Advice: Torn Achilles Tendon

[KENZ]

Folks,
Anybody with experience of a Torn Achillies Tendon. How long before they got full mobility, how many casts were used. How long off work?

Unfortunately I did mine on Tuesday.I've put a thick quilt under the mattress to ensure I sleep with it upright. However on the first nite I almost got cramp. Drinking more water to hopefully reduce the chances if re-occurrence.

I'm active, swim,cycle,weights and very healthy. Age 43

[rog007]

Have you had your injury professionally diagnosed? If not, your diagnosis may be incorrect. If you have had it diagnosed, the professional should have advised you based upon their investigations and assessment. As a minimum however, and assuming the worst, 6 weeks of no weight bearing followed by 6 weeks rehab is the normal programme. If it's not torn, then 6 weeks rest (from sports) should do it. But still see your GP and a physio ASP if you havent already. Good luck!

[KENZ]

rog007 said:

Have you had your injury professionally diagnosed? If not, your diagnosis may be incorrect. If you have had it diagnosed, the professional should have advised you based upon their investigations and assessment. As a minimum however, and assuming the worst, 6 weeks of no weight bearing followed by 6 weeks rehab is the normal programme. If it's not torn, then 6 weeks rest (from sports) should do it. But still see your GP and a physio ASP if you havent already. Good luck!

It's was diagnosed by the specialist at A&E using the feeling of calf and looking for the foot to respond. My foot was swollen but when shown I did see it as missing. Plaster will come off in for 4 weeks. But they mentioned another 3x3 weeks with the foot casted in different positions..

Can someone give me some hope that in 4 weeks it may have healed..ie anything I can eat or do to speed it up.. I've moved locations recently and have just registered with a new practice so I'd like to discuss options with GP.

As I live on my own and on 3 floors, I spend a lot of time crawling and hoping around. Although once I leave my bed where my leg is elevated, I get a soreness pulsating feeling on my calf. Any ideas?

[Pickled Piper]

I'm not medically qualified but I did tear my Achilles a few years back. It's imposiible to say how long you will take to recover without knowing how bad the tear is. I am guessing it is quite severe otherwise it would not have been put in a cast. My tear didn't warrant a cast. I had a it reviewed by a Consultant, this was followed by an Ultra Sound scan that confirmed the size and nature of the tear. This was followed by regular Physio sessions. A 100% recovery took about 12 months for me.

There are some well qualified people on here who can probably advise you better. The good news is that even people with a complete rupture and requiring surgery, regularly make a 100% recovery.

Good luck.

pp

[buzzeh123]

Ive had this injury, ill add my 5p worth.

I did mine when i was 13 playing football, kid with Blades on hacked me double footed from behind, felt like id been shot in the back of the leg, was later diagnosed as a full rupture.

Treatment... At first it was 2 weeks total bedrest no movement etc just in a Tubigrip with lots of anti-inflammatories, then it was back to hospital for a full 8 weeks in plaster cast.

Then it was 12 weeks of physio, Towards the end light running etc... untill it ruptured again...

Another 6 weeks in plaster, followed by 6 weeks in a moonboot, lots of physio etc.

By the time id turned 15 (got fat and lost my football abilities! haha) it was ok, ached badly if i had to go any long walks or strenuous exercise.

About a year later and i forgot id even had the injury, do not feel any pain from it at all anymore, and im playing football, squash etc all the time.

In regards to driving, i would say that if its your left foot, wait alot longer than your right, alot of the action of pressing the pedal is directly done by your achillies and the accelerator is usually alot easier that the clutch/brakes (sorry to state the obvious). Trust me you dont want a recurrance like me!

Hope this helps mate

[KENZ]

Discussed with GP who wasn't a great help. Wish I had private Health care. He actually said to keep mobile and not to rest and only in the first few days to keep foot elevated.

Anyways got a line to sign me off for 28 days..

[D1ngd0ng]

You should have had a referral to the physio if you'd been treated in A&E (they should also have done an x-ray to see if any fractures) I did mine 2 years ago. Involved about 6 weeks of rest and elevation every day. I also gave the foot an ice bath for 10 minutes everyday when I got in from work to help combat the swelling. You'll want to be chewing ibuprofen for the next 2 weeks too (it does help)

Once the physio was happy that I could start to rehab it then had an hour a week at the hospital gym which involved things like walking heel to toe, standing on a mat on injured leg for a minute (more mats added as leg got stronger) walking up and down stairs calf raises etc.. until they were happy that I was ok to start my own exercise regime again.

