Did I rupture my calf or my achilles?
Discussion
Last night playing squash I felt the mother of all snaps/pop at the back of leg and thought my opponent had smashed me on the back of the leg. Then I felt an intense pain but was able to hobble off the court (this was 40 mins into the session so full of adrenaline).
Went to A&E where the junior doc did some examination and he felt near the heel and toe areas, said it's unlikely to be the achilles but probably a torn calf muscle. Had an xray to check for aversion fracture which was all clear. However he wasn't too sure what "squash" was and there wasn't any palpation of the tendon.
The swelling today is all down the back of the heel and around the achilles, the spot where the swelling started and feels really painful today is along the back of the leg which is where the achilles is. About 2 inches up from the level of my ankle bone.
Anyone with more intuition able to comment?
Went to A&E where the junior doc did some examination and he felt near the heel and toe areas, said it's unlikely to be the achilles but probably a torn calf muscle. Had an xray to check for aversion fracture which was all clear. However he wasn't too sure what "squash" was and there wasn't any palpation of the tendon.
The swelling today is all down the back of the heel and around the achilles, the spot where the swelling started and feels really painful today is along the back of the leg which is where the achilles is. About 2 inches up from the level of my ankle bone.
Anyone with more intuition able to comment?
From when I had a torn calf muscle they were more concerned whether I had detached the muscle from the back of the knee . I hadn't.
Yours sounds very painful and I would imagine the decision for surgery depends on rupture or detachment.
My calf went black after a couple of days then as that faded the shin went black .
Yours sounds very painful and I would imagine the decision for surgery depends on rupture or detachment.
My calf went black after a couple of days then as that faded the shin went black .
I did mine last October, also playing squash, identical to your description, about 20mins in. I had an Ossar boot on for 12 weeks or so then it’s quite a long recovery of very careful physio after that, just over a year after now and I’m starting to jog and had my first game of squash a couple of weeks ago, albeit a very easy game!
I went to addenbrookes, Cambridge who said they don’t operate anymore unless the rupture is very low or you’re a pro sports person.
To begin with you have to keep the boot on full time, even in bed which is a nightmare, later on you can take it off overnight. I’m sorry to say if it’s a complete rupure you have a long and slow recovery ahead of you.
Don’t hesitate to ask if you have any questions, I feel for you.
I went to addenbrookes, Cambridge who said they don’t operate anymore unless the rupture is very low or you’re a pro sports person.
To begin with you have to keep the boot on full time, even in bed which is a nightmare, later on you can take it off overnight. I’m sorry to say if it’s a complete rupure you have a long and slow recovery ahead of you.
Don’t hesitate to ask if you have any questions, I feel for you.
Ruptured my tendon around 4 years ago and I know how painful it is. Mine ruptured 80% of the tendon which was highlighted by the ultrasound. As said before they prefer not to operate and let the tendon fuse back together itself.
I had a cast on from toes to just below the knee for around 4 months and then the mechanical boot for another 5-6 weeks. After that it was intense physio for another few months. Its a long process but 4 years on I don't have any issues.
I had a cast on from toes to just below the knee for around 4 months and then the mechanical boot for another 5-6 weeks. After that it was intense physio for another few months. Its a long process but 4 years on I don't have any issues.
Thanks for the kind words and support, really appreciated as it’s hit me for six.
Had a ski trip and other holiday plans which have been scrapped as well as sitting at home with a massive backlog of work.
I work in healthcare so have been studying the evidence base and am happy with the non surgery option, however I’ve been given a cast above the knee which makes anything impossible. I’ve yet to speak to an orthopaedic consultant which happens on Tuesday so I’m going to push for the early weight bearing functional rehab with the boot rather than cast. I’m an active (was) and it seems silly to have my quads waste away with an above the knee cast.
http://www.londonorthopaedicsurgery.co.uk/therapie...
The above is similar to the most upto date guidelines rather than the 8 weeks in a cast which is inferior according to the evidence.
Anyone in the know that could advice further?
Had a ski trip and other holiday plans which have been scrapped as well as sitting at home with a massive backlog of work.
I work in healthcare so have been studying the evidence base and am happy with the non surgery option, however I’ve been given a cast above the knee which makes anything impossible. I’ve yet to speak to an orthopaedic consultant which happens on Tuesday so I’m going to push for the early weight bearing functional rehab with the boot rather than cast. I’m an active (was) and it seems silly to have my quads waste away with an above the knee cast.
http://www.londonorthopaedicsurgery.co.uk/therapie...
The above is similar to the most upto date guidelines rather than the 8 weeks in a cast which is inferior according to the evidence.
Anyone in the know that could advice further?
