Will it effect your rehab with Achilles?

This time around the actual join of your achilles is miles stronger than last time. You are two and a bit weeks away from 6, when the join is done.the 3 exercises above are just gentle stretching, in the comfort zone.

I was doing them at end of week 2 and you are 3.5 weeks so I would start if I was you. What were your Rom exercises 1st time round round ?

That's excellent, Jonathan, I'm so pleased they took their time with you at the new hospital. I expect you're feeling more positive now. 

I went for my first swim last night and it was bliss! It was in a small hydrotherapy pool, which is lovely and warm, with lots of bubbles for massage and jets to swim against. It felt great bobbing around and kicking my legs. I even managed a few two leg calf raise / single leg lower against the side - really felt my calf working! Looking forward to going back again next week.

My leg is now *just* over 90 degrees, but still feels very tight up the front and back of my calf. I hope that if just keep doing the stretches it'll get there eventually. Slowly slowly wins the race and all that.

ALso brilliant. You are progressing nicely. I found the pool sessions gave me a lot of confidence, and was great for stretching and low impact. I found that standing on injured leg, and using toes to maintain balance felt good.

Keep it up ! 

Hi J. Re ROM, I received a Rehab pamphlet when I went to my PT for the first time.  It breaks down rehab into 4 phases. I will try to attach copy (3 pages photographed) of Phase 1 for your reference. As always be guided by your PT.

Pages 2 and 3.

My back is a pain.  I dont walk right, so in a way it does detract from concentrating on my foot. It is a chronic issue that I had resolved when I took up walking as exercise, but I guess the enforced idelness brought it back. Right now doing stretches for both foot and back. Back should be ok in a day or so.

I hope you can see the Phase 1 of rehab I sent. And hope it helps.

I wasn't given any range of motion exercises first time.

Last time around there was no physio till 11 weeks in and then that was wall stretch and calf raises. No range of motion stuff first.

Wow that must have been a shock to the system when you started. It's like leaving steps 1 to 6 out and jumpng in at level 7 , when you are at your weakest

Hope back sorts itself soon for you so you can get back to focusing on rehab of your Achilles. Funnily I have historic knee troubles as had my acl done on the opposite leg to my Achilles injury, so al of this has put strain on that and it is clicking like mad at the moment.

I didn't know any different at the time, but the doctor this time seems keen to get it started asap. He said the sooner you start with physio the easier it is when you come out of the boot.

As I've said before, I am pretty sure that the physio had a lot to do with my rerupture. However, specialist did suggest that it may not have even been a rerupture as he said that if they didn't ever check it properly then it may never have healed properly at all last time.

How is the achilles feeling re pain and discomfort level ?

DO you have a pool available ?

Even if you are scared to do any ROM exercises, I think taking boot off and doing some massage will definitely help get things started.

At 3.5 weeks I was doing ROM, exercise bike with no rersistance, heel forward on peddle, and started my pool sessions. I was also full weight bearing in boot. 

By full weight bearing what do you mean? I am walking on boot. That's what I should be doing isn't it?

No real pain or discomfort at all. Occasional tingling sensation, but no pain as such.

Sorry, pool wise, only local swimming baths.

Yes, walking on boot is full weight bearing. No pain is good, seems like everything is healing nicely. This time round you are 2 weeks away from  solid rejoin of the achilles and it should be much stronger already.

Oh good. How much walking around were you doing on the boot? I was on it a lot yesterday so a bit achey today. Nothing major, it just feels tired.

Don't know how much is too much?

I hope physio starts soon, want to get some strength back in the calf.

I came into physio after 4 weks without crutches, just walking in boot and the physiotherapist was not happy. Said I needed at least 1 crutch. In the boot I don't think you can do to much. The leg is well protected in there.

I don't think you will be able to get strength into the calf, until the muscles loosen up. For me Wed coming is 8 weeks, and I can now do calf raises where my ankle does not react or swell.

When is your physio appointment ?

Yeah I am using the crutches. Taken to odd step without e.g from one side of kitchen to the other but not far.

No physio appt booked yet, they should be getting in touch in the coming week.

Good news on the calf raises, your recovery seems to be going really well. How often are you having physio?

I stopped physio on 5th week. Was tired of paying to be tickled and given a couple of exercises. Having also had knee ligament reconstruction, I know that things just settle down over time.

I think you are being over cautious (understandable) with your leg, but you really need to start doing some ROM exercise. The three simple motion exercises will not hurt you at all. You are almost 4 weeks which is plenty

The two easy ones I would do is point foot down (you are mimicking your foot position when it was in boot with 3 wedges), and left/right windscreen wipers.

