Achilles Tendon Rupture – 5 Months Post-Surgery

It’s been a while – the site was down for about a month due to me not getting around to troubleshooting a database error – which is too bad, cause I had some posts queued up in my brain that will now never make it to digital paper.  However, I thought I should do an update on how things have gone for my Achilles tendon, which is now almost 5 months to the day post-surgery.

The first month or so was actually not the hardest.  You just happen to be handicapped.  You can’t bear any weight, you have to sleep with the thing propped up and iced, you are constantly worried about knocking it on things, or getting pushed onto it, or your other Achilles tendon breaking from the strain of hobbling around.  Going up and down stairs is a real pain in the ass, and it’s sometimes terrifying for a crutch to slip or your momentum to get ahead of you on your way down the stairs.  This also means you just don’t get around very much, and simple things, like grocery shopping or laundry take an enormous amount of time.  At this point, though, I could completely accept that; I was injured, and I didn’t expect much more than this.

Just after new years.
This was what it looked like right after new years.  It hasn’t quite closed yet.

By mid January, I had started to partially weight bear with the crutches, and was limping around in the boot.  Instead of the black monstrosity that the surgeon had given me, I had went out and found the best boot I could find.  It cost a pretty penny – over $300 – but given that I was in it for almost 3 months, it was totally worth it.  In case you are wondering it was a VacoCast Pro, which allows for hinged motion in the ankle, as well as interchangeable treads on the bottom, as well as washable liners.  This made a huge difference – the black boot was effectively unwashable, and even after only a few days, it was disgusting.  I can’t imagine wearing that thing for long.  The VacoCast also was quite comfortable to sleep in, and has the added benefit of looking like the boot of a robotic suit of armor.  If you are some random reader looking for advice on Achilles tendon rehabilitation, I wouldn’t recommend this being your highest priority purchase – get a cryo cuff; it’s really useful all the way through your rehab and beyond – but I’d rank the VacoCast pretty high up.

I started rehab at a local PT clinic at the end of January that was not only recommended to me by a friend’s fiancee, who is a trainer for Cirque du Soliel, but was also very well reviewed on Yelp.  I have to give them a shout out here: Tru Physical Therapy, for readers in Vegas/Henderson, is one of the best PTs I’ve been to.  For those of you who know me, I’ve had a lot of physical therapy from a lot of very good physical therapists, but few have provided the kind of personal attention and support that Tru has, and none have produced such a familial environment.  It probably helps that I go there 3 times a week.  To start, we were mostly focused on range of motion and simple flexibility and balance exercises.  These were startlingly challenging.  This was probably the hardest time for me; realizing how long a road I had to walk to get back to normal was discouraging, and going home 3 times a week in pain – lasting pain that would eat at you throughout the rest of the evening and into the next day – was really difficult.  Around this time, I ditched the crutches permanently.

End of Jan.
Here’s the scar right before I started PT. It looks nice, because I was still in the boot – there’s no
abrasion and it wasn’t getting stretched much.

After a few weeks of this, I graduated to stationary bike, as well as exercises to strengthening leg muscles (though not immediately my calf).  I was grateful for this, because I had effectively been sedentary for 3 months, was putting on weight like crazy, and was going out of my mind with boredom.  It was around this time that I transitioned out of the boot full time, and into shoes.  Invest in some good shoes, and look for at least a couple pairs that hit at different points of your Achilles.  The abrasion between the back of your shoe and your scar will be a consistent point of pain.  Get some quarter length socks and some heavy moisturizer.

We did modified squats and lunges, squats on a Pilates reformer, steps, and, after a few weeks, started on calf raises.  Man, this was hard and painful.  Part of it is the fact that your calf muscles haven’t been used in a long time, and they are atrophied like crazy.  Part of it is that you got sliced open, and the muscles are still healing.  The rest of it is mental; you don’t trust the fact that your newly sewed together tendon is going to support this movement, and every minute pain seems like the unwinding of tendon tissue, or the sutures tearing away from the frayed ends of your Achilles.  Fun!

At this point, some of the consistent pain started to subside, and most of the pain is reserved for times when you accidentally put your weight on the ball of your injured foot or during and after therapy.  For this reason, I’ve stayed away from crowded places, where I might need to maneuver around people or other obstacles, or could possibly be pushed onto that foot.  This has been a difficult change to deal with – you don’t realize that this means any kind of public event; no concerts, no sporting events, no happy hours, etc.  This is probably the hardest thing for others to understand; unlike a knee or ankle ligament, which can be braced and still take weight fairly well, your Achilles is the only thing that takes the weight as it moves towards your toes.  There are few other supporting structures to help it out.  As such, you may be coerced into going to places that make you feel really uncomfortable and laughed at (by your family!) for being uncomfortable about it.  Just accept that they have no idea what it’s like, and move on.

I never took any pain meds, other than a few ibuprofen on doctor’s orders post surgery, throughout this whole ordeal, by the way – I’ve learned that pain is an important indicator that you need to use during an injury.  Would they have helped?  I don’t know.  I’m confident that I’ve done everything I could from a therapy perspective so far, and pain (especially what type of pain you feel) is  a useful tool to know when to back off and when to ramp up effort.

In the last few weeks, it has seemed like I take 2 steps forwards, and 1 step back.  Some days/hours, I feel pretty good, with pain only when I try to put more weight through the ball of my foot, and others it’s pretty rough, and I limp pretty badly.  I’ve worn a calf sock that helps to keep the swelling down and supposedly helps blood flow since January.  Two months ago, if I didn’t wear the calf sock, my ankle would be a balloon by the end of the day.  Now, I just get minor swelling if I don’t wear it.  Keeping the scar moisturized to keep it from cracking is a constant battle.  Sometimes, some scar tissue will break up, and my ankle will crack.  It’s liberating and terrifying all at the same time.  A few times, it’s done this while at PT, and I’m scared I’ve torn it again.  Again, FUN!

