Hi Docs. I’ve just had Achilles Tendon Repair with using flex tape and Spur removal. I’m going into my 5th week post op and it’s getting better with each passing day. I must say, this has been the roughest surgery I’ve experienced compared to other previous surgeries that I’ve had and I’m sure that the foot being the part operated on accounts quite a bit regarding the pain. I’m looking so forward to completing the healing process and complete recovery. Wearing the Cam Boot when walking and doing flexion exercises daily as instructed. I’m so grateful and appreciative for my doctor. Thanks for posting this video. A video on heel spurs would be great. I’m a subscriber.
I had Achilles’ tendon repair 1 1/2 years ago. The surgeon also had to cut off 1/2 my heel due to a very large heel spur( which another Dr.said wasn’t a problem) therefore the spur cut my tendon and and my Dr. had to cut off 1” of my tendon. Now, 2 months ago I had to have a tendon transfer! Big toe won’t move. I’m realistic that I’ll always have a limp . I sure wish I’d found my second surgeon first! I’m 67 and this has been very painful and long process! Good luck everyone going through this and if your regular Dr. says for years not to worry about a little ole heel spur… go see an orthopedic surgeon!! Thanks for the great video!!
Thanks so much Cindy. You are very welcome. Sorry to hear you are having a difficult time. Hopefully you can continue to improve range of motion and strength. All the best. Thanks for watching, subscribing and sharing with someone if you did.
Thanks very much Doc's. Lots of very helpful info. 59 years old, lifetime of biking, running, free weights. Have pushed legs very far, only results were some muscle soreness and strong lower legs. Went trail running 8 weeks ago. Felt like superman for some reason. Ran far and long. Lots of time on my toes hopping over rocks, etc. All good until the next morning. Limping, pain, right leg. Educated myself, played it smart on my own. 8 weeks, some mild pain still. Walking much better, but still long way from normal. Hearing you say 6-12 months makes sense. This is the real thing. Makes me totally appreciate my overall fitness at my age.
I’m currently recovering from Achilles Tendon rupture surgery. My tendon completely pulled off the heel bone. This has been eye opening. I was just trying to avoid stepping on my dogs paw. Thanks for the great information! Jill
Hi Jill. Sorry to hear about your operation. Dogs are awesome however they do get in the way sometimes. All the best during your recovery and glad we could provide a little info. Thanks for watching.
The doctor ain the orange caps reminds me of Adam Sandler! Thankyou for this video! I tore my Achilles 2 weeks ago now! I had a walking boot put on 4 days ago. Seeing a surgeon on Monday!
Hi bambis46. Thanks for the kind words - Adam Sandler is very funny. The walking boot will help immobilize the tendon and your surgeon can spell out the recovery path for you. Good luck on what sometimes seems like a long journey. Thanks for watching.
Well. Not sure about the weekend warrior thing. I am 43, been active my whole life, been going to the gym and working out since I was 13.... played HS and college sports, stayed active after college.... training for mud races, 5k's, half marathons...go to weight room weekly, yearly physicals for my job, healthy and fit. Tore mine in 2016. No signs or symptoms, no pain....playing basketball. I agree weekend warriors get hurt but sometimes "life's wear and tear" can get you too even when are a physical specimen, freak of nature . My point is, don't think it can't happen to you even when you are in great shape and not a "weekend warrior". Good luck out there. Good video too.
Hey Cyber Cop, how did your achilles heal? I tore mine 2/25/18 playing in a Police v. Fire bball game at 32. Pretty active especially for my career and also lift, run, and do obstacle course races. I am just over 12 weeks post-operative and mainly had issues with my ankle joint. Hope to get back on the streets by 4 months. I stopped playing bball 10 years ago because of family history of knee issues and a bad sprain of my left knee in college playing bball.
Agree 100% Cyber Cop. I am a 51 y.o. male , i have been active my entire life. I love boxing, jiu jitsu, running, yoga and do lots of things to keep me in shape. I missed work for almost 1 week now due to achilles tendonitis and it is driving me crazy. My Doctor warned me that if i do not listen to his advise i that i may need surgery and possibly be out of work for 1 year. That is when i realize that i needed to listen to my doctor and needed to make a decision.
Cyber Cop Your story is exactly why I haven’t picked up a basketball in four yrs. I can count on three hands the number of friends\ relatives I have that suffered the same fate.
Thanks for posting this informative video. Surgery likely... will take me away from my long hikes in the Colorado Rockies for some time. Grateful that technology exists to have this surgically repaired. Very watchable video.
Hi Alec. Thanks for watching. Surgery is a very personal choice and there are pros and cons to both. The goal of either type of treatment - operative or non operative - would be to get you back hiking in the Rockies. Good luck.
Thanks for such a reassuring video the doctor who saw me at the hospital for complete Achilles’ tendon rupture yesterday just put my leg in a cast and told me to turn up to the fracture clinic next Wednesday. No information provided on what options will be considered during that appointment. Glad I now know what to expect thanks for your time in making the video for foolish people like me. (It was football which I haven’t played for 2 years...started sprinting and snap it went)
thanks Docs, Really appreciate that video. It has come across as the most important thing is patience and managing my mid forties expectations of being a weekend warrior. Non op for me , protein diet and heaps of dull yet necessary phiso. Thanks again from the UK
Hi guys, thanks for this video. I had an accident 11 years ago and had partially cut my achilles tendon. I only went to see my orthopedic surgeon last year and considered Achilles Tendon Reconstruction. It involved grafting (they made a small incision under my knee). Now I am 7 weeks post-op undergoing physical therapy, with the help of an adult walker and an airboot. Still waiting for my wound to completely heal so they can bend my legs and progress with the therapy. I hope I can walk again normally and wear heeled shoes, like I did before the accident. My surgeon is great and supported me all the way. All the best to you guys.
You two doctors are great in explaining procedures along with really good sense of humor. Some of my doctors have the bedside manners of a prison guard.
Thanks so much The Bear. That's funny. We do our best to get the information out there in a useful and entertaining fashion. All the best. Thanks for watching, subscribing and sharing if you did.
Hi T Lu. You are very welcome. Good luck to you. We are sure your doctor will discuss this but soccer is likely 9-12 months away. Don't want to re-rupture. Thanks for watching and subscribing if you did.
Came over to this one because of the weekend warrior video you just did. GREAT discussion about this injury!! Loved the information. Since this has been a few years since you did this video, has much changed for 1) the approach of surgery vs. non-surgery or 2) the advances on the things like boots used for recovery? Thanks again for this!
Hi Gregg. So we haven’t changed our practice. There are some surgeons who routinely will advocate for surgery. Yes the boots often have different wedges to adjust the amount of ankle flexion during recovery. Thanks for watching and subscribing
@@TalkingWithDocs Thanks. One other question. In professional American football, there are a lot of Achillies ruptures. Many of them return to playing before the time frames you talked about for being back to "normal". Are they getting treatments and/or therapy that the average person doesn't have access to, or is it because they are in such good shape to begin with?
I am having surgery on mine in 2 weeks. I have to have my heel shaved where it's shredding my tendon and damaging it. I am scared of the pain but have no choice. I had knee replacement surgery 10 months ago so I hope the foot will be easier. Thanks for the video.
I broke the aquiles tendon 2 months ago, this video answer all the questions that I had at the beginning. Great doctors, that has no problem to suggest to have a second opinion, 21st century doctors. THANKS
This is really helpful. Mine ruptured a few days ago which is annoying as i had many big plans for this year. I am non-operative, have had the boot/brace on for 2 days so I have a little way to go. Hoping it allows me to go on holidays etc, within next few months without the boot.
Hi girlgayle. Thanks for watching and glad we could be of assistance. It is important to discuss timing with your surgeon but most patients with a complete tear would still be in a boot at two months. Good luck in your recovery!
I definitely ruptured my achilles. Only found out because I did the Thompson test on myself. I went to the ER they said it was a sprain and sent me on my way. Then 2 week later i went to the doctor and saw a nurse practitioner who said it was just a strain and she put me in a 90° boot *which is super painful* and I've been in the 90° boot for 2 weeks. If I get maybe surgery and do physical therapy could I walk normal? Because I was just about to start training with a personal trainer. I'm frustrated.
Hi Macyloves. The most important thing to do is to confirm or rule out the diagnosis of an Achilles tendon tear. This should be done by a health care professional. At home if you are unable to push down hard like you are trying to depress a gas pedal, that is often a sign of a tear but you could have a partial Achilles tear or a gastrocnemius (calf muscle) tear and both of these can be painful but require different treatment. It is hard to say if you would need surgery - you first need a diagnosis. Good luck
Hello doctors! Love watching your channel on UA-cam. I recently ruptured my left achilles tendon playing racquetball. I decided on the "recommended" braided suture repair surgery so I can quickly get back to my "weekend warrior" activities :) I'm still confused on how a completely ruptured tendon can heal non-operatively on its own. Pulling the two ends together and ensuring they're aligned, then suturing them makes the ONLY sense to me. Can you explain how two ends of "a broken rubber band" align back together, touch each other, and heal together without any surgery? I just don't get it!!! Thanks so much! Keep up the great work! (sent an email as well).
Hi Ray. Those broken ends sit inside the same tube so when you point your toes down they come together and that is when your body starts to connect them with a combination of scar and connective tissue. Then you slowly stretch it out while it is healing to elongate the tendon. Voila!
I’m a 58 year old woman who is short. I was at the grocery store and couldn’t reach something on the top shelf. I just stepped on the bottom shelf reaching and when I came down I felt it pop. I knew it had to be tendons because my bone didn’t hurt. I also had a big indentation on the back of my ankle. Note to self: never step on a shelf. I chose surgery, which will happen next week.
Hi Warrior Loft. How do you know you ruptured your Achilles? In Canada, you have to be referred to a specialist however if you can go directly there, that may be a more practical approach. Good luck and keep us posted.
Great video ! So lately I’ve been having soreness in my left Achilles while playing basketball. Any recovery tips ? Also is soreness common prior to a tear?
Thanks for making this video guys. I am ten weeks post Achilles rupture. Treated non operatively. I guess I won’t be back on the golf course anytime soon. Terrific.
Hi Eric S. We tell our patients usually around 4 months for golf. With a cart. Make sure your surgeon and physio sign off on it. Until then, work on your putting - that is where all the money is anyway! Thanks for watching.
Appreciate the knowledge (& humor!). Docs, is there a certain gap distance on a full rupture that would make you think non-op is a bad idea, such as 2. 5 cm?
Hi Joe. Thanks for the positive feedback. We try to keep it informative but light. There is not a specific distance where we would consider surgical intervention. The main reasons for us to consider surgery would be delayed presentation or re-rupture. Hope that helps. Thanks for watching.
Thanks for the video, docs! Great overview. You started to talk about instances where someone has ruptured both tendons (not at the same time, but with a couple years in between). Once both tendons have been ruptured, what is the risk of either tendon being re-rupturued following treatment and eventual return to sport? Is the fact that both tendons have ruptured in the past indictaive of higher risk factors in the individual? Or once the tendons have healed (in my case, both operativly, and both have grown back much thicker than pre-injury)? Thanks again!
Hi Matt. The risk of re-rupture does not necessarily go up if you have ruptured both tendons. The risk of re-rupture varies from study to study but generally is around 5% for surgical treatment and 7% for non surgical treatment. The tendon often heals slightly thicker than the native tendon in both scenarios. Hope that helps
Great video guys! And much appreciate you putting out this type of education. I just ruptured my Achilles tendon on Sunday, July 9th. Got the boot on yesterday, July 10th and scheduled for surgery on July 18th. After watching your video, I'm now thinking about non-operative and just being patient, rest, and physical therapy. My question is, can I start physical therapy right away? Are there some things I can do right now to start the recovery process besides just wearing the boot?? Again, thank you very much for this invaluable education.
Hi Greg. First, it is a good idea to have a discussion with your treating surgeon before changing your mind. There are pros and cons to both treatments. With respect to early physiotherapy, there is a trend toward that in the literature and likely why more and more of these types of injuries have been successfully treated without surgery. As well as the invention of the adjustable boot. Hope that helps but as for physio, discuss this with your surgeon and therapist first. Good luck
@@TalkingWithDocs Thank you! Do you know what has really moved me forward in the last couple of weeks? Icing. Unfortunately I was never guided to do this by anyone. Only a colleague said I should be icing, 10 mins every so often throughout the day. I've come on leaps and bounds in the last 2 weeks. If I'd been doing this before, I think I'd be a lot further in front. All the best!