So do I point foot down and then bring it back up as far as I can until I feel it pull?

Morning. Yes 

#1 point toes down and then bring foot up. You will feel the stretch when the toes/foot is brought up. But stay in a zone of 5/6 out of 10

#2 Windscreen wipers moving foot left and right are just helping the lateral motion. 

#3 Easy circles with foot, clockwise and counter clockwise. Again stay well within  your comfort zone.

Those were my 1st three exercises for week 2 to week 3

Good speed with the recovery.

I am walking easily with no limp at all. Calf and  achilles has settled down, with no stiffness, and no swelling.  Am starting strength exercises today which is really just lots of standing 2 footed calf raises.

I am looking forward to hearing about your progress and achilles recovery success story  

Good morning.  I am walking fairly easily now, almost no limp. My husband says he does not see me limp, but I feel that I am still favouring my foot a bit. But still, happy with the progress.  Have decreased visits to PT to once every 2 weeks now. I agree that there is not much more she can do now. Just watching my progress and providing some advice. Although I still really like the massages to the foot that I cannot seem to duplicate myself.

The last goal I need to reach is to stand on toes on injured foot. And there has been the tiniest bit of improvement.

As for walking, have started again with daily walks. They start out fine, but within 15 minutes the heel starts to ache. I concentrate to keep a steady, non limping pace. Then rest for 5-10 minutes and continue.  I think I just have to persevere and I will get back to normal walking for a longer period.

I still have stiffness in the morning, that dissipates throughout the day.  Quite hot in my area, so there is some swelling during the day, but down by morning.

Hi JW11. It seems to take forever to get the foot over 90 degress, so congrats. At 14 weeks my foot was up to 102 degrees, so I am pleased with that. Still have to stretch it every day to maintain that progress and hope to increase it still more yet.  My foot also felt tight in both front and back of calf. Still does to some degree. I just keep on stretching.  Good luck.

Hi Sandy, thanks, I'm only just over 90 degrees but stretching it every day - it takes forever doesn't it?! The front of my calf is tight too. I have a bath each morning and do my ROM exercises in there, which I find helps it to get going. Good to hear you're walking limp free, I'm still a way off that, although find I'm much better with the wedges in my shoes. I managed a mile walk today, just over half of which was crutch-free, so I'm making progress.

Hi j.w its bobbers .i just had to say well done a mile how good is

that.ive not updated my progress because i didnt want to tempt

providence as im not doing to bad ,if you remember i had

complete Rupture april 5th with boot for 8 weeks followed by

falling off my cruthes crutches on the 7th week and tearing my

calf muscle in the other leg .getting quite a lot of swelling on both

Lower legs and ankles /feet ,pm mostly .other than that now

walking quite well with only a stick ,no lifts now ,iwalk round the

block everyMorning (not mile yet)and im helping around the house and

pottering in theGarden ,seeing physio every 2 weeks and have

done some .local trips in my which car feels good .if i remember

Were on nearly the same schedule so its good to compare notes .x

Hi Bobbers, great to hear from you. I know what you mean - part of me wants to shout my progress from the rooftops, but then another part says don't, as you don't want to jinx it! (I just managed that mile without putting my crutches down, but ssshhhh, don't tell anyone! ;-) It took me half an hour, but the important thing is that I got there.)

My rupture was on 17th March. I'm not getting too much swelling, thankfully, just a bit around my ankle and top of my foot, but my leg still goes a funny shade of purple-red sometimes, especially first thing in the morning, or if I'm on it too long. 

It feels good to do things around the house again, doesn't it? My hubby's really appreciating me doing a few odd jobs, I just can't carry much up and down the stairs yet, as I like to hang on to the rail! 

Great that you're driving, that must be so liberating. I'm hoping to have a go at the weekend to see how it feels.

I've attached a pic of where I'm up to on my calf stretch - feels like a real milestone getting over that 90 degree barrier. And my knee-to-wall test is slowly getting closer. 

Keep up the good work, and do keep us posted of your progress. x

Wow. 1 Mile is fantastic JW. I don't think I am there yet. Have walked to the village, and I think it is close to a mile, but will need to clock it to be sure. I did that on the weekend, then had to sit for about 20 minutes, then walked around, sat, walked sat. Pain in heel gets me everytime. LOL. Could not walk home. Hubby had to run home and get the car. Yesterday was day of rest, no walking other than around the house and yard.

Also in sister's pool with water at chest height, could do a few standing calf stretches. Only lifted heel about half an inch, but I did do it.

