Achilles tendon injuries - anyone had one? (MRI, high pain, ankle)
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Well, I've been diagnosed with a torn, degenerative Achilles tendon. I am a very active 52 year old woman who loves to power walk. Been walking (wearing very good shoes!) for most of my adult life. I stepped backwards off a ladder about four years ago and over a period of a few weeks after that, my left Achilles tendon swelled and began causing me trouble and eventually I had an MRI that showed a 2" lateral tear and some degeneration. My doctor did surgery, rebuilt the tendon and though it was a very long recovery time (due to the long round of physical therapy) the left leg was good to go within about 6 months, though I've never recovered full strength in that calf muscle.
When the right Achilles tendon swelled up a few months ago, I really couldn't believe it. I tried a brace, rest, ice, compression, elevation, you name it, to no avail. Finally went back in and my doctor told me after the MRI that I was the first patient he's ever had to have nearly identical Achilles tendon tears. He told me that my Achilles tendons have been doomed since I was knit together (apparently improperly!) in my mother's womb!
Anyway, surgery is scheduled for early February (due to conflicting schedules) and I'm in the big Robocop boot till then. ARGH!!!!!! SO FRUSTRATING!!!!!!
If you are asking if anyone has had the same type of tears in both, then I shouldn't be responding.
However, I did just got out of the 'boot' after trying desperately to avoid surgery for a many-months neglected 50% tear.
The last exam (ultrasound) showed it 95% healed and although both he and PT 'released' me, you better know I am going to keep on babying for awhile it rather than taking any chance on a re-tear.
If you are asking if anyone has had the same type of tears in both, then I shouldn't be responding.
However, I did just got out of the 'boot' after trying desperately to avoid surgery for a many-months neglected 50% tear.
The last exam (ultrasound) showed it 95% healed and although both he and PT 'released' me, you better know I am going to keep on babying for awhile it rather than taking any chance on a re-tear.
No, I'm just asking about tears in general - thanks for responding!
On my first tear, they tried the boot for about four months total - it didn't work. At the end of the four months, I still had a two inch tear. This time my doctor said we weren't even going down that path, because of the muscle loss associated with wearing the boot.
If you have more trouble with yours, ask your doctor about the surgery. What my doctor did was go in, scrape out all the "frayed" fibers, then make lots of fresh, tiny cuts in the tendon and he stitches those up with some sort of stuff. This reinforces the tendon and makes it stronger, between the stitching and the new scar tissue that's "controlled." My tendon is a little thicker than normal but it's straight and the scar is not bad, and the most important thing is - IT'S STRONG! I haven't had any trouble out of it since, though I will admit that the rehab is long and painful (about four months of PT at least twice a week - and the new technique to keep the scar healing very smoothly is called debriding or something like that and it's very painful but it works).
I am actually looking forward to the surgery because it works and I'm ready to get over this!!! I hate wearing DAS BOOT worse than anything else. GRRRRR!!! I am in the big Robocop boot for three more weeks, then the surgery, then a cast for two or three weeks, then the boot for about a month, then the physical therapy for about two or three more months, if it all goes well. WHAT AN ORDEAL.
Are you doing any physical therapy? What's their plan for you to regain the strength in your leg?
I don't have time to read your whole blog but read enough to know that what I went ...and am going ...through is in no way as severe with what you did.
But you asked so.....
I did not have surgery, which , with all the other insults of surgery, make it much different.
The first doctor(NY) I went to fitted me with a shorter boot than most use.
Because I'm not too bright I wouldn't wear it and ended up having to start all over agin when I got to Florida.
That doctor didn't think the shorter cast is restrictive enough to inhibit movement and gave me the knee high one.
For reasons not important to this discussion, I continued with the shorter boot and believe it made a huge difference in how much atrophy there was of the calf muscle.
The original prognosis was that I would probably end up having surgery if the tendon wouldn't knit itself back together....which wasn't too likely since I had gone months without treatment other than wrapping,babying it, walking stiff legged and allowing what were probably smaller tears become a 50% tear.
One proposal was a Platelet rich plasma injection ( PRP)...something that's not covered by insurance since it hasn't been proven yet to be effective enough to do so.