Just ruptured my achilles on Saturday and Im going non surgical. I should be in a boot next week. Hopefully when im in the boot i can start walking again
Hi Dbergkamp. All protocols are different but there is some evidence and a trend to early mobilization with the proper device. Good luck to you and thanks for watching and subscribing if you did. Good luck in your recovery.
Hi Hiltz0007. So prognosis for recovery from levofloxacin induced Achilles rupture is comparable to other types of tears. There is still a chance of rerupture whether it is treated surgically or non-surgically. It is a long process but patients traditionally do quite well. Thanks for the question and for watching.
I stood up in a restaurant to pay the check and thought I had been shot. So loud and so painful. Fainted and passed out for 30 minutes. Complete left Achilles rupture. Surgery 2 days later. Fell in boot and sprained ankle of same foot at about 1 month post-op. Delayed healing and PT. Unfortunately, other foot Achilles problems slowed progress. MRI shows tendonosis and corrosion where surgery is also needed and a tendon will be taken from my toe of that foot for repair. COVID postponed my second Achilles surgery and now I’m freaking out at the thought of doing this again. I was 47. NOT a weekend warrior. More like a “sit on your asser.” 4 sport athlete back in the day and quite active until about 2 years prior to rupture when I did start to have constant pain, and called it “aging.” So, I’m a complete mystery. Maybe overuse. Maybe CIPRO although it had been many years since I had taken it. Maybe due to my premature birth at 6 months. No one knows, but this recovery is no joke and I’m not looking forward to doing it again. Thanks for all the info. I had no health issues and no sudden sports movement but somehow ended up with two bad Achilles. Lucky me.
Hi J Y. Thanks for sharing your story. Sorry to hear you are having such a difficult time. Best of luck with your recovery and your upcoming surgery. COVID has messed us all up. Take care of yourself and thanks for watching
Every few months my Achilles will hurt incredibly badly when I raise my foot up this will stop after about 10 minutes but will happen again later on in the day or in the next few days. Eventually it will stop happening and then happen again in a few months. I can’t walk when this happens. This has been happening for almost two years. It is incredibly painful what could this mean doc? I also have had the ability to “pop” my ankle for as long as I remember. Thanks!!
I'm not sure where you guys are located, but I'm in the USA and my doctor highly recommends surgery and doesn't even want to talk about non surgical treatment. I don't have insurance and the operation is going to cost me around $7,500 if we go surgical. I feel like they're only wanting the money. Should I go see another doctor? It's $250 per visit and I don't want to just keep going to doctors until one tells me what I want to hear, but I would like to atleast have the option. I'm 3 days into a ruptured Achilles tendon and it really doesn't feel bad. I had a boot on within 16 hours of it happening. What should I do?
Hi Joshua. Sorry about your Achilles. We are in Canada and many surgeons treat these non operatively. There is a small increased risk of Re-rupture for non operative vs operative. . Seeing someone else is not unreasonable. Best of luck. Thanks for watching and subscribing Check out this article from fhe New England Journal 2022 pubmed.ncbi.nlm.nih.gov/35417636/
5 weeks ago I ruptured left Achilles tendon.. MRI results on day 4 post trauma/injury showed complete tear at myotendinous junction through the proximal critical zone, 14mm tendon gap. Initial ortho consult at that time ordered 4-6 weeks of PT and rest/rehab. Now have ortho f/u this week, minimal pain on weight bearing with a walker but tenderness with dorsiflexsion beyond neutral; 64 yom hospital pharmacist hoping to get back to work, biking and kayak, NO running/tennis, basketball, golf. Is non operative still an option, or just continued rest & PT?
Hi Gary. We typically put people in a hinged brace that controls the amount of dorsiflexion and adjust it every 2 weeks. We let you walk around 6 weeks with ankle locked at 0 dorsiflexion and full plantar flexion and then increase to 15 dorsiflexion and then 30 and then full. Physio usually starts around the 4-6 week mark for you. Thanks for watching, subscribing and sharing if you did.
Hi Docs, thx for d great video. My achilles is FULLY ruptured, what's the chance of having the tendon connect back together again? My orthopaedic surgeon said it's like very low chance and it's gonna be very long to wait for it if I choose a non operative approach.
Hi Wandy. So there is still a good chance that a completely ruptured Achilles tendon can heal non operatively. Every case is different and without examining you and reviewing your imaging it is difficult to give a specific answer, however, it is very possible. You should discuss pros and cons of surgery and non operative treatment with your surgeon. Good luck
@@TalkingWithDocs two weeks out from ruptured achilles tendon surgery. Looking forward to a strong and healthy recovery. Thanks again for the very informative video!
I twisted my ankle on a decent sized rock with those darn gladiator style sandals with the loop over the big toe and a piece of cloth across the top of the foot. The back of my foot went one way and the toe loop pulled my toe the opposite way. I had thought it was just a sprained ankle and so continued to walk on it for about 8 weeks before feeling a weird burning tearing feeling slowly develop on the back. Also in the same week I had some weird muscle spasm when I put my foot up to ice it and felt an excruciating shin splint-like pain. By the time I got to the doctor for this about 8-9 weeks in, there was a decent sized lump on the medial side of my achilles. He took X-rays and put me in a cam walker, 6 months later the bump is still there. If I walk on it too much it swells and feels like its tearing in the back.....I am at a loss of what to do and am so tired of not being able to walk on this. Does anyone have any insight? What you said about the boot positions and starting off with the toes pointing makes sense but was not what I was told to do, it was just the cam walker. Is it still possible to do the invasive side? I think there is a partial tear or something....but I just don't know what to do, this isn't something I can just push my way through the pain and deal with. I have not gotten the MRI yet, but am feeling desperate about getting this fixed. How can you tell a tear versus tendonitis? Its pretty stiff in the mornings too. I apologize for the novel, btw.
Hi gladiator Anna Salerno. It is always difficult to give specific answers without actually seeing your foot and ankle to examine and reviewing any imaging. Xrays will be normal unless you fractured something. Usually the next steps in investigating an Achilles tendon issue would be an ultrasound and then an MRI. Tendonitis usually is associated with pain and swelling. If there is a complete tear, it would be difficult if not impossible for you to press your foot down or go up on tippy toes. That is the main job of the Achilles - to connect you foot/ankle to your lower leg through the calf muscles. The lump is not uncommon with an Achilles tear - partial or complete - and often will not go away. This could be your body's attempt to heal it. It is likely best for you to be assessed by a physician and have some further imaging. Hope that helps. Good luck
Thank you! My gladiator days are over, apparently, I just hope I can go on 5 mile walks again someday, at least. For now, the tendon aches if I do too much walking or too many stairs. I will definitely be pursuing further imaging to see what is going on. Thank you for the clarification, on things like the bump not going away being normal. It is almost as if there is a weird vein over the back of the bump, it's so strange the way the bump is angled too. I had wondered if it was maybe a different tendon that was partially ruptured underneath. Anyway, hopefully the imaging will give me answers and I can get this healed. I appreciate your response and the video was informative, as well!
@@TalkingWithDocs thank you! Just wanted you to know things are getting closer toward surgery. My dental visit has started the ball rolling, I got a good dentist this time, the saga continues. Stay well.
The prognoses are outdated. With physical therapy starting at 4w (before the boot comes off), re-rupture risk is equal between surgical and nonsurgical treatment. Also for some injuries such as a complete tear, operative is the only feasible option and it skews the results.
We would respectfully disagree. We treat complete tears in adjustable MC walkers every week. And can’t remember the last rerupture. Both treatments have low rerupture. Surgery just has all the risk of surgery.
I’ve ask this question on multiple channels but no good answers yet. Why aren’t long lasting absorbable sutures used for this repair? I understand the tendon needs support at first but eventually the tendon heals and supports itself. So those permanent sutures are just there for no reason.
Hi Damien. So that is a good question. The main issue is that the tendon and scar tissue that fills in the tear is not normal tissue and does not have the same strength. The thought is that this provides long lasting support for the tendon to reduce the risk of rerupture. Hope that helps. Thanks for watching, subscribing and sharing with someone if you did
Thank you for your work. I play soccer weekly. I feel the same pain in the back of my ankle almost every time after playing. Then I struggle to even walk properly for a couple days. Where do you feel the pain with an Achilles injury? As I say I feel pain the back of my ankle, more specifically the heel bone. Many thanks for your channel and your answer in advance.
Hi MrMessyb. You are welcome. So if you have Achilles tendonitis you would feel the pain usually above the bone along the tendon and if you had a tear often 2-3 inches above the insertion at the bone (which happens to be called the calcaneus). Hope that helps.
Talking With Docs thank you for your speedy response. I hope you get the recognition for your quality and attentive work! I am experiencing a sharp pain specifically in the “subcutaneous calcaneal bursa” area. It hurts especially if I press on this area whilst the area is relaxed. And it is worst when walking or after sports like soccer.
Hi MrMessyb. Sounds like you have an insertional tendonitis. Typically this is treated with physio and anti-inflammatories either by mouth and/or topically. Good luck
I wish I saw this video as soon as I had my rupture. I had no idea there was a problem until after a full month, I could still not push off my injured side. Finally saw a doctor then Orthopaedic surgeon doctor and had surgery 5 weeks post Injury. Had three weeks in a cast non-load at home. Switch to angled Air Boot 4 weeks post op. Just returned from a pre-booked 10 day family holiday in Spain with crutches and a Knee Mobile ( which I highly recommend) which helped a lot. Seeing my Orthopedic surgeon next week for evaluation. Hoping to start therapy and DRIVE again soon. Still a little tender. Very concerned about a Re rupture as It was 5 weeks after my injury before my surgery. I had no idea I had hurt myself so badly. Please wish me luck.
Hi Mark. Glad you enjoyed the video. Sounds like you actually did try to "walk it off". Happy to hear that you are through surgery and well on your way to recovery. Lots of physio ahead but you have the right approach. Risk of rerupture is always a concern for both operative and non operative patients however the risk is still low. Work on getting strong and mobile and don't return to sports too soon. Good luck.
Great job guys! I am a 71 y/o retired anesthesiologist who took up pickleball in order to give my cycling induced piriformis syndrome a rest. Out of the frying pan, into the fire. Two week anniversary of the rupture today. My Ortho foot specialist was recommending surgery mainly because I didn't have any health risks for surgery. I will see him again tomorrow, but I will probably go the conservative therapy route. My biggest problem is sleeping with the boot on. Is there a boot that makes this easier? I have an Aircast ($60). Is the Vacoped ($300) any better?
Hi Cleveland. Thanks for the kind words. So the main difference between the aircast and other fancier and more expensive boots is the ability to allow some range of motion. We often use a boot that we will fix at 30 plantar flexion at 3 weeks and then adjust to 15 fixed plantar flexion and then at 6 or 7 weeks adjust to 0. We fix the dorsiflexion but allow active plantar flexion in the boot. We feel this is better as it will allow some range of motion and engage the calf muscles while walking. Good idea to have this discussion with your treating surgeon. Good luck and keep us posted. Thanks for watching.
Hi !!Watch you two all the time, Love you both.... Now I need answers and I come to you.. I am in my 2 weeks of Achilles Conservative repair. I didn't know I had the rupture until a week in. Thought I bruised a heel.. But I am wondering is there any therapy I should be doing, I was just told come back in 4 weeks .. Each week start adding my 25% weight, 50%, 75%, then 100%..seems like I should be doing more??? What do you think? JJ
Hi Jan. Sorry to hear this. Usually no physio for first 6-8 weeks then slowly stretch and strengthen. Best of luck. Thanks for watching and subscribing
Great video, thanks for sharing! I am an active 22 year old and I ruptured my Achilles tendon playing ultimate frisbee. I had surgery about 7 weeks ago and am in a full weight bearing walking boot. When should I start physical therapy? I am also concerned that my tendon will never be what it used to be, will it ever be 100% again? What can I do to maximize strength/ mobility in the long run?
Hi Austin. Thanks for the positive feedback. Usually physio will start somewhere around the 6-8 week range with limits placed on dorsiflexion (the amount that your toe goes up). This definitely needs to be discussed with our surgeon and your therapist. Your tendon will often get close to 100%. The only thing you can do to help that is work hard with physio on both range of motion and strength - and be patient. Good luck.
Hey guys- thanks for the great resource. My question concerns the viability of non operative treatment with a severe rupture. Is there a limit to non operative treatment in that regard? How common is a full rupture? My physician seemed to discount (immediately) any course but surgical. I'm sure his reasons are valid- I'm just curious.Thanks so much.