The knee to wall exercise is tough and I use it as my guage for progress. I can now touch wall (knock on wood) when toe is about 2 inches from the wall. Still a long ways to go.

Just shows how we're all different, Sandy, I'm nowhere near touching my knee to the wall, as you can see, yet you're doing really well there. I'm sorry your knee's still playing you up and it's stopping you from walking. I won't go too far on my own and always have my crutches with me - glad I did yesterday, as I would've had to crawl home otherwise! We'll all get there eventually, one way or another.

Just been catching up on peoples posts. Well done all, seems like good progress is being made by all.

It is interesting how we all recouperate on different ways. Before mine went again, I could do knee to walll test pretty easily, but struggled with other areas. Wonder how much is to do with how long you are in boot, cast and the surgical and non surgical routes.

I think those things definitely factor into it, plus age, weight, fitness level, mental ability, fear, determination... then there's each individual's body's ability to heal, the position of the rupture, the amount of scar tissue, how well the tendon stretches back out.... it's no wonder the doctors can't agree on the best course of action!

Have you be getting on with the stretching exercises ?

My calf muscle is slowly rebuilding, but I can't do a bad leg calf raise. But my stability and movement on the leg feels excellent. I am probably doing about 70 calf raises a day, with some cycling and a 2 step up and down. Up and down stairs fine. Going to the tennis club and will just roll the shoulder over the ball and hit some serves on Sunday.

Yeah ok, although not as much movement as I had last time around. I wonder how much of that is down to calf strength though. It doesn't hurt trying to bring foot up, it just won't go at the moment.

Wow, your rehab seems to be going great. Take it easy at tennis though, don't do too much too soon.

Quite interesting, because it seems like you had more flexibility, but a weaker join,  without surgery.  I think you need to get in the pool at the first opportunity. Just sitting on a floater and kicking gently will be very good.

Regarding tennis, im just gonna hit serve a little standing still. Absolutely no running.

Hey Jonathan,

How is the recovery going ?

Been to see the physio yet ?

Neil.

Hi Neil,

No, not heard from physio yet. Been doing the exercises you said though and boot off at home whenever I can do so and sit with it raised.

Get the odd tingling feeling in my Achilles from time to time. Not sure what that is. Whether that is it healing or nervous system kicking back or what.

How did the tennis go?

Hi jw thanks for the pics ,my physio gets me to stand with back

to a Door heels 10 inches away(25 cm)with feet 10 inches apart

and then lean back to touch the door and then bend your knees

and slide down the door untill the discomfort is only just bearable

And hold for 3to4 seconds and then come back up x 10.

I tried your method and could only do a inch and a half ?can you

tell me what is the target distance away ?.keep up thegood work

Yesterday i was very daring and drove to tesco and did 15minutes

Shopping and got back safely but felt very nervous ,luckily people

make allowances if your 70( i might have been pushing my luck

But hey ho if you dont try you dont find out .im still walking round

the block daily and yesterday i took my well behaved dog.

.Well done with the mile without the crutches and its good your

swelling is minimal Onwards and upwards .keep smiling .x

WIll go to the tennis club Sunday morning, and will see. I notice that if I load my bad leg (standing calf raises, or nordic elipse stepper at low resistance), I get swelling on both sides of ankle above achilles. So having a rest day, with some stretching.

Week 4 I was doing stationary bike, heel forward (so you dont really extend the achilles), on no resistance. I think I also added a stionary 1 step. You stand with your bad leg on a step and then step up and down with your good leg.

I think the tingling is common from surgery. They have cut/disrupted some nerves and it is just resetting itself.

 

Keep going you will get there.

Hi Bobbers, your exercise is a good one (I just tried and wasn't very good at it - I want to put all my weight on my good leg!)

I've attached a diagram showing the knee-to-wall test. I can't even do it with my toes touching the wall yet, let alone with my toes back from the wall! It's like there's a clamp around my ankle, which I assume is the scar tissue, but I am getting there - like everything with this injury it's slowly but surely.

Well done on your Tesco trip, that's great, and taking your dog for a walk - good job he/she's well behaved, the last thing you want is to be pulled along. I find having my crutches to hand, even if I'm not using them, makes people keep their distance! xx

Thanks for the diagram j.w .im seeing my physio on tuesday and

i will ask her if its ok for me to do your version as well ,because

It seems to me that progress Can be measured better that way ..

Take care x.

That is a great diagram; shows exactly how to do it.  I use my good leg as a guide, as some people are very fit and their good leg can be quite far from wall; others may be less fit, so good leg may be a shorter distance.

