Achilles Tendon Rupture Treatment - Postcode Lottery?

Posted , 24 users are following.

Hi All,

First time poster here.

I wanted to find out a little more about various NHS trusts treatment of Achilles Tendon Rupture (ATR).  I'm especially interested as I get the feeling the treatment on offer to me is not optimal and I wonder if I'm the victim of being under the wrong trust.  One that is trying to save costs.

My Background : 44 yo male, healthy and fit, with suspected ATR.  currently 3 weeks in short leg cast.

I have an Ultrasound tomorrow (4 weeks after incident).  No Surgery being offered at all, Consultant says they only provide conservative treatment with cast as surgery gives to many risks. Treatment is 3x3 weeks of short leg casts, final cast is 90 degree to floor. It seems no load to be applied at all during this time.

My main concerns are :-

(1) Risk of re-rupture seems to be on average 20% with non surgical option.

(2) 1 in 3 patients on non surgical never recover function fully.

(3) No option of Airboot being offered to me.

(4) Various studies show that early restricted mobilisation of ankle in non surgical option reduces chance of RR to same levels as surgical.  This will obviously not be available if I'm in cast for 9 weeks.

(5) I don't see how I can be offered a set treatment path prior to Ultrasound.

I've never heard of 3x3 weeks cast only option.  What are you being offered?  I'm absolutely not going to settle for walking with a limp or a weakened leg because my trust are watching their pennies.  I will be taking a private second opnion but also wanted to hear your thoughts?

Thanks

David.

 

1 like, 109 replies

109 Replies

Prev Next
  • Posted

    ah well samantha i could be normal , i will google the achillies swelling like tim said .thanks for the replies.

    rob

     

    • Posted

      also Robert, the swelling you are experiencing is completely as expected, 8 months in, my leg still swells every day and my circulation is rubbish, if I wear a sock my leg looks like a sausage!!
    • Posted

      ha ha i can sympathise with you there if my socks are short it looks like i have sausage link before me knee . eight months that is a long time i am justy  pleased that i am normal thats not something i get called often lol.

      thanks again for the info

      rob

       

  • Posted

    Hi David   

                 Like you I am so frustrated at the level of treatment I am getting from the NHS ,I am a 43 yr old male and I hurt my achilles playing in the park with my daughter running after a ball heard a popping sound went to A and E told them what happened and was sent home and told to rest it after 2 weeks still in pain went back and was told to go to my G.P who then referred me for an ultrasound scan which I had 6 weeks after the injury happened and was told I had a partial tear and now I have been referred for an MRI scan it is now 13 weeks and I am still waiting I have had no medical advice no cast no boot no nothing and here I am leg still swollen still limping and been told it could take another 3 weeks to get the scan so that would be 4 months of absolutely nothing I am thinking the same as you now surely there  is something wrong here but i keep getting told I have to wait I am at the end of my tether with it and now seriously thinking of contacting a solicitor about the treatment I have received

    • Posted

      I'd buy a air cast off the internet and wear it. This is serious stuff.  Im 11 months post opp from Achilles tendon rupture surgery and I've still got big problems.  I've got incredible Achilles tendinitis in both legs and im not too sure that the repaired tendon is good enough.  Bottom line in a couple weeks it will be a year since the rupture and I'm not sure I'll ever be close to what I was.  Being physically active was everything to me.  And I need to be active just to do the work I do, so I can keep a roof over my head.
    • Posted

      Also if put a couple inches of heel lifts in the boot and that should take all the stress off it.
    • Posted

      paul that is a serious amount of time that to wait , i never had an MRI type  scan i only had that to find the blood clots that occured afterwards due to imobility .

      rob

       

  • Posted

    It does seem like some places aren't taking it seriously enough. I know it might not be classed as life threatening but having long-term impaired mobility would be tough. I got the impression I wasn't young and fit enough for the surgery. I'm only 45, work, and run round after a 5 year old so i'm not too happy about that. Anyway I decided I wasn't convinced this is right. I've just written to PALS asking how to get a scan and 2nd opinion on the surgery.

    i got an orthopaedic leg trolley today for in the house. Brilliant! I think i must look daft paddling it along with my crutch - but definitely easier than crutches. 

    • Posted

      sorry emma but i am laughing not funny but i can relate i was going round on my knees and up the stairs on the bum . didnt hel pthe wife calling me a silverback either !! i know what you mean about the crutches tho it is hard going .

      rob

       

    • Posted

      Hi Emma, I do sympathise, I have a disabled daughter who also keeps me busy, I've not been able to help her for months, my husband has totally taken over. I also feel achilles injury is not taken seriously, but I do know you can only have the operation up to 7 days after the incident, I have spoken to people who have had it and people who havn't. I'm afraid the jury is out. My friend had hers done 3 years ago and the other day it bled.See how you go without it,mine has healed really well, I just need to build up strength and flexibility
    • Posted

      So sorry - missed this post. Its hard with children. My leg was agony this evening helping son to brush his teeth. I am getting some help but still a lot to do alone of course. He is only 5. Some school mums have saved me with a rota to fetch and collect from school - thank goodness they stepped in. Thankfully, he loves that as he often gets a play date thrown in. 