Its not as black and white about surgery/non-surgery as has been made out
https://www.cochrane.org/CD003674/MUSKINJ_surgical...
https://www.researchgate.net/publication/232147441...
Surgery can give better outcomes, but at a risk.
There is no clear proven answer
And those guidelines you linked to are about the most up to date on non surgical rehab, if you go down that route. The main leap forward in the last 10yrs has been the safety and efficacy of early weight-bearing.
https://www.cochrane.org/CD003674/MUSKINJ_surgical...
https://www.researchgate.net/publication/232147441...
Surgery can give better outcomes, but at a risk.
There is no clear proven answer
And those guidelines you linked to are about the most up to date on non surgical rehab, if you go down that route. The main leap forward in the last 10yrs has been the safety and efficacy of early weight-bearing.
Edited by The_Doc on Friday 2nd November 21:18
An older friend of mine ( was 72 at the time) snapped his Achilles's when messing about dancing with some friends- and it was all caught on video!
You can actually hear it snap and his consultant asked if he could have the footage to show medical students!
He was in a cast for 3 months but its healed very well.
I was lucky some years back- walking the West Highland Way with some mates, my Achilles's was giving me huge problems- could barely walk first thing and couldn't wear boots- only shoes but, I carried on as I was with the lads and didn't want to cop out.
Went to the Docs on return home and he said I was very lucky It didn't rupture and to take a week off work with it elevated, and regular ice on the area.
Probably wouldn't get away with that now I am 10 years older!
You can actually hear it snap and his consultant asked if he could have the footage to show medical students!
He was in a cast for 3 months but its healed very well.
I was lucky some years back- walking the West Highland Way with some mates, my Achilles's was giving me huge problems- could barely walk first thing and couldn't wear boots- only shoes but, I carried on as I was with the lads and didn't want to cop out.
Went to the Docs on return home and he said I was very lucky It didn't rupture and to take a week off work with it elevated, and regular ice on the area.
Probably wouldn't get away with that now I am 10 years older!
Just went to Youtube to see what this was about. Wish i didn't now 
https://youtu.be/rsvcqS6tCLs?t=23
That looks and sounds horrible! Hope you have a speedy recovery OP!
https://youtu.be/rsvcqS6tCLs?t=23
That looks and sounds horrible! Hope you have a speedy recovery OP!
You have my complete sympathy. I ruptured mine in April this year and again in June then had surgery in early August.
I've just come out of wearing The Boot for 6 continuous months (save the 1 week in June when they thought self healing had worked). A long long horrible time throughout which I don't think I ever really slept well.
A friend, albeit a vet, is a strong supporter of the surgical route if you can force it. Better and stronger final solution.
Just at the first stages of rehabilitation and physio. Never before have i had a life goal of standing on tiptoes. Let's not start on my fitness levels!
Good luck, keep us informed. Hope you have an easier progrss than I did.
I've just come out of wearing The Boot for 6 continuous months (save the 1 week in June when they thought self healing had worked). A long long horrible time throughout which I don't think I ever really slept well.
A friend, albeit a vet, is a strong supporter of the surgical route if you can force it. Better and stronger final solution.
Just at the first stages of rehabilitation and physio. Never before have i had a life goal of standing on tiptoes. Let's not start on my fitness levels!
Good luck, keep us informed. Hope you have an easier progrss than I did.
sleepezy said:
You have my complete sympathy. I ruptured mine in April this year and again in June then had surgery in early August.
I've just come out of wearing The Boot for 6 continuous months (save the 1 week in June when they thought self healing had worked). A long long horrible time throughout which I don't think I ever really slept well.
A friend, albeit a vet, is a strong supporter of the surgical route if you can force it. Better and stronger final solution.
Just at the first stages of rehabilitation and physio. Never before have i had a life goal of standing on tiptoes. Let's not start on my fitness levels!
Good luck, keep us informed. Hope you have an easier progrss than I did.
What kind of protocol did you have for the non surgical treatment? How long did you have a cast for? Did they start early rehab?I've just come out of wearing The Boot for 6 continuous months (save the 1 week in June when they thought self healing had worked). A long long horrible time throughout which I don't think I ever really slept well.
A friend, albeit a vet, is a strong supporter of the surgical route if you can force it. Better and stronger final solution.
Just at the first stages of rehabilitation and physio. Never before have i had a life goal of standing on tiptoes. Let's not start on my fitness levels!
Good luck, keep us informed. Hope you have an easier progrss than I did.
Was there a slip/fall or anything untoward when the re-rupture happened?
In a plaster cast in the day of the rupture. In an aircast from the day after the rupture with full heel lifts for 2 (may have been 4) weeks. Heel lifts then removed one wedge at a time over the next 4 weeks until flat. In the boot without heel lifts for 2 weeks.