I have just returned from a wedding in the interior of my province (BC). Our province is on fire and there is lots of smoke. Was on my feet and walking more this past weekend than at any other time previous. Which felt great, so glad I could do it. However, last night after the wedding and some dancing, I woke up to "charlie horses" (painful muscle cramps) in my calf on bad leg. It happened three times during the night. I think calf was well used, and let me know. Home today, so more restful, but I now have the courage to walk to my village to pick up my mail.

Also going to add that sitting position, back to the wall, that bobbers has described. See how that goes.

It's really just a measure of how flexible your ankle/calf is, rather than an exercise in its own right, but it does give you something to aim for x

Hey Jonathan,

How are things progressing ?

I did'nt go to the tennis club on Sunday. Leg was feeling a little bloated, and tired. Think I had overdone things (what's new, so just took a break for a few days. Swelling settled down, and it the redness went away as well.  So the break did me good. 

Hi Neil,

Yeah ok. Back at hospital for pt next Wednesday and then to see specialist on Thursday. Hopefully find out a bit more then.

Don't know what to make of my leg though. I can feel that Achilles' tendon is there this time, but I can feel couple of bumps and steps in it. Not sure if that is just the stitching or scar tissue etc. Did you have any of that?

Not really had any swelling at all this time around though. First time the swelling was constant throughout.

I'm down to no wedges in boot now.

Since taking the wedges out, I can feel a bit of aching in the Achilles. Did anybody else find this? Is this normal?

Concerned as haven't had any aches throughout really.

No, I never had that. I could not feel the difference when I removed wedges.

Do you have any swelling around the achilles ?

I  have a little bump, where the achilles was joined.

I have found that if I load up on exercise, ie Nordic Track Elliptical, or overdo the standing calf raises I get a swelling reaction. Have really just been taking it easy this week. Done a light cycyle a few times this week.

DO you have access to a stationary bike ?

No that's the strange bit, no swelling just feels a little achy really.

I don't know whether I have overdone walking around on it and that is causing the ache.

No I don't, there is one at my parents house so I could try that. A little worried about doing so while its tingly. I may just be overthinking it, but I'm worried after last time round.

Maybe you have overdone the walking around. The no swelling is a good sign , I think. Maybe just give it a little rest for a day or so.

You must be pretty close to 6 weeks post op. After 4 weeks my physio had me on exercise bike. No resistance, and heel forward, so that you are not extending the achilles at all. It was very good to get a little bit more range in the ankle.

Yeah I've taken it pretty easy on it today, trying not to put weight on it if I can avoid it. Tuesday is 6 weeks post op so hoping if all gone well, it should be pretty much connected again.

I'm hoping seeing physio on Wednesday will help matters and get some exercises to do and get it checked over.

For me from week 4.5 post surgery to week 8.5 I really worked hard on physio. I was either in the pool, on the exercise bike, stretching and massage  almost every day for 30 straight days. I found things then leveled out. My surgery was May 14th. I am walking with no limp at all, no pain. 

Hopefully your physio will give you a nice set of exercises to do, and you will be set on your way.

 

Hi Jonathan, I found that at first no pain or discomfort, but once last wedge came out, then I started to feel a pulling ache on achilles. I think it is slightly different for everyone, some feel no discomfort or pain and others do. Either way is normal. However, as always, check with your PT.  I have continued to have heel pain and to a lesser degree, achilles pain. I listen to my foot and when pain is constant or has kicked up a notch, I realize that I have been pushing farther than previous with walking or exercise, so I stop and have a day of gentle stretching, walking half of previous days.  I have now at 17 weeks worked up to 1.5 miles walk - and by the end my heel is really painful and so is the achilles. I then rest my foot for about an hour or so, then take it easy for the rest of the day.  I try to be consistent with my stretches - morning, mid day, and evening. And each day set a small goal, working on that til I can reach it.

You can try putting one wedge back in and see if that eases your discomfort. If it does, leave it in for the day and try removing it the next day. Or leave it in until you see your PT on Wed.  There is no harm in that.

You might also want to check out this other blog: agnesatr

I found it great to review.

Thanks Sandy. It's not excruciating and it isn't constant, just strange tingle pain every now and again.

As I say back at PT on Wednesday so ask them to look and specialist on Thursday.

Hoping it is something similar to yours where it is simply just it stretching out again. Can't compare it to last time as it was a different procedure so can't tell what's normal and what isn't.