Hi Duane. Complete ruptures are common. There is good success with non operative treatment. Similarly there is good success with surgical treatment as well. There is a slightly higher chance of a rerupture with non operative treatment (some say 5% VS 7%). The main benefit of non operative treatment is that you still heal but avoid the risks of an operation. Newer protocols of early mobilization and better appliances have helped non operative treatment improve greatly over the last 20 years. Hope that helps.
Hi guys, just wondering when would a patient be ready to return to golf and skiing? My rupture actually occurred from a pickup game of basketball which I'll never do again but I'm keen to get back to golf and skiing and I was wondering if those sports use the achilles tendon much? Also which country are you guys from? I'm glad to hear that most of your patients went down the non-surgical route as I am currently doing.
Hi Doctors. Great video I'm really impressed how many information you could transfer in this short video. I'm raptured my achilles tendon playing futsal one week ago, surgery occurred next day. I had also two cuts in my heel bone from both sides where some wires have been put into the center of tendon. Do you know this method of repairation? I'm one week post operation and it's still hurts a lot cannot sleep due to this. I see that my leg is swollen. I'm taking injections in belly every night to avoid blood clots. Is that normal that is painful for 7 days after surgery?
Hi Tomasz. Thanks for the questions. There are many types of repairs for Achilles tendon ruptures. Pain at 7 days is not uncommon. You want to ensure that the pain is not increasing and if so you should likely follow up with your surgeon. Good luck!
Talking With Docs Hi. Yesterday I had follow up visit with my surgeon 2 weeks past operation. They removed stitches and said that wound is ok and I can wash it two days later. They put my foot to the orthopedic boot Walker with 3 of 5 wedges. They tried with only 2 but my ankle was totally blocked. I have to remove one by one wedge each week on Fridays. In the morning when I was sleeping I woke up with huge pain below my heel. It was like burning with tingle feeling. Is it because a foot has new position (angle) or it can hurt due to boot itself. Do you think that this pain will pass away soon? I was reading that this can be due to damaged nerves that are rebuilding. Can it be true?Happy Easter
I had an accident in the toilet and had a cut on my leg which included slightly my achilles tendon, i had a surgery, when should i start walking? I am in bed with a cast for ten days now... With a pillow under my leg.
Find this very useful guys.Thank you. When you mention re-rupturing Ac. tendon,,do you mean with non surg. method is bigger % or re rupturing tendon while healing ,or when is totally healed??
Hi Armin. So typically non surgical treatment has a slightly higher re-rupture rate however both are quite low. Complete healing is variable but typically 1 year. Hope that helps.
Hey Docs, over the last few years I’ve been having pain on and off at my heel that comes on suddenly and goes away after a few weeks, I finally convinced the VA to give me an MRI. Imaging reveals a small tear, scar tissue and a tiny bone fragment in the tendon. Advised by OS I would use a heel lift, orthotics and PT to help me stretch my Achilles’ tendon and calf. If that doesn’t help, then surgery this fall. What do you think of this plan? Will PT be worth the time?
Hi Howard. Without examining you and your imaging sounds very reasonable. Physio is for sure worthwhile. Best of luck! Thanks for watching and subscribing
Hello, gentlemen! It may sound like a stupid question, one I forgot to ask the surgeon. I had a pars surgery on my Achilles and I am wondering if u could tell me what happens to the strings or whatever they are called that were used to bring the two ends of my ruptured Achilles together? I mean, are they going to absorb themselves through time or am I going to have them inside my leg forever. I am speaking about those inside, not the ones used to seal the wound.
Hi ladyyyygaga. So good question. It really depends what they used. Some surgeons choose to use non absorbable suture that will be there forevever where others choose a very slow absorbing stitch that can take more than 2 years to absorb. Either way your body will form a scar tissue type layer around it. Best of luck during your recovery. Thanks for watching, subscribing and sharing with someone if you did.
Nice Video Doc, I ruptured my achilles last Dec 8, and was placed on cast since then. My question is, the gap on the torned tendon as noted on the MRI is around 4cm.. can Non-Surgical path able to fix and connect it? Thanks in advance.
Hi PorkAdobo PH. So the short answer is yes that gap can be filled because the torn tendon remains within a sheath or sleeve so by holding your foot down and slowing bringing it up your body repairs the tear. This is not with totally normal fibers but fibers that can be strong and allow you to return to the vast majority of your pre-injury activities. Hope that answers your question. And thanks for watching.
@porkadoboph naoperahan ka ba? I just tore mine tonight it hurts i cant walk but i dont want surgery. But I'm afraid I wont be able to play 100% anymore
My tendon snapped in half i havent had any treatment or anything its been almost 2 years now .my calf got really small will it stay like that forever? Is there anything i can do to get my calf looking normal again ?
Hi Ananymous. Physio may help but it may not be connected to the distal tendon which is critical. Maybe see a surgeon. Thanks for watching and subscribing
Hi earl. Well ... you are most of the way there. It does take a long time to do a single foot toe raise which is part of the return to sport measure. Best of luck in the rest of your recovery. Thanks for watching.
Hi Docs, I'm scheduled to have surgery on my achilles next Thursday. I'm supposed to be flying from NY to Michigan on Monday. Should i reconsider traveling? Are blood cloths a serious concern even if I'm on a blood thinner ?
Hi Theron. Good luck with your surgery. Travelling may be a bit tricky but if on a blood thinner blood clots are much less of an issue. Confirm with your surgeon though. Thanks for watching and subscribing
I just ruptured my LT achilles hurts like heck. So I'm in a Aircast takes some getting used to but can you take it off while sleeping? Got a bit of swelling around the ankles 3wk followup with my Ortho ** Non surgical route. Thanks for informative video.
Hi Keri. Our approach is only to take it off for short periods when cleaning. Otherwise keep it on including sleeping for the first 6-8 weeks anyway to avoid the risk of dorsiflexing your ankle and disrupting the healing. Thanks for watching and subscribing
Hey, ruptured my right achilles two weeks ago. The boot was causing a lot of swelling, pain and discomfort from the heat. Found that removing the boot and resting the foot angled down and sideways on a pillow when working during the day eliminated all these issues. However, slightly unsure if this is okej or if it may affect the healing process, could not find anything on it online. So, my question is, is this a sensible thing to do. I'm still using the boot when sleeping and when moving around. Thanks
I didn't even know there was a non operative option. It just doesn't seem possible if there is a full rupture. I assume something needs to hold the tendon together while it heals.
Hi Clarence. The torn tendon remains with a sheath (a tube) and the ends are able to reconnect that way without surgical intervention. Hope that helps. Thanks for watching.
Please tell this layman how that huge tendon reconnects without surgery. I get the cast pointed down for a while helps, making the gap shorter but aren’t the calf muscles pulling the other end away from the lower end of the tendon bundle? And since there are so many small tendons, do they naturally re connect to their original tendon place? How many calf muscles winnow down the the Achilles’ tendon?
Hi Mark. Great question. The tendon is within a sheath and because you are not walking the calf muscles are not contracting and the tendon ends are brought together by pointing the toes down. Then slowly stretching them out allows them to heal further. The insertion of the muscle to the tendon is a broad and long one rather than an abrupt transition which makes healing possible but also makes this area vulnerable. Hope that helps. Thanks for watching.
I have a plantar fasciitis tear and tendinitis/tendenosis along with tear . I am interested in platelets treatment option? Whst is outcome on this treatment?
Hi Fallon. There is some scientific evidence for using PRP for soft tissue conditions like Achilles Tendonitis. Best to discuss with your surgeon because the severity of your condition will impact the outcome. Good luck. Thanks for watching and subscribing if you did.
Hi doctors. Is it normal that after 11 weeks post surgery my ankle is still swollen? In fact I have swelling all the time. In the morning little bit less but during the day it's getting more and more. Regarding doing calf raises I cannot do this without pain in affected foot. I'm doing bicycling and leg presses on machine there I don't have pain. What would you advise?
It depends on which study you ready but likely in the vicinity of 5-10%. If you already have symptoms of Achilles tendonitis on that side it may be higher. Hope that helps.
your video is great .i ruptured both my tendons had operation on bothnlegs .one has healed and one is causing me pain on walking why is this and how do i correct it please .this is after 6 years .thank you
Hi Christine. So after 6 years it may be related to tendinitis. If you have an intact tendon and good power that is the most likely reason. An ultrasound or MRI would help. Often topical anti inflammatory and Physio can help. Some people use an orthotic. Best of luck. Thanks for watching and subscribing if you did
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Hi docs how are you... I've got injured and injured playing soccer and I have question... To be considered a full thickness tear of the Achilles tendon the gap how separate it's has to be? My ultrasound shows that gap in my tendon is 1.1cm and 7.7cm to the insertion. Thanks and nice job on you tube.
Hi What's Up Australia BR. Thanks for the compliment. If there is a gap on ultrasound then it would be considered a full thickness tear. Sometimes the ultrasound will comment on intact fibers and that would mean that it was a partial tear however if there is a 1.1 cm gap then it is probably complete and the location is very typical. Hope that helps.
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Talking With Docs Thanks doc appreciate your attention. I'm in a non operative treatment I hope soon I'll able to practice sport again. Thanks a lot.
I'm pretty sure have a partial tear, weird trampoline accident. I can't fully dorsiflex and I can't do a single leg calf raise. I started rehabbing for two weeks, the first week I just iced,elevated and slept. Week 1. Rehab couldn't walk on my toes. Week 2. I can walk on my toes again, still no power in my Achilles and I lost a inch of calf muscle. Before the accident I was jumping 39-41 inches and my top speed was 25mph. I'm just scared I got some of this information to slow and might've lengthen my Achilles. How would I know if this is the case?
My left ankle is back to being healed, but my right ankle(Achilles injury foot) seems to be extremely stuff along with the ability not to do a single leg calf raise and I have my balance back on single leg 100% left leg and maybe 80% or so on my right leg from having 0% stability.
Hi David. If you think you have a torn Achilles you should see a doctor ASAP. if you have good power in plantar flexion you likely do not have a tear. Get checked out. Thanks for watching and subscribing if you did
@@TalkingWithDocs thanks and I can only walk on my toes, but has to be assisted. I can't do a deficit single calf raise properly or do a regular single calf raise on my (suspected torn calf it has zero power) before the injury I could do 445 or so for calf raises sets and now on a seated calf I can barely do no weight for 8 on the bad leg. Also no insurance atm.
Hello, docs. I did first conservative mode which is supposed to be for senior people or not very active and close to the end of the third month it broke again even though I did all therapy correctly. Now with this second shot, I had my surgery and need to start from scratch again. So sad I didn't lose just summer but also I will lose fall. Any additional suggestions for a reoccurring case? Thanks
Hi Gabriel. It sounds like you are doing all of the correct things. Just progress slowly and do what your surgeon and physiotherapist recommend. Avoid extremes of dorsiflexion. No high impact activity for 6-12 months. Good luck.
Hi, I'm 42 not a runner any more but I am very active. My job requires allot of walking. So when my rupture happened which was a week ago, I just kept on going to work. Did some digging and found you two. I don't have insurance at the moment, but I know I need to let my Achilles heal. I have be limping, some days are better than others. Any advice will be appreciated. I saw a boot online for $100. I'm just saying, if a boot is all I need for the Next few weeks then, why not cut out the middle man. I can't afford to take off from work. I'm moving in 3 weeks. Ugh???????Oh yeah never had any kind of injury like this in my whole 42 yrs of living.
Hi Sweetascandy42. First of all, it is critical to determine whether or not you have a complete or partial tear of your Achilles tendon as the treatments are very different. At a minimum you should be assessed by a health care professional and then they can fit you with the correct boot. Typically we would start in plantar flexion (foot down) and gradually move you up. Hope that helps. Good luck and get some help.
Im about a week in since I got. If I did have a ruptured would I be able to point my toes or flex it back? I feel a lot of pain in my Achilles area but still have motion with flexing and stretching. Thanks for your help!
Tore my achilles a month before diagnosed with cancer two years ago and was told to not worry about until after my surgeries and C treatments. I heard it pop at work and couldnt walk very well for a few weeks but to this day i still cant push off. Is it too late to have surgery to fix it? I was cleared of c yesterday.
Hi Sparta Spartan. Sorry to hear about your cancer however glad to hear you are clear! So no, it is not too late to have it fixed however it can be somewhat more challenging with delayed treatment. It would be best to see someone with a specific interest in foot and ankle surgery. Good luck and keep us posted. Thanks for watching.
