Achilles Tendon – PRP – Post-Surgery Update

My last report was 10 days post-op. Here is an update at 12 weeks post-op.

I was relieved from my walking boot after 6 weeks. At that time I could walk but with a pronounced limp. It was not due to pain but due to atrophy in my calf. The gastrocnemius and soleus muscles were very weak.

I am so fortunate to be able to go to a progressive physical therapy office [Spooner Physical Therapy]. And I have been more fortunate to have progressive and aggressive therapists (Nicole and Matt). [Nicole just finished Ironman Arizona in 12:19 and has run a 3:19 marathon – she understands runners!]

It took a week to get into physical therapy. So at the beginning of the 8th week I began three-days-a-week of physical therapy. I am in on Mondays, Wednesday and Fridays. Here is how my therapy routine started:

  • Stationary cycle 10 minutes warmup
  • Ultrasound treatment
  • Deep tissue massage and strip muscle
  • 45 minutes of continuous leg exercises, 1-leg squats, balance board, wobble board, stretches, leg press, you name it…
  • Electrical muscle stimulation 15 minutes with leg packed in ice
  • This routine took a about an 90 minutes and lasted the first 4 treatments. I was compliant, worked hard and was very sore.

At that time, Nicole introduced the Alter-G treadmill into my rehab. (I had used this once before. Click here for demo video.) This treadmill is like no other in that it encases you from the waist down. It fills with air and “lifts” you to reduce actual body weight on your lower extremities while still performing neuromuscular specific training for runners!

The rest of the daily routine remained however (I am now in physical therapy for 2 hours at a time). I now had 15-20 minutes on the Alter-G while I still had fresh legs – right after the ultrasound, stretches and deep-tissue massage. The first week I “ran” at 60% of my bodyweight. The second week I experimented with 60-70%. The last couple minutes I did the higher bodyweight percentage. In my third week I am now starting at 70% and using the last few minutes at 85% of my normal bodyweight. Regardless of pace (9 mph to 12 mph) the sensations in my calf/achilles remain the same: stiff, dull ache, weak. Only as the weight increases on my legs do I feel more discomfort – but no pain. It is a matter of being weak and having sore muscles.

The Alter-G is like being set free! Just being able to do the running motion is amazing. It is also a psychological boost because you start to see yourself as a runner again and that there is light at the end of the tunnel.

My doctor appointment 8 weeks post-op was uneventful. However, the swelling in the achilles is still pronounced. And he now introduced criteria for “real running”. I have to be able to do a one-leg toe raise. Ugh.

This past week another treatment modality was introduced – ASTYM. This replaced the deep tissue massage – muscle stripping. OUCH! [Matt is the therapist in charge of this masochistic treatment.]

At this point, I have experimented with “lightly” jogging across a parking lot (400 meters or so at maybe 10 minute mile pace). I get the same sensations as on the Alter-G. I still cannot do a full toe-raise. I can raise my heal up about 1 inch or so. I am constantly sore. I am progressing and I see light at the end of the tunnel. I should be able to run on terra firma within the first couple weeks of December. My goal back in August was to run before the end of the year. I have my next doctor appointment in 2 weeks.

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About Dean Hebert

I’m a mental game coach, author and speaker. I work with individual athletes, parents, coaches, and teams on sports performance enhancement. Beyond my academic post-graduate work in sports psychology - the psychology behind athlete performance – I am a certified Mental Games Coaching Professional (MGCP) and certified hypnotherapist. I’ve authored several books and hundreds of articles. “Coach, I didn’t run because…” (2008) is a seriously light-hearted look at making excuses not to workout and how to overcome them. “Focus for Fitness” (2009) and “Screw the Goals Give me the Donut” (2010) are two of my eBooks on mental game approaches for the everyday athlete. I wrote these because I believe that everyone can benefit from the powerful mental techniques that the world’s best athletes use. I have been cited in Runners World, Best Health magazine (CN), SWEAT Magazine, and the Washington Examiner amongst many other publications. I have been a featured mental games coach in Runner’s World and for the internationally acclaimed trail running resource - trailrunningclub.com. I also regularly appear on sports and fitness talk shows such as LTKFitness, Runnersroundtable and for more than three years I have co-hosted a weekly video series with Coach Joe English for Running-Advice.com. I specialize in mental toughness training. My clients include tennis, synchronized swimming, golf, race-kart, soccer, motocross, volleyball, MMA, cycling (road, off-road, time-trialist), running, duathlon and triathlon, basketball, football and baseball athletes. I have coached world-class athletes and athletes internationally. I have a passion for working with youth athletes and helping them apply mental game skills and techniques to all areas of life. Most importantly, my aim is to have people enjoy sports and life to their fullest through peak performances.
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41 Responses to Achilles Tendon – PRP – Post-Surgery Update

  1. Trish says:

    Thanks for sharing the details. Love that treadmill. Could running at 80% inspire me to lose 20% of my body weight? =) Best of luck for a speedy recovery.

