#1 WEEK 1 - Achilles Tendon Rupture (ATR) - Non Surgical Treatment - decision to go non operative

#1 Achilles Tendon Rupture (ATR) WEEK1 Treatment Decision to go Non-Operative Route
More info:
MY ATR BLOG: www.achillesblog.com/agnesatr
MY ATR PLAY LIST: • Agnes Achilles Tendon ...

[@michaelwilde545]

I am on week 3 following a 75% rupture. I'm having such a hard time getting medical care, and so am having to treat myself. If not for videos like yours, I would be lost. Thanks for making it.

[@captainandrewcrabtree6535]

How did your healing process work out?

[@KeepingFresh100]

6 years ago I ruptured my Achilles and watched every single one of your videos. They were super helpful and provided me with multiple additional tips and tricks which my Physio did not tell me. I have just ruptured my achilles again on the other foot so I am back again to view content. 😪😅

[@nf7126]

Thanks Agnes I never posted years back when I had a full rupture. My surgeon at time mentioned it was possible I could take conservative treatment like you and I found your videos which helped me make the decision to follow same path you did. 5 years on and I have progressed well. I was told I would never play tennis or run again but o was focused on proving people wrong, and I have achieved both. Thanks so much for motivation to push through and follow rehabilitation closely as frustrating as what it was especially first year. Hope you are doing well.

[@alexilexrunsmartinez]

Thanks Agnes, glad I found your videos. After watching I've been inspired and hopeful for a quick full recovery.Can't wait till Doc gives me the go ahead for advanced PT, Much love and respect!

[@fufubass]

Thank you so much! This is kind of the thinking/progression I went through. My rupture was 3 days ago. Your research and clear explanation are really good.

[@lvfreeAdventures]

thanks for sharing, not pleasant for anybody - but helpful for those who are going through this inquiry. Hope you fully recovered and back to normal

[@jesuscrespo-diaz956]

Nice video Agnes

[@gokhanozhan1950]

Thank you for your post. I helped me decide on going for non-surgical treatment.

[@agnes76atr]

Good luck in your recovery Gokhan!

[@ajaykumara7158]

Thank you very much for sharing your experience. I ambin week 16 post operation without weight bearing still

[@skylekmoss622]

Scheduled for surgery. Thanks so much for this. WIll be asking questions

[@jesuscrespo-diaz956]

I'm a Nurse Practitioner and I first I thought surgery is the way to go. But after reviewing the current evidence (AAOS 2010 guideline, Cochrane Reviews, and several SR and Meta Analysys) the outcomes are pretty minimal. I went the non-surgical route. I did not do the early non weight-bearing and range of motion. I spent the first six weeks in plantar flexion. I've started functional rehab 2 weeks ago, and I feel I'm coming along well. I can load bear about 75% of my weight on the injured leg. I race road and mountain bikes and that's the most devastating part of my injury. I had a complete rupture of my left Achilles playing basketball. But when it happened I was barely moving. Good luck.

[@thomasclick9197]

Great video. I have to decide surgery or not in the next week. This helps!

[@ingodwetrust7648]

So what did you decide my guy?and how's recovery? Hope extremely well 👍

[@mariavillanueva9374]

Thank you for making this and for all the advice. My husband just ruptured his Achilles' tendon last week. He really doesn't want surgery either.

[@agnes76atr]

Sorry about your husband's rupture... Just make sure to get ultrasound done to see if he is a good candidate for non op. As you saw my treatment was very successful with no surgery, but my gap was not large and my rupture did not impact any muscles (straight forward tendon rupture). Good luck with your decision!

[@jasminemiles3872]

Maria Villanueva I opted put of surgery. I am currently in a gard cast. I injured my foot plating basketball. I ruptured my achilles tendon and decided non operative route because i had no time for scar tissue nor did I desire to be out of work that long. It is going on the 6th week that i have been n my hard cast and I get another one on the 26th of this month that will change the position of my foot. It has been quite the experience. Best wishes with his foot

[@brussell316]

I am in week 3 of recovery from an 3/4 mm achilles tear. In the first week ,Dr suggested non surgical method with amniotic fluid injection for healing. Foot was not that swollen before shot after shot and while wearing the boot, all parts of foot swelled up .considerably . I am in 3rd week still with boot , swelling has decreased but still swollen around ankle area. I also tore my Achilles playing pickle ball.

[@jorge7860]

Thank you so much for sharing your experience. I also have a full rupture and chose a boot instead if a cast and was concerned it may cause a difference in healing.