Does age play a role in how fast you recover? I’m on the younger side, I ruptured mine and had surgery back in May playing basketball. Is it rare that someone my age (16) could come back in that 6 or 7 months period? Because I play basketball year round! And wanna try to play the beginning of my season this November or December, but my surgery says January which is 8 months:(
Hi Ja'Kea. Yes younger patients probably heal faster however it still does take 6-12 months to get back to game strength and speed. Wishing you the best of luck during your recovery. Thanks for watching, subscribing and sharing with someone if you did.
Hello Docs! I sliced the back of my foot yesterday at work . I have at least a partial cut of my Achilles according to urgent care physician. I got stitched up and he gave me a boot but it’s 90 degree. I took it off and just point my toes down because it doesn’t hurt as bad. I can’t stand on my toes. I’m supposed to go to orthopedist sometime next week. If the orthopedist suggests surgery, can I request to not have a surgery?
Hi Evan. Sorry to hear about your injury. Traumatic lacerations are a little different and more frequently require surgery because the tendon sheath has been violated. Best to follow your surgeon's advice. Good luck to you. Thanks for watching and subscribing if you did.
One day after the rupture, I had the surgery. It's been 3 days now. First surgery ever. It feels weird. When do you think I'm suppose to not feel slight pain anymore ? Sometimes my toes tingles and I feel swollen (sometimes). Thanks
Hi JuleZ. So it will feel swollen for weeks for sure. As long as the pain is not getting worse you are probably on the right path. It will feel odd when you stand up - like blood is rushing to your toes and this is normal and gets better with time. Best of luck to you! Thanks for watching, subscribing and sharing it if you did.
hey guys thank you for this very informative vid. So unfortunately 3 weeks ago i was an achilles tendon rupture victim while playing soccer. i'm 27 and i have decided not to have surgery, i was put on a splint asap and then the ortho put me in a plaster cast. I'm concerned that being in the cast for 6 weeks will inhibit my progress because i have read a lot about early functional rehab reducing the chance of re-rupture and increased strength of my tendon. What should i do?...also, is being pain free and having good strength of my toes a positive sign? Thank you.
Hi Braiam. Often we will keep patients in a cast for 2-3 weeks. The exact protocol for non operative treatment varies between surgeons. Early movement has recently been shown to be beneficial. Ultimately this is a discussion to have with your surgeon. Pain is often less of an issue as time progresses and movement in the toes is a good sign. Hope that helps. Good luck.
@@TalkingWithDocs Thank you! after 3 weeks of being in a cast i asked the doc to put me in a orthoses walking boot with wedges. He agreed and told me that the gap from the rupture is no longer there! i am currently on a 3cm wedge. Another question i have for you is, how long until i pass the Thompsons test?
@@B_ElitePerformance Hi Braiam Duran, Do you by any chance know how far the gap was between the broken ends of your tendons? Mine are 3.5 cm apart and my Dr. wants to pull them together.
Silencer1914 hi according to my doctor I had about a 3cm gap. It’s been 5 months and a half and I feel great. To see some of my progress you can follow my channel under my name, and you can also follow my IG page futbol_sst. If u have more questions feel free to ask! =)
I was playing 🏀 ball and a guy accidentally kick or came down on my Achilles, I felt a pop, but I was not sure if it was my Tendon or the guy stomping down on my Achilles. When I point my toes as you guys stated I do feel my gastrocnemius flex but it’s very sore and a lil inflammation going on around my ankle.
Hi Mikey Mike. The only way to know for sure what is going on is to get properly assessed but if you can actively point your toes down a complete tear of your Achilles is unlikely. It can be painful in that area as a result of direct trauma however. Good luck.
Hi i had a surgery in my akilles tendon in march 2016 and 3 months ago i found a lump in my scar so i went to my dr and he did an MRI and it was a tear in the same tendon that i had a surgery so dr.put me back in the bootcam for 6 weeksis anything that i can do to prevent it again
Hi Rosy. It sounds like you are doing the right thing. Allow the tendon to heal in the boot and then return to physiotherapy to stretch and strengthen the tendon. Good luck.
Hi Do you know how to fight with adhesions after surgery?Is there some way to eliminating its side effects as soon as possible?I'm 23 days post surgery of fully ART and when I try to just put my foot in neutral position is totally blocked and I'm bit worried if that can be due to already created adhesions inside?
Hi Tomasz W. Scar tissues, or adhesions, are often a part of the healing process in both surgical and non surgical cases. In the setting of an Achilles tendon tear, that scar tissue can be part of what is holding the tendon together. Typically the ankle is mobilized slowly to gradually stretch the healing tissue but allowing it to remain intact. Best way to deal with this situation is be under the guidance of a good physiotherapist and do what you are told. Good luck.
Hi Talking With Docs. Thank you for response - it is always professional and completed. I would like to ask you about one thing. I started physio last week - 2 sessions so far. Massage , electro stimulation of scar tissue and ankle moblization. Since yesterday I have a big pain in my calf muscles when I want to stand up. Is that normal or I should check with physio or doctor? I started Physio when I was 4 weeks post open method surgery
Hi Docs. Many thanks for answer. I'm 6th week after surgery, walking in normal shoes but still limping. On physio session therapist is using shockwave therapy around my scar tissue and also on calf muscles ( but I have never heard about this that is used after surgery) He also suggested to doing calf raises with both feet and doing ankle stretching. Is this not so fast? However I don't have any pain when doing these excercises. Can you advice?is not too aggressive approach???I have never seen in internet that someone is doing that so fast..and this shockwave therapy....worried if it's good..
Hi Docs, I ruptured my achilles tendon last week I am scheduled for surgery in a couple of days, im wondering if I made the right decision as to operative vs. non operative. I am 36 years old and I am wanting to get back to work as soon as possible. Felling Frustrated.
Hi Adrienna. This can be a difficult decision and most appropriately discussed with your treating surgeon. Surgery and non operative treatment are both successful options both with their specific risks and benefits. You just have to decide which is right for you. Hopefully that helps with our decision making and good luck with healing.
Talking With Docs non surgical... it’s been a little over a month I have moment with my toes now can point them down a tad feel my gastrocnemius firing a little. Able to put some weight on it no pain. Have any suggestions for me?
Hi Ewan. It is not uncommon for Achilles tears to not hurt. Often patients will complain of pain at the time of the injury but after that the main issue is weakness in plantar flexion. No specific need to be concerned about a lack of pain. Good luck during recovery.
I ruptured mine while walking to the beach, the initial snap an pain brought me to my knees. After that it didn’t hurt anymore. Just knew something wasn’t right saw a Orthopedic Dr. the next day, was put in the boot for a week,then surgery.
Hi k5669. Don't feel stupid. Weekend warrior is not meant to be a negative term. It is used to described middle aged people who love to still compete at sports. It's a good thing!
Talking With Docs omg thanks for reply, recovering 2nd week from ruptured achillies, they took xray and did the squeeze calf test and said it was mild rupture, but from all the reading ive done i dont knw if there such thing as mild rupture or what is even the difference or for example a moderate/servre rupture is. could you guys help explain? ps watched this vid night i ruptured achillies and it gave me amazing info, comfort and solace. thanks
Hi k5669. So the difference between a partial versus a complete tear is the severity of the rupture - or if there are any fibers that remain intact. The treatment typically remains the same.
There are many factors that are taken into account when discussing operative versus non operative treatment of Achilles tendon injuries - the size of the tear being one of them. There is not a specific number that makes surgery the best option. This is something that should be discussed with a health care provider along with the other risks and benefits of both surgical and non surgical treatment
Thank you docters, i have injury Achilles tendon nd 6weeks ago serjery is completed,pls any suggestions of these,i want to do walk,running,when i do that pls suggest me.
Hi Nagani. Glad you enjoyed the videos. The first priority for Achilles tendon injuries is to allow the tendon to heal and then to gradually restore strength and range of motion. This should be done under the supervision of a physician after confirming the diagnosis. You should see a surgeon locally and then get referred to a qualified physiotherapist. Hope that helps.
Hey guys.New update.I took cast off yesterday,foot is so so badly swollen,and can barely move my fingers.Any try of pushing anything down wity my toes does not give result.My Doc is like"I THINK parts came together and thats it,no UV no MRI no anything,but hes Doc,not me.Everything is just fresh so...maybe my worries are worthless Just would like to hear your opinion on this. for how long period is my foot supposed to look like this,,so I know if thing is ok ,or it is not??
Hi Armin. Without knowing the full story and performing a physical examination it is difficult to answer your question. However, the toes and midfoot will often be quite swollen for awhile. The movement should gradually come back. With respect to the question about ultrasound or MRI, you can confirm that the Achilles tendon has healed with a physical examination. If you are able to plantarflex your foot and ankle (pushing down like on a gas pedal), that would confirm the fibers have united. Then the task of gradually stretching and strengthening them begins with physiotherapy. You should typically discuss this with your surgeon. Hope that helps.
Yes,fibers have united,but I got blood clot,thats main reason for being so swolled.Dr did analysis. need to solve that and start with physio.Anyways,thank you guys
Hi Docs,i re-ruptured my tendon 2 months ago,and had surgery.Everything went well I would said.I am 9 week post op,and can walk with just little limp,or no limp but quite slowly.The thing is..my leg becomes really swollen if I do 7-8 km walk,or work all day.It is swallen in area 20 centimeters bellow knee,to ankle.Foot is not swallen almost at all. Is it normal?How long is gonna take for this condition to end ?
Hi 404chillwill. Yes blood clots can happen with any lower extremity injury regardless of operative or non operative treatment. Thanks for watching and good luck.
Hi Docs. I’ve just had Achilles Tendon Repair with using flex tape and Spur removal. I’m going into my 5th week post op and it’s getting better with each passing day. I must say, this has been the roughest surgery I’ve experienced compared to other previous surgeries that I’ve had and I’m sure that the foot being the part operated on accounts quite a bit regarding the pain. I’m looking so forward to completing the healing process and complete recovery. Wearing the Cam Boot when walking and doing flexion exercises daily as instructed. I’m so grateful and appreciative for my doctor. Thanks for posting this video. A video on heel spurs would be great. I’m a subscriber.
Best of luck during your recovery Linda. Thanks for watching and subscribing
I had Achilles’ tendon repair 1 1/2 years ago. The surgeon also had to cut off 1/2 my heel due to a very large heel spur( which another Dr.said wasn’t a problem) therefore the spur cut my tendon and and my Dr. had to cut off 1” of my tendon. Now, 2 months ago I had to have a tendon transfer! Big toe won’t move. I’m realistic that I’ll always have a limp . I sure wish I’d found my second surgeon first! I’m 67 and this has been very painful and long process! Good luck everyone going through this and if your regular Dr. says for years not to worry about a little ole heel spur… go see an orthopedic surgeon!! Thanks for the great video!!
Thanks so much Cindy. You are very welcome. Sorry to hear you are having a difficult time. Hopefully you can continue to improve range of motion and strength. All the best. Thanks for watching, subscribing and sharing with someone if you did.
Thanks very much Doc's. Lots of very helpful info. 59 years old, lifetime of biking, running, free weights. Have pushed legs very far, only results were some muscle soreness and strong lower legs. Went trail running 8 weeks ago. Felt like superman for some reason. Ran far and long. Lots of time on my toes hopping over rocks, etc. All good until the next morning. Limping, pain, right leg. Educated myself, played it smart on my own. 8 weeks, some mild pain still. Walking much better, but still long way from normal. Hearing you say 6-12 months makes sense. This is the real thing. Makes me totally appreciate my overall fitness at my age.
Hi Michael. Sounds like you have a pretty good perspective on things. Listen to your body and keep moving! Good luck.
I’m currently recovering from Achilles Tendon rupture surgery. My tendon completely pulled off the heel bone. This has been eye opening. I was just trying to avoid stepping on my dogs paw. Thanks for the great information! Jill
Hi Jill. Sorry to hear about your operation. Dogs are awesome however they do get in the way sometimes. All the best during your recovery and glad we could provide a little info. Thanks for watching.
The doctor ain the orange caps reminds me of Adam Sandler! Thankyou for this video! I tore my Achilles 2 weeks ago now! I had a walking boot put on 4 days ago. Seeing a surgeon on Monday!
Hi bambis46. Thanks for the kind words - Adam Sandler is very funny. The walking boot will help immobilize the tendon and your surgeon can spell out the recovery path for you. Good luck on what sometimes seems like a long journey. Thanks for watching.