    • Dean Hebert says:

      Trish… you are reading my mind… if only I weighed 135 pounds which I haven’t since ohhhhhhhh sophomore in high school… I’d have it made!!!!!!!!!

      • sandy says:

        hey anyone that has any ideas I am 9 months after surgery ( ruptured achilles) I did all of the exercises then went to med school and well didn’t have a whole lot of time but walked a lot – that was back in 2 months ago – I still have pain and a lotof tightness — any ideas on why and if I’ll ever get back to playing football/basketball and running not just jogging?

      • Dean Hebert says:

        Ruptures are serious so patience is needed. Pain and tightness at this point might just mean more and/or different PT work is done to rehab your lower leg. AND remember… often an achilles injury is due to an imbalance or issue with an entirely different part of your body (like lower back). So, you need a comprehensive work up. Then know this, once done with PT you will need to continue exercises specific to the cause of injury at SOME LEVEL forever. And when you stop you can count on aches and pains to return. You can get back to everything you like… but you can’t do what you did before and expect different results right? You’ll need to go about these things in conjunction with things that give you a healthy stronger and more balanced body. Hang in there.

  2. James Kahler says:

    Dean, you are a tough cookie and an inspiration. I thought I had it tough “recovering” from a 3-4 month semi-layoff while I switched jobs. Just today did I run my first 5 miles @ tempo in under 8:00 pace. (granted, I did manage 3 slow marathons this season 🙂 ). But with my endurance base established I have been longing getting back to some pace work and wondering if I will ever see a BQ time. I’m sure that I will, but at times, I’m sure you can attest, it feels a million miles away (pun intended).

    Keep keeping us posted . . and inspired!

  3. David Shumate says:

    I started running in 2004 and averaged 2,100 miles a year through July 2010. I completed 18 races, 5k’s, 10k’s, and half marathons the first five months of 2010. My MRI this summer revealed scar tissue and enlarged Achilles as well. I tried PRP injections 8 weeks ago but saw no improvement. Too much damage. Finally I was convinced something had to be done to keep from limping around the office and the stop the burning pain that followed ever run. Yesterday, 11-22-2010 I had the debridement surgery and the same tendon transfer. All went well, but as the reality sets in it’s a bit depressing to be honest. I look forward to any improvement and opportunity when allowed to deep water train and just begin some rehabilitation. I actually hope to run a marathon again next November. Just curious what I may expect. I’m 50 but stayed around 8% body fat during my running days, and I still plan to lift weights twice a week. I ran 10 miles Saturday at a 7:30 pace and ran an easy 8-miler Sunday before the surgery (Monday) just to enjoy the runners high one more time. Any advice is appreciated.

    • Dean Hebert says:

      David – Let’s stay in touch. I can tell you… it was worth it. I’m still not running YET but I keep an eye to the long term. This is not about doing another race… it’s about returning to a lifestyle. Patience is NOT a runner’s best friend… but… we can and will do this.
      Keep an eye to the light at the end of the tunnel.. and move towards it.
      Do not rush it or you will be back to what put you here in the first place.

      I’ll see you at the races…. I’m coming back.. I’m always coming back… and so will you!

      • David Shumate says:

        Thank you Dean! It’s so nice to actually meet someone that is going through it as well, and understands how hard it is mentally to not be able to simply run. I ran across your blog the night after my surgery, almost in tears, wondering, “Did I do the right thing?” I look forward to reading about your progress and encouragement in your blog.

        Below is a rewrite I did of a Robert Frost Poem Sunday night before my surgery. I know you’ll understand!!!

        Stopping Why on a Running Evening?

