Achilles Tendon Rupture Non-Surgical Recovery and Proper Rehab – The First 6 Weeks

Ossur Air Walker Boot and Evenup

This is my journal documenting the recovery from a ruptured Achilles tendon. It serves as my own reminder of the physical recovery and an aid in my emotional ups and downs from this devastating injury. I also hope all of my first-hand experiences can help others who are going through the same injury. Here goes.

There was a time when sports played a major part in my life. I remember the summers after Grades 6 and 7 were mostly spent on the tennis court. I fell in love with tennis and rode my bike 2 kilometers to the courts and played tennis for 6+ hours each day. In high school, sports continued to be important. Being in a public school with a trimester system, I took part in all 3 seasons of high school sports. During that span, I got to play on the school’s rugby, basketball, tennis, badminton and even volleyball team. Basketball, among all of these was my favourite. There were a few years in high school where year round, every recess and lunch break was spent hooping in the gym. In fact, that carried over into after school hours as well. When the school was officially closed, a lovely caretaker by the name of Cathy would leave the gym lights on (and not kick us out) so a few of us could continue to play into the night. Funny how I can remember the caretake’s name but not all of the teachers who taught me. Even into my studies at the University of British Columbia, I played some intramural basketball. Unfortunately, after my time as a student, I stopped playing team sports all together.

I Love Basketball Again

Since my daughter started playing youth basketball 3 years ago, I have completely fallen in love with the sport all over again and love to hoop with her. Basketball is once again an important thing in my life and I became my daughter’s coach. I am lucky to be coaching in the largest organized youth basketball program in Canada called the Tri-Cities Youth Basketball Association (TCYBA). This league has allowed me to learn from many senior coaches and even master coaches like Allison McNeill, former head coach for the Canadian Women’s Olympic team. Even now, coach Allison still answers all of my emails and continue to provide great advice. What a fantastic and gracious person she is; much respect!

After the players leave the gym, the coach gets to play!

Ian Dunking

Practice at game speed!

It’s been 3 years since I have started coaching and throughout this time, team practices were opportunities for me to run and enjoy basketball again. My coaching style is to teach youth players to firstly, really think about the game of basketball, be explosive and play what I call Run Ball. Not just at the youth level, I believe that if players at any level run faster and run longer than the other team, they will always see a good outcome. Actually, this is how I have approached every sport that I have played. Work hard, practice harder and results will show themselves. Practice at game speed!

ian-basketball

Full Achilles Rupture – Felt Like I Got Kicked

So on a typical Sunday practice, my daughter and I were at the local gym scrimmaging with other players and coaches. In basketball, my first-step explosiveness has always been one of things that brought me success on the court. That Sunday, with the ball at hand, I made a quick stutter step and pushed off to get around my check just like I have done a thousands of times before. I distinctly remember that my check was my daughter at that moment. Something gave way and I just fell forward straight to the ground. There was a wrenching pain in my right ankle, just above the heel area. I felt something pop on my foot and thought someone had hit me extremely hard with a basketball as there were other scrimmages going on at the same time. In fact, I clearly remember looking behind to see who hit me and then not seeing anyone around. That’s when I knew something was wrong. After speaking with three friends who also ruptured their Achilles, this was a common theme. We all thought someone hit our heel when really, there was no one around at the time. In fact, when Kobe Bryant tore his Achilles in a game, he described it as “it felt like I got kicked”. The doctor in the ER also confirmed that many athletes say this same thing after an Achilles injury.

Right after the tear, aside from the excruciating pain, there was also an unfamiliar feeling. I tried to stand up but just could not hold myself upright. I can feel myself falling forward and had to turn and point my injured foot outwards just so I can stand up straight. Managed to hobble to the sideline and then tried to stand up again and sure enough, I kept falling forward. It was a very odd, memorable and scary feeling. I was still able to hobble to a friend’s car in the parking lot. They took me home and I had hoped it was just a bad sprain because about 10-15 minutes after the injury, the pain subsided quite a bit. But because after taking off my shoes, I really did have have good control of my right foot, my wife reminded me that I should go to emergency. Yes, it took my wife to get me to the ER. I was just hoping a hot bath will fix whatever was wrong!

ER doctor diagnosed it was a full Achilles rupture in my right ankle. They performed the Thompson’s Test where they squeezed an area of my calf muscle. My foot should have moved but nope, there was no movement at all. Plus, the ER doctor asked me to touch where the tendon had fully snapped. There was now a ridge in the back just above my heel! Kind of grossed out still thinking about it.

So this post will be in draft mode until at least Week 7 when I return to see the orthopedic surgeon. I will then continue to document my recovery from a full Achilles tendon rupture in hopes that it will help others who may be going through this same debilitating injury. I am learning that there is not only physical stress and injury, but there is an emotional side of things that needs to be addressed during recovery. For me personally, thank goodness my wife and daughter are always here to help me. Otherwise, I am not sure how I could have gotten by the last few weeks by myself.

Day 1 – Day of the Injury

Having so much fun hooping with my daughter, other players and coaches. Gym surface was re-done so it was super sticky. Got me some new Adidas basketball shoes and these had pretty good grip. There must have been so much grip that I exerted what my right Achilles could handle and it fully ruptured. There was nothing out of the ordinary as far as intensity goes. For the last 3 years of team practices, I have always gone hard; that is how I played and coached. Went to the ER, doctor splintered my foot and wrapped it in bandages with an order that no weight be placed on the injured foot. The splinter was kind of cool. It was a thick cloth-like material long enough to cover just up my calf. The doctor wet the splinter, held it in place and adjusted my foot so it pointed down past neutral and waited for the splinter to quickly harden. An elastic bandage was used to wrap the splinter in place.

Splintered Foot

Interestingly, today I learned that if you sit with your feet dangling and not touching the ground, your normal foot position is actually slightly pointed downwards and not at or even close to 90 degrees! After 5 hours of being in the ER, I got to go home. Was surprised to learn that crutches from the hospital costs $24. Being in Canada, I thought this would be covered as I don’t remember paying for crutches in high school when I came out of the ER for an ankle sprain. Got that in an exhibition basketball game when I stepped on Paul Kariya’s foot and made a 2nd degree tear in my ankle! Mind you, that was many years ago :)! Thinking about it now, I think $24 is already partially covered as this is fairly cheap as far as medical equipment goes.

Day 2 – Not Much Pain

I did not feel much pain, just did not have good control of my injured foot. Most of the pain I felt was from the bandage bunching up and cutting off blood circulation. Once the bandage was re-adjusted, the pain quickly went away. It was very difficult to get around as I was not allowed to put any weight on my injured foot down. Things I took for granted were now extremely difficult to do. Things like getting a glass of water, going to the washroom, putting clothes on are just a few of these things. In the weeks to come, I learn that many things have become difficult tasks now that I have a ruptured Achilles tendon.

Day 3 – First Appointment with Orthopedic Surgeon

Still not much pain in the injured area, just a lot of a fullness feeling and pressure. I remember thinking to myself that this was not so bad. Little did I know, things will change.

Was very lucky to get an appointment on Day 3 to see Dr. Farhad Moola, the orthopedic surgeon at the Fraser Orthopaedic Institute. Dr. Moola is a member of the Clinical Faculty in the Department of Orthopedics at the University of British Columbia. He practices at Royal Columbian and Eagle Ridge Hospitals and also practices out of the Cambie Surgery Centre.

For my type of Achilles rupture, (with swelling and slight ecchymosis), Dr. Moola recommended that I go the non-surgical recovery route. Recent science findings, especially here in Canada, has shown that re-rupture rates of patients who have recovered from an Achilles rupture to not be significantly different from patients who underwent surgery. More about the scientific research a little later. Dr. Moola confirmed that my Thompson’s Test was definitely positive (positive when the right ankle doesn’t plantar flex when the calf is squeezed).

Today, I was very surprised to learn that even a fully ruptured Achilles tendon will re-attach and grow back by itself! Our bodies are pretty amazing to be able to heal itself. Here is a photo while I was at the surgeon’s office. You can actually see the boot in the rear of the image but you can really see the ridge in the heel where the tendon snapped. The ridge was was actually even deeper on Day 1 at the ER.

With this info at hand, I was happy to leave the surgeon’s office knowing I do not have to undergo surgery. The only downside is that I will be out of commission for a slightly longer period of time as it takes more time for the tendon to re-attach and grow back. Dr. Moola and his Orthopaedic Technologist, Milt Tingle fitted me up with an Össur Rebound Air Walker boot and an Evenup Shoe Balancer. In addition to the boot, I was also given an Achilles wedge kit that has removable wedges. Wedges (3 in my case) are placed in the heel of the boot and angles your foot in place at the correct healing angle. In time, you remove a wedge at a time to help lengthen the Achilles. If you end up in a recovery boot, your technician will tell you that you always remove the most bottom layer each time. So throughout your time in the boot, your heel is actually always resting on the same wedge (the upper most layer). You can see the cross section of the boot with the 3 wedges installed on the following image that shows the proper healing angle.

The boot itself is a few inches high so to prevent hip injury, the Evenup Shoe Balancer raises the height of your uninjured foot so you don’t walk like a penguin and injure your hip and joints. Here is what the Össur Rebound Air Walker boot and Evenup looks like.

Ossur Rebound Air Walker Boot and Evenup Shoe Balancer

The biggest surprise of the day was that the Air Walker boot, Evenup shoe balancer and Achilles wedge kit came to a cost of $300! I thought this type of recovery equipment would be covered by the Canadian public medical system but apparently not.

Day 4 – Not Much Sleep

Did not do much walking, kept the boot strapped on most of the day, including sleep time. It was not easy to sleep with the boot on. Not just because I was injured, but the boot is heavy enough to rotate my hip completely to the right and if I slept in that position for too long, my hip would hurt. Had to change my sleeping position often so that also meant not getting very good sleep at all.

Dr. Moola’s instructions were to continue to use crutches to get around but start weight bearing on the injured foot right away. He was saying that within a week, I probably will not need to rely on the crutches anymore. Based on my research and speaking with friends and colleagues who have torn their Achilles, their surgeons have recommended varying degrees of weight bearing on the injured ankle. Some start at 25% and gradually move up but Dr. Moola suggested I try 100% as long as it is not painful. I am happy to report that with the boot on and some practice, I could start to slowly walk around the house without crutches today. This was a huge relief. Hobbling on one leg with or without crutches is NOT an easy way to get around. Even when I need to use crutches, just being able to partially use my injured foot has helped tremendously with mobility.

I am still using crutches in the morning when I first get out of bed and of course when I need to get out of the house. It was a tiring day and I could not attend basketball practice. Luckily my wife and another parent coached in my place. Happy to report that I only missed 1 practice and no games!

Day 5 – Game Day with Crutches and a Wheelchair

It’s Friday and that means game day for a coach. I was able to participate in the game. Luckily I had access to a wheelchair so with the help of my wife and the crutches, I was still able to coach the team. #basketballneverstops

Basketball Never Stops

Day 6 – Some Ankle Swelling

Not much to report but I did notice my ankle began to swell a bit more. Pain was tolerable and very low since Day 1. Still trying to figure out a position so that I may get a longer stretch of sleep. Continuing to use crutches in the AM and later in the day when ankle begins to swell more.

Day 7 – Even More Ankle Swelling

Surprisingly, a week after my injury, my ankle swelled up even more. Did not get much sleep. This boot is rather heavy and I have sore hips from repeatedly trying to adjust and find a comfortable position that would give me the most pain relief. I did find that taking my boot off and giving myself a quick calf massage gave some comfort.

Day 8 – Excruciating Pain!

There was excruciating pain in the morning after sitting up with my feet hanging over the bed. Had to lie down a few times (and elevate my ankle) to relieve pressure and pain. It actually hurt as much as immediately after the rupture on Day 1. Ankle is extremely swollen. Then later that day, I realized I could relieve pain by taking off the boot and keeping my foot elevated. Most of the time, the pain will go away. My ankle is pretty swollen and tender. Not only does the torn tendon hurt but the boot is also pinching and decreasing blood circulation and that brings on even more pain. Thank goodness I was not fitted with a cast. The boot can easily be taken off to relieve some pain and I can wash my foot and ankle on a daily basis.

The orthopedic surgeon have instructions to exercise my toes by curling them up and down. The instruction sheet also mentioned tilting the bottom of the foot inward and outward. I am trying to do some of the recommended exercises but since I do not have full control of my foot yet, I can only wiggle my toes and point the toes down (active plantar flexion) and up (dorsi-flexion). I cannot raise my foot yet from my ankle joint. Not that I tried very hard as I know I need to give the tendon enough time to re-attach first so I don’t tear it again). I have very limited movement to rotate my ankle and angle the sole of my foot inwards (subtular inversion) or outwards (eversion) while in plantar flexion (with toes pointed down).

Besides the limited movement, the strangest feeling is that I cannot contract my injured calf muscle. No matter how I try to flex, the right calf muscle just would not contract. Not even a little bit. I definitely feel my calf muscle going into atrophy as I cannot use it. It’s a scary and gross feeling all at the same time.

Day 9 – Pain Kept Me From Sleeping

Did not get much sleep last night. The pain kept waking me up and I had to readjust position for relief. This morning, I took the boot off before dangling my feet to the ground. Sat there for 20 minutes until the pain subsided enough to comfortably get out of bed. Taking off the boot really helped to relieve the early morning pain. It took about 20 minutes to get out of bed today.

Throughout the day when the pressure and pain was too much to handle, I would take off the boot and elevate my foot. This almost always alleviated the pain rather quickly. It seems my ankle has swollen so much that that it is now being pinched by the boot, which is already super wide I might add. That is how swollen my injured ankle has become. Today I started taking Advil regularly every few hours to help with the pain and swelling. Before now, I have used Advil sparingly and only when it hurt too much. Not anymore. Advil is now necessary to try and keep the swelling down throughout the day.

Day 10 – Dealing With Pain From Swollen Ankle

Ankle is still extremely swollen and tight. Taking 400mg of Advil about 3-4 times a day to try and keep the swelling down and to manage the pain. Was able to attend basketball practice today and coach my youth girls team. Yeah! Except ankle is so swollen and tight that night, it hurt to sleep. Had to remove the boot for almost 2 hours just to deal with the pain before strapping on the boot again to sleep.

Swollen Right Ankle

Day 11 – Not Good Sleep

This was a rough night of sleeping. Took almost 2 hours to fall asleep as I just could not find the right position to alleviate the pain. Did not want to take the boot off before sleeping as I had done that on previous nights and fell asleep with the boot unstrapped only to wake up in pain as I moved my injured foot unknowingly. Pain management was better today. After waking up, resting my foot on the ground brought on that excruciating pain again so I unstrapped the boot and rested for 20 minutes until the pain subsided enough to get out of bed.

I remembered to take Advil every 5-6 hours and used a bag of frozen peas & carrots to ice the front and outside of my ankle. Keeping the foot raised helped as well. I did notice minor pinches of pain in the ruptured area. Feels almost as if it’s healing and with the slightest of movement, would rip again.

Day 12 – Helps to Ice Ankle Before Sleep

Before sleeping last night, I iced my ankle several time for a good 30 minutes each time. Putting on the boot and going to sleep was better and I felt less discomfort. Waking up today, I also needed to unstrap my boot and sit for 20 minutes until the pain in the ruptured area subsided. There is no pain when in bed but once I put my foot on the floor, the blood rushing to the injured area causes pain. I feel more of the pinching I felt yesterday where I think there is a bunch of micro-tearing in the healing area. Feels kind of gross actually so I strapped the boot on extra tight today to try and lock the foot in place as much as possible.

Day 13 – No More Excruciating Pain

What a relief! There was no excruciating pain this morning when I sat up to get out of bed. I loosened the straps on my boot and rested my foot on the ground. Cringing and waited for the throbbing pain to hit the back of my heel like previous mornings but was pleasantly surprised that there was minimal pain. Perhaps staying on Advil and icing my ankle throughout yesterday brought the swelling down enough. Let’s hope this continues and the worst pain from this rupture is behind me.

However, I did notice my right calf muscle, around mid-calf, was tender and tight. Tried stretching it out but was also mindful not to overdo it since the Achilles does attach to the calf muscle and I do not want to re-injure anything. Hoping it’s just a muscle cramp and nothing more serious. There seems to be less micro-tearing in my injured heel. On previous days, I could feel sharp slices of pain with the smallest of foot movement. There is definitely less today. Yes, I am still grossed out that something seems to be repeatedly tearing inside my heel area! Continued to ice and take Advil to keep the swelling down.

Day 14 – Luckily I have Oversized Socks

Another morning without too much pain when getting out of bed! There was less swelling in the ankle today. But I did notice that on the days that I do venture out of the house, there is more swelling that evening. Also missed one dose of Advil today, just simply forgot. This may have also contributed to a bit more swelling. When my ankle was too swollen to comfortably take off my sock, I would ice with my sock on. On a side note, luckily a few months ago, I mistakenly purchased 2 pairs of socks that were a little larger than normal. Call it fate or just a lucky mistake, I now have 4 over-sized socks to wear on my injured foot.

Day 15 – Unbearable Knee Pain

Before waking up, I adjusted my sleeping position to find the least amount of strain on my ankle and ended up sleeping for a bit in the fetal position. Although I did have a pillow in between my knees, it was obviously not the best position. I have used the fetal position the last few nights to find relief but this time, the weight of the boot wreaked havoc on my knee.

My knee was weighted down inward as I slept and when I woke up, the outside of my knee was frozen with pain and I just could not un-bend my knee. Only with my wife’s help could I remove the boot and try to sit up. I managed to struggle and rest my foot on the ground. Knee pain was extreme but it subsided quickly as I was finally able to straighten my leg again. Luckily, there was no heel pain from quickly putting my foot on the ground; only felt pressure from the blood rushing to the injured area. Thank goodness.

In the evening during an icing session, I took my sock off and noticed that calf of my injured foot was significantly smaller than my left calf. It was a little devastating to see. Ever since I haved play sports, I have always had large and fairly defined calf muscles. Pretty sure this was due to genetics and just being very active all year round. Needless to say, I was shocked because I have never seen myself with such a skinny calf after finishing primary school! Swelling is less and it’s way easier to wear the big sock now. Still did not try wearing a normal-sized sock yet.

Also, today was the first day that I could even gently flex (ever so slightly) my injured calf muscle. I tried doing this a week ago and there was no calf movement at all. Although I have some strength to move my toes up and down, I still have very little control trying to lift my foot upwards. Doing this gently of course so I don’t tear anything in the heel. It’s just an odd feeling when you have no control of your own foot. I may be getting some first-hand experience of the mental drain and discouraging feeling athletes and patients go through with a devastating injury.

I guess I could not hide the disappointment in my face as my wife re-assured me I will fully recover and she will help me with the rehab to get back into shape. She even showed me how skinny her calves were and told me that many great NBA players have skinny calves. I am one lucky dude.

Day 16 to 30 – Found a Better Way to Sleep

The first week, I was still in shock. The second week was denial and anger actually. These next 2 weeks, I will lump all my notes together. The main thing to note for these 2 weeks is that waking up in the morning and putting my foot down, there was no more excruciating pain. I feel pressure in the injured area and around my ankle and can sit for a few minutes before tightening my boot to walk around (with some limping). The surgeon has asked me to be full weight bearing (FWB) on my injured foot as early as I can so I have been doing that since getting my boot. But I do notice on days that I take less Advil and / or when I walk more, there is more swelling in the ankle (inner and outer). I have been using ice and Advil to keep the swelling and pain down. The pain comes from the swelling more than the injured area. In fact, there is hardly any pain from the torn tendon, just tightness and no control of my ankle. I can put much more pressure down using my toes now and can even wiggle them upwards a little more, but I am still unable to lift my foot up very much. I would say only about 1 cm maybe before it starts to wobble from lack of control. I am still unable to flex my calf.

Luckily, I discovered a way to wrap my boot up with a towel and bungee cord so that I can sleep with my toes pointed up instead of letting the heavy boot twist my leg to the side. This saved a lot of grief, decreased hip pain significantly and I can actually sleep undisturbed for a few good hours again.

Boot Sleeping Hack

Week 4 – Surgical vs Non-Surgial Achilles Recovery

Not much has changed in week 4 except I am beginning to figure out more efficient ways to complete day-to-day tasks like putting on my shorts and showering. Even the simplest of things is now a challenge.

For those of you going through an Achilles rupture recovery, or any type of injury that prevents you from standing normally, the following is a great tip to remember. Find better ways to accomplish tasks that require you to stand up and sit down repeatedly. You will put less strain on other joints and muscles that you by now are probably favouring due to your injury.

Began to felt pain in my left (uninjured ankle) and right wrists from over using and favouring them. As long as I remember to stretch them, the pain can be managed. The daily doses of Advil I am taking probably helps with this as well.

I take a shower everyday and have figured out a routine to do a quick wipe down of the boot so that once I am done showering, it would be dry enough to use right away. Unfortunately, no amount of wiping is completely getting rid of the funky smell. I finally traced the odour to the heel of the inside boot lining. Wiping alone won’t get rid of the smell, I may need to remove the inner lining and wash it by hand. On sunny days, my wife and daughter brings the boot out to the back deck to sit in the sun. This helps with sanitizing it but there hasn’t been many sunny days lately.

Even previously, I was beginning to worry a little since I cannot flex my injured calf muscle and my calf itself probably shrunk 30-40% from it’s original size. Yes, I have fairly muscular calf muscles so it is disconcerting to look at the weak one when the boot is off; just not used to seeing it so frail. I spoke with my family doctor and he said it’s normal not to be able to flex my calf. You need an attachment on both ends of the muscle to flex it and I do not have that given my Achilles rupture.

More recent reports in various news sources and even in PubMed (US National Library of Medicine National Institutes of Health) shows re-rupture rates of non-surgical Achilles rupture is comparable to surgical when active rehab is done early enough and properly. Because I have a life sciences background, I feel comfortable reading medical journals and all recent findings from PubMed does lean towards non-surgical rehab, especially in Canada & the United Kingdom.

Here is a news article reporting re-rupture rates between surgical and non-surgical treatment of patients who ruptured an Achilles tendon. From that article, I reached out to Dr. Mark Glazebrook, Orthopaedic Surgeon and Researcher whose specialty is in reconstructive foot & ankle surgery and orthopaedic sports medicine based out of the Queen Elizabeth II Health Sciences Center in Halifax, Nova Scotia. Dr. Glazebrook, the surgeon quoted in that article, got back to me right away and sent me a document with a process for treatment of achilles tendon ruptures for non-operative patients. It highlights things you should do at various stages of the recovery process and most of these were in line with what my own orthopedic surgeon, Dr. Moola, had outlined. This document was actually more detailed in the specific things to do. I have received permission from Dr. Glazebrook to re-post this document as long as I referenced Willets et al JBJS modified by Rubinger and Glazebrook. Hope it can help others out there. Here is the document (original was a .docx, I converted it into a PDF format): June 2105 Accelerated Rehabilitation Program.

I am happy to report that I can wiggle my toes a little more now in active plantar flexion and dorsi-flexion. I still cannot raise my foot to neutral yet. I have limited rotation of my ankle inwards (subtular inversion) or outwards (eversion) while in plantar flexion (with toes pointed down) but it is getting a little more each day as I try to gently perform these exercises.

Definitely, I can now feel the injured area is less jello-like and is at the initial stages of re-growing back. I can still feel a small ridge where the tendon had ruptured but it’s no where as deep as it was when I first tore it. Also happy to report that I am no longer grossed out by my injury. Your mind will adapt when it has to.

Week 5 – No More Icing And Doing More Rehab Exercising

I stopped icing my foot all together. My personal experience from high school sports was that heating the injured area has always given me better results than icing. Icing gives immediate relief from pain but it also constricts blood flow. Our bodies are good at repairing itself and need increased blood flow to do the actual repair. So this week and partially last, I started to use hot water to soothe both of my ankles while showering. I did this early on at around week 2 and the injured ankle swelled up too much and was very uncomfortable to even put on the boot. I stopped using heat until now. No more major swelling, just pressure now with the odd pain when the foot is not elevated for an extended period of time.

I am able to do more pointing of the sole of my foot inwards (subtular inversion) or outwards (eversion) while in plantar flexion (with toes pointed down).

I started looking for braces to help with recovery and support for when I can step back out on the basketball court. I know Steph Curry (NBA MVP form 2015) wears ankle braces full time when he plays a game so I looked up the brand that he uses. It’s actually called Zamst and he swears by them saying they are so lightweight, they don’t get in way of performance.

I was looking to get a pair of ankle braces but to my surprise, Zamst also makes an Achilles tendon brace. Amazon reviews are not very good on these but after researching some more, I think these negative reviews may be due to user error. In order for this brace to work, at least on the demo videos that I have found, you have to set your foot in a specific position before strapping in all the velcro. I can see if someone just put these on without setting the foot in the proper position first, you would think you are just wearing a sock with many velcro pieces.

Whether I am right remains to be seen. I just was not able to located ANY reliable 3rd party review of the Zamst AT-1 brace besides the Amazon reviews. Well, there was a Physiotherapist who did a quick video review but I am pretty sure he strapped the brace on incorrectly as well as he did it OVER his patient’s sock rather than on the bare ankle. I will talk more about braces at a future date as I get closer to getting back out on the basketball court.

In the meantime, basketball never stops. Practicing with my daughter continues with the help of crutches and a wheelchair.

Gym Time in Wheelchair and Crutches

Week 6 – Healing and Getting Rid of the Stinky Boot Smell

Day to day things become easier as I learn to do things more efficiently. For instance, I have been able to shower everyday early on as it’s easy to remove and wear the boot. Thank goodness I have a removable boot as opposed to a cast. The boot can be removed so I can clean and wash my foot. Not only that, sometimes when the pressure gets to be too much and pain sets in, I can remove the boot for immediate relief from that pressure. The last few weeks, the boot has been a bit smelly even though I have been wiping the inside cushion portion on a daily basis. There is no getting around this I guess, feet generate stank!

I tried spraying Febreeze into the boot but that didn’t really help. Just made the it smell like a Febreezed stinky boot. There are suggestions to use baking soda or vinegar to try and soak up the smell but I wanted to not just mask the smell, I am actually trying to kill the bacteria that is causing the smell. So I tried wiping the inside of the boot with some Exact brand medicated body powder with zinc oxide and menthol. Well, wiping the powder in with a damp paper towel and then vacuuming the remaining powder away actually. I am not sure if the zinc oxide kills the bacteria or if the powder keeps the boot more dry, but the stinky boot smell almost disappeared when I continued to wipe it down on a daily basis.

When there is lots of sunshine, I try to leave the boot out on the deck to sit in the sun for an hour or 2 at a time. The biggest thing is to keep your foot and ankle clean. That means trimming toe nails, keeping them short and washing diligently everyday.

And whenever my boot is off, I have a small USB fan airing it out. In fact, I also find some comfort with the fan blowing directly on my foot as well so luckily we have 2 USB fans at home. The fan makes the boot less smelly, dries it out quickly after my daily wipe down and if I place it in perfect alignment, I can also keep my sock and foot dry at the same time. The second fan is used during sleep. I find it soothing to have air blowing at my leg and boot. All of the above seems to keep the stinky boot smell under control. Thank you again to my wife who actually got me the USB fan a while ago to be used when I was working on the computer! Yeah!

Another thing that I found helpful was to find more efficient ways to do things. For instance, after showering, I will pull my under wear and shorts on up to my thigh first. Then strap my boot on so I can actually stand up, then completely dress myself. This way, I don’t have to stand up on one leg multiple times. This helps to decrease aches from other joints that I am now over using during my daily routine. My left (uninjured) ankle and my right wrist hurts most as I am favouring these now. This may be too much info for some of you but as I mentioned, simple things I used to take for granted has now become a difficult task. I hope someone can find this information helpful.

This was an odd week with regards to pain. I am definitely feeling more pain from the sides of my heel and even the injured area (slightly above the back of the heel). This was the area of pain where I initially ruptured my Achilles.

I did stop icing a while back and am trying to manage the swelling with elevating my foot and taking Advil. Science (and from my own experiences during previous injuries like rolling my ankle) shows that the body heals itself in stages. At some point during the healing stage, blood is required to circulate throughout the injured area so it can begin to heal. This is the main reason why I stopped icing the injured area. In fact, I started to use warm to hot water to massage the injured heel and ankle while showering. Also, even when I iced, I only iced the swollen ankle (outside and inside). I never iced on the heel directly as I did not want to restrict blood flow to the injured area.

There was also more tearing like tiny little fibers ripping apart (in the back of the heel) from the slightest of movement even though my foot was solidly locked inside the boot. There must be lots of healing here and it may be tearing as the area moves. I still cannot flex my calf but I can now slightly move my ankle from side to side but only when the toes are pointing down in plantar flexion. When the ankle is in neutral position, I still cannot rotate my ankles (subtular inversion and eversion). It is indeed a very odd feeling looking at my ankle and not being able to move it like it would normally.

A few more days until I see Dr. Moola, ortho surgeon, for a follow-up. Let’s hope the tendon is growing back as it should.

Achilles Tendon Rupture Non-Surgical Recovery – What I Have Learned In My First 6 Weeks

For me, the most important thing that I have learned is that I am one lucky guy to have my wife and daughters.

It was and still is crucial that they have been supporting me physically and emotionally. The load I have placed on my family has been pretty enormous. Without them, I would not have been able to continue coaching basketball. Without their constant love and support, I would not even be able to take care of myself very well at home and be as comfortable either. And for them, I am eternally thankful!

Look at the beautiful food I get to eat at home!

Ian Boot Quinoa Salad

Luckily there is technology like the Össur Rebound Air Walker boot so I am at least able to slowly walk.

Listen to your surgeon. And ask lots of questions so you are absolutely clear about your condition to help best plan your recovery protocol. Listen to your body during recovery. When it hurts, slow down. I will continue to document my non-surgical Achilles rupture recovery as the weeks go on.

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Ian Lee

Ian Lee

Work from home dad, marketer and photographer. Fallen in love with basketball all over again as I coach my daughter's team.

9 thoughts on “Achilles Tendon Rupture Non-Surgical Recovery and Proper Rehab – The First 6 Weeks”

  1. Avatar

    Hi Ian, I see your first post was in March 2016. Just wondering how your recovery went after the 6 week mark? Are you back playing basketball and if so, how long did it take for you to get back on the court? I ruptured my left Achilles 3 weeks ago. My incident occurred EXACTLY the same way you’ve described yours. I’m taking the non-surgery journey also. However, I was in a front slab/cast for the first 2 weeks (completely immobile with my leg elevated most of the time) and now I’m in a removable cast. I’ve been told I won’t go into a boot and be weight bearing for a few more weeks. The crutches are a killer! I live in New South Wales, Australia. Regards, Jody Sharpe

    1. Ian Lee

      Sorry I missed your comment Jody. I changed commenting systems on this blog so it’s been a while. How is your journey to recovery?