I think because I haven't seen the PT yet, I don't want to do too much and I think I am probably being a little cautious as it is the second time too. Really

Hope it's ok and boot comes off on Thursday. That would be a massive step in the right direction.

Are you back driving and if so, how soon were you doing so?

Hi Jonathan,

I was driving (in boot) at 3 weeks. I simply had to get around, and it was no problem at all.   When you see the PT on Thursday, get them to give you at least 5 or 6 exercises. You will find some will be much easier than others, and the ones that feel good will encourage you more than the ones that don't.

That said, nothing should cause any pain at this stage. I can almost do a one legged calf raise. I can do a 2 legged and hold the raise on the bad leg, so am definitely getting there.  

Was this driving an automatic car or manual Neil. Mine is manual so I need both feet. Last time I drive about 4 days after the boot came off. Don't know whether that was too soon or not.

One day to PT.

Mine is a manual, Nissan Patrol pertrol guzzler. It has a very light clutch. I found that I could drive easily by just putting my heel on the clutch, instead of the toes. 

I think you have to forget about what happened previously. Hard to do !

I remember reading a post where you were not convinced the previous rupture had ever healed. You are at 6 weeks, the join is probably 100%. Now you have to get the stiffness out, and start firing the muscles.

If you can, try and get in the pool for an hour. Just walking around will give you confidence in the bad leg. 

I am 10 weeks tomorrow. Was at gym this afternoon. Did 2 footed calf raises, 30 minutes on exercise bike, and 15 minutes on nordic eplitical stepper. No pain, all good. So is hope, and you should be getting around in a couple of weeks. Just keep working at it

Fingers crossed that will be the case. If I'm out of it by Thursday, my partner is insured on my car until Monday, so I may not renew it after that and get back to driving next week. See what happens.

Just be glad to get someone to look at it again tomorrow. It's the not knowing more than anything else.

Your recovery seems so fab. Hope mine is just as smooth.

Have you been doing all the  stretching and ROM exercises ? How has it been going ?

You need the reassurance of a good physio, who will set you on your way to a speedy recovery. How has weight bearing felt in the boot ?

Hi Neil. You are a great example of a success story. I am now at 17 weeks. I can do 2 foot calf raises, but not single ones. I have walked on my toes using crutches for some weight bearing, but just cannot manage to do a heel raise on injured foot alone.

My one concern is the constant ache in my Achilles Tendon. It is not too bad, maybe 1-2 / 10 most of the time and 3-4/10 during a mile long walk. I know Jonathan mentioned he had some aching, but otherwise, no one else seems to have this ache. I have asked my PT, but she seems to think it is par for the course. However, you do not have any pains or aches. Any words of wisdom?

Also, I am wondering, when you first get up in the morning, do you have any stiffness? I always feel slightly stiff. I always do my first round of stretching and strengthening when I first get up, then 2-3 times during the day, but not as intensely. 

Weight bearing in the boot has been fine. To be honest using the crutches is a pain now as I can actually manage without.

But it was similar last time too.

Range of motion has been ok, however i haven't pushed it too far yet. Have a feeling they will probably move it further than I have been tomorrow, but we will see.

Hi Sandy, I don't have a constant ache, but mine does feel a bit sore sometimes during my daily mile walk, or a bit tender afterwards, but nothing a rub doesn't sort out.

I can't yet do a single leg calf raise - it's my understanding that it takes a very long time to build the strength up to do that - but I can now do a two leg calf raise, and lower on my bad leg.

My leg's very stiif in the mornings too. I do my ROM before I get out of bed and then again in the bath, I find that really helps.

If anyone's on Instagram you can find me jowoods11 where I've been posting progress pics and vids and there are others doing the same too if you search. Jennanz12 is particularly inspirational.

Hi Sandy,

I think I was just lucky in my recovery process. First thing in the morning my leg actually feels better than at the end of the day. Everything just seems to relax after a nights rest. No stiffness and  zero pain.

I have not been in the pool for at least 2 weeks. I found it was really good initially for balance,  range of motion, and gaining confidence (say weeks 4 to 7).

From weeks 6 to now, the stationary bike has been really good. A 1/2 hour low intensity session, gets the blood flowing, and loosens up the ankle. If I do a 7 out of 10 session on bike (with raises, and step ups), and 15 minutes on eliptical stepper,  I get some puffiness around the ankle, but it goes away.  

One exercise I like to do when sitting  barefoot. Have your foot flat on the floor (knee bent at about 90', and push your leg forward while keeping your foot in the same place. I find it works the area around the ankle nicely.