Then out the boot with the intent to start physio.
Rerupture from walking up stairs. Moment of carelessness from me but indications are it hadn't healed properly and really should have had surgery from day 1. Wasn't doing anything stupid.
Then out the boot with the intent to start physio.
Rerupture from walking up stairs. Moment of carelessness from me but indications are it hadn't healed properly and really should have had surgery from day 1. Wasn't doing anything stupid.
Edited by sleepezy on Sunday 4th November 23:25
sleepezy said:
In a plaster cast in the day of the rupture. In an aircast from the day after the rupture with full heel lifts for 2 (may have been 4) weeks. Heel lifts then removed one wedge at a time over the next 4 weeks until flat. In the boot without heel lifts for 2 weeks.
Then out the boot with the intent to start physio.
Rerupture from walking up stairs. Moment of carelessness from me but indications are it hadn't healed properly and really should have had surgery from day 1. Wasn't doing anything stupid.
That’s very interesting and I guess supports the evidence that some re rupture do happen but I’ve spoken to more people who have re ruptured after surgery than non surgery. Then out the boot with the intent to start physio.
Rerupture from walking up stairs. Moment of carelessness from me but indications are it hadn't healed properly and really should have had surgery from day 1. Wasn't doing anything stupid.
Edited by sleepezy on Sunday 4th November 23:25
Did they ask you to do any ankle mobilisation exercises after the 4th week at home with the boot off?
Were you walking up the stairs in the boot when it re-ruptured?
I wasn't doing any exercises without the boot on - I literally had it off twice a day while getting changed, during one of those times I washed it. Other than that I was wearing the boot 24/7 over nearly the hottest summer on record!
Was out of the boot when re-ruptured - you don't have any movement in the boot at all so no chance of damaging it further (the boot is rigid). I went to go upstairs and instead of putting my foot flat onto a step I left the ankle hanging over the edge (as you do normally). As a result it went straight away when I put my weight onto the foot as I couldn't hold the position.
Was out of the boot when re-ruptured - you don't have any movement in the boot at all so no chance of damaging it further (the boot is rigid). I went to go upstairs and instead of putting my foot flat onto a step I left the ankle hanging over the edge (as you do normally). As a result it went straight away when I put my weight onto the foot as I couldn't hold the position.
Sounds like you were unlucky!
I have read that going from non weight bearing to full weight bearing is what causes most re ruptured in the 6-12 week period and that sounds like what happened with you.
Have a consultant appointment later so see what he says but still favouring a non surgical approach.
I have read that going from non weight bearing to full weight bearing is what causes most re ruptured in the 6-12 week period and that sounds like what happened with you.
Have a consultant appointment later so see what he says but still favouring a non surgical approach.
So the joys of living in a rural area with limited healthcare options (no private hospital within 2 hours).
Agreed on non operative but the surgeon who's a hip and knee specialist agreed that early weight bearing functional rehab is the best route (non operative) however neither him nor the physios at the hospital have any experience therefore they can only offer the old style 8 weeks in plaster followed by physio but that's a really long road back with regards to ankle mobility.
Have sent some queries out to a private hospital 80 miles away and fingers crossed they can help. It's turning into a nightmare.
Agreed on non operative but the surgeon who's a hip and knee specialist agreed that early weight bearing functional rehab is the best route (non operative) however neither him nor the physios at the hospital have any experience therefore they can only offer the old style 8 weeks in plaster followed by physio but that's a really long road back with regards to ankle mobility.
Have sent some queries out to a private hospital 80 miles away and fingers crossed they can help. It's turning into a nightmare.
8 weeks in plaster is not the best result - presumably they have your foot pointed down slightly? Do you have an appointment to return so they can reset the plaster every few weeks and gradually lift your foot to 90 degrees?
FYI - I found the best shower cover for the cast from Boots - simple blue rubber 'sock' that I used even when I was wearing the boot as I found it easier to shower with the boot on rather than balancing with the boot off : https://www.boots.com/bloccs-waterproof-protector-... get the full leg version whatever you need as it's easier. Much better than the rubbish I initially bought from Amazon (that took about 3 weeks to arrive so I didn't end up using it anyway)
FYI - I found the best shower cover for the cast from Boots - simple blue rubber 'sock' that I used even when I was wearing the boot as I found it easier to shower with the boot on rather than balancing with the boot off : https://www.boots.com/bloccs-waterproof-protector-... get the full leg version whatever you need as it's easier. Much better than the rubbish I initially bought from Amazon (that took about 3 weeks to arrive so I didn't end up using it anyway)
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