Well. Not sure about the weekend warrior thing. I am 43, been active my whole life, been going to the gym and working out since I was 13.... played HS and college sports, stayed active after college.... training for mud races, 5k's, half marathons...go to weight room weekly, yearly physicals for my job, healthy and fit. Tore mine in 2016. No signs or symptoms, no pain....playing basketball.
I agree weekend warriors get hurt but sometimes "life's wear and tear" can get you too even when are a physical specimen, freak of nature .
My point is, don't think it can't happen to you even when you are in great shape and not a "weekend warrior".
Good luck out there. Good video too.
Thanks Cyber Cop. We agree, it certainly can happen to anyone. Keep active for sure!
Hey Cyber Cop, how did your achilles heal? I tore mine 2/25/18 playing in a Police v. Fire bball game at 32. Pretty active especially for my career and also lift, run, and do obstacle course races. I am just over 12 weeks post-operative and mainly had issues with my ankle joint. Hope to get back on the streets by 4 months. I stopped playing bball 10 years ago because of family history of knee issues and a bad sprain of my left knee in college playing bball.
Agree 100% Cyber Cop. I am a 51 y.o. male , i have been active my entire life. I love boxing, jiu jitsu, running, yoga and do lots of things to keep me in shape. I missed work for almost 1 week now due to achilles tendonitis and it is driving me crazy. My Doctor warned me that if i do not listen to his advise i that i may need surgery and possibly be out of work for 1 year. That is when i realize that i needed to listen to my doctor and needed to make a decision.
Cyber Cop Your story is exactly why I haven’t picked up a basketball in four yrs. I can count on three hands the number of friends\ relatives I have that suffered the same fate.
Sounds like overuse caused your problems
Thanks for posting this informative video. Surgery likely... will take me away from my long hikes in the Colorado Rockies for some time. Grateful that technology exists to have this surgically repaired. Very watchable video.
Hi Alec. Thanks for watching. Surgery is a very personal choice and there are pros and cons to both. The goal of either type of treatment - operative or non operative - would be to get you back hiking in the Rockies. Good luck.
Thanks for such a reassuring video the doctor who saw me at the hospital for complete Achilles’ tendon rupture yesterday just put my leg in a cast and told me to turn up to the fracture clinic next Wednesday. No information provided on what options will be considered during that appointment. Glad I now know what to expect thanks for your time in making the video for foolish people like me. (It was football which I haven’t played for 2 years...started sprinting and snap it went)
Literally my scenario. Lying here trying to decide whether to have surgery or not.
Realise this was 2 years ago 😂 let me know how you got on!
thanks Docs, Really appreciate that video. It has come across as the most important thing is patience and managing my mid forties expectations of being a weekend warrior. Non op for me , protein diet and heaps of dull yet necessary phiso. Thanks again from the UK
Physio and realistic goals are certainly important for Achilles tendon injuries. Slow and steady usually wins the race.
Hi guys, thanks for this video. I had an accident 11 years ago and had partially cut my achilles tendon. I only went to see my orthopedic surgeon last year and considered Achilles Tendon Reconstruction. It involved grafting (they made a small incision under my knee). Now I am 7 weeks post-op undergoing physical therapy, with the help of an adult walker and an airboot. Still waiting for my wound to completely heal so they can bend my legs and progress with the therapy. I hope I can walk again normally and wear heeled shoes, like I did before the accident. My surgeon is great and supported me all the way. All the best to you guys.
Thanks Buffe Slayer. Thanks for sharing your story and for watching our channel. Good luck in your recovery.
You two doctors are great in explaining procedures along with really good sense of humor. Some of my doctors have the bedside manners of a prison guard.
Thanks so much The Bear. That's funny. We do our best to get the information out there in a useful and entertaining fashion. All the best. Thanks for watching, subscribing and sharing if you did.
Hey docs! Very interesting and informative video you guys deserve a 10! You should also post a video about bunions for the toes.
Yes Alida. In the works. Thanks for watching and subscribing
Thank you for the valuable details. I got injured two weeks ago and my doctor suggested non-op. Hope I can go back to soccer after 12 mo.
Hi T Lu. You are very welcome. Good luck to you. We are sure your doctor will discuss this but soccer is likely 9-12 months away. Don't want to re-rupture. Thanks for watching and subscribing if you did.
Came over to this one because of the weekend warrior video you just did. GREAT discussion about this injury!! Loved the information. Since this has been a few years since you did this video, has much changed for 1) the approach of surgery vs. non-surgery or 2) the advances on the things like boots used for recovery? Thanks again for this!
Hi Gregg. So we haven’t changed our practice. There are some surgeons who routinely will advocate for surgery. Yes the boots often have different wedges to adjust the amount of ankle flexion during recovery. Thanks for watching and subscribing
@@TalkingWithDocs Thanks. One other question. In professional American football, there are a lot of Achillies ruptures. Many of them return to playing before the time frames you talked about for being back to "normal". Are they getting treatments and/or therapy that the average person doesn't have access to, or is it because they are in such good shape to begin with?
@@GreggBB man thats a great question
I am having surgery on mine in 2 weeks. I have to have my heel shaved where it's shredding my tendon and damaging it. I am scared of the pain but have no choice. I had knee replacement surgery 10 months ago so I hope the foot will be easier. Thanks for the video.
We suspect it will Becky. Tkr is a brutally painful operation. Good luck with your upcoming procedure. Thanks for watching and subscribing
I broke the aquiles tendon 2 months ago, this video answer all the questions that I had at the beginning. Great doctors, that has no problem to suggest to have a second opinion, 21st century doctors. THANKS
Mine it is operative, subcutaneous
Hi zzrufus. So glad to hear that we could help as you recover from your Achilles tendon rupture. Good luck
This is really helpful. Mine ruptured a few days ago which is annoying as i had many big plans for this year. I am non-operative, have had the boot/brace on for 2 days so I have a little way to go. Hoping it allows me to go on holidays etc, within next few months without the boot.
Hi girlgayle. Thanks for watching and glad we could be of assistance. It is important to discuss timing with your surgeon but most patients with a complete tear would still be in a boot at two months. Good luck in your recovery!
@@TalkingWithDocs Thanks for your response and for giving me a reality check...Lol. I appreciate it. Keep up the good work!
This the most information I've found on Achilles Rupture I've found on UA-cam you guys are great. I'm 9 weeks non op
Thanks so much Ike. Thanks for watching and subscribing if you did
I definitely ruptured my achilles. Only found out because I did the Thompson test on myself. I went to the ER they said it was a sprain and sent me on my way. Then 2 week later i went to the doctor and saw a nurse practitioner who said it was just a strain and she put me in a 90° boot *which is super painful* and I've been in the 90° boot for 2 weeks. If I get maybe surgery and do physical therapy could I walk normal? Because I was just about to start training with a personal trainer. I'm frustrated.
Hi Macyloves. The most important thing to do is to confirm or rule out the diagnosis of an Achilles tendon tear. This should be done by a health care professional. At home if you are unable to push down hard like you are trying to depress a gas pedal, that is often a sign of a tear but you could have a partial Achilles tear or a gastrocnemius (calf muscle) tear and both of these can be painful but require different treatment. It is hard to say if you would need surgery - you first need a diagnosis. Good luck
Sue the hospital
You two are great. Thanks, non operative here and going well.
AliveAgain how did you heal is everything back to normal
Why thank you AliveAgain. Thanks for watching and subscribing if you did
Hello doctors! Love watching your channel on UA-cam. I recently ruptured my left achilles tendon playing racquetball. I decided on the "recommended" braided suture repair surgery so I can quickly get back to my "weekend warrior" activities :)
I'm still confused on how a completely ruptured tendon can heal non-operatively on its own. Pulling the two ends together and ensuring they're aligned, then suturing them makes the ONLY sense to me.
Can you explain how two ends of "a broken rubber band" align back together, touch each other, and heal together without any surgery? I just don't get it!!!
Thanks so much! Keep up the great work! (sent an email as well).
Hi Ray. Those broken ends sit inside the same tube so when you point your toes down they come together and that is when your body starts to connect them with a combination of scar and connective tissue. Then you slowly stretch it out while it is healing to elongate the tendon. Voila!
Thank you for the prompt response. I did not know they were in a “tube”, so that makes more sense.
Thank You guys, this info was very helpful
Our pleasure rizzo! Thanks for watching, subscribing and sharing with someone if you did.
I’m a 58 year old woman who is short. I was at the grocery store and couldn’t reach something on the top shelf. I just stepped on the bottom shelf reaching and when I came down I felt it pop. I knew it had to be tendons because my bone didn’t hurt. I also had a big indentation on the back of my ankle. Note to self: never step on a shelf. I chose surgery, which will happen next week.
Sorry to hear that. Good luck with surgery Sheila. Thanks for watching and subscribing if you did
Dam, wish I had you guys! Great bed side manners!!!
Thanks Alex! We do our best. Hope the video helped.
Thank you. Could I use the special boot right away without the cast? And is 30 degrees angle a save adjustment?
Thanks for the great information! I just ruptured my Achilles tendon today. Should I still go the ER or do I go directly to an orthopedist?
Hi Warrior Loft. How do you know you ruptured your Achilles? In Canada, you have to be referred to a specialist however if you can go directly there, that may be a more practical approach. Good luck and keep us posted.
Great video ! So lately I’ve been having soreness in my left Achilles while playing basketball. Any recovery tips ? Also is soreness common prior to a tear?
Thanks for making this video guys. I am ten weeks post Achilles rupture. Treated non operatively. I guess I won’t be back on the golf course anytime soon. Terrific.
Hi Eric S. We tell our patients usually around 4 months for golf. With a cart. Make sure your surgeon and physio sign off on it. Until then, work on your putting - that is where all the money is anyway! Thanks for watching.
Appreciate the knowledge (& humor!). Docs, is there a certain gap distance on a full rupture that would make you think non-op is a bad idea, such as 2. 5 cm?
Hi Joe. Thanks for the positive feedback. We try to keep it informative but light. There is not a specific distance where we would consider surgical intervention. The main reasons for us to consider surgery would be delayed presentation or re-rupture. Hope that helps. Thanks for watching.
Thanks for the video, docs! Great overview. You started to talk about instances where someone has ruptured both tendons (not at the same time, but with a couple years in between). Once both tendons have been ruptured, what is the risk of either tendon being re-rupturued following treatment and eventual return to sport? Is the fact that both tendons have ruptured in the past indictaive of higher risk factors in the individual? Or once the tendons have healed (in my case, both operativly, and both have grown back much thicker than pre-injury)? Thanks again!
Hi Matt. The risk of re-rupture does not necessarily go up if you have ruptured both tendons. The risk of re-rupture varies from study to study but generally is around 5% for surgical treatment and 7% for non surgical treatment. The tendon often heals slightly thicker than the native tendon in both scenarios. Hope that helps
Great video guys! And much appreciate you putting out this type of education. I just ruptured my Achilles tendon on Sunday, July 9th. Got the boot on yesterday, July 10th and scheduled for surgery on July 18th. After watching your video, I'm now thinking about non-operative and just being patient, rest, and physical therapy. My question is, can I start physical therapy right away? Are there some things I can do right now to start the recovery process besides just wearing the boot?? Again, thank you very much for this invaluable education.
Hi Greg. First, it is a good idea to have a discussion with your treating surgeon before changing your mind. There are pros and cons to both treatments. With respect to early physiotherapy, there is a trend toward that in the literature and likely why more and more of these types of injuries have been successfully treated without surgery. As well as the invention of the adjustable boot. Hope that helps but as for physio, discuss this with your surgeon and therapist first. Good luck
Thank you very much and will have that discussion first.
You are very welcome
Thank you, from UK. 18 weeks in. 1cm gap rupture. Non operative.
Hi James. Well you are well on the road to recovery then. Good luck going forward! And thanks for watching.
@@TalkingWithDocs Thank you! Do you know what has really moved me forward in the last couple of weeks? Icing. Unfortunately I was never guided to do this by anyone. Only a colleague said I should be icing, 10 mins every so often throughout the day. I've come on leaps and bounds in the last 2 weeks. If I'd been doing this before, I think I'd be a lot further in front.
All the best!
Just ruptured my achilles on Saturday and Im going non surgical. I should be in a boot next week. Hopefully when im in the boot i can start walking again
Hi Dbergkamp. All protocols are different but there is some evidence and a trend to early mobilization with the proper device. Good luck to you and thanks for watching and subscribing if you did. Good luck in your recovery.
What are the demographics of the patients that went non-op vs op in terms of age and tear gap size (full rupture?)
What is the prognosis for recovery from levofloxacin induced achilles rupture?