      All the best!

  2. Avatar

    Bro. Just popped my Achilles tonight playing ball. Felt like someone hit me with a metal bat, but when I looked behind me…nothing. Everyone in the gym knew the instant it happened. So of course, I started researching (I came home to ice and elevate and plan to go to ER in the morning) and I just read this entire article. Thank you so much man. I’m a little shook daddy (scared) but reading your story truly brought me comfort. It also has made me seriously consider the non-surgical route as well. In general, I’m pretty healthy and I 1,000% believe in the power of the body to heal itself. I’m also in America. And I also don’t have insurance. Thank you thank you thank you. God bless you and your family.

    1. Ian Lee

      Hi Lenox,

      I am sorry to hear about your injury. Thank you for your kind words, I am glad my posts has helped you in some way. This is a very tough injury to recover from. It takes a ton of time and a lot of proper rehab to get better. Kobe was able to come back in 12 months and he is a machine. Most of us do not have access to medical care that professional athletes do. We just do our best. The good news is, I am playing ball once again so there is sports after an Achilles rupture.

      Keep reading. It helps to heal in both the physical and mental capacities. Knowing this is half the battle.

      All the best in your recovery journey!

  3. Avatar

    Hey Ian,
    How’s the recovery for the Achilles tear? I too rekindled my love for the game of basketball and at 47 years old, tore my Achilles 1 1/2 inch or 6 centimeters. It popped, hurts, swelled up and bruised badly. I’m just over 3 weeks non-surgical recovery. My surgeon put me on that exact plan that is in your post. I am hopeful and looking forward to loosing the boot!!

    1. Ian Lee

      Hey Richie,

      I am sorry to hear about your Achilles rupture. Rest up and do a ton of reading. You will get differing advice from others and even health care professionals. Just go with your own gut feeling as to what you need to do. No one will know your body better than you! Listen to your body.

      Stay positive and know that there is a mental aspect that needs healing as well. Knowing this will help guide some of the decisions you will need to make on your path to recovery.

      On the bright side, I am able to play ball again and hope you can find some comfort knowing this. I am now learning (slowly) to not play at the maximum level. Many other coaches who have undergone this same injury is doing the same.

      All the best!

  4. Avatar

    Hey Ian,

    Just came across this. I ruptured mine playing volleyball just over two weeks ago. I looked back and was in disgust that my teammate didn’t apologize for kicking me in leg….tried to get up, almost fell forward and iced down my ‘calf strain’ on the sideline. I spent 6 days limping around, assuring myself I had pulled something until my AT got real quiet when she assessed me and told me to get to the doctor ASAP. Another week went by and I finally saw a surgeon last Thursday (12 days post-injury, limping around). He was going to do surgery but noticed the swelling and tightness in my calf. Like you, I have enormous calves (18 inch, relaxed). He discovered DVT’s in my leg and put me on blood thinners immediately. Because of the DVT’s he will not operate. As of this writing, I have to go the non-surgical route and will only be fitted for my boot tomorrow (Canadian Thanksgiving today) after giving my leg 3 days of elevation and pills to reduce the swelling. I have enjoyed reading about your journey and fully intend on fast tracking the rehab program you attached. I was a high level athlete in my youth and the thought of no longer being able to play competitively has taken an emotional toll on me. Thanks for sharing.
    *Interesting note: As I seem to be have taken an unusually long time to get immobilized, comparatively speaking, I have noticed in the last 3 days I can plantar flexion with very light pressure on the ball of foot when walking, dorsiflexion is good, but tight. It will remain to be seen how much recovery I will have post rehab and if waiting this long to get immobilized was a good think.

    1. Ian Lee

      Hey Glen,

      Sorry to hear about your injury! The good news is, you have some movement so perhaps not a full rupture but not being an expert, I cannot truly say. What I will share is that when I was going through rehab, I was determined to go hard to make sure I get back to 100%. It actually slowed down my rehab as I maxed out on exercises. No massive side effects but the physio did not like that I pushed too hard. What I learned was to listen to my body and go at that pace instead.

      We cannot compare our downtime to Kobe Bryant. He had surgery very quickly and had the newest procedure possible. Way less invasive than what regular mortals can get at a public or even private health care system. There was a team surrounding him for all those months of recovery and he was definitely back on the court super early. Plus, pretty sure he was extremely fit to begin with 🙂

      Be ready emotionally. There is a road to recover on that front as well. But knowing it’s part of the journey will give a better result at the end of the day. Just know that one day, you will be able to play again if you manage your rehab well.

      Good luck in your recovery. I wish you all the best!

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