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11-19-2010, 06:09 AM #1
Achilles Tendon Rupture - Conservative treatment
I would be interested to hear from anyone who has experienced a full achilles tendon rupture and used the non surgical conservative method of treatment.
September 11th 2010 was a bad day for me as I ruptured my left achilles after landing from a clear to push forward to the net. (rupture is 40mm up from the heal)
The surgeon suggested that I use the conservative method of “non surgery”. This involved a fibreglass cast up to my knee with my foot pressed down into planterflexion for 4 weeks. After this it was 3 weeks with my foot in a more neutral position/slight dorsiflexion. Then two weeks in an aircast with heal wedges. After 9 weeks I went back into my trainers.
After 10 weeks my left calf is now 2.5 inches smaller than my right. I have limited movement in the soleus muscle and very little action of the gastocnemius (larger outer muscle). 1st Physio session today and the therapist was impressed at the range of movement and repair made so far. I have to admit that I was very sceptical that non surgery would work as I my GP friends, and later a different surgeon, suggested that for a sportsman "you have to have surgery". Well, in making this decision I had to bear in mind a previous leg infection from a skin graze after falling from a ladder. I didn't fancy an infection post surgery! So I made the choice, telling myself to be prepared for 12 months of zero competitive badminton.
The main lesson of recovery so far is “take it easy”. I’m still on court coaching so it’s not all doom and gloom.
11-19-2010, 10:46 AM #2
Interesting story. 20 years ago there was a debate on wether conservative treatment or surgery was better. Over time (and probably clinical studies), surgical intervention won as giving a better outcome. I'd say it's still early days for you and the results will not be known until much later.
11-26-2010, 12:07 PM #3
I'd hate to sound gloomy, but I'd be more fearful of a re-rupture in the future from the non-surgical approach. This fear itself would prevent me from playing at 100%.
11-29-2010, 05:53 AM #4
I'm nearly 3 months post injury and I'm about 15 degrees from full dorsiflexion. Once I have full range of movement, then strenghtening exercises will begin.
I'm having two sessions per week at the NHS Physio, yes NHS, and very impressed with the sessions, ultra sound, massage and a range of exercises for stretching etc. A mixture of passive and active stretches.
01-13-2011, 11:09 AM #5
Now that I full range of movement the Physio will allow more strengthening exercises to start. The chief discomfort comes from the soleus and not the achilles as one would imagine. The achilles has thickened somewhat but is not painfull anymore.
The Physio assures me that with regular stretches and exercise the bottom of the soleus will soon free up, although he did infer caution as over confidence could lead to over working the muscles causing injury.
There we are, a small update of non surgical therapy of full rupture of Achilles.
Will update again after 3-4 weeks of calf raises!
01-30-2011, 04:42 PM #6
Hi. I cannot tell you about the non-surgery approach but I do have experience with the surgical one. I ruptured my Achilles during the 2009 Sydney World Masters Games. Second day of competition for my team. Surgery for me 2 days later, part of the bone had come off the heel with the Achilles attached and some tearing. 2 months in a full cast, then 1 month in the aircast boot, further physio, then 6 months or so after injury, I could play badminton again - but of course taking it easy. Right now my Achilles is about 3 times the thickness of the non-injured one. It is taking a long time to get fit again - not sure why, but losing 10Kg should have helped. I can still play competitively but seem a bit slower - maybe old age is catching up.
Anyway, I wish you well and get back to badminton soon. I think that was the worst part - feeling like I could play, but the doctor saying not to until he gave me the go-ahead.
01-31-2011, 08:50 AM #7
02-07-2011, 10:01 PM #8
Just wondering if you experienced any sort or pain before your achilles tendon ruptured
I'm just kinda worried cause sometimes I feel pain after badminton around the achillies area
Was it just something that was just totally unexpected?
I'm worried cause I have a physically demanding job to go to the next day. Can't afford to sit on my ass for a year to recover
02-08-2011, 08:28 AM #9
You need to be sure that you haven't sustained any significant tissue damage before playing again.
02-08-2011, 10:37 AM #10
I'll be sure to get a doctor's opinion
Get well soon
11-15-2011, 08:34 AM #11
It has now been some more months. Do you have an update for us on how you are now? Back to 100% yet?