My doc says he's had pretty good success ( about 70%) but if it didn't work after about 6 weeks it would still be on to surgery.
Why yours refused to mend and mine did may have something to do with the theory behind this injection but
$1000 was more than I wanted to spend for a theoretical 'maybe'.
So I insisted on first going with a conservative approach... 6 weeks in the 'boot' being absolutely 110% compliant (unusual for me)
At 4 weeks my diligence was rewarded and he said it was apparently healing and it was time to start limited PT to avoid further atrophy of the calf.
For some reason I didn't lose a lot of strength or range of motion ( maybe the shorter boot??) and after only 5 PT visits was declared good enough to only schedule 2 more to assess endurance and walking normally.
I am told the 'bump' will probably never go away where the tendon has thickened but it doen't cause any problems.
The 6 week picture of the tendon showed a 95% healing which he said was good enough to get rid of the boot completely.
I am told the 'bump' will probably never go away where the tendon has thickened but it doesn't cause any problems.
One day of happily looking at two feet clad in sandals and I slid sideways off a low curb, wrenching the foot into a very painful mid-foot sprain.
So I don't have an end to the saga yet but reading your blog certainly makes me more than happy that I didn't opt for the surgical approach regardless of how it was promoted as a better way to insure a stronger end result.
I don't have time to read your whole blog but read enough to know that what I went ...and am going ...through is in no way as severe with what you did.
But you asked so.....
I did not have surgery, which , with all the other insults of surgery, make it much different.
The first doctor(NY) I went to fitted me with a shorter boot than most use.
Because I'm not too bright I wouldn't wear it and ended up having to start all over agin when I got to Florida.
That doctor didn't think the shorter cast is restrictive enough to inhibit movement and gave me the knee high one.
For reasons not important to this discussion, I continued with the shorter boot and believe it made a huge difference in how much atrophy there was of the calf muscle.
The original prognosis was that I would probably end up having surgery if the tendon wouldn't knit itself back together....which wasn't too likely since I had gone months without treatment other than wrapping,babying it, walking stiff legged and allowing what were probably smaller tears become a 50% tear.
One proposal was a Platelet rich plasma injection ( PRP)...something that's not covered by insurance since it hasn't been proven yet to be effective enough to do so.
My doc says he's had pretty good success ( about 70%) but if it didn't work after about 6 weeks it would still be on to surgery.
Why yours refused to mend and mine did may have something to do with the theory behind this injection but
$1000 was more than I wanted to spend for a theoretical 'maybe'.
So I insisted on first going with a conservative approach... 6 weeks in the 'boot' being absolutely 110% compliant (unusual for me)
At 4 weeks my diligence was rewarded and he said it was apparently healing and it was time to start limited PT to avoid further atrophy of the calf.
For some reason I didn't lose a lot of strength or range of motion ( maybe the shorter boot??) and after only 5 PT visits was declared good enough to only schedule 2 more to assess endurance and walking normally.
I am told the 'bump' will probably never go away where the tendon has thickened but it doen't cause any problems.
The 6 week picture of the tendon showed a 95% healing which he said was good enough to get rid of the boot completely.
I am told the 'bump' will probably never go away where the tendon has thickened but it doesn't cause any problems.
One day of happily looking at two feet clad in sandals and I slid sideways off a low curb, wrenching the foot into a very painful mid-foot sprain.
So I don't have an end to the saga yet but reading your blog certainly makes me more than happy that I didn't opt for the surgical approach regardless of how it was promoted as a better way to insure a stronger end result.
Oh wow....that ending up being awfully long!
Very interesting! Just proves everyone is different, and not only that, my doctor tells me that every ANKLE and tendon is different too - so I can't expect an exact repeat of my first experience.
I wore the boot and did PT religiously for about 6 months prior to the surgery - the short boot and then the higher boot. Neither worked - in fact, my ankle got worse. We finally opted for the surgery and personally I'm very glad I went with that route - and glad that we're going that route again. My left ankle (the first surgery) is very strong and sturdy now. I've had no issues with ankle weakness or range of motion, but I did stick very religiously to the extensive PT post surgery. Anyway, the first surgery was a great success, and I healed well ahead of schedule - but I'm very healthy and very motivated to return to full mobility and a very active lifestyle (not saying that others aren't, of course). So we'll see how this next one goes.