        Whose running shoes these are I think I know.
        That used to run through the village though;
        They will not like me stopping here
        While this cast keeps still my toes

        My little Ipod must think it queer
        To stop without a running trail near
        Between the walls of my warm home
        It sits and charges all alone

        The shoes and laces question their fate
        No this is not a mere mistake
        The only other sound’s the sweep
        Of ticking clock while lying awake

        For now I must resign to retreat
        But I have marathons left in me,
        And miles to run before I sleep
        And miles to run before I sleep

  4. dave flory says:

    Dean–
    First I had heard of your Achilles issue. Was this result due to a traumatic event or just a lifetime of accumulated trauma? I wish you well in your continued recovery. Sounds like you have a great support group to get you back on the roads again. I never thought I had the patience either. But, two years without a single step of running can change your mindset and help youdevelop a deeper appreciation of how patience can be the right medicine.
    Hang tough,
    Dave

    • Dean Hebert says:

      Dave… good to hear from you… it was tendonosis and those past surgeries I had… but I’m coming back.
      You are certainly someone I can look to for inspiration… thanks

  5. karim jessa says:

    I had a secondary repair of my right achilles tendon with graft on Dec 3. I read your blog and wanted to inquire on the best way to rehab from your experience. I have had the knot/bump on my tendon for five yrs now – degeneration and scar tissue and finally decided to go the surgery route to hopefully finnaly be relieved on the constant pain and hobbling. I am in a splint for 2 weeks post op and then a cast for 4 wks and then a boot. Please provide any feedback to help. thanks…

    • Dean Hebert says:

      This last post really outlines a very good rehab. Once out of the boot get right to it. The hardest part as an athlete is to monitor and moderate effort based on what your body is telling you – we cannot just go after it and have the mindset of “no pain no gain.” We’re used to pushing our bodies… now we have to do it smarter.
      The ultrasound treatments in the first 3 weeks post boot is important for swelling reduction.
      ASTYM is superior to anything else in regaining tendon flexibility and decreasing fibrosity.
      I am only 4 months out from surgery now, and I can jog. The tendon is still swollen and will remain so for the next 3 months and some residual swelling may be there up to a year my orthopedist told me. But that is different than having discomfort. At this point despite the swelling and beginning of running my discomfort is at a “1” on a scale of 1-10. It feels more tight, restricted and weak than painful.
      The Alter-G treadmill is what kick-started everything – made a world of difference to run even if at a “lighter weight”. That motion and activity allowed natural strengthening and rehab.
      Finally, keep up with the lower leg exercises until the calf and achilles are 100%. (toe/calf raises, wobble board, balance board, etc.).
      Stay in touch let us know how you progress.

  6. Seb says:

    Hi Dean, I’ve just discovered your blog through Constantine’s in Kenya. Your post on the old Achilles is very timely. I have finally recovered “touch wood” from a painfully enlarged left achilles. It was a drag having to take time off, but that was all I could do to fix the problem. Thank goodness I didn’t have to have surgery. Great blog, glad I found it.

    Pedometer Watches for 2011

  7. Pingback: Achilles Tendon – PRP – Post-Op Update #2 | The Running World According to Dean

  8. Kerry Yaz says:

    Coming upto 8 weeks post Achilles Rupture Op…and I’m doing quite well. Am walking in the house without my air cast boot, and performing 2-3 sessions of physio for my leg daily. I am able to do Pilates daily, and am happy that I’ve maintained my core/upper strength. I can now walk outside in two shoes/boots, but find after 10 mins, I do need my boot, or at least, one crutch, as my leg tires quickly. I am walking without pain, but my leg does feel ‘sore’ and is certainly slightly swollen in the achilles area by mid afternoon. Find periods of elevated rest beneficial. I am worried about a re rupture, especially as I’m a self employed fitness instructor! What I want to know is…is ultrasound really going to aid my recovery/rehabillitation?

    • Dean Hebert says:

      Kerry,
      I’m now 5 months post op and still feel some fatigue in my affected lower leg. It just feels a bit weaker and after long days on my feet sometimes it just feels good to get off my legs. My achilles/lowercalf/ankle area still feels like it’s swollen. (I imagine it like my enlarged tendon being like in a too small sausage casing!) Putting my legs up helps a lot.
      So, I’d say get used to it.

      My calf is still atrophied and NOT 100% in strength or size. So, be patient. I find that when I run right now after a few miles I do seem to favor that leg and don’t run “neutral”. I have to be careful not to favor otherwise I’ll end up with a compensation injury.