11-15-2011, 11:47 AM #12
I had a lengthy discussion with the consultant who was quite relaxed about either way of treatment. My achilles ruptured aprox 25mm above the heal connection. This he explained was a good thing as the gap between the ends was very small thus with immobilisation in plantarflexion for 3 weeks would be sufficient for the tendon to connect. After the 3 weeks it was time for a new cast with my foot pressed into dorsiflexion as far as was physically bearable in terms of pain! I think my foot moved all of 5 degrees! Same thing happened again, every week for 3 weeks. After six weeks I went into an Air Cast with 2 heel wedges and this is when the physio began. After 8 weeks no wedges, and another 2 weeks I was into my shoes at last. Physio and strenghtening exercises carried on. I changed from NHS physio to private practitioner to have deeper frictional therapy about 6 months post injury. This was due in the main that the calf muscles, soleus and Gastroc were complaining from the strengthening exercises and needed to be freed up to reduce the stress on the achilles. I got back to gentle running around the athletics track after 8 months and now I'm back playing badminton to 70% pre injury performance although I reckon the other 30% is split between pychological and fitness.
The achilles is healed (excuse the pun), I still have minor aches n pains and I'm told by a doctor friend that the scarring can take upto two years to dissipate.
Another reason for the conservative method is that I had only recovered 8 weeks previously from a serious infection in my other leg after a fall from a ladder. High doses of two different anti-biotics were prescribed. I had been visiting my mother in hospital for a number of weeks and probably should have been tested for MRSA at the time, however I suspect my GP kept quiet about the type of infection. One of the anti-biotics was Ciprofloxacin which was probably the cause of my achilles rupture. See here. http://en.wikipedia.org/wiki/Ciprofl...dverse_effects
02-08-2012, 09:06 AM #13
Reading your story is very relevant to me now, as I havejust done the same as you. Been playing for the last 22 years when I hadunexpected rupture on last Sunday morning, our usual session. Never had arupture before but had tendonitis a few years ago but then it stopped recently.When the rupture happened, I felt someone had kicked me on my ankle it was notthat painful but still very uncomfortable. Then later that day went to A&E deptand they confirmed it was a rupture. Then the hospital staff put a plaster caston my right leg just below my knee and gave a pair of crutches to move about. Gaveme an appointment on a sealed envelope to see a specialist in fracture unitnext week.
I would prefer to have a ‘conservative treatment’ as Iam worry about operations, which I never have had. I am 44 and don’t think operationis suitable for me, as I read it’s mainly for younger people and who’resportsmen. Though it early days yet, and no doctors suggested what I shouldhave. From reading your comments, it seems it would take several months beforeI can go back to court again
02-08-2012, 09:57 AM #14
02-08-2012, 01:08 PM #15
The first orthopedist I went to just shook his head and asked when I wanted to schedule surgey. I got a second opinion from a doctor who actually gave me options and pros and cons. I went the non-surgical route. Previous posters made good comments. You'll have to weigh for yourself, but let me know if you have questions.
02-08-2012, 04:16 PM #16
For me, it has now been a little more than 2 years since my Achilles surgery (Oct 2009). My right Achilles tendon is still about 2-3 times thicker than my left Achilles. I was also told that it could take at least 2 years for the scar tissue to dissipate, but obvious that is very optimistic. I am playing at around 100% now in terms of speed, agility - but as you say, there are a few more aches and pains - not around the Achilles but elsewhere so maybe that is not the tendon. My right calf is still noticeably smaller than my left calf. But all in all, I am playing.
02-10-2012, 10:03 AM #17
Mine was a full rupture in september 2010. You need to ask the specialist if he has a good experience of the conservative treatment. The older method was to just leave you in a plaster for a couple of months. Mine was a fixed plaster for 4 weeks in plantarflexion, then it was adjusted and pressed into dorsiflexion every week for another 4 weeks. I then moved into an aircast boot for another 2-3 weeks with heel wedges. Wedges removed then into my shoes/trainers.
Physio began once I was into my shoes, so we're talking nearly 12 weeks. The nhs physio didn't perform any frictional massaging/stripping of the tendon at all but they used ultrasound, stretching and exercises. After about 7 months I returned to very gentle play on court and walking and easy jogging. I had 6-7 sessions with a private physio whom I have to say was amazing! He's gave me confidence to push my training a bit more although I think I am only just now over it mentally.
There are some great video's on youtube http://www.youtube.com/watch?v=LwQA9...eature=related. this chap had surgery but the blogs are great and will give you some inspiration.
Another badminton player here snapped his 3 months after me, had surgery, and was back to international badminton after 9 months. But hey, he's only 24! I'm 43 this year. His achilles looks normal, didn't lose much calf muscle, whereas i lost 3 inches around and the tendon is still twice as thick as normal.!!
All in all I'm happy with my re-hab. I still have scar tissue in my soleus and a certain amount of stiffness because of it but the tendon is stronger than before.
Last edited by coachgary; 02-10-2012 at 10:05 AM.
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