Back from PT. complete waste of time, although not their fault. Previous hospital still not transferred my notes across so they had no notes on the history of my injury. So I had to explain all the background to them so then no time left and the PT said as it's a complicated one she wanted to seek advice from head PT and from specialist in orthopaedics. Said didn't want to give me anything yet until coordinated with the specialists.

Back next week. So frustrating.

Back to see specialist tomorrow though so hopefully find out a bit more about my actual injury then.

Man, I don't know how you keep your patience. EIther the new or the old place should have transfered the notes. It is not exactly your responsibility.

Perhaps the specialist can advise you on a couple of PT things to do for the coming week. Wow, how annoying  !  

Wow JW.  I am not on instagram, however I was able to see your recent post. I just looked at your video of 2 leg calf raise, lower on bad leg. I was going to say that I can do that, but hahaha. Nope.  I can raise on two legs and lower the injured leg, but I still have my good leg on solid ground when I do so.  Just tried to lift good leg while standing on toes. No can do at all.  So good on you.  I am going to have a pity party for one. 

I do the same things in the morning - ROM, stretching, strengthening. Then get on with the day.  But obviously I need to pay more attention to the strengthening.

I have given in and have started to take two Advil tablets in the morning, before I go for a walk. Not sure it makes a difference. Normally I do not take any pain meds.

I think yes a bit of luck. But also maybe because you went so strong for the first 30 days has helped. I only hope that as time goes by the aches and pain will dissipate. I do not have access to a pool regularly. And no gym close by for machines. The exercise you mention. Sitting,knee ben 90 degrees and push leg forward - you mean push leg forward so that knee is over the foot? I do that.  I feel the pull when I do it, but no pain or aches. (YAY). I do practice that when sitting as well. I dont get a lot of swelling, but when I do, it is always gone by morning. Thanks for the help.

Hang in there jonathan. I know it is frustrating, but they have said your case is more complex than normal.  Keep up with ROM that you can do and the other exercises to keep thigh muscles and hips strong, so that you are ready when the time comes.

Thanks people. You are right about frustrating. I need to stop getting myself into a frame of mind of thinking it's going to be good news and just go with a let's see what happens attitude, then it won't be such a pain when it's not what I expect.

more than anything, I just want to know it's heading as it should this time.

What they did say was the treatment at previous hospital was not normal protocol and were very surprised at what had happened, particularly the trampette incident 🤦🏻???.

Thanks for your kind words.

Hi all,

Back from my appt with specialist. I am in and out of the boot. They have said if I go outside, do so in the boot for the next few days. However if I am inside then I can walk in my shoe with a wedge in. They said keep using the crutch for a few days until I feel more confident. Don't know how much of this is then being cautious and how much is the advice I should have had last time.

What do you think?

I think that advice sounds spot on, Jonathan. They are being cautious, but with every reason to be.

Sandy, it's good that you can raise/lower as you've described. We're all going to recover at different rates, so all we can do is keep plugging away at it. I'm doing a series of exercises and stretches every day, but I'm still cautious. I went swimming last night and did quite a few lengths and my ankle's been sore today, so I've been extra careful.

Yeah very true. So different to last time, where they took the boot off me in clinic and put it in the bin and said off you go. Scary the difference in treatment between two hospitals 20miles apart.

Just need to take it slow I guess.inasked about swimming and they did just hold off for now and we can discuss again in a week or two.

Was there something specific you did for thighs and quads to keep strength there throughout this?

It sounds about right to me.

Regarding the swimming, I think that walking around in the pool will definitely not hurt you.  If they are saying you can walk around inside the house without boot, then you could definitely get in the pool without boot.

Obviously less weight on the leg, and you can start gentle movement, stretching and mild leg paddling. 

For me week 4 to week 7.5 in the pool was brillinat for my leg. It also got rid of any knee aches as well. 

I have been quite fortunate in the fact that since I've been in the boot, I've not had any knee aches.

Just walking around the house, leg feels a lot weaker than last time. I'm guessing this is the impact of 6 months worth of muscle wastage compared to 2 and half months last time.

I don't feel ready to drive yet, definitely best to give that a few days I think.

Once I can drive it'll hopefully help me to get a bit of independence back.

Hoping once I see the physio again, I can ask about the pool again, she really didn't seem keen yesterday.

Were you walking without the crutches once out of the boot Neil?

How's the ankle after swimming now JW, has it settled back down?

I was walking without crutches straight out of the boot (at week 6). I think at week 4 I was taking boot off, and using exercise bike in gym, and also doing similar in pool.  The pool got my confidence up, and also got me trusting the bad leg a lot more.

