So about two years ago I ruptured my right achilles playing church basketball. This was about 3-4 weeks before we were set to move from Utah to Texas. My orthopedic surgeon recommended surgery. He did state that some people do it non-operatively which, honestly, didn't make any sense to me at the time. He stated that in anybody young, active and wanting to return to sports, that surgery is the standard. I went with surgery and began the slow recovery. My wife essentially packed up the whole house and my contribution was driving to Texas with my left foot. Anyhow, I've recovered from that but still notice the limited range of motion and some relative lack of strength in that side. If returned to regular running probably 8 or so months out. I never had returned to basketball and just was cautious.
Anyway, I eventually went back to church basketball about a month and a half ago and the first night back ruptured my other achilles. Having thought about it for the past couple years and as I've continued to look at some of the research, I'd wondered if I would have opted for surgery had I gone back and done it again. I'd come to the conclusion over time that I would not. So, this prepared me that I knew I wasn't going under the knife again.
I called the next morning to get an appointment with the foot and ankle guy o saw once after surgery (not the guy who did my surgery). They ended up scheduling me with another orthopedic surgeon (not foot and ankle) 45 minutes later. Anyway, achilles ruptures are something any ortho guy can handle, however, I don't know that any of them really handle many ruptures non-operatively. So, he ends up recommending surgery and I politely decline. He states that, not doing surgery, it will be a much longer recovery (nearly two times) and that is be in a cast for 8-12 weeks followed by a boot and slow recovery. He also mentions a higher re-rupture rate not doing surgery. I again decline. However, his 8-12 weeks of casting stuff had no basis to it as nowhere is casting people that long. Also, more of the recent research is showing increased re-rupture rate by increased length of time being immobilized.
Long story short, I go back at two weeks and express my concerns and essentially tell him I'm not staying in a cast that long. He then states that he would have me casted for 6 weeks then go into a boot (I think he read the literature on this [as a side note this is not a fault on him as non-operative achilles repair would be something I'd expect a foot and ankle guy to know]). By the time the 4 week mark rolled around I went in to the appointment with my boot (from my last injury) with me to out on after getting the cast removed (and as a non-verbal sign that I wasn't down with the prolonged immobilization).
Today I'm 6.5 weeks past rupture. I've been out of the cast and in a boot for 2.5 weeks. I've been doing some pretty good rehab on my ankle by myself. I'm now beginning to walk around the house without a boot or any assistance, which is pretty good especially considering that I was not able to make this much progress with surgery and that I'm pretty far along. Im excited to walk into my 8 week appointment unaided (which, according to his original plan, was going to be the earliest date is even get out of a cast, let alone begin to bear weight).
It's been good this far and I prefer it to the other one at this time. I feel more strength and fine muscle control and proprioception has been preserved. I do believe that you'll start to see a swing in management of ruptured achilles over the next couple decades. The studies showing surgery being superior don't have very good controls. The non-operative groups are always much older and they're also not rehabbing them at the same rate as surgical groups out of caution. The articles comparing the same rehab protocol groups aren't showing any difference.
That's the end of my rant for now.
Anyway, I eventually went back to church basketball about a month and a half ago and the first night back ruptured my other achilles. Having thought about it for the past couple years and as I've continued to look at some of the research, I'd wondered if I would have opted for surgery had I gone back and done it again. I'd come to the conclusion over time that I would not. So, this prepared me that I knew I wasn't going under the knife again.
I called the next morning to get an appointment with the foot and ankle guy o saw once after surgery (not the guy who did my surgery). They ended up scheduling me with another orthopedic surgeon (not foot and ankle) 45 minutes later. Anyway, achilles ruptures are something any ortho guy can handle, however, I don't know that any of them really handle many ruptures non-operatively. So, he ends up recommending surgery and I politely decline. He states that, not doing surgery, it will be a much longer recovery (nearly two times) and that is be in a cast for 8-12 weeks followed by a boot and slow recovery. He also mentions a higher re-rupture rate not doing surgery. I again decline. However, his 8-12 weeks of casting stuff had no basis to it as nowhere is casting people that long. Also, more of the recent research is showing increased re-rupture rate by increased length of time being immobilized.
Long story short, I go back at two weeks and express my concerns and essentially tell him I'm not staying in a cast that long. He then states that he would have me casted for 6 weeks then go into a boot (I think he read the literature on this [as a side note this is not a fault on him as non-operative achilles repair would be something I'd expect a foot and ankle guy to know]). By the time the 4 week mark rolled around I went in to the appointment with my boot (from my last injury) with me to out on after getting the cast removed (and as a non-verbal sign that I wasn't down with the prolonged immobilization).
Today I'm 6.5 weeks past rupture. I've been out of the cast and in a boot for 2.5 weeks. I've been doing some pretty good rehab on my ankle by myself. I'm now beginning to walk around the house without a boot or any assistance, which is pretty good especially considering that I was not able to make this much progress with surgery and that I'm pretty far along. Im excited to walk into my 8 week appointment unaided (which, according to his original plan, was going to be the earliest date is even get out of a cast, let alone begin to bear weight).
It's been good this far and I prefer it to the other one at this time. I feel more strength and fine muscle control and proprioception has been preserved. I do believe that you'll start to see a swing in management of ruptured achilles over the next couple decades. The studies showing surgery being superior don't have very good controls. The non-operative groups are always much older and they're also not rehabbing them at the same rate as surgical groups out of caution. The articles comparing the same rehab protocol groups aren't showing any difference.
That's the end of my rant for now.