Then I bust my ankle again and ended up seeing a private physio. Never looked back after that, quality of care was on a different level. So my advice is don't scrimp, find a decent private physio, spend £35 to get it evaluated properly and get some decent advice. If they're decent they'll suggest some stuff you can do now and say don't bother coming back for 6-8 weeks as I'll only give you the same advice. Then do go back when they say.

[Robbo66]

I had a tear, not full rupture. Tennis.
6 months rest, no running or stretching. Nothing. Frustrating doesn't come close.
Physio and huge amounts of calf raises following. 15 months until I felt confident to push off again and run. Get it MRI'd and get a professional to look at it.

I would hate a full rupture. Playing a guy one year, and heard what I thought was a clap due in a rally. He ruptured his. Went down in agony. Awful injury and career threatening to the professional.

Edited by Robbo66 on Sunday 23 December 09:50

[KENZ]

I was given the thompson test at A&E where the specialist could see no movement in my foot when calf was being felt and there and then was told it was completely torn. After 4 weeks in cast, it will be removed and a x-ray carried out to see how we'll it doing. The guy that did the cast told me it would probably be cast 3 times for the period of 3 weeks in different positions. Toe pointing down, normal and raised. Then physio..

[General Bilko]

Sorry to hear about your achilles tendon rupture and thought I'd share my experience, it's a nasty injury and one that will take a long time to recover from. I ruptured my right achilles mid June this year playing 5 a side football, it felt like someone had kicked me really hard in the back of my ankle. I went to A&E the following evening and was given a temporary leg plaster and an appointment to see the specialist the next day. He confirmed a full rupture with the Thompson test and suggested non surgical treatment, as although surgery was an option he normally only recommended it for younger keen sportsmen (I'm neither). The downside of non surgical treatment was a higher incidence of re-rupture compared to surgery however surgery had its risks with infection of the wound. So I agreed to have the 'conservative' treatment regime and he then fitted me with a removable leg brace (shin pad with velcro straps attached to a carbon fibre foot plate with 1 fixed and 3 removable wedges underneath my ankle). I was told to take out one wedge every 3 weeks and then see the specialist in 12 weeks.

I didn't feel the hospital were giving me enough information so researched on the various websites, and found this one to be helpful http://achillesblog.com/atrs-in-uk/ where various ATR recovery protocols were discussed, and one from the University of Western Ontario was suggesting early movement of the ankle and early weight bearing gave better outcomes of reduced re-rupture rates with conservative treatments. Having a removable brace meant I could get my ankle moving from about the 3rd week with stretching and rotating movements that I progressively increased. I used an ice pack and tried to keep my leg raised as much as possible which I found very helpful in keeping the swelling down. I started putting partial weight on my foot from about week 4 and was fully weight bearing at week 8. My brace came off at week 12 and the specialist gave me a pair of heel wedges to put in my shoes for the following 4-6 weeks. I could walk albeit with a significant limp and also started to drive again (just the best moment!) then started physio. I had a series of strengthening exercises which have now got me to the point where I can walk around on tiptoe, but my right leg is still a little bit weaker than my left. My right achilles is still stiff and painful in the mornings.

From my experience the medical profession have very different approaches to treatment protocols, and often times they are not up to date with the latest research, and some protocols may not be appropriate for you, so you need to take charge of your own recovery programme. I suggest you look up surgical repair of an ATR as that may be more suitable for your active lifestyle. Alternatively if you go for non surgical treatment I would recommend looking at the UWO recovery protocol and insist on a removable brace or boot rather than plaster casts, on the ATR website the Vacoped boot was strongly recommended, although given the NHS budget cuts you probably have to buy one yourself.

Good luck!

Edited by General Bilko on Wednesday 26th December 10:29

[The_Doc]

You should really see someone in fracture clinic, and by someone I mean an orthopaedic consultant

He may just agree with the plan, but.....

Sometimes we operate on ruptured Achilles

First week after rupture is the window

[topgunkos]

The_Doc said:

You should really see someone in fracture clinic, and by someone I mean an orthopaedic consultant

He may just agree with the plan, but.....

Sometimes we operate on ruptured Achilles

First week after rupture is the window

Would you not operate on a rupture with a 2-3 week delay? What about chronic ruptures?