[@agnes76atr]

Jorge, I saw a lot of people going into the boot directly and they healed fine, including myself. The important part is to keep the boot on as directed and not be tempted not to follow the instructors given by the doc and one's protocol. Some ppl are tempted to remove the boot when they should not and that can cause problems with healing and it puts one at the risk of an accident. As long as your foot is in the appropriate angle with the toes pointing down and you are keeping the boot on as instructed by your doc, you should be healing the same as in the cast. Good luck with your recovery!

[@jorge7860]

Again thanks so much for all your dedication on doing these videos, I am on my 4th week and I was very encouraged to learn through your videos (way more than all the fancy google medical searches I had done, you gave it the human touch). So glad you devoted all the “free” time the ATR condition gives oneself to productive use. Hope all is going well for you and that above and beyond the ATR therapy, good things are coming your way after this experience.

[@agnes76atr]

Glad to see the vids helped you. I was also watching lots of vlogs during my early recovery and it was helping for sure. There is also a fb group for people recovering from ATR: "Achilles Tendon Rupture Group", where one can learn from the experiences of others, but also discover how differently this injury is treated by every doctor, which makes it a bit confusing for the patients, unfortunately. And thank you, yes, I am completely recovered from ATR and back to all my sports, so it is definitely possible to get back to life as one knew before this injury. Hang in there and just be diligent about your rehab once you get to that stage! :)

[@dongko19]

Thank you! This is very helpful

[@agnes76atr]

Your welcome Abraham. :)

[@yprime651]

Agnes, what does the elevation do for the leg/injury? Is it just to decrease the swelling and pain? I just ruptured my achilles tendon yesterday but, there is hardly any swelling and so, I am debate if I should keep my foot elevated or not. It is an uncomfortable position. In fact, it is more pain with the leg evaluated.

[@brucetingle770]

70 and active, more tennis on soft courts, little pickle ball on hard courts, and golf. Surgeon gave me the options and it was my choice to make. Had ultrasound due to cochlear implant requiring such. Ultrasound is a good diagnostic tool but the MRI is more conclusive. Had surgery and not looking back......several professional athletes we know of and one is on TV this week have had ruptures and are back to playing in NBA. Good video and do your research. I will add this, if you feel that you have a blister on your heel and none is there and you change tennis shoes thinking the shoe is cutting the heel and still no blister but the heel is tender, lay off and RICE for 10 days. In my case, golf once, tennis 4X and pickle ball 2X in the 10 days prior to injury on pickle ball court made for a weakened tendon susceptible to injury.

[@matthewlabo9155]

Nice. And cute Agnes

[@abulfazrzayev4027]

Non surgical will depend from case to case and MRI result...if rupture is ideal then non surgical option might work, but if rupture not ideal then it might end with

[@borinean2036]

Agnes, did you do your treatment with a podiatrist or orthopedist? It's been 2 weeks since my ATR and the podiatrist that I've seen is leaning more towards surgery. I'm currently in a cast and I really don't want surgery.

[@agnes76atr]

I saw and stayed by an orthopedic doctor. I saw multiple orthopedic doctors in my first week after the injury and chose the one, whose treatment I was comfortable with. If you prefer non operative treatment just make sure you are a good candidate for it (gap size, type of rupture, etc). You might want to ask your doc what is his /her reasoning for surgery and make an informed decision with all the facts that pertain to your case. Sorry about your rupture and good luck with your decision!

[@TheRushour23]

Hi Agnes I am here coz I ruptured my achilles last week :) !!!

[@ibrahimtirur2555]

Are you ok now ??

[@TheRushour23]

@@ibrahimtirur2555 Yes I am ok now 😊😊😊. Every now and then it hurts but I am good 😊

[@AbdulBasit-ie6mo]

Can you travel with this injury??

[@cccEngineer]

How big was your tear gap? Was it a full rupture?

[@cecelorthioir5199]

Did you sleep with the boot on too? I just ruptured my Achilles yesterday, and opted to have non surgical treatment. So many emotions right now. I am like you very active, and the news is devastating.

[@agnes76atr]

I am sorry about your rupture. It is a major injury and it will take time to recover, but it is possible to fully recover and get back to the activities. I am very active and I was working my butt off in physical therapy to get back to pre-injury level and I managed, so there is hope. Just make sure to find a physical therapist that is familiar with non-operative rehab approach and follow the program diligently. As far as boot- yes, I slept in the boot for many weeks. For at least couple of months I was wearing boot 24/7 including sleeping and shower. Was just taking the boot off for few minutes to do spot cleaning with wipes and for the range of motion exercises. Good luck with your recovery.