Even with the one that's currently injured and swollen, I have excellent range of motion in both ankles. Thank goodness for that! I also haven't started walking flat footed, which also helps. The long range effect I've had with the left leg is that it's weaker than the right leg. But I think I've subconsciously used the right one more - and that's about to change. My doctors know that one of my goals is to equalize the strength in both legs over this year and the prognosis is good.
My tears are a form of shredding degeneration of the tendons - a congenital defect from what my doctors have told me. So the surgery in effect knits together the tendon again via "thread" and resulting scar tissue - they debrade the tendon, and clean out the useless shredded section. Then they make a series of lots and lots of tiny cuts in the tendon and sew those up as well as create additional scar tissue. This is what strengthens the tendon again. That would not happen without the surgery, so that's the only option for me from what they have explained.
Whatever - I am just very glad it worked the first time and I'm actually looking forward to getting the right one fixed too - ONCE AND FOR ALL.
My tear was minor in that it healed without surgery, but the pain was not minor and I generally have a high pain tolerance. It's similar to the pain I feel from my rotator cuff impingement, but I was walking on it, not just moving it around. Just awful. You have my sympathy. Good luck with your treatment!
Not the same thing but I did cut mine once. I was picking up pizzas for a party and was wearing flip flops. Backed out of the door - one of those heavy metal frames one with glass - and put my heel up to hold the door. There was a bit of a step down from the door. My heel didn't catch the door and the bottom edge of the door, which was raw metal basically slammed into my tendon, cutting it. Didn't even know it except when I tried to walk, I wasn't able to. When I finally looked down and saw all the blood, then it started hurting. Off topic but I always wonder why that is.
They surgically repaired mine. I can't remember how long I had it immobile after that and then lots and lots of PT which was NOT fun. It's pretty much healed but if I'm doing something that will cause it a lot of stress, it can inflame. Also, doing heel stretches or something, I can feel the tearing of the scar tissue even now and this was years and years ago when I did this.
The Achilles Tendon takes quite a bit of abuse and for that reason, it's never felt 100% like before. However, I went on to continue to play sports, etc. I just would have to be a bit careful about it if it got inflamed. In that case, ibuprofen, ice, and rest were absolutely necessary. One thing that I would generally do, especially if it was cold, was to put moist heat on it before exercising and then I would stretch it. That seems to help me avoid it getting inflamed.
Not the same thing but I did cut mine once. I was picking up pizzas for a party and was wearing flip flops. Backed out of the door - one of those heavy metal frames one with glass - and put my heel up to hold the door. There was a bit of a step down from the door. My heel didn't catch the door and the bottom edge of the door, which was raw metal basically slammed into my tendon, cutting it. Didn't even know it except when I tried to walk, I wasn't able to. When I finally looked down and saw all the blood, then it started hurting. Off topic but I always wonder why that is.
They surgically repaired mine. I can't remember how long I had it immobile after that and then lots and lots of PT which was NOT fun. It's pretty much healed but if I'm doing something that will cause it a lot of stress, it can inflame. Also, doing heel stretches or something, I can feel the tearing of the scar tissue even now and this was years and years ago when I did this.
The Achilles Tendon takes quite a bit of abuse and for that reason, it's never felt 100% like before. However, I went on to continue to play sports, etc. I just would have to be a bit careful about it if it got inflamed. In that case, ibuprofen, ice, and rest were absolutely necessary. One thing that I would generally do, especially if it was cold, was to put moist heat on it before exercising and then I would stretch it. That seems to help me avoid it getting inflamed.
Interesting story and wow, what a traumatic event for you!
My left one was repaired several years ago and I've thankfully had very little problem with it since - like you, it can be a bit stiff or I can "feel" that it's different if I do something intensive, but since about eight months out of the surgery, it has never even swollen up on me once. I am very very pleased with the results of that surgery. Even the scar has healed to being hardly noticeable.
I sure do hope I have the same results with the upcoming surgery on the right one.
It didn't hurt right away b/c your body went into shock to protect itself, giving you time to do something to help yourself before you felt the pain.
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