Achillies non surgery recurrence followed by surgery off work 6 monthes

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Hi guys this is gonna be long winded but i will try to shrink it as much as poss. Had a virtual snap of achillies just hanging by athread,had non surgical cast on for the usual 8-10 weeks cast came and they gave me an appointment for the physio they gave me exercises to do at home but it was really just the one where you stand and lean against a wall to stretch the calf 10 times 30 seconds each wich i thought was to much but you trust them i suppose. After a week and a half it snapped again this time they did the surgery in acast again for 8-10 weeks this time they gave me no physio and when i tried to talk to the surgeon about what i could do and what not to do he didnt want to know. If i were to stretch the tendon and it snapped again i would get an earfull, if i leave it and it goes stiff they will say you havent stretched it enough. I have been reading letter after letter on this forum and others and they all boil down to pretty much the same thing, you have to stretch the tendon to avoid stiffness and not reduce flexibility but no one can say how much is to much , and you must not over do the exercise and stretches but no one can tell you how little is to little. My calf muscle has disappeared and im very wary about it going again having virtually 6 months off.   Any suggestions cheers Gaz

0 likes, 13 replies

13 Replies

  • Posted

    Hi Garry

    Really sorry to read you had a re-rupture. Awful news, as is your lack of aftercare. I think some of the consultants are only concerned about the active stage, and not after recovery at all.

    I have no faith in physios due to some bad experiences. However, my suggestion would be to find one, or an osteopath preferably, who specialise or have an interest in sports injuries as this pretty much is one even though we weren't all doing sports. Rubbish to have to pay but you might not need many sessions and they more likely to spend a lot of time with you listening and working with you. As soon as I get the OK i'm off to an osteopath who I trust.

    I would agree that doing 30 second stretches x 10 is a lot.

    • Posted

      Thanks very much Em yeah did mine on squash court I've played 30 years but squash apparently is one of worst things for achilles the heel was aching for months but i had no idea that was an indicator for a rupture will take your advice on board thankyou
  • Posted

    Garry, 

    Sorry to hear your story...I can relate on a couple of levels I'm currently recovering from AT partial tear following a basketball injury ... did 8 weeks conservative treatment...now 11 weeks on I am back in cast again because of tendonitis which may have been caused by physio being too aggressive too soon! Or me doing too much too soon!  I did AT complete rupture on other leg 10 yrs ago and my previous experience was cast no physio for 10 weeks and my leg never recovered - my calf muscle was completely wasted.  The consultant I'm now seeing is excellent and has a v pragmatic approach he believes that the patient must be active in their own rehab. Ie listening to their body.  He also believes in contemporary protocol which encourages weight bearing straight away and get physio ASAP.  The calf muscle will waste in 72 hours so important to do some exercise. Sadly there is do much conflict on this that it's difficult to know what's best... I do light stretches ultrasound, cryotherapy and calf massage at home using "the stick"  do what you can manage and if you're not happy get another opinion..best of luck! 

    • Posted

      I totally believe that contemporary protocol. I have nothing to base it on particularly but my instinct as an OT is that 11/12 weeks inactivity could have massive long-term effects. But equally of course, doing too much can! It's finding that balance and being helped to find it. There seems to be a lot of treatment which goes either end if the spectrum and not much inbetween. 

      But it's early days for me so I could easily be getting it wrong. I do know that I'm going to insist on another scan before I start rehab to make sure it actually has healed. If it's still torn surely starting rehab will make it re-rupture?

    • Posted

      Good point Em i was discussing this with a friend about having a scan post i know people who have had this option but it was never offered to me would have been nice to know that it was all ok as you say before doing anything physical.Another point was my calf muscle,it has disappeared lol that's gonna take a lot of work to get it back i was quite shocked at the extent of the wastage.
    • Posted

      Thanks very much Jac really appreciate your views and wishes and likewise to you.
    • Posted

      You're right to insist on another scan - I did once I felt things were not proceeding as planned. I thought I'd re-ruptured but thankfully not, yet tendonitis and torn ligament was diagnosed! I'm guessing you guys are in UK so your health system is different. I'm using private healthcare here in Irl so MRI is covered 100% on my policy so I insisted on another..my other costs however is another story...!  I'm cautious to a point but having done this before I don't want to have the same level of wastage I experienced before - I literally could not walk properly for months let alone resume sporting activities...! Upside I'm off Christmas dinner duties 😉 you have to find a silver lining!!!!!!!  
  • Posted

    More or less you're going to build the muscle and work with the tendon from the ground up.  I'm not sure exactly were you are at this moment, so you will have to excuse me if i'm not right on point.

    As I was recovering from my ruptured achilles I had somethings that really helped.

    1.  Before I'd even get out of bed in the moring I'd do some passive range of motion excercises; I'd just move it around with my hands flexing it into every flextion I could to losen it and flex it a bit 

    2.  Then I do the alphabets with my big toe as if im writting the letters in the air.  I'd pass through the alphabet two or three times.

    3. Then I'd do some light shallow streched with the wall like you did - just enough to get some more flex for walking.

    4.  Then I'd go out in the living room and work with therabands.  I'd use the bands for resistance to do eversion, inversion, planarflection (heel lift), and also use it for resistance coming out of planarflexion approaching dorsiflexion.  For some of these you just rap the band around a leg of a table.  Eventually I moved on to using a calf machine as it's hard to regulate weight when just having body weight as a choice.  Eventually I got to the one legged heel lift!

    5. Now the muscles are a little warmer now after working it, so I'll do some more wall stretches.  And then I'd proceed to do some walking down the street.  Or stationary bike would be better before walking - I didn't have one at home.

    Do everything gradual and consistent and ice when you're done.  Let your ankle warm up after icing before walking much.  And keep elevating it if it swells too.

    Youtube will show you many of these exercises.  You can find protocols for  rehab on the web too.  I also used the lesure pool to do some of the early walking too.

    Plan and plot your way.   I hope didn't confuse you with all this.  Good luck. 

    • Posted

      Very well explained Dan will use a lot of your exercises thankyou
    • Posted

      Hi Danny, 

      I have a similar schedule to yourself - that early morning motion is vital to wake up the muscles.  My physio sends me video links to healthclinic plus to show the exercises I need to follow week by week. Strengthening the quads is important too using light weighted leg lifts or place a rolled towel under knee keep leg straight and lift a few inches off bed. Pressing the ball of my bad food onto the instep of good foot creates some resistance too..!  Great to see other experiences thanks for posting! 

  • Posted

    Hi Garry, sorry you've had such an awful time,  I also have felt very vulnerable and worried about a retear,I can't believe you have suffered such shoddy treatment. My physio gave me great confidence, by telling me that if you do non weight bearing exercises you CANNOT retear your achilles. So sitting  on the sofa with your feet up point and flex your feet about 10 times each 3 times a day and get cycle exerciser that you put in front of a chair and do 5 - 10 minutes and increase resistance as you get stronger.
    • Posted

      Thanks Odette that sounds very encouraging so concerned about it going again i can't have any more time off work will end up losing my house have been doing all the foot stretching non weight bearing and swimming and will continue with that till new year then slowly,very slowly lol increase again Thankyou O

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