Hi Hiltz0007. So prognosis for recovery from levofloxacin induced Achilles rupture is comparable to other types of tears. There is still a chance of rerupture whether it is treated surgically or non-surgically. It is a long process but patients traditionally do quite well. Thanks for the question and for watching.
I stood up in a restaurant to pay the check and thought I had been shot. So loud and so painful. Fainted and passed out for 30 minutes. Complete left Achilles rupture. Surgery 2 days later. Fell in boot and sprained ankle of same foot at about 1 month post-op. Delayed healing and PT. Unfortunately, other foot Achilles problems slowed progress. MRI shows tendonosis and corrosion where surgery is also needed and a tendon will be taken from my toe of that foot for repair. COVID postponed my second Achilles surgery and now I’m freaking out at the thought of doing this again. I was 47. NOT a weekend warrior. More like a “sit on your asser.” 4 sport athlete back in the day and quite active until about 2 years prior to rupture when I did start to have constant pain, and called it “aging.” So, I’m a complete mystery. Maybe overuse. Maybe CIPRO although it had been many years since I had taken it. Maybe due to my premature birth at 6 months. No one knows, but this recovery is no joke and I’m not looking forward to doing it again. Thanks for all the info. I had no health issues and no sudden sports movement but somehow ended up with two bad Achilles. Lucky me.
Hi J Y. Thanks for sharing your story. Sorry to hear you are having such a difficult time. Best of luck with your recovery and your upcoming surgery. COVID has messed us all up. Take care of yourself and thanks for watching
Every few months my Achilles will hurt incredibly badly when I raise my foot up this will stop after about 10 minutes but will happen again later on in the day or in the next few days. Eventually it will stop happening and then happen again in a few months. I can’t walk when this happens. This has been happening for almost two years. It is incredibly painful what could this mean doc? I also have had the ability to “pop” my ankle for as long as I remember. Thanks!!
I have a partial tear of left achilles tendon,tendinitis and very large bone spur,what would you recommend
I'm not sure where you guys are located, but I'm in the USA and my doctor highly recommends surgery and doesn't even want to talk about non surgical treatment. I don't have insurance and the operation is going to cost me around $7,500 if we go surgical. I feel like they're only wanting the money. Should I go see another doctor? It's $250 per visit and I don't want to just keep going to doctors until one tells me what I want to hear, but I would like to atleast have the option. I'm 3 days into a ruptured Achilles tendon and it really doesn't feel bad. I had a boot on within 16 hours of it happening. What should I do?
Hi Joshua. Sorry about your Achilles. We are in Canada and many surgeons treat these non operatively. There is a small increased risk of Re-rupture for non operative vs operative. . Seeing someone else is not unreasonable. Best of luck. Thanks for watching and subscribing
Check out this article from fhe New England Journal 2022
pubmed.ncbi.nlm.nih.gov/35417636/
5 weeks ago I ruptured left Achilles tendon.. MRI results on day 4 post trauma/injury showed complete tear at myotendinous junction through the proximal critical zone, 14mm tendon gap. Initial ortho consult at that time ordered 4-6 weeks of PT and rest/rehab. Now have ortho f/u this week, minimal pain on weight bearing with a walker but tenderness with dorsiflexsion beyond neutral; 64 yom hospital pharmacist hoping to get back to work, biking and kayak, NO running/tennis, basketball, golf. Is non operative still an option, or just continued rest & PT?
Hi Gary. We typically put people in a hinged brace that controls the amount of dorsiflexion and adjust it every 2 weeks. We let you walk around 6 weeks with ankle locked at 0 dorsiflexion and full plantar flexion and then increase to 15 dorsiflexion and then 30 and then full. Physio usually starts around the 4-6 week mark for you. Thanks for watching, subscribing and sharing if you did.
Hi Docs, thx for d great video. My achilles is FULLY ruptured, what's the chance of having the tendon connect back together again? My orthopaedic surgeon said it's like very low chance and it's gonna be very long to wait for it if I choose a non operative approach.
Hi Wandy. So there is still a good chance that a completely ruptured Achilles tendon can heal non operatively. Every case is different and without examining you and reviewing your imaging it is difficult to give a specific answer, however, it is very possible. You should discuss pros and cons of surgery and non operative treatment with your surgeon. Good luck
Great video 👍 thanks Doc's
Glad you like it Brian! Thanks for watching, subscribing and sharing with someone if you did
@@TalkingWithDocs two weeks out from ruptured achilles tendon surgery. Looking forward to a strong and healthy recovery. Thanks again for the very informative video!
I twisted my ankle on a decent sized rock with those darn gladiator style sandals with the loop over the big toe and a piece of cloth across the top of the foot. The back of my foot went one way and the toe loop pulled my toe the opposite way. I had thought it was just a sprained ankle and so continued to walk on it for about 8 weeks before feeling a weird burning tearing feeling slowly develop on the back. Also in the same week I had some weird muscle spasm when I put my foot up to ice it and felt an excruciating shin splint-like pain.
By the time I got to the doctor for this about 8-9 weeks in, there was a decent sized lump on the medial side of my achilles. He took X-rays and put me in a cam walker, 6 months later the bump is still there. If I walk on it too much it swells and feels like its tearing in the back.....I am at a loss of what to do and am so tired of not being able to walk on this. Does anyone have any insight? What you said about the boot positions and starting off with the toes pointing makes sense but was not what I was told to do, it was just the cam walker. Is it still possible to do the invasive side? I think there is a partial tear or something....but I just don't know what to do, this isn't something I can just push my way through the pain and deal with. I have not gotten the MRI yet, but am feeling desperate about getting this fixed. How can you tell a tear versus tendonitis? Its pretty stiff in the mornings too. I apologize for the novel, btw.
Hi gladiator Anna Salerno. It is always difficult to give specific answers without actually seeing your foot and ankle to examine and reviewing any imaging. Xrays will be normal unless you fractured something. Usually the next steps in investigating an Achilles tendon issue would be an ultrasound and then an MRI. Tendonitis usually is associated with pain and swelling. If there is a complete tear, it would be difficult if not impossible for you to press your foot down or go up on tippy toes. That is the main job of the Achilles - to connect you foot/ankle to your lower leg through the calf muscles. The lump is not uncommon with an Achilles tear - partial or complete - and often will not go away. This could be your body's attempt to heal it. It is likely best for you to be assessed by a physician and have some further imaging. Hope that helps. Good luck
Thank you! My gladiator days are over, apparently, I just hope I can go on 5 mile walks again someday, at least. For now, the tendon aches if I do too much walking or too many stairs. I will definitely be pursuing further imaging to see what is going on. Thank you for the clarification, on things like the bump not going away being normal. It is almost as if there is a weird vein over the back of the bump, it's so strange the way the bump is angled too. I had wondered if it was maybe a different tendon that was partially ruptured underneath. Anyway, hopefully the imaging will give me answers and I can get this healed. I appreciate your response and the video was informative, as well!
Thanks Docs! Just wanted to say hello!
Stay safe Darlene!
@@TalkingWithDocs thank you! Just wanted you to know things are getting closer toward surgery. My dental visit has started the ball rolling, I got a good dentist this time, the saga continues. Stay well.
The prognoses are outdated. With physical therapy starting at 4w (before the boot comes off), re-rupture risk is equal between surgical and nonsurgical treatment. Also for some injuries such as a complete tear, operative is the only feasible option and it skews the results.
We would respectfully disagree. We treat complete tears in adjustable MC walkers every week. And can’t remember the last rerupture. Both treatments have low rerupture. Surgery just has all the risk of surgery.
I’ve ask this question on multiple channels but no good answers yet. Why aren’t long lasting absorbable sutures used for this repair? I understand the tendon needs support at first but eventually the tendon heals and supports itself. So those permanent sutures are just there for no reason.
Hi Damien. So that is a good question. The main issue is that the tendon and scar tissue that fills in the tear is not normal tissue and does not have the same strength. The thought is that this provides long lasting support for the tendon to reduce the risk of rerupture. Hope that helps. Thanks for watching, subscribing and sharing with someone if you did
Thank you for your work. I play soccer weekly. I feel the same pain in the back of my ankle almost every time after playing. Then I struggle to even walk properly for a couple days.
Where do you feel the pain with an Achilles injury? As I say I feel pain the back of my ankle, more specifically the heel bone.
Many thanks for your channel and your answer in advance.
Hi MrMessyb. You are welcome. So if you have Achilles tendonitis you would feel the pain usually above the bone along the tendon and if you had a tear often 2-3 inches above the insertion at the bone (which happens to be called the calcaneus). Hope that helps.
Talking With Docs thank you for your speedy response. I hope you get the recognition for your quality and attentive work!
I am experiencing a sharp pain specifically in the “subcutaneous calcaneal bursa” area. It hurts especially if I press on this area whilst the area is relaxed. And it is worst when walking or after sports like soccer.
Hi MrMessyb. Sounds like you have an insertional tendonitis. Typically this is treated with physio and anti-inflammatories either by mouth and/or topically. Good luck
Talking With Docs thank you for your response. Keep up the good work. Thanks again. All the best
Do you have a video on calcific non insertional achilles tendon?
Unfortunately no. But We can add it to the list Sharon. Thanks for watching and subscribing
I wish I saw this video as soon as I had my rupture.
I had no idea there was a problem until after a full month, I could still not push off my injured side.
Finally saw a doctor then Orthopaedic surgeon doctor and had surgery 5 weeks post Injury.
Had three weeks in a cast non-load at home. Switch to angled Air Boot 4 weeks post op. Just returned from a pre-booked 10 day family holiday in Spain with crutches and a Knee Mobile ( which I highly recommend) which helped a lot.
Seeing my Orthopedic surgeon next week for evaluation. Hoping to start therapy and DRIVE again soon.
Still a little tender.
Very concerned about a Re rupture as It was 5 weeks after my injury before my surgery. I had no idea I had hurt myself so badly.
Please wish me luck.
Hi Mark. Glad you enjoyed the video. Sounds like you actually did try to "walk it off". Happy to hear that you are through surgery and well on your way to recovery. Lots of physio ahead but you have the right approach. Risk of rerupture is always a concern for both operative and non operative patients however the risk is still low. Work on getting strong and mobile and don't return to sports too soon. Good luck.
Great job guys! I am a 71 y/o retired anesthesiologist who took up pickleball in order to give my cycling induced piriformis syndrome a rest. Out of the frying pan, into the fire. Two week anniversary of the rupture today. My Ortho foot specialist was recommending surgery mainly because I didn't have any health risks for surgery. I will see him again tomorrow, but I will probably go the conservative therapy route. My biggest problem is sleeping with the boot on. Is there a boot that makes this easier? I have an Aircast ($60). Is the Vacoped ($300) any better?
Hi Cleveland. Thanks for the kind words. So the main difference between the aircast and other fancier and more expensive boots is the ability to allow some range of motion. We often use a boot that we will fix at 30 plantar flexion at 3 weeks and then adjust to 15 fixed plantar flexion and then at 6 or 7 weeks adjust to 0. We fix the dorsiflexion but allow active plantar flexion in the boot. We feel this is better as it will allow some range of motion and engage the calf muscles while walking. Good idea to have this discussion with your treating surgeon. Good luck and keep us posted. Thanks for watching.
Hi !!Watch you two all the time, Love you both.... Now I need answers and I come to you.. I am in my 2 weeks of Achilles Conservative repair. I didn't know I had the rupture until a week in. Thought I bruised a heel.. But I am wondering is there any therapy I should be doing, I was just told come back in 4 weeks .. Each week start adding my 25% weight, 50%, 75%, then 100%..seems like I should be doing more??? What do you think? JJ
Hi Jan. Sorry to hear this. Usually no physio for first 6-8 weeks then slowly stretch and strengthen. Best of luck. Thanks for watching and subscribing
Great video, thanks for sharing!
I am an active 22 year old and I ruptured my Achilles tendon playing ultimate frisbee. I had surgery about 7 weeks ago and am in a full weight bearing walking boot.
When should I start physical therapy? I am also concerned that my tendon will never be what it used to be, will it ever be 100% again? What can I do to maximize strength/ mobility in the long run?
Hi Austin. Thanks for the positive feedback. Usually physio will start somewhere around the 6-8 week range with limits placed on dorsiflexion (the amount that your toe goes up). This definitely needs to be discussed with our surgeon and your therapist. Your tendon will often get close to 100%. The only thing you can do to help that is work hard with physio on both range of motion and strength - and be patient. Good luck.