      I agree about the outcomes with surgery or not. I asked a few physios and surgeons plus i've realised the people in the plaster rooms see ALL! They know exactly what treatment they would have for most things. 

      Brilliant you have healed so well. I am praying for same result. 

  • Posted

    tore my achilles in april ,wasn't picked up sent home with torn muscles, physio picked it up 4 weeks later,sent back ultrasound scan, full rupture,too late to have surgery it needs to take place in the first 7 days. However i have met people who struggled after the op and still havent fully recovered. Mine has healed well but still needs strengthening and flexibility, can't dance yet!!
    • Posted

      HI odette that s not good that they have not picked it up so early . i can vouch for the dancing bit thats how mine happened+alcohol .

      not good . it does seem that it indeed does take a VERY long time in recovery , its this bit that worries me .

      rob

       

    • Posted

      Hi Robert, I actually did mine at work when a stool gave way,I love to dance so this is my criteria for normality, I would really recommend pilates, I have been attending an injury clinic which the insurer is paying for, but I am also going for a personal injury claim, because recovery is slow, and full functionality not guaranteed, this is too awful to contemplate. However I have made good progress , we just want everything to happen quickly don't we?
    • Posted

      hi odette i am sorry to hear how its gone for you , i think you are right to pursue it . i know what you mean about back to normality never in my wildest dreams did i think it would take 3 months as of now to get somewhere . i am now walking with a limp and normality does seem an eternity away to be fully functional will be my wish , i really do this is possible . i enjoyed walking and with two springer spaniels its not good not being able to walk as far i would wish .

      rob

       

    • Posted

      Hi Robert you sound as if your'e doing really well, I know what David means about leaving the leg to wither this is exactly what happened to me I virtually had to learn to walk again, I think the difficulty lies in pushing yourself but not overdoing it. Today I left my crutch behind for several hours and felt proud .
    • Posted

      well done on leaving the crutches behind, it is hard leaving them for me i even now i have the swelling i still feel as tho i am trying to protect it when walking by the way i do walk if that makes sense. it is the pushing oneself that will be hard as you dont want to do too much and have it go agaon god forbid.

      rob

       

    • Posted

      I am already quite nervous about the physio. How do they know how far to go? Eeeeek
    • Posted

      I'll let you know on Friday, that'll be end of week 11 for me. I suspect it'll be wiggle foot, stretch tendon until it starts to be uncomfortable and then then STOP!
    • Posted

      I started physio 3 weeks ago , my physio seems quite rough I think but she says it's my mind that's making me think my foot won't move like they won't me to, as for nearly 9 weeks it's been in a cast and then an air casts and for nearly 5 weeks of that it was NWB , I'm now in trainers took bit of convincing to go from air cast as I was scared my achillies would rupture again , I potter around house in trainers and one crutch but use two to get down garden path to the car if we're going out and wheelchair shopping , I've tried going round shop with just one crutch as we parked right next to shop we were going in , we were in there for 20 mins by time I'd got back to car I was in agony and frustrated as people walk so close behind you and nearly knock crutches out my hands , I'm getting there slowly, I've still got numbness in my toes have pushed Gp for MRI scan as they seem to think it's my back problems that causing it which is also hindering recovery as can't move about as much as I'd like , my husband says I'm doing too much so I asked physio , she said do as much as pain will allow as my body will tell me my limits , I personally think this injury is so frustrating as its a slow recovery I also think it's time of year as well trying get Christmas shopping done etc and shops are more crowded than usual , since I've been in wheelchair I've certainly seen world in different light you get 3 kinds of people the ones that are sickly nice and as husband how I'm doing whilst im sitting there (it's my foot that's the problem not my head) then you get ignorant people who let doors go in your face even though your right behind them and don't think they've done anything wrong and then you get genuinely nice people who will go back to hold doors etc yes still some genuinely nice people about thank god 
    • Posted

      I had same experience when in wheelchair, mine had a wheel fall off in Oxford circus heaving with people,but generally I found people only too willing to help. If you can afford it try pilates lots of stretching and non weight bearing exercise, without this I don't know what I would have done. Saw my physio today said I was progressing well, but my ankles are weak in 3 places, side tendons and front flexion, he said not to worry it takes months and months, I am 8 months in, get someone else too sweat the small stuff for you.
    • Posted

      you start off very gently with a band flexing and pointing the foot and doing what i call windscreen wipers, each week the physio will give you new exercises, to improve flexibility and strength, once your foot has healed, theywill encourage you to push yourself ,as long as you don't weight bear you cannot re tear.
    • Posted

      Hi. I am due to go back to the hospital Monday to hopefully get the boot removed. I just wondered whether people were just expected to walk out. I worry about trying to walk on the leg again. Do they just tell you to walk, do they expect you to use a crutch still, do they tape/bandage the leg etc?

      Any help would be great.

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.