Ankle as of May 18th.
Ankle as of May 18th. It has some keloid scarring, and you can see where
it is dry, and where my shoes generally hit.

I’ve yet to start any real activities.  No golf yet, though I think I’m getting close to being able to do that.  Hockey is still a long ways off.  I’m looking forward to the 6th month mark, when, supposedly, normal things, like walking, should be comfortable.  Am I ahead or behind schedule?  Well, my therapist would say that everyone’s schedule is different, and that it’s so variable.  I’d probably say I’m a bit behind schedule, but there are definitely days where I feel much better than others; it’s just a case of increasing the number of those days.  Until next time!

9 Replies to “Achilles Tendon Rupture – 5 Months Post-Surgery”

  1. Just caught your blog – had surgery May 22nd to debride calcified tendon, remove a spur (all
    after detaching the tendon) and then reattaching the tendon with anchors into the bone. 6-8 weeks NWB. Loooong recovery. I have a wonderfully understanding husband and daughter but it is astonishing
    how many people think this surgery is a “walk in the park” and don’t really understand how painful and
    scary the process of trusting your tendon is. I have to make the difficult decision whether to repeat the surgery
    on my right foot which also has a problematic spur … tough choice to make – especially at this early NEEDY juncture!! Thank you for your honest blog. I am no athlete – my spurs have put paid to that for the past 4 years – but I, too , understand the frustration and hope. 🙂 Please keep updating. When I put my blog up I’ll send you a link. 😉

    1. Yikes! I have a friend at work who had both surgeries to remove spurs. I can imagine it’s a hard decision to make to have the second after you go through the pain of the first! Good luck!

  2. Hi

    I’m having surgery on the 13 of June for a nasty bone spur on my Achilles. I read your blog and I’m very encouraged by it. I do have one question. Do you wear the vaco cast as a cast or boot or both? My friend had a cast and then a boot but she did not have an Achilles issue. I see that you were in the vaco cast for 3 months. I was told I would be in a cast for 6 weeks and a boot for 6 weeks. That’s 3 months so I’m wondering g if you used it as a cast and boot. This whole process is freaking me out but I’m so tired of the pain that it over rides my fear.

    Thank you for any advice you may have.

    Patricia

    1. Hi Patricia,

      The Vacocast is definitely not a replacement for a cast; unfortunately, you’re probably going to get a regular, old hard cast. A friend of mine had the surgery for bone spurs done, and had exactly that – cast for 6 weeks, then boot for a while. He had it on one foot, and then the other. Good luck! My friend healed way faster than I am healing, so that’s some good news, right? 🙂

  3. Hi, I wonder if you can advise how I should be feeling after 5 months post rupture, opted not to have surgery and still unable to get on toes and can’t stand or walk for long, still limping badly and have a large lump at back of heal, I have been referred to a specialist surgeon but really do not know what to expect

    1. Hi,

      I can’t give you any info from personal experience, and I’m not a doctor; I never considered not having surgery, and I don’t know what it might feel like not to have it. I have read that non-surgical options generally are not great, and what happens is that a ball of scar tissue grows in the space between the ends of your ruptured tendon. I hear that the pain never really goes away, and that there is a much higher likelihood of re-rupture. I’d expect your surgeon to lay out your surgical options – probably including repair. But I wouldn’t take my word for it; I’m just a survivor, not a doctor. 🙂 Good luck!

  4. 60 years old,complete rupture with 1″ of seperation july 29,2013.surgery aug 16.today is dec 10. I’m in my second month of pt and hope to return to work in jan. I should mention injury occured during pickup hoop game.I work construction so I need to be as close to fully healed as possible.walking 80% normally,but the real test will be an 8 hour day!. therapist told me he thinks I’ll be able to work but will probably experience soreness and swelling initially.He also advised feeling “normal”,like where you forget about the injury,can take a year!! In reply to Tracyanne,I’m no expert,but I was advised because mine was completely seperated surgery was my option if I wished to regain up to 90-95% healing.the incidence of improper healing and re-rupture can be higher without surgery.

  5. Good luck to all who have had this rupture. I have ruptured each of my Achilles tendons. First time I was 28 and was jumping in a basketball game. Second time I was 43 and was jumping in a basketball game. I did not have surgery the first time, but did the second time. The key to coming back from this injury is patience, patience and more patience. It is a brutal injury, but over time it gets to a point where you mostly forget about it. But, I don’t know if I’ll ever feel confident playing basketball again. I don’t think I want to go through the recovery again. I’m looking for alternative sports I can play where you break a sweat.

  6. hey was nice to read your blog as I am currently going through the same process you seemed to mention to a T. I had surgery on a complete rupture back in November. I just exceeded the 5 month mark. I have been going to physical therapy 3 times a week for about 3 months now. I am now doing a bunch of agility and jumping drills (i.e latter drills, bosu jumps, ski jumps, etc). walking pretty well now but still unable to run. most days I feel pretty good. if I am on my feet a lot throughout the day I will become very sore on and inflamed on my heel. I also feel not a sharp but an uncomfortable pain sometimes by the tendon after a long day. i think i am on schedule but as you mentioned my physical therapist says everyone heals differently and timetables vary. i too am looking forward to the six month mark. i see your injury is now about 2 years ago. how long from you surgery did you start to play hockey again?

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