Hey guys- thanks for the great resource. My question concerns the viability of non operative treatment with a severe rupture. Is there a limit to non operative treatment in that regard? How common is a full rupture? My physician seemed to discount (immediately) any course but surgical. I'm sure his reasons are valid- I'm just curious.Thanks so much.
Hi Duane. Complete ruptures are common. There is good success with non operative treatment. Similarly there is good success with surgical treatment as well. There is a slightly higher chance of a rerupture with non operative treatment (some say 5% VS 7%). The main benefit of non operative treatment is that you still heal but avoid the risks of an operation. Newer protocols of early mobilization and better appliances have helped non operative treatment improve greatly over the last 20 years. Hope that helps.
Hi guys, just wondering when would a patient be ready to return to golf and skiing? My rupture actually occurred from a pickup game of basketball which I'll never do again but I'm keen to get back to golf and skiing and I was wondering if those sports use the achilles tendon much? Also which country are you guys from? I'm glad to hear that most of your patients went down the non-surgical route as I am currently doing.
How did it go
Usually 6 months SJ. Carefully. Thanks for watching and subscribing if you did
Hi Doctors. Great video I'm really impressed how many information you could transfer in this short video. I'm raptured my achilles tendon playing futsal one week ago, surgery occurred next day. I had also two cuts in my heel bone from both sides where some wires have been put into the center of tendon. Do you know this method of repairation? I'm one week post operation and it's still hurts a lot cannot sleep due to this. I see that my leg is swollen. I'm taking injections in belly every night to avoid blood clots. Is that normal that is painful for 7 days after surgery?
Hi Tomasz. Thanks for the questions. There are many types of repairs for Achilles tendon ruptures. Pain at 7 days is not uncommon. You want to ensure that the pain is not increasing and if so you should likely follow up with your surgeon. Good luck!
Talking With Docs. Thanks for reply. Do you know if it's worth to take some supplements for joints/tendons? To complement recovery process??
Hi Tomasz. There is little evidence for most supplements. Stick with a healthy balanced diet and you usually can't go wrong.
Talking With Docs Hi. Yesterday I had follow up visit with my surgeon 2 weeks past operation. They removed stitches and said that wound is ok and I can wash it two days later. They put my foot to the orthopedic boot Walker with 3 of 5 wedges. They tried with only 2 but my ankle was totally blocked. I have to remove one by one wedge each week on Fridays. In the morning when I was sleeping I woke up with huge pain below my heel. It was like burning with tingle feeling. Is it because a foot has new position (angle) or it can hurt due to boot itself.
Do you think that this pain will pass away soon? I was reading that this can be due to damaged nerves that are rebuilding. Can it be true?Happy Easter
I had an accident in the toilet and had a cut on my leg which included slightly my achilles tendon, i had a surgery, when should i start walking? I am in bed with a cast for ten days now... With a pillow under my leg.
Find this very useful guys.Thank you.
When you mention re-rupturing Ac. tendon,,do you mean with non surg. method is bigger % or re rupturing tendon while healing ,or when is totally healed??
Hi Armin. So typically non surgical treatment has a slightly higher re-rupture rate however both are quite low. Complete healing is variable but typically 1 year. Hope that helps.
It helps.Have all info that I needed.Guys,thanks a lot.Salute from Bosnia
Hey Docs, over the last few years I’ve been having pain on and off at my heel that comes on suddenly and goes away after a few weeks, I finally convinced the VA to give me an MRI. Imaging reveals a small tear, scar tissue and a tiny bone fragment in the tendon. Advised by OS I would use a heel lift, orthotics and PT to help me stretch my Achilles’ tendon and calf. If that doesn’t help, then surgery this fall. What do you think of this plan? Will PT be worth the time?
Hi Howard. Without examining you and your imaging sounds very reasonable. Physio is for sure worthwhile. Best of luck! Thanks for watching and subscribing
Hello, gentlemen! It may sound like a stupid question, one I forgot to ask the surgeon. I had a pars surgery on my Achilles and I am wondering if u could tell me what happens to the strings or whatever they are called that were used to bring the two ends of my ruptured Achilles together? I mean, are they going to absorb themselves through time or am I going to have them inside my leg forever. I am speaking about those inside, not the ones used to seal the wound.
Hi ladyyyygaga. So good question. It really depends what they used. Some surgeons choose to use non absorbable suture that will be there forevever where others choose a very slow absorbing stitch that can take more than 2 years to absorb. Either way your body will form a scar tissue type layer around it. Best of luck during your recovery. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs thank you so much for the answer. God bless u!
Nice Video Doc,
I ruptured my achilles last Dec 8, and was placed on cast since then. My question is, the gap on the torned tendon as noted on the MRI is around 4cm.. can Non-Surgical path able to fix and connect it? Thanks in advance.
Hi PorkAdobo PH. So the short answer is yes that gap can be filled because the torn tendon remains within a sheath or sleeve so by holding your foot down and slowing bringing it up your body repairs the tear. This is not with totally normal fibers but fibers that can be strong and allow you to return to the vast majority of your pre-injury activities. Hope that answers your question. And thanks for watching.
@porkadoboph naoperahan ka ba? I just tore mine tonight it hurts i cant walk but i dont want surgery. But I'm afraid I wont be able to play 100% anymore
My tendon snapped in half i havent had any treatment or anything its been almost 2 years now .my calf got really small will it stay like that forever? Is there anything i can do to get my calf looking normal again ?
Hi Ananymous. Physio may help but it may not be connected to the distal tendon which is critical. Maybe see a surgeon. Thanks for watching and subscribing
Week 13 for me. Out the boot and walking with a limp. 🤨
Hi earl. Well ... you are most of the way there. It does take a long time to do a single foot toe raise which is part of the return to sport measure. Best of luck in the rest of your recovery. Thanks for watching.
Hi Docs,
I'm scheduled to have surgery on my achilles next Thursday. I'm supposed to be flying from NY to Michigan on Monday. Should i reconsider traveling? Are blood cloths a serious concern even if I'm on a blood thinner ?
Hi Theron. Good luck with your surgery. Travelling may be a bit tricky but if on a blood thinner blood clots are much less of an issue. Confirm with your surgeon though. Thanks for watching and subscribing
I just ruptured my LT achilles hurts like heck. So I'm in a Aircast takes some getting used to but can you take it off while sleeping? Got a bit of swelling around the ankles 3wk followup with my Ortho ** Non surgical route. Thanks for informative video.
Hi Keri. Our approach is only to take it off for short periods when cleaning. Otherwise keep it on including sleeping for the first 6-8 weeks anyway to avoid the risk of dorsiflexing your ankle and disrupting the healing. Thanks for watching and subscribing
Hey, ruptured my right achilles two weeks ago. The boot was causing a lot of swelling, pain and discomfort from the heat. Found that removing the boot and resting the foot angled down and sideways on a pillow when working during the day eliminated all these issues. However, slightly unsure if this is okej or if it may affect the healing process, could not find anything on it online. So, my question is, is this a sensible thing to do. I'm still using the boot when sleeping and when moving around. Thanks
Hi Shad. Just need to make certain that the toes are always pointing down. Be careful. Thanks for watching and subscribing
@@TalkingWithDocs Thanks 4 your input and your videos.
I didn't even know there was a non operative option. It just doesn't seem possible if there is a full rupture. I assume something needs to hold the tendon together while it heals.
It's basically like popping a rubber band
Hi Clarence. The torn tendon remains with a sheath (a tube) and the ends are able to reconnect that way without surgical intervention. Hope that helps. Thanks for watching.
Please tell this layman how that huge tendon reconnects without surgery. I get the cast pointed down for a while helps, making the gap shorter but aren’t the calf muscles pulling the other end away from the lower end of the tendon bundle? And since there are so many small tendons, do they naturally re connect to their original tendon place? How many calf muscles winnow down the the Achilles’ tendon?
Hi Mark. Great question. The tendon is within a sheath and because you are not walking the calf muscles are not contracting and the tendon ends are brought together by pointing the toes down. Then slowly stretching them out allows them to heal further. The insertion of the muscle to the tendon is a broad and long one rather than an abrupt transition which makes healing possible but also makes this area vulnerable. Hope that helps. Thanks for watching.
Thanks this is really helpful I think repured my Achilles and I want to get back to playing basketball again and going to the gym
I have a plantar fasciitis tear and tendinitis/tendenosis along with tear . I am interested in platelets treatment option? Whst is outcome on this treatment?
Hi Fallon. There is some scientific evidence for using PRP for soft tissue conditions like Achilles Tendonitis. Best to discuss with your surgeon because the severity of your condition will impact the outcome. Good luck. Thanks for watching and subscribing if you did.
Hi doctors. Is it normal that after 11 weeks post surgery my ankle is still swollen? In fact I have swelling all the time. In the morning little bit less but during the day it's getting more and more. Regarding doing calf raises I cannot do this without pain in affected foot. I'm doing bicycling and leg presses on machine there I don't have pain. What would you advise?
If you suffered an achilles tendon rupture, what can you say about the risk of the other side rupturing as well?
It depends on which study you ready but likely in the vicinity of 5-10%. If you already have symptoms of Achilles tendonitis on that side it may be higher. Hope that helps.
your video is great .i ruptured both my tendons had operation on bothnlegs .one has healed and one is causing me pain on walking why is this and how do i correct it please .this is after 6 years .thank you
Hi Christine. So after 6 years it may be related to tendinitis. If you have an intact tendon and good power that is the most likely reason. An ultrasound or MRI would help. Often topical anti inflammatory and Physio can help. Some people use an orthotic. Best of luck. Thanks for watching and subscribing if you did
Hi docs how are you...
I've got injured and injured playing soccer and I have question... To be considered a full thickness tear of the Achilles tendon the gap how separate it's has to be?
My ultrasound shows that gap in my tendon is 1.1cm and 7.7cm to the insertion.
Thanks and nice job on you tube.
Hi What's Up Australia BR. Thanks for the compliment. If there is a gap on ultrasound then it would be considered a full thickness tear. Sometimes the ultrasound will comment on intact fibers and that would mean that it was a partial tear however if there is a 1.1 cm gap then it is probably complete and the location is very typical. Hope that helps.
Talking With Docs
Thanks doc appreciate your attention.
I'm in a non operative treatment I hope soon I'll able to practice sport again.
Thanks a lot.
I'm pretty sure have a partial tear, weird trampoline accident. I can't fully dorsiflex and I can't do a single leg calf raise. I started rehabbing for two weeks, the first week I just iced,elevated and slept. Week 1. Rehab couldn't walk on my toes. Week 2. I can walk on my toes again, still no power in my Achilles and I lost a inch of calf muscle. Before the accident I was jumping 39-41 inches and my top speed was 25mph. I'm just scared I got some of this information to slow and might've lengthen my Achilles. How would I know if this is the case?
My left ankle is back to being healed, but my right ankle(Achilles injury foot) seems to be extremely stuff along with the ability not to do a single leg calf raise and I have my balance back on single leg 100% left leg and maybe 80% or so on my right leg from having 0% stability.
Hi David. If you think you have a torn Achilles you should see a doctor ASAP. if you have good power in plantar flexion you likely do not have a tear. Get checked out. Thanks for watching and subscribing if you did
@@TalkingWithDocs thanks and I can only walk on my toes, but has to be assisted. I can't do a deficit single calf raise properly or do a regular single calf raise on my (suspected torn calf it has zero power) before the injury I could do 445 or so for calf raises sets and now on a seated calf I can barely do no weight for 8 on the bad leg. Also no insurance atm.
Hello, docs. I did first conservative mode which is supposed to be for senior people or not very active and close to the end of the third month it broke again even though I did all therapy correctly. Now with this second shot, I had my surgery and need to start from scratch again. So sad I didn't lose just summer but also I will lose fall. Any additional suggestions for a reoccurring case? Thanks
Hi Gabriel. It sounds like you are doing all of the correct things. Just progress slowly and do what your surgeon and physiotherapist recommend. Avoid extremes of dorsiflexion. No high impact activity for 6-12 months. Good luck.
Hi, I'm 42 not a runner any more but I am very active. My job requires allot of walking. So when my rupture happened which was a week ago, I just kept on going to work. Did some digging and found you two. I don't have insurance at the moment, but I know I need to let my Achilles heal. I have be limping, some days are better than others. Any advice will be appreciated. I saw a boot online for $100. I'm just saying, if a boot is all I need for the Next few weeks then, why not cut out the middle man. I can't afford to take off from work. I'm moving in 3 weeks. Ugh???????Oh yeah never had any kind of injury like this in my whole 42 yrs of living.