Everything that I read on the injury, suggested that early weight bearing, and exercise definitely accelerated the recovery.  I was def on exercise bike at week 4, and it really helped my thigh muscle and knees.

When I can drive, I will be able to get to the gym and get on the exercise bike. When you say cycling with heal forward what do you mean exactly?

Yeah I was walking no crutches last time, but I guess the second time round, just need to be more cautious.

If the bike has a foot strap on the peddle, try and remove it or use the other side of the peddle (on bad leg side). Instead of having your toes and the front of your foot on the peddle, you have your heel on the middle of the peddle, and toes well in front of the peddle. Keep your heel forward and cycle gently. You should be able to do a comfortable circle, with no resistance on the bike. Initially just for range of motion..

Thanks Neil. When I can get back to the gym, I will give it a try

Just keep your heel on the middle of the peddle, so that it does'nt really move when you cycle, to start off.  As you get more comfortable (after a few sessions), you can add some resistance

I posted 3 pics/pgs of these exercises - see 22 days ago my response. I am not sure if you can see these clearly. But they do describe hip and thigh exercises you can do - with boot on. If you can't view these pages, let me know.

I have taken a few days off from walking. It seems to be my biggest pain in the ankle. So concentrating on stretching, strengthening and balancing.

By hanging on (for dear life??) to the edge of my bathroom sink, I can manage 10 eccentric calf raises (2 legged rise, then lift uninjured foot and lower injured foot). I still have a constant ache in the 3 to 4 out 10 range on the outside of my ankle.  Hoping that will go away with my break from walking.

Found them sandy thanks. Have you continued with these since out of the boot?

Hope the break in walking is helping the ankle. I've not had any pain since out of the bot yet, but taking it very easy at present. Pain I have is if I put the boot back on again and walk in that.

I tried to do that, two footed raise and then lift good foot.

Mission impossible ! Absolutely no chance...

My recovery has gone well, but there is just no POWER in the calf.

 

I think the calf raise  should be done barefoot, as you land up gripping the floor better with your toes on bad leg. 

My specialist said that one legged calf raise is the end goal: reach that point and you are pretty much there, so I'm not expecting this for a good while yet.

Going to attempt driving in a day or two. Any tips to avoid too much pressure. I'm guessing it's the real easing of the clutch where damage could come so the pushing it down.

re the driving, if you can put your heel on the clutch, not your toes, it will help.  As you put pressure down, you are not stressing the achilles. Try it once or twice just sitting in the car, before you drive.

Yeah I was thinking I need to give it a go with the car parked up first. Then see how it goes from there.

How is the physio going? How often are you having it now?

I've had a go at driving a couple of times now and it's not so much the putting pressure through my toes - that's fine and it doesn't hurt my Achilles (we have a Fiat 500X so I think the upright sitting position helps) - but it's more the lack of strength in my leg. The 'spring'/resistance on the clutch pedal feels SO much stronger than pre-injury, it's really hard work to push it down!

I have not been back to physio since week 5 or 6. For me it is an additional cost I can't afford, and at this stage it would have limited effect.

The 1st few weeks was important, because you have such a steep recovery ahead, but it levels out and then it is slowly slowly. 

I'm going to really work hard on calf raises and eliptical stepper in gym this week, and see if it has any effect. Want to try and spend 40 minutes on stepper, doing calf raises every 10 minutes, with a little rest in between. 

Wake up calf muscle

 

Wow the stepper. You are brave. Not sure when I will reach that point.

Yeah I get that with physio, cost is a bit much. Hoping that the new hospital physio is better than the previous one and I won't have to pay private again.

The stepper feels fine, but its the nordic one, and not the straight up and down. 

Try this exercise if you can. I think I started it in week 5.

You stand with your bad leg on a step, and step up and down with the good leg. Start slowly at first and hold onto something if required. That combined with the bicycle was excellent.

I really wish I had access to those exercise machines, but I don't. My village has an outdoor area with about 12 machines, including those two. Unfortuneately, they were built for a very tall person (or our local Sasquatch) and they are not adjustable.  I have used the machines that work the upper body and arms, but haha to no avail. I found thru this experience that I have absolutely no upper arm strength.  So using my 5 lb weights to work on that part of me. 

I really try to listen to my foot and I think there are three areas that need strengthening.  One obviously is the calf muscle I don't feel any pain or discomfort, but I also don't feel a lot of support there. But another area, for me, is under the foot between the heel and the toes. I still feel like there is a piece of tape along that part of my foot. The third area is definitely right behind my ankle where the tendon is. This is where I actually feel pain and resistance(?) for progress.