[KENZ]

Thanks for your help. That's 10 days now. Not had that onset of cramp again since the first nite which is good. Calf size has noticeable reduced. I can wiggle my toes quite freely too. I do feel somewhat isolated. Forums have been a great fountain of knowledge, however I'm not sure if surgery would have been the right option. Will find out when my appointment is due on the 15th when cast is removed..

Edited by KENZ on Thursday 27th December 14:13

[KENZ]

Update: no pain at all now on the achilles. Can wiggle the toes freely and move the foot a bit in the cast. I suppose the tendon has reattached itself?
Frustrating being stuck at home and getting out on crutches is quite tiring.

[General Bilko]

KENZ said:

Update: no pain at all now on the achilles. Can wiggle the toes freely and move the foot a bit in the cast. I suppose the tendon has reattached itself?
Frustrating being stuck at home and getting out on crutches is quite tiring.

AFAIK wiggling your toes is possible even with no tendon attached, so probably doesn't indicate anything. Not sure if the tendon would have reattached after 3 weeks, perhaps the beginnings but definitely not strong enough to support putting any weight on your toes.

I guess your cast has some wedges under the heel? When are you going back to get a wedge taken out, should be soon? Will you get put back in another cast or have you asked about getting a support boot (Vacoped) instead? With a boot that you can take off you would be able to start moving your ankle and putting some gentle stretches on you achilles. Also you can take it off for baths / showers.

[KENZ]

General Bilko said:

KENZ said:

Update: no pain at all now on the achilles. Can wiggle the toes freely and move the foot a bit in the cast. I suppose the tendon has reattached itself?
Frustrating being stuck at home and getting out on crutches is quite tiring.

AFAIK wiggling your toes is possible even with no tendon attached, so probably doesn't indicate anything. Not sure if the tendon would have reattached after 3 weeks, perhaps the beginnings but definitely not strong enough to support putting any weight on your toes.

I guess your cast has some wedges under the heel? When are you going back to get a wedge taken out, should be soon? Will you get put back in another cast or have you asked about getting a support boot (Vacoped) instead? With a boot that you can take off you would be able to start moving your ankle and putting some gentle stretches on you achilles. Also you can take it off for baths / showers.

Correct I was able to wiggle my toes before but it does feel a lot easier now. I do use my toes to balance a fair bit when I'm hoping around the house.
Regarding my cast. It has no wedges, just a plain cast. I hope to get a support boot when I go back next week.. Should I ask for one in advance. It is the NHS. The forums suggest getting movement in it as soon as its healed.. So the boot to me sounds ideal, as I could take it off at night and do stretches. however the doc said it would be recast again with foot in a more downward position?

[KENZ]

Forgot to mention. Before the injury I never felt any soreness in the Achilles, however my left one is now starting to become quite tender. I think when I get back training I'll have to be careful and just stick to weights and swimming with very little leg work. I do enough leg work on the stairs at home :-)

[General Bilko]

KENZ said:

Correct I was able to wiggle my toes before but it does feel a lot easier now. I do use my toes to balance a fair bit when I'm hoping around the house.
Regarding my cast. It has no wedges, just a plain cast. I hope to get a support boot when I go back next week.. Should I ask for one in advance. It is the NHS. The forums suggest getting movement in it as soon as its healed.. So the boot to me sounds ideal, as I could take it off at night and do stretches. however the doc said it would be recast again with foot in a more downward position?

I would ask for a boot, otherwise you won't be able to follow a UWO recovery protocol, which suggests getting your ankle moving from 2 weeks post rupture. I think you'd have to wear it at night though. Your foot should already be cast in a full downward position and as you recover it gets put progressively back to a horizontal position.

[General Bilko]

KENZ said:

Forgot to mention. Before the injury I never felt any soreness in the Achilles, however my left one is now starting to become quite tender. I think when I get back training I'll have to be careful and just stick to weights and swimming with very little leg work. I do enough leg work on the stairs at home :-)

I think that's expected as you are only using your good leg so it's doing more work.

[KENZ]

Update. I've received my appointment with not much options on the table from Aberdeen NHS other than to recast foot in flat position. They don't use the boot treatment. However I think this is the right approach. Doc was happy. Tendon looks to have reattached but ankle was still swollen with a small amount of bruising which surprised me. When getting the foot in the flat position. I had a tingley sensation round the ankle. I cannot believe how much movement I've lost. So its the next two weeks in flat then another two in upward position then physio. I'm hoping when cast comes off I get some sort of movement which will allow me to drive and get back to work..

Edited by KENZ on Thursday 17th January 18:39