Hi Sweetascandy42. First of all, it is critical to determine whether or not you have a complete or partial tear of your Achilles tendon as the treatments are very different. At a minimum you should be assessed by a health care professional and then they can fit you with the correct boot. Typically we would start in plantar flexion (foot down) and gradually move you up. Hope that helps. Good luck and get some help.
Im about a week in since I got. If I did have a ruptured would I be able to point my toes or flex it back? I feel a lot of pain in my Achilles area but still have motion with flexing and stretching. Thanks for your help!
Hi Arturo. The limitation will be pointing your ankle down. Good luck. Thanks for watching and subscribing
Tore my achilles a month before diagnosed with cancer two years ago and was told to not worry about until after my surgeries and C treatments. I heard it pop at work and couldnt walk very well for a few weeks but to this day i still cant push off. Is it too late to have surgery to fix it? I was cleared of c yesterday.
Hi Sparta Spartan. Sorry to hear about your cancer however glad to hear you are clear! So no, it is not too late to have it fixed however it can be somewhat more challenging with delayed treatment. It would be best to see someone with a specific interest in foot and ankle surgery. Good luck and keep us posted. Thanks for watching.
Does age play a role in how fast you recover? I’m on the younger side, I ruptured mine and had surgery back in May playing basketball. Is it rare that someone my age (16) could come back in that 6 or 7 months period? Because I play basketball year round! And wanna try to play the beginning of my season this November or December, but my surgery says January which is 8 months:(
Hi Ja'Kea. Yes younger patients probably heal faster however it still does take 6-12 months to get back to game strength and speed. Wishing you the best of luck during your recovery. Thanks for watching, subscribing and sharing with someone if you did.
Hello Docs!
I sliced the back of my foot yesterday at work . I have at least a partial cut of my Achilles according to urgent care physician. I got stitched up and he gave me a boot but it’s 90 degree. I took it off and just point my toes down because it doesn’t hurt as bad. I can’t stand on my toes. I’m supposed to go to orthopedist sometime next week. If the orthopedist suggests surgery, can I request to not have a surgery?
Hi Evan. Sorry to hear about your injury. Traumatic lacerations are a little different and more frequently require surgery because the tendon sheath has been violated. Best to follow your surgeon's advice. Good luck to you. Thanks for watching and subscribing if you did.
Thank you for your response. Quite frankly I’m terrified of having surgery.
One day after the rupture, I had the surgery. It's been 3 days now. First surgery ever. It feels weird. When do you think I'm suppose to not feel slight pain anymore ? Sometimes my toes tingles and I feel swollen (sometimes). Thanks
Hi JuleZ. So it will feel swollen for weeks for sure. As long as the pain is not getting worse you are probably on the right path. It will feel odd when you stand up - like blood is rushing to your toes and this is normal and gets better with time. Best of luck to you! Thanks for watching, subscribing and sharing it if you did.
hey guys thank you for this very informative vid. So unfortunately 3 weeks ago i was an achilles tendon rupture victim while playing soccer. i'm 27 and i have decided not to have surgery, i was put on a splint asap and then the ortho put me in a plaster cast. I'm concerned that being in the cast for 6 weeks will inhibit my progress because i have read a lot about early functional rehab reducing the chance of re-rupture and increased strength of my tendon. What should i do?...also, is being pain free and having good strength of my toes a positive sign? Thank you.
Hi Braiam. Often we will keep patients in a cast for 2-3 weeks. The exact protocol for non operative treatment varies between surgeons. Early movement has recently been shown to be beneficial. Ultimately this is a discussion to have with your surgeon. Pain is often less of an issue as time progresses and movement in the toes is a good sign. Hope that helps. Good luck.
@@TalkingWithDocs Thank you! after 3 weeks of being in a cast i asked the doc to put me in a orthoses walking boot with wedges. He agreed and told me that the gap from the rupture is no longer there! i am currently on a 3cm wedge. Another question i have for you is, how long until i pass the Thompsons test?
@@B_ElitePerformance Hi Braiam Duran, Do you by any chance know how far the gap was between the broken ends of your tendons? Mine are 3.5 cm apart and my Dr. wants to pull them together.
Silencer1914 hi according to my doctor I had about a 3cm gap. It’s been 5 months and a half and I feel great. To see some of my progress you can follow my channel under my name, and you can also follow my IG page futbol_sst. If u have more questions feel free to ask! =)
What is the gap become more width than since the first time injury? And when the gap filled?
Hi Dhika. If it is a closed injury, sometimes the gap can increase at first. Usually the gap is filled by 3-4 months. Good luck in your recovery.
@@TalkingWithDocs thank docs.. I have partial injury 7 week ago, what is the gap/curve will filled by new tendon muscle or by scar tissue?
I was playing 🏀 ball and a guy accidentally kick or came down on my Achilles, I felt a pop, but I was not sure if it was my Tendon or the guy stomping down on my Achilles. When I point my toes as you guys stated I do feel my gastrocnemius flex but it’s very sore and a lil inflammation going on around my ankle.
Hi Mikey Mike. The only way to know for sure what is going on is to get properly assessed but if you can actively point your toes down a complete tear of your Achilles is unlikely. It can be painful in that area as a result of direct trauma however. Good luck.
thanks 👍
You are very welcome Rancho!
Is this Durant Durant
Hi Jose. Yes this is the injury that Kevin Durant has. Thanks for watching.
Where do you get your scrub caps from docs?
Hi Yelizaveta. There are different companies that sell them and some of our nurses actually make them.
Hi i had a surgery in my akilles tendon in march 2016 and 3 months ago i found a lump in my scar so i went to my dr and he did an MRI and it was a tear in the same tendon that i had a surgery so dr.put me back in the bootcam for 6 weeksis anything that i can do to prevent it again
Hi Rosy. It sounds like you are doing the right thing. Allow the tendon to heal in the boot and then return to physiotherapy to stretch and strengthen the tendon. Good luck.
Hi
Do you know how to fight with adhesions after surgery?Is there some way to eliminating its side effects as soon as possible?I'm 23 days post surgery of fully ART and when I try to just put my foot in neutral position is totally blocked and I'm bit worried if that can be due to already created adhesions inside?
Hi Tomasz W. Scar tissues, or adhesions, are often a part of the healing process in both surgical and non surgical cases. In the setting of an Achilles tendon tear, that scar tissue can be part of what is holding the tendon together. Typically the ankle is mobilized slowly to gradually stretch the healing tissue but allowing it to remain intact. Best way to deal with this situation is be under the guidance of a good physiotherapist and do what you are told. Good luck.
Talking With Docs thank you for help. By the way I started FWB with orthopedic boot after 4 weeks. Do you know when I could sleep without this boot?
Hi Talking With Docs. Thank you for response - it is always professional and completed. I would like to ask you about one thing. I started physio last week - 2 sessions so far. Massage , electro stimulation of scar tissue and ankle moblization. Since yesterday I have a big pain in my calf muscles when I want to stand up. Is that normal or I should check with physio or doctor? I started Physio when I was 4 weeks post open method surgery
Hi Docs. Many thanks for answer. I'm 6th week after surgery, walking in normal shoes but still limping. On physio session therapist is using shockwave therapy around my scar tissue and also on calf muscles ( but I have never heard about this that is used after surgery) He also suggested to doing calf raises with both feet and doing ankle stretching. Is this not so fast? However I don't have any pain when doing these excercises. Can you advice?is not too aggressive approach???I have never seen in internet that someone is doing that so fast..and this shockwave therapy....worried if it's good..
Hi Docs, I ruptured my achilles tendon last week I am scheduled for surgery in a couple of days, im wondering if I made the right decision as to operative vs. non operative. I am 36 years old and I am wanting to get back to work as soon as possible. Felling Frustrated.
Hi Adrienna. This can be a difficult decision and most appropriately discussed with your treating surgeon. Surgery and non operative treatment are both successful options both with their specific risks and benefits. You just have to decide which is right for you. Hopefully that helps with our decision making and good luck with healing.
Talking With Docs Thanks so much!
You are welcome. What did you decide?
Talking With Docs non surgical... it’s been a little over a month I have moment with my toes now can point them down a tad feel my gastrocnemius firing a little. Able to put some weight on it no pain. Have any suggestions for me?
I have a full ruptured Achilles’ tendon, should I be concerned that it doesn’t hurt at all?
Hi Ewan. It is not uncommon for Achilles tears to not hurt. Often patients will complain of pain at the time of the injury but after that the main issue is weakness in plantar flexion. No specific need to be concerned about a lack of pain. Good luck during recovery.
I ruptured mine while walking to the beach, the initial snap an pain brought me to my knees. After that it didn’t hurt anymore. Just knew something wasn’t right saw a Orthopedic Dr. the next day, was put in the boot for a week,then surgery.
so sad to find out I'm a 'weekend warrior'feel so stupid now lol
Hi k5669. Don't feel stupid. Weekend warrior is not meant to be a negative term. It is used to described middle aged people who love to still compete at sports. It's a good thing!
Talking With Docs omg thanks for reply, recovering 2nd week from ruptured achillies, they took xray and did the squeeze calf test and said it was mild rupture, but from all the reading ive done i dont knw if there such thing as mild rupture or what is even the difference or for example a moderate/servre rupture is. could you guys help explain? ps watched this vid night i ruptured achillies and it gave me amazing info, comfort and solace. thanks
Hi k5669. So the difference between a partial versus a complete tear is the severity of the rupture - or if there are any fibers that remain intact. The treatment typically remains the same.
I was placed in a boot with I think 5 pads..
Yes that can work. Thanks for watching and subscribing
When you talk non operative... What is the percentage of an Achilles tear do you decide That having an operation is the best method
There are many factors that are taken into account when discussing operative versus non operative treatment of Achilles tendon injuries - the size of the tear being one of them. There is not a specific number that makes surgery the best option. This is something that should be discussed with a health care provider along with the other risks and benefits of both surgical and non surgical treatment
Thank you docters, i have injury Achilles tendon nd 6weeks ago serjery is completed,pls any suggestions of these,i want to do walk,running,when i do that pls suggest me.
Hi Nagani. Glad you enjoyed the videos. The first priority for Achilles tendon injuries is to allow the tendon to heal and then to gradually restore strength and range of motion. This should be done under the supervision of a physician after confirming the diagnosis. You should see a surgeon locally and then get referred to a qualified physiotherapist. Hope that helps.
Talking With Docs thank you
Woah you have 911 subscribers right now. That's like such a quinkydink
927 now!
Ruptured both left in my 30’s my right at 50 that one got infected and they went back in smh
Hi ty. That's tough having both rupture. Hopefully the infection cleared and you went on to heal. Thanks for watching.
Hey guys.New update.I took cast off yesterday,foot is so so badly swollen,and can barely move my fingers.Any try of pushing anything down wity my toes does not give result.My Doc is like"I THINK parts came together and thats it,no UV no MRI no anything,but hes Doc,not me.Everything is just fresh so...maybe my worries are worthless
Just would like to hear your opinion on this. for how long period is my foot supposed to look like this,,so I know if thing is ok ,or it is not??
Hi Armin. Without knowing the full story and performing a physical examination it is difficult to answer your question. However, the toes and midfoot will often be quite swollen for awhile. The movement should gradually come back. With respect to the question about ultrasound or MRI, you can confirm that the Achilles tendon has healed with a physical examination. If you are able to plantarflex your foot and ankle (pushing down like on a gas pedal), that would confirm the fibers have united. Then the task of gradually stretching and strengthening them begins with physiotherapy. You should typically discuss this with your surgeon. Hope that helps.
Yes,fibers have united,but I got blood clot,thats main reason for being so swolled.Dr did analysis.
need to solve that and start with physio.Anyways,thank you guys
Hi Docs,i re-ruptured my tendon 2 months ago,and had surgery.Everything went well I would said.I am 9 week post op,and can walk with just little limp,or no limp but quite slowly.The thing is..my leg becomes really swollen if I do 7-8 km walk,or work all day.It is swallen in area 20 centimeters bellow knee,to ankle.Foot is not swallen almost at all.
Is it normal?How long is gonna take for this condition to end ?
Achilles tendon rupture 2020 I rupture my Achilles tendon can it be repaired
It can be Arthur. Both operative and non operative treatment are successful
Do potential of blood clots apply to both options?
Hi 404chillwill. Yes blood clots can happen with any lower extremity injury regardless of operative or non operative treatment. Thanks for watching and good luck.
@@TalkingWithDocs thank you and great video.