I was in my sister's pool the other day and I was able to stand on toes, then lift uninjured foot and lower on injured foot.  Without holding on to the edge.  Chest deep water.  That is progress for me.

Calf raise barefoot is what I do. Both on hard floor surface and on carpet.

I do not regularly do the thigh strengthening exercises, but from time to time witll go through all the exercises in all phases. Just to be sure I can still do them. But for the most part I have now concentrated on strength and flexibility centered on the Achilles. Everyday. Twice a day if I am really busy with other things. Three times a day if I am home. The progress now is so minute, that it is hardly noticeable. But it is progress.

So glad you are not feeling any pain.  I took two days off from walking my usual 1.6 mile walk and felt a lot better. Then went to IKEA and walked around there for 2.5 hours. By the end my heel pain was at 9/10 and Achilles 7/10. So will continue to back off the walking for now. I see my PT on Wednesday and will discuss with her.

As for PT - I am fortuneate that my plan pays 80% of the cost. I still go every two weeks. It is good for me to have someone with an educated and critical eye to review my progress. I need that outside opinion to keep me on track. And she will either work on a specific area of my ankle, or give me a massage. Both are very helpful. Because progress is so tiny now, I will probably switch to once every 3 or 4 weeks.  

Which is the Nordic stepper Neil? The one in my gym is like a set of stairs that goes around and around. Is this a nordic one?

It kind of looks like the attached picture. The steps go forwrds and backwards in an eliptica movemnet, and not up and down like a stair master machine

I had a good session in gym today, nordic stepper for 30 minutes, with calf raises every 10 minutes. Calf feels excellent. No pain, no swelling, and I had it on elevation 9 and speed 11. Wednesday will be 11 weeks for me, but I have definitely found my exercise of choice.

How did the experiement with the car/clutch go ?

 

Yeah we have both Nordic one and the normal stepper by the look of that picture. Do you find the Nordic one doesn't put too much strain on Achilles? Have you only started that recently?

As for car, haven't tried yet, will try build up a bit of confidence later today and give it a go.

From about week 5 to 9.5 I did a lot of cycling in gym, and only after week 9 did I start the nordic stepper. Started very easy, no resistance, and no 'elevation, so on level 0 0, but quickly up to level 5 5.

My attitude was ' any pain or discomfort, stop immediately, not ready for this yet'.  My only problem on that machine is boredom, and it is hard to keep going for 30 minutes. Need a difficult soduko, or some sport on TV to get through it more easily.  But the after effect, of feeling the bad leg calf workout, and seeing a soleous muscle grow is great !   

At your stage now your achilles is 100% joined, it is just a matter of time and effort in buidling up the muscles. Just don't do anything that causes pain, but try a few things.

I went for a walk in the park yesterday for the first time. Took one crutch, only because it was busy and to make other people aware. I'm going to go for a walk shortly without my crutch and see how I get on. I want to try the bike, but may wait and see what PT says Friday as its only a few days to wait, not too long.

I know what you mean about machines in the gym though. Tedious doesn't even come close. So is your calf size similar to your good leg now?

No, my calf seems like it is slow to grow on injured leg.  I can see things happening though. Stiffness is less and less, and the soleous muscle is definitely strengthening. The whole process is so gradual that you don't really see improvement on a day to say basis

So I need to get used to stick leg for a while yet then?

Looks great 🤦🏻???

Tried driving before too. All was surprisingly ok. Didn't feel anything through the Achilles which was good.

Hey everyone great to read you are all progressing well. Not been on in a while as I've been busy working.

Really interesting to read the difference in your recoveries Jonathan. It does really sound different and Defoe makes me think the surgical route sounds far better for a quicker recovery. But I guess they go for the cheapest option in the UK and as most people say after a year you results are similar.

Hey JW had a look at your Instagram and the calf raises look great. That is the one area I am still really struggling. Feel like I have very little strength in the front of my foot. Flexibility wise it's going great. Guess I just need to be patient and I'm sure I will get there.

Hi Davie, good to hear from you. I was the same with not having much strength in the front of my foot, but I've been working on it every day, so I think that's made a difference.Even just standing on both feet and raising up, concentrating more on the injured leg helps with building strength there. You'll get there.

Hi Davie

Early days for me yet, but it seems a lot smoother up to now with surgical route, but I guess time will tell.

I've probably been a little more careful this time too. Changing

Hospitals has definitely helped too. 

I think the single calf raise is the end goal, so don't worry yet.

From what I gather, I was told don't expect to be anywhere near that for a good while yet.