Torn achilles - HELP!

ratsbeyfus

Hi - I posted this message on another forum, but got no replies (sniff), so I thought I'd have another go here...

I managed to tear part of my achilles tendon during xmas (not cycling, but DIYing )and am currently waiting to hear from the orthopaedic outpatients' dept. I don't think it's a major tear... I can walk OK with just a small ache. However, my GP says I shouldn't ride until I've seen a consultant, and I'm a bit worried as this could be months without being on my bike. I'm worried that my GP might be being over cautious - I looked on the web and some sites say that cycling can be quite beneficial for people recovering from achilles damage.

Has anyone out there suffered a similar injury? How long before you were allowed to cycle? Did it heal completely? Are there any useful supports for the achilles?
Should I jack it all in and buy a moped?

amnezia

ratsbeyfus wrote:

Hi - I posted this message on another forum, but got no replies (sniff), so I thought I'd have another go here...

I managed to tear part of my achilles tendon during xmas (not cycling, but DIYing )and am currently waiting to hear from the orthopaedic outpatients' dept. I don't think it's a major tear... I can walk OK with just a small ache. However, my GP says I shouldn't ride until I've seen a consultant, and I'm a bit worried as this could be months without being on my bike. I'm worried that my GP might be being over cautious - I looked on the web and some sites say that cycling can be quite beneficial for people recovering from achilles damage.

Has anyone out there suffered a similar injury? How long before you were allowed to cycle? Did it heal completely? Are there any useful supports for the achilles?
Should I jack it all in and buy a moped?

you should listen to your GP. How you expect people to give your better advise online without seeing the extent of the injury is beyond me?

sounds nasty, hope it heals quickly

Wallace1492

I haven't torn achilles but tore my calf muscle playing squash.
Couldn't walk properly for nearly 3 weeks, and only recently gone totally pain free.

Managed gym night before last, first time in nearly 6 weeks. Taking it real easy.
On static bike and it felt ok......

Hope you heal soon and get cycling again.

UndercoverElephant

I wouldn't take the advice of people you don't know from an internet forum over a trained GP.

It could be a long time off your bike with a minor tear, it would be even longer if you make it worse. You could try getting the opinion of another GP, or a physio.

ratsbeyfus

Thanks for advice

I wouldn't usually go against my GP, but as I say I've seen conflicting advice from medical websites which suggests cycling may help my achilles. I've had problems with other doctors' advice before which left me with a dodgy knee. It took a total of 7 years from first being referred to a specialist to finally having an operation! SEVEN LONG YEARS!

I won't go for a second opinion as I can't ask for more than being referred to a specialist, but whilst I'm waiting to get my appointment (which should be confirmed in the next week) I'd just like to get an idea of what kind of lay off I may or may not have in store. I am desperate to get back on the bike - not just for fitness, but because without it it is very difficult for me to get home from work once a week!

Thanks in advance for any help from fellow achilles sufferers.

lost_in_thought

I partially (80%) tore my achilles last December.

I was in plaster to my knee for 8 weeks, 2 weeks in a walking cast, and off the bike for approximately 2.5 months.

In all seriousness, this is an injury not to mess about with.

It sounds like your tear is minor in comparison, but any activity can worsen it. Really, your GP should have immediately referred you to your nearest A&E for a 'back slab' which is a half-cast to prevent the tear from extending.

Your best move at this point would be to go to a specialist (I know a good one in London if you're interested) and have an ultrasound on the achilles, which will establish the extent of the tear and the necessary action. You may be able to persuade your GP to set you up an ultrasound on the NHS if this isn't an option.

I cannot stress enough the importance of refraining from any activity.

You do not want to make this worse. Seriously.

Cycling is helpful once the tear is fully healed and you've been signed off.

spennyj

I fully echo LiT's post. I completely tore mine four years ago and it took a good 4 months until I even considered getting on my bike. To be honest, once it completely goes rehab is horrible and it is never quite the same (although perfectly fine for cycling and being on the bike will eventually help to restore strength to your calf). Just make sure you protect it until you know you can't make it any worse - seeing a specialist is vital.

Just to reiterate the importance of LiT's post, I will repeat her most pertinent lines....

I cannot stress enough the importance of refraining from any activity.

You do not want to make this worse. Seriously.

ratsbeyfus

Thank you... I guess it wasn't what I wanted to hear, but inevitable really! More research online suggests that mine is a minor tear, but that once an achilles tears once it is liable to go again.

I'll see if I can find a support for it as I spend all day on my feet (teaching) and promise I won't ride my bike - scout's honour - until I get the all clear!

Thanks again for your help - anyone got a vespa they want to sell?

lost_in_thought

You shouldn't really be on it at all, and you need a splint, or something to completely immobilise the ankle while it heals, not just a support.

Anything that causes it to hurt could be worsening the tear.

I'd head back to your GP sharpish, and ask him why he hasn't sorted you out with a back slab or similar, or see a specialist as I say above.

I'm sorry this is a bit doom and gloom, but this requires immense caution!

ratsbeyfus

Ooh blimey! :shock: Like I say, I've got appointment to see specialist, but I'll get in contact with GP about immobilising it.