[@chauntehardy3072]

How is your injury now? I had surgery on mine Monday bc I would like to recover fast and get back to running. I know it will take time regardless but I’m interested in how your recovering without surgery:) Hope all is well.

[@Barcity85]

Hello Agnes and thank you for your videos . 8 years ago I torn apart my Achilles' tendon on the right foot , I took the surgery and it was a really painful experience . On may 21 2017 less than a week ago I just injured my achilles on my left foot . This time I was lucky it didn't tear apart completely . They put a cast on me and I hate it . I need a flexible boot , so I can remove it at night and put ice when is necessary. Can you tell me please what brand of boot you wear the first weeks . By the way I choose not to take the surgery this time. Thank you again for your very instructional video 😊. Fabian

[@agnes76atr]

Oh man, sorry about your second rupture. At least this time around you know what to expect... I was first put in the boot that does not need wedges, since it's bottom had adjustable angle. It was MaxTrax walker. I have a pic of it here: achillesblog.com/agnesatr/atr-equipment/ Then when this boot's straps wore out, I was switched to Aircast boot that has a flat bottom. I was already in neutral then, so did not need any wedges. I liked Aircast better, it had inflation option to make it tighter, it was lighter and easier to walk in. Saying that, you would need wedges in it before going neutral. I have a pic of it here: achillesblog.com/agnesatr/2016/09/02/week-10-11/ Many people swear by Vacocast. I do not have experience with it though. www.vacocast.com/ If I was to do it again, I would choose Aircast of Vacocast probably. Btw, I am not 100% sure about the differences in protocols between partial tear vs. full rupture, but are you supposed to remove the boot (once placed in it) at night? As far as icing, try icing behind the knee. That helps a lot. Also, I saw some ppl in cast putting cast bag on and placing the whole foot in a bucket full of ice water. Good luck with your recovery. Hopefully it will not be as painful as your first one!

[@Barcity85]

Agnes S . Thank you very much for your answer ! I already order mine Max Trax the same day that I saw your video . It has to be here in 2 or 3 days more. Hopefully with that new boot I'll be able to move better . I hate this cast 🤣🤣 . Again , thank you for your videos . This is helping me and a lot of people!

[@agnes76atr]

You will like the fact you do not need wedges in this boot. That is the reason my doc chose this boot initially. Good luck with the transition to the boot and glad you found the vids helpful. :)

[@Barcity85]

Agnes S , yes exactly the same reason . I will not take out at night and I'll put some ice under my knee. Hopefully you are doing great too . I didn't finish all your videos yet ! 😳

[@agnes76atr]

Yes, thank you. Pretty much fully recovered as far as achilles goes, just doing maintenance work on the calf strength and flexibility.

[@dingo1223]

what about the pain, i mean i have also a complete rapture but every time when i went to the toilete my place of the injury started to hurt. im on day 11 and the pain is going away but still is present, was that normal for you? i also went for the non surgical treatment

[@agnes76atr]

I really did not have much pain at the site of injury, but I know that some others were experiencing it. This is a bit different for everyone. I had more of a discomfort rather than pain. Swelling was not feeling good and sleeping at that stage was also uncomfortable, but not really painful. I remember that the first few days when I was put in a 25-30 degrees plantar flexion boot I was a bit uncomfortable, so my doc checked and my natural plantar flexion was more than that and changed the boot to something like 35 degrees. That eliminated all discomfort. Might be best to talk to your doc to see if your source of pain is normal or not...

[@dingo1223]

Agnes S thank you for responding

[@damianmarley8239]

how did you shower? did you shower with the boot on or off? i take off the boot to shower but I'm not sure if that's the right idea

[@agnes76atr]

I was ordered to shower in the boot. I was in it 24/7 initially. I would put a cast cover over my boot and tape up the top for extra protection with body tape. I would use stool in the shower when I was non weight bearing. I washed the injured foot separately with adult wipes after I was done in the shower and in safer environment. I would then spray the boot with Odor Eaters spray.

[@surfer21]

Gday Agnes. Great informative videos by the way! Im in Japan but from Australia.I just did my achilles 6 days ago and only went and got cast put on today. I did the test at home to check and my foot moved so i thought it was partial tear. However after hobbling around house for 6 days i went to doctor and he said is full tear. So feeling bit down at the moment! Anyway the japanese generally use casts here and he discouraged me from going the boot method saying result is not as good. I was wondering when you change your sock or clean do you lift your leg entirely out of boot? If you do are you allowed small movement if out of boot especially when changing sock? thanks Lee

[@agnes76atr]

Hi Lee, Sorry about your rupture. No fun for sure. It is a long road to recovery, but keep your head up, you can recover and get back to your normal life. Just try to accept that your next few months will be more challenging, but things do get easier as the time passes by. Over here in USA some doctors still cast and some use boots. I read research that showed that early mobility and early weight bearing brings best results for non-op patients. My doctor also follows this philosophy, hence he puts his patients in the boot from the beginning. Saying that I was under strict orders to not remove the boot even for showers. I was allowed to spot clean. So, for the that I removed my leg from the boot very gently and always kept the same foot angle (toes pointing down). That was very stressful initially (first 2-3 weeks) and in the first week my husband was helping me with cleaning the foot and putting on the sock. I was using loose socks in order for the foot not to move at all while putting it on. Having the boot allowed me to start range of motion exercises at week 2 in my protocol (week 3 since my rupture). These were very gentle and all in plantar flexion position (toes pointing down). I believe these range of motion exercises helped with my ankle mobility later on. This was the only movement I was allowed out of the boot. Is your doctor open to discussion about protocols and different way of treatments? Why is he saying boot does not have good results, when so many are so successful with it and there are studies that show this approach is successful? He might have a specific reason. I know some doctors are cautious, because patients remove boot when they are not supposed to and re-injure themselves. Here is still common to cast for couple of weeks and then switch to the boot, which is more or less the same. Try to keep positive, it does not seem like it now, but it will get easier with the leg and life. See if you can get iWalk in Japan. This thing made things possible pretty early on.

[@surfer21]

Agnes S just bought the iwalk!!! The doctor here said the boot is western method..Doctors here dont really discuss much with patient and also he cant speak english. PT and rehab seems to be a little backward here as well. .thanks again for your detailed response. I think I will do some meditation now and help the healing process with mind power!!😀 namaste

[@agnes76atr]

Lee - Hope the iWalk will help you out as much as it did me. Life was fairly normal with it. Just take your time to adjust it appropriately before using it (vids on iwalk website). Hope you speak Japanese in this case! Looks like your care in Japan will be an interesting one!

[@surfer21]

Hey Agnes! got the iwalk and its certainly made a big difference around the house. glad i saw your blog about it!! Did you do Dr Bruce Twaddles recovery plan by the way? did you follow step 2 shown below? "2. After 2 weeks up until 4 weeks from injury the patient can be placed in a removal orthosis set at 20deg of equinus. The patient is allowed to remove their foot from the boot for 5 minutes of every hour and move their ankle with dorsiflexion and plantar flexion, being careful not to come beyond a right angle, as the greatest risk is having a tendon that heals long. This should be repeated 5 minutes of every hour where possible" I cant stand the cast and hope to get boot soon! Good luck with shoulder rehab!! im doing rehab for both shoulders caused by years of weightlifting

[@agnes76atr]

Glad the iWalk is helping you out as well. :) Yep, Dr. Twaddle was practicing in the clinic my doc is in and introduced local doctors (including mine) to the non-op treatment of ATR. My doc followed Twaddle protocol. We were adapting the protocol a bit here and there depending on my progress. I was putting pressure on my leg earlier and was FWB earlier. The range of motion exercises that I started at week 2(as stated above) really helped with my ankle mobility later on, I believe. I hope your doc will move you into the boot soon! I know some ppl that were in the cast for 2-3 initial weeks (some longer) and healed just fine, just many different approaches... Ouch, hope your shoulders recover soon! You will be rehabbing a lot with both shoulders and the leg(s). And thanx, the shoulder is getting stronger every day with PT.

[@miguelfloriano9039]

How does it happen? Is it Just over usage ? or Just strong impact ?

[@agnes76atr]

It is different for everyone. For me it was overuse. I did not have an impact move that caused the rupture. Many have a strong push off move, like a jump in basketball or badminton. Mine was a push off, but very minimal. I was returning a serve, but really did not move very dynamically on that particular move...

[@jerzeymade7880]

Very helpful, i ruptured my left Achilles yesterday and my right one 20 years ago.

[@marlenewhare1835]

I did mine 5 days ago.

[@jerzeymade7880]

@@marlenewhare1835 im so sorry i know it sucks😞these are very helpful videos🙏

[@DBergkamp]

I did mine last Saturday! Stay strong mate!

[@jerzeymade7880]

@Gigi xx hello sorry to hear about your injury, i ruptured my Achilles tendon at the myotendon junction on February 16 of this year Playing baseball so theres no surgery even if i wanted to lmao, it took me about 4 weeks to firmly walk on the boot, a couple of days after i started doing calisthenics again im on week 7 now

[@jerzeymade7880]

@@DBergkamp thank u and likewise💪🙏 this shit sucks lol

[@oscargar63]

HI..I also broke my Achilles tendon...did your calf hurt as well? This is my second week since I injured my Achilles tendon...my calf hurts so much...is it normal?

[@lossodon8989]

oscargar63 Garcia completely normal

[@TheTank8]

I have the same pain. How is everything going?

[@JasonGBASKETBALL22]

I ruptured my Achilles 1 week ago today. I do have pain in calf and Achilles when I stand up from the blood rushing. However this goes away as soon as I elevate my leg .

[@Guidemaster11B]

I rupture my achilles tendon 3/26/17 (Left)

[@Priyan0000]

R u completely Ok now????

[@benjaminthedford3235]

My achilles has been ruptured for about a month now and ive had no help just been in the splint the whole time! Idk what to do

[@AlanTrades]

How has your recovery been

[@benjaminthedford3235]

@Uttam Jha yea i recovered pretty decent actually

[@benjaminthedford3235]

@@AlanTrades recovered pretty good

[@benjaminthedford3235]

@Uttam Jha it wass fully ruptured

[@AlanTrades]

@@benjaminthedford3235 glad to hear. Have you been able to get full lift? Is it still getting better each day? Is your gait slightly off or getting better as well

[@Bball930]

I ruptured my achilles playing basketball about 2 weeks and a half ago, this is my second week in a cast. Did u elevate your foot when u slept?

[@agnes76atr]

Bball930 - I tried to elevate the first 2-3 nights on the pillow, but it was very uncomfortable for me. I felt more pressure on achilles that way, so I decided to not do it and I was fine at night on keeping my foot flat. I saw some people using memory foam for elevation, something like: www.amazon.com/ProCare-Elevating-Cushion-Support-Pillow/dp/B00P3D4PG4/ref=pd_sim_201_5?_encoding=UTF8&psc=1&refRID=V6Q6G6JRXV7E22A9K5B5 , but I have never used it, so cannot comment on it.

[@Bball930]

Agnes S Thank you for your reply :) Also, what type of exercise did u do to for cardio or to get your heart beating a little faster?

[@agnes76atr]

It was hard to get the heart rate up in the first 2-3 weeks. Then I was cleared for stationary biking and using rowing machine while wearing a boot, so I was able to increase heart rate some. Since I was not allowed to use big resistance on either of the machines, it was not the easiest to get the heart pumping really fast though. So I started doing one legged burpees. Basically, doing push up while using only the healthy leg and then jumping up on the healthy leg, doing reps until I was out of breath. This got me breathing hard pretty fast very quickly and became my daily challenge. Btw, if you had an operation, be careful not to get the wound wet with sweat as it can cause infection!

[@danielbarron3932]

How bad was pain with cast. I have splint and it’s killling me I’m on second day

[@Hotkila]

Hi i just ruptured mine a week ago. I did the ultrasound but haven’t seen the orthpetic specialist yet. I was told that the gap is 4cm apart. May i ask what was the gap when u did the ultrasound?

[@agnes76atr]

I am sorry about your rupture. I was told that my gap was minimal and that is what my doctor's documentation states as well. There was no actual number put on it. Also, I was told that when I plantar flexed (had foot with toes down) the ruptures tendon ends were able to touch based on ultrasound. The ultrasound was done by my doctor himself, so he was able to move my foot around while performing the ultrasound and watching the monitor.

[@Hotkila]

Thank you very much~! Your comments and videos are helping me a lot~! Thank you:)

[@Silencer1914]

Hello Hsiang-Yuan Kung, My MRI states that my gap was 3.5 cm. I really want to go the non-surgical route. Did you have surgery with your 4cm gap? Thanks

[@ajaykumara7158]

Mine was7cm but it went well by Orthopedic Dr

[@brokenbabes]

I'm just trying to help..... Please dont get mad at me, dont take me wrong :)

[@earlraglin4597]

Week one for me 😫

[@jorgeencerrado3311]

earl raglin week 1 and half for me.

[@brokenbabes]

Please read all the comments I made on your other video and then go watch my videos..... The casts I had in my videos THOSE are plantar flexion.... Yours is almost at 90 degrees!!

[@agnes76atr]

Hi Anita, actually my boot is fully adjustable. My first 2 weeks of protocol were 35 degrees plantar flexion and am now at 22.5 degrees in my week 4 and 5. Some doctors place patients in casts, but a lot of people are placed in the boot. There is not difference as long as the angle of plantar flexion complies with person's protocol. Hope your healing is going well!