      As for ultrasound. I was told by my physical therapist that after 4 weeks or so there is diminishing return on its effect. The most benefit comes in those early treatments. I kept mine going for about 6-7 weeks.

      My experience tells me clearly that your rehab exercises as well as progressive walking/jogging/running/exercising is what is needed and are far more key in rehab than other modalities. If you listen to your body (easier said than done I know) you should not have issues with re-rupturing.

      Keep it going one day at a time!

  9. Kerry Yaz says:

    Hi Dean

    Thanks for your quick response. I guess I’m being pro active, but sensible in my rehabilitation. I will have to include more Rest & Relaxation episodes into my day, I quite enjoy it now! You’re absolutely right, one day at a time is the protocol…I plan to begin walking more outside, now that the weather here is a little less frosty! I am teaching a couple of Pilates classes now, and it was great to get back into ‘the zone!’

    Glad to hear you’re back running, that is certainly my goal, to be able to run in summer!

    Just one final question, what trainers to do you find the best to run in, post ATR?

    Regards,
    Kerry

    • Dean Hebert says:

      Shoes – Good question with no prefect answer. Shoes are very individual. Do not for even one second believe anyone who tells you “this is the shoe for XYZ”. 100% myth. Experiment a bit. If you need support or correction then you simply need to get a support shoe. On the other hand, if you are neutral then stick with that neutral family of shoes. I have taken the approach (with success so far) of rotating shoes. I use lightweight trainers and racing flats. I’m trying to retrain my lower legs to be a bit more flexible. I happen to like Asics shoes and so for ME that is what I use.

  10. Keith says:

    I’m a pro rugby player and am 2 and a half wks after my repair and I’m in a cast to my knee.. I felt fine for nearly the first two weeks no pain at all, but for the last five or so days the pain in my Calf is unbearable, it’s at the point were nothing gives me relief… Did you experience any of the same??

    • Dean Hebert says:

      Keith,
      I didn’t have the same experience but a similar one. The first week I had VERY minimal discomfort. It was week 2-3 that I had intermittent intense discomfort. I was in a walking boot and not a full cast. I attributed it mostly to getting up and moving. But, I know my doc said it would be a day or two before all the nerve block wore off. For me it was at least 3-4 days.

      Monitor this closely. My medical background tells me a few things. Never ignore pain it’s the body’s way of telling you something. Take pain meds – it’s what modern medicine is about. There is no reason to suffer. Get something stronger. Maybe you need a muscle relaxant to augment the pain relief. And finally, it does go in cycles. The pain may go away, then mysteriously appear. It’s ok. Just monitor it and listen to your body.

      You’ll be back!
      Hang in there.

  11. Lori L says:

    So glad to find your info. I have surgery for my A.T. rupture scheduled on this Monday. I know there is a long road ahead of me to recovery, but am hopeful that I’ll be back running again after reading everything.

  12. chrissy says:

    Just curious, I am not a runner, but had an injury to my achillies tendon and it had healed with scar tissue, over five years . I also have had some damage to the gastrocnemius muscle that seperated from the tendon, I decided to get the prp surgery done about 2 and a half weeks ago, after going to physical therapy for 8 weeks first. I now have such terrible pain in the bottom of my heel that is unbearable. Has anyone ever heard of this before? I don’t go back to the doctor until a week and a half more. I am still in the boot, but when I walk around at home without it, I see stars. Thanks>
    Chrissy

    • Dean Hebert says:

      Chrissy,
      This pain is very unusual – at least the severity. Certainly in the healing process you’ll have discomfort. Your Achilles tendon of course does wrap around the bottom of your heel. But by now your pain should be subsiding not increasing.
      I would contact your doctor and not wait.

  13. Scott Muench says:

    Hi Dean,
    First of all, it’s refreshing to read your blog and all the questions and responses. I had my right AT repaired July 18, 2011. My surgeon performed an open surgery cleaning up the torn area (35%) of my AT and transplanting my HFL tendon through the AT attaching it the heal area. I’m 12 weeks post op and the area feels very good with little pain. I really haven’t had much pain since the first week post op. I sort of feel the area is just tight (not painful) and have full ROM side to side and forward but not dorsiflextion (just 15%…I have 20% in my left non-surgery AT) My doctor says that is good enough for anything I’ll ever need to do. I’m not sure about that since I’m an avid runner and triathlete. I tried running on the Alter-G at therapy two times and loved it, but my doctor has asked me to quit ‘dic&ing around’ (his exact words…lol). He wants me to wait six weeks to run. I really disagree with him on this but am sort of afraid to push it and mess something up. I’m able to do single leg heal raises (have done 15 reps). I’ve also been able to hit the road bike as much as I feel like.
    I hate to hear that others have also fought negative thoughts and bit of depression as I have during this period but just know deep down I will run and run strong again.
    One small issue that I have encountered is a possible #2 metatarsal stress fracture according to my doctor. I started experiencing pain a couple weeks following having the boot removed (before ever running on the Alter-G). I reported this but at the time I was told that I was
    probably just overworking the foot following shedding the boot. I’ve felt the same pain following a lay off from running in years past and was able to adjust my stride and run through it just fine without completely stopping (I just thought it was a nerve issue).
    Can you tell me when you were able to run without any issues if you’re at that stage yet?
    Do you continue to do PT? or just work on strengthening the gast. and soleus?
    Any words of wisdom are much appreciated.
    Thanks for everything,
    Scott

    • Dean Hebert says:

      First, don’t run too early. If your mechanics are off at all you will most certainly reinjure it… not worth it.
      You’ve been out this long, and another few weeks won’t make a difference. Get the stress fractures healed. If you rush back you are asking for chronic issues and up and down recovery.
      Alter-G rocks. I am still using it one year after surgery to augment my ground running. I really had an up and down recovery period injuring a hamstring and the opposite calf over the past year.. so I took the whole summer off. I have now been running 4 weeks. I avg. 20-25 miles per week and 2 of those runs are on the Alter-G (8 miles total). Though I am not formally in PT now, i have an agreement with them that I can schedule time on the Alter-G and use equipment. I like that because I am more likely to do all the drills and exercises THERE versus at home.
      Heel raises are good but you also need to focus on eccentric stretch/strengthening (heel drops).
      For me I also had to incorporate hip flexibility AND foot/forefoot flex exercises with balance drills – and THESE have made the most difference by FAR. The toe raise thing for me is minor in comparison. If the full power chain isn’t right… it won’t matter how strong your calf is.
      I run 5-6 times a week. I find consistency is better for my body than more days off. My easy day is 2 miles jog. My long run right now is a 7 miler. I just started some modest track work this week (14×400 @ 1:35 with 1:00 rest between).
      I will run my first 5k the first week of Dec. and my goal is to do a modest sub-20. (I know it’s a matter of perspective on this but I can run sub-17 healthy and in shape so modest by my standards).
      Keep it rolling. You’ll be back.

  14. Scott Muench says:

    Thanks for the quick response Dean,
    I’ll listen to your advice on not rushing back into running before everything’s ready…man o’ man have I been itching to get back to running here lately. I have also been blessed to be a fast master runner running in the very low 16s-5k…I want to believe that I’ll be able to get back to that level someday but have concerns to be honest.
    The PT had me doing a lot of balance work and stretching exercises which I agree have helped a lot. I plan to continue to work on balance, ROM and strength. I think I’ll give it another month before getting back on the Alter-G. I’m glad to hear that it has worked for you.
    Good luck with the training and 5k in December and keep up the good work encouraging and educating others! Scott

  15. keith says:

    hi dean
    i had my repair to my right AT on 31st aug 2011.i was 7 weeks in a cast.when i had the cast removed i was told by my doctor not to fully weight bear and use either one or two crutches for the 1st week after cast removal.it is now the 2nd week since i had my cast off and i have now (with the aid of the crutches )placed 50% weight on the operated AT.my problem is,that since i have placed even a small amount of weight on the foot it has swollen alot. my fear is that any weight i have placed on the foot it is now swelling up.i know that swelling happens alot in AT repairs but my swelling just doesnt seem to be going down…….is this normal??????

    • Dean Hebert says:

      Keith,
      Some swelling is indeed normal but “normal” is a relative thing and different for everyone.
      I had to keep my foot up and ice on it almost any time I wasn’t up and about. Even when I worked, my foot was up. Mine did swell sporadically for weeks afterwards. Keep it up up up. Keep it on ice.
      I think it is way too soon for you to panic over the swelling.
      Hang in there.

  16. Pam says:

    Great information and support conversation here.
    I completely ruptured my AT in July (accident backpacking on snow, undermelt cave-in ), then I walked on it for 5 weeks, then had surgery. (Not a good idea to wait so long). Due to the extra-time with the AT ruptured I had a bit of extra time in the boot and staying off the foot entirely. It is shocking how much a calf can shrink in two months.

    My PT is really basic compared to yours, but all seems to be going well. It is the slow-controlled heel raising & lowering on the injured foot that I haven’t quite conquered. I can walk about a 13.5 minute mile and feel jogging might be right around the corner. I am focused on pushing hard while maintaining form (not limping).
    My questions – 1) how many months after surgery were you able to run/jog a mile without the aid of the machine? 2) The back of my heel area still has a sort of tingling sensation – how long do these phantom symptoms continue?

    Thanks
    Pam

    • Dean Hebert says:

      Pam,
      You know, I never really chronicled my ramp up. Here it is. I looked at my running log to be exact.
      Surgery was 9/3,
      Out of boot 10/13,
      1st Alter-G treadmill run @ 60% body wt. 11/3,
      Ran my first mile on a track in 8:06 on 12/3 and had no symptoms – just out of shape and weak so I couldn’t push off at all.
      I did a 4 mile run on 12/18 in 30:30.

      I ended up jogging off and on through the spring but had other issues cropping up because I was still structurally weak and so had hip, hamstring, knee issues. I ended up stopping last summer for 3 months. Got it all straightened out. Now I have been running 4 consecutive months. I averaged 25 miles per week most of it and now I’m at 30 miles per week. I can do a 20:00 5k and a 5:55 mile. My longest run is 10 miles in 74 minutes. I am 17 months out from surgery. I’m sure I could have shortened this but I was not in a hurry. I’m still not.

      As for the tingling sensation this is probably from some nerves that were irritated or nicked or cut or something during surgery. It will be a while for them to repair. But, as long as that doesn’t adversely effect your gait – cope with it and don’t obsess on it. It may be your “friendly reminder” to take it easy.

  17. rootyk says:

    Dean,

    I am so glad I stumbled on to your blog. I had a previous partial tear, scar tissue developed which lead me to my surgery this past January 25th. I’ve been out of my boot for a month. I’m doing 2 footed calf raises but putting about 75% of my weight on the injured leg. My PT group doesn’t have the Alter G treadmill, very disappointing!!! However, I have the mini trampoline to give me the ability to have a similar running feeling. My goals are to be walking with out a limp by the end of May, running by the end of the year and to run in my first 1/2 marathon (princess 1/2 in WDW) next February. I have learned to be patient and to listen to my body. Running isn’t supposed to be painful!!!!!

  18. Susan Monts says:

    Hi Dean, I also am glad I hold your blog! I am not a runner however had the achilles tendon surgery, June 29th was progressing very well ahead of schedule started putting weight on foot at 2 months. Came out of the aircast and was doing great then apparently according to doctor some scar tissue broke off, now had intense pain for over a week (the keep you awake kind for 3 days) he did an injection into area, brought only about 6 hrs relief, swelling fairly severe. In pt they said bring heat to area and stretch? So painful can’t even touch. I’m worried something else is wrong. I don’t see doctor for another 3 and half weeks. He seemed to think injection would calm down and pt would get me back on track. Any thoughts or comments would be greatly appreciated. I am 15 wks post op. thanks, Susan

    • Dean Hebert says:

      Susan,
      Certainly there are a lot of possibilities re:scar tissue. Yes this could be it an yes that can be painful. But, it should resolve itself if it weren’t large enough to adversely affect the surgical area. Your pain level is pretty high. A shot of cortisone often does calm things down by reducing inflammation and decreasing pain. Often docs want no activity for a week or so after the shot. Since the shot will mask pain it’s too easy to over do it. I’ll assume the swelling is new swelling and not as a result of the surgery. In which case the swelling is the thing to me that is not good and should be going down.
      Swelling from the surgery itself may last a year of more I was told. And my doc was right. My Achilles did not return 100% to normal size until almost a full year though of course the majority was down in the first months. Today the tendon is thicker than the other side but it’s not inflammation.
      I would not stretch while swollen at all!!! If the pain is still intense and swelling not reducing, I’d get into the doc sooner. Get an MRI and get answers. Hang in there.

  19. Richard C says:

    Great blog and very relevant! I’m due to have an operation next week (secondary repair of Achilles’ tendon with tendon or fascial graft) and admit that I’m nervous ahead of the procedure.