Thanks again for help.

teticio

hi there

i suffered from this last year and it took a good two months to cure. there are different grades of injury - mine was not completely torn but the inflamation continued for most of those two months, i could even feel the tendon rubbing.

what i found REALLY helped was a chapter from this excellent book which happens to be fully available online. its a bit technical but it is authortative. http://www.clinicalsportsmedicine.com/chapters/32.pdf

i followed "alfredson's painful heel-drop protocol" (yes, its really called that!). for once it was nice to have a remedy that HURT a bit because it felt like i was doing something. if you immobilize (your doctor will be the best person to judge) then your achilles will come out hopelessly feeble and you'll spend another 2 months getting it back to strength. this heel-drop exercise basically stimulates the production of collagen, which is the building block of the tendons. it is slow because the blood flow is particularly poor to the achilles.

having said that, it doesn't mean you should be doing anything else that hurts, especially no running or cycling until it is fully recovered. towards the end of the recovery period you can try running / cycling 10 mninutes or so and waiting til the next day to see whether there is any adverse reaction before stepping up to 20 minutes etc. but it is important to wait because the inflamation can set on after some time.

you should also apply ice packs and consider taking ibuprofen (perhaps with something to protect the lining of your stomach) for the inflation. the ice should be applied several times a day and for bouts of 20 minutes or so.

good luck!!

ps: if you consider following something i (or anyone else for that matter) have said, i suggest you show it first to your doctor.

teticio

amnezia wrote:

you should listen to your GP. How you expect people to give your better advise online without seeing the extent of the injury is beyond me?

sounds nasty, hope it heals quickly

GPs often only take into account the injury and not the recovery afterwards (or the fact that we are going to feel depressed if we can't do any activities for months). i'm lucky to have found one who understands that. in fact, with a stress fracture i had i was able to recover much more quickly than the average patient by carefully and gradually mobilising and loading it. again, the bones also respond to stress by strengthening (or to lack of stress by decalcifying). if the doctor only has responsibility while you are injured and not while you are recovering then he may give biased and overly conservative advice.

lost_in_thought

teticio wrote:

what i found REALLY helped was a chapter from this excellent book which happens to be fully available online. its a bit technical but it is authortative. http://www.clinicalsportsmedicine.com/chapters/32.pdf

i followed "alfredson's painful heel-drop protocol" (yes, its really called that!). for once it was nice to have a remedy that HURT a bit because it felt like i was doing something. if you immobilize (your doctor will be the best person to judge) then your achilles will come out hopelessly feeble and you'll spend another 2 months getting it back to strength. this heel-drop exercise basically stimulates the production of collagen, which is the building block of the tendons. it is slow because the blood flow is particularly poor to the achilles.

OK, I wouldn't normally be so blunt about this, but disregard this poster's advice.

If you actually read this, page 11 of 22 shows a clinical management chart which very specifically points out that before prescribing this 'painful heel drop' exercise, you must exclude the possibility of there being a rupture.

If you do this with a torn achilles you are pretty much certain to worsen your injury.

teticio

lost_in_thought wrote:

OK, I wouldn't normally be so blunt about this, but disregard this poster's advice.

If you actually read this, page 11 of 22 shows a clinical management chart which very specifically points out that before prescribing this 'painful heel drop' exercise, you must exclude the possibility of there being a rupture.

If you do this with a torn achilles you are pretty much certain to worsen your injury.

just before i saw this post i added a "ps" to my post. i wouldn't go so far as to say he should do what i did, but he could check it with the GP. there is a test you can do for the rupture - i did it myself but, you are right, always best to at least get the diagnosis spot on. then the treatment, that's not always "one-size-fits-all". if it is not a severe tear (see book chapter for definition) then the research claims (and my own experience) that it helps significantly. if it is a severe tear then LIT is right, it will make it worse.

teticio

lost_in_thought wrote:

OK, I wouldn't normally be so blunt about this, but disregard this poster's advice.

If you actually read this, page 11 of 22 shows a clinical management chart which very specifically points out that before prescribing this 'painful heel drop' exercise, you must exclude the possibility of there being a rupture.

If you do this with a torn achilles you are pretty much certain to worsen your injury.

i've just thought of something... maybe you reacted so strongly because you understood "ruptured achilles" to be the same as "torn achilles". rupture means complete tear and torn achilles can refer to tendinopathy which occurs as a result of a partial tear. so it is perfectly valid advice even if he has a "torn achilles" (AS LONG AS THE DOCTOR AGREES).

the test for rupture, by the way, involves squeezing the calf muscle and observing whether the foot moves or not.

lost_in_thought

teticio wrote:

lost_in_thought wrote:

OK, I wouldn't normally be so blunt about this, but disregard this poster's advice.

If you actually read this, page 11 of 22 shows a clinical management chart which very specifically points out that before prescribing this 'painful heel drop' exercise, you must exclude the possibility of there being a rupture.

If you do this with a torn achilles you are pretty much certain to worsen your injury.

i've just thought of something... maybe you reacted so strongly because you understood "ruptured achilles" to be the same as "torn achilles". rupture means complete tear and torn achilles can refer to tendinopathy which occurs as a result of a partial tear. so it is perfectly valid advice even if he has a "torn achilles" (AS LONG AS THE DOCTOR AGREES).

the test for rupture, by the way, involves squeezing the calf muscle and observing whether the foot moves or not.

Indeed it is. Also, it's not advisable to self-test due to the angles required - you can get a false result.

And a 'partial rupture' is the diagnosis I was given - a rupture can be partial or complete, according to every medical expert I saw last winter who used that exact terminology.

ratsbeyfus

Blimey I've stirred up a hornet's nest... I really appreciate all the advice.

I've just had a telephone consult with another GP at my surgery. She doesn't believe that the tear sounds bad enough to immobilise, and from previous sporting injuries I know that recovery from immobilisation itself can take ages.

Her only bit of advice was that I should wear high heels! :oops: Not sure if Mrs RatsB would be too impressed if I did, nor the kids at school. More helpfully, she said I should definately stay clear of the bike, and that she'd help me to chