Achilles Tendon Rupture - Conservative treatment

Discussion in 'Injuries' started by coachgary, Nov 19, 2010.

  1. coachgary

    coachgary Regular Member

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    After a week of boredom I went back to work!

    When the cast is changed in a couple of weeks you'll be horrified at how little your foot moves into dorsiflexion. Don't worry it does get better, you may think it won't, but I promise it does. My consultant pressed my foot into dorsiflexion until the pain was on the verge of unbearable then said to the plaster technician, wrap it up there my friend! The burning sensation reduced fairly quickly but at last the cramp from 2 weeks in plantarflexion was also easing.
     
  2. pretzel

    pretzel Regular Member

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    I had a removable, but heavy, boot that I was able to take off for showers, but on all other times...got used to sleeping with it. I had a small bench to sit on whilst showering. You'll get accustomed to crutches, too, but don't let your guard down...slick surfaces like concrete or tile can be treacherous - your sticks can go right out from under you. Also, don't rest on your armpits with the crutches - they should be pressed more to your sides...you can get sheepskin covers for the pads or use washcloth to wrap if you get sore. If i think of anymore tips I'll let you know. 6 weeks - wow, i don't think I got more than a couple days off from work except when it came time for therapy (but then again, i was in an office job).
     
  3. coachgary

    coachgary Regular Member

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    Hi LondonPlayer,

    I was wondering how the re-cuperation is going? Not too long now before you can go into the aircast boot.
     
  4. London_Player

    London_Player Regular Member

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    coachgary,

    forgot to update you guys. From next week will have a boot with an wedge, for a month a I think. Still on plaster cast. So going back to hospital next Monday when they'll change the plaster cast and fit a boot, so that I can walk.

    Does anyone how far you could walk or if you could climb stairs. Thinking of commuting to work, but have to use stairs on London underground.
     
  5. coachgary

    coachgary Regular Member

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    Have they changed the plaster at all in the last month?
    You should be ok commuting although it may depend on the type of boot they give you. Mine was too flat to be able to walk very far.
     
  6. tobradex

    tobradex Regular Member

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    Some surgery experience

    Just to add my experience. I had two ruptures, both full. Yeah I'm the idiot who kept playing after I did the one leg in to balance myself out. :)

    The ruptures for me happened 12 years apart. 1997 i think it was? And 2009.

    In the first case, since I was still relatively young, I opted for surgery. Back then, the scar they left was much longer (bout 10 cm). As an Asian, I have the typical condition where scars turn hypertrophic. So for about 4 years I had an angry looking red mark on my back ankle. It's finally beginning to go down. Most of the top end of the scar is now a white line but the bottom half still has a very slight bump and it's sort of rosy pink. My movement is just about normal as far as I can tell. I can jump, lift, push etc without discomfort or problems, and flexibility seems the same though they told me I would lose some. I went through about 2 weeks of physio after I got out of my cast and continued exercises on my own (which I don't recommend) afterwards for about 2 months.

    The second time it happened I was obviously older and medicine advanced. So again after talking with a few doctors (some of them friends), I decided to go with surgery again. Living in a larger city I had multiple hospitals to choose from and I opted for a new procedure that only leaves a approx 5cm incision and is located to one side (the inside) rather than right down the middle of the back of my heel/tendon. As such, my scar healed much flatter though it was still quite red for 2 years. Now it's toned down but there is a slight dark area around the top half of the scar that will take some time to go away. Mobility returned after this procedure much faster than before. It took almost a whole year before I was back to a comfortable range the first time. But with this new procedure you spend half the time you do normally in a cast and the other half in an air cast that can be removed so that you can start physio much sooner. Physio lasts longer (since you start sooner) but you are way stronger by the end of it. I pretty much had no limp or restriction of movement by the time my physio was over, and strength was about 65%. A month or two after that, I pretty much forgot I had surgery as my strength returned.

    Anyway, now I got both feet knocked up, I'm back on the court having fun, taking lessons etc. Funny enough, I'm faster than I ever used to be (because of the lessons), but I have no discomfort in my feet at all. I even do weight training and speed exercises with my feet to keep in condition and strengthen the muscles.

    Mentally it took a month or two to get over it. Now I don't even think about it anymore.

    Cheers.
     
    #26 tobradex, Mar 28, 2012
    Last edited: Mar 28, 2012
  7. London_Player

    London_Player Regular Member

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    Thanks for sharing your experiance. I'm too scared to have surgery and the Doctor mentioned that it's mainly for Pros and there is 5% diff. Not sure how true it is though but glad did not have surgery.
     
  8. London_Player

    London_Player Regular Member

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    Yes, they changed the plaster and re-angled the foot and then plastered again. Don't know what boot I'll have but if I can't use the stairs on the Underground to go to work, then I have to work from home, again.
     
  9. pretzel

    pretzel Regular Member

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    There aren't any elevators? What do people in wheelchairs do?
     
  10. London_Player

    London_Player Regular Member

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    Now I'm doing physio therephy excercises at home but don't see much improvements. Still limping when I walk, though my physio tells me to try to walk normally, but that's hard to do as you try to compensate for the painful affected ankle. Does physio alone helps the recovery or can anyone recomomend complementing it with other forms of therephy. It does seem like a very slow recovery.
     
  11. coachgary

    coachgary Regular Member

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    Don't rush it. You may hear stories of people getting back to normal in 6-8 months. The last thing you need is a re-rupture.

    Be guided by your physiotherapist who can tell you when the right time is to push the exercises. Mine worked on getting full range of movement before working the calf muscles. Strong calfs on a shortened tendon range is a recipe for disaster beleive me. It's important to have your calfs massaged as much as the work done to the tendon to keep the muscles supple, especially the soleus.
    It's only about 4 months post rupture so it's really early days yet. Another 3-4 weeks of stretches and you'll see a marked difference. I couldn't even flex the gastroc at 4 months!

    The normal exercise of standing on flat feet and raising up onto your toes is a good one. But the reverse works the tendon even more but not to be done until you're given the go ahead by the physio. You start up on your toes and drop down into the stretch. You can start with weight on both feet whilst holding onto something t okeep your balance.

    I can also recommend doing your stretches and walking exercises in a swimming pool. Check tha tyou have full range of movement first though

    Regards

    Gary
     
  12. London_Player

    London_Player Regular Member

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    Thanks Gary for the reply. I'm not getting any massage at all from my NHS physio, only excercise that they want me to do.
     
  13. coachgary

    coachgary Regular Member

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    No i didn't either with NHS. The exercises and stretches were ok though. had ultrasouns treatment also.
    I had to go private for the massage/friction therapy.
     

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