    I did some damage over Christmas running 7km per day on a treadmill to get fit for football. It resulted in inflammation under my Achilles, so have not torn it. I could play games, but then have to hobble around for 5 days following the match. Been told that after exploring all other options I can either carry on with the pain following exercise, which has eased a bit recently, or have the operation to try to be pain free.

    It seems like a big operation, but would be worthwhile if I can get back to being pain free (running or playing football).

    I’m not worried about the hard work needed during rehab, but do people get back to a fully functioning ‘normal’ foot afterwards? So the real question, is it worth it?

    Thanks for all the advice you’ve already supplied…..

    • Dean Hebert says:

      Richard,
      I can only speak for myself and say – I wouldn’t have it any other way. It worked. Period. I can do probably 99.9% of what I used to do. And only in certain high intensity ballistic workouts (i.e. plyometrics) do I need to tone my effort down a bit.
      So, if you are up for the rehab then you are the right candidate for the surgery. IMHO
      Good luck!

  20. Joan Kaczmarczyk says:

    I am so happy to have found your blog. I am 58 now and I have had achilles problems going on for 30 years. I was an avid runner and very competitive in racquetball and other sports .l stubbornly ran through the pain in it’s early stages. I did not see a doctor until I was well into the chronic phase. Needless to say, I’ve done some irreparable damage in both legs. I’ve been forced to give up all high impact activies and each year I manage to reinjure the area and spend 1-2 months unable to do much of anything. I’ve often considered surgery but noone ever encouraged going that route. As a result, I’ve been forced into a more sedentary lifestyle. Recently I decided to go to a foot/ankle specialist for another evaluation. The MRI showed extensive scarring and this doc recommends surgery – FHL tendon transfer, debridement with 2 incisions – one in the arch area and the other in the achilles. I’m leaning toward going through with it and am trying to find people who have had this procedure to get some feedback. The idea of cutting a healthy tendon and moving it is what really gets me. What are the consequences in terms of function and balance? The doc assures me there is very little and that some people don’t even notice a difference (hard to believe), Would I still be able to rock climb, do martial arts, dance? He mentioned somehow attaching the big toe and the adjacent toe to restore some function to the big toe. I forgot to grill him furthur on this so I don’t know exactly where and which tendon is involved. Has anyone out there had this procedure and can they share the final outcome? I’ve read some success stories here and elsewhere in that they could get back into running. Can anyone tell me if they have impairment in balance, range of motion, etc. that limits their activities? I know that rehab takes a long time. I’ve been frustrated with this for a very long time and it seems that this is the most promising route to get me back to a more active lifestyle…….

    Thank you in advance.

    • Dean Hebert says:

      Joan,
      I did not have that exact surgery but what I know is that this is a common surgery and appears to have a good success rate. At some point we do have to make that decision and weigh our current status with the potential gain. That is why I went with surgery… and am glad I did. Though I have not returned to my old form (speed and power) I love that I can run again.
      Your balance question is interesting. I will pose that it may more depend on your rehabilitation than the surgery itself. But… do quiz your doc more on that. AND ask for references from ACTIVE people (i.e. athletes) he has done the surgery on.
      Good luck.
      Drop a line on how it goes… as you can see, we all benefit from everyone else’s experiences.

      • Joan says:

        Dean,
        I’ve made an appointment for a second opinion with a doc who can also do that same surgery and I will again have an opportunity to ask more questions. I believe you’ve given very sound advice as to getting references from athletes who have had this surgery and, yes, we do have to weigh current status with potential gain. Thank you so much for responding and for your insights. I will keep you and all posted.
        Joan

  21. Roger says:

    Complete tear of right Achilles on 3/1, surgery 3/6. Was in a splint with foot angled down for about 2 weeks, then ROM boot with lifts for about another two weeks (although I didn’t wear it that much). I started physical therapy at 4 weeks, and was 100% weight bearing around 5-6 weeks. Every day I seem to get more strength, but still cannot do a single leg heel raise (I can walk tippie toes since yesterday, which I was unable to do last week). During all of this, I have never really experienced much pain, just the stiffness and weakness. My surgeon told me mine was a best case scenario with regard to the tear and repair, so I would love to be back running by the end of summer, but we will see. I was training for my first marathon before this happened (actually ruptured it playing basketball with my 3rd grade daughter’s team). Would like to hear about anyone’s experience resuming plyometrics (insanity, etc) after a tear. I am male/43 and generally good shape. I appreciate blogs like this where I can read about similar circumstances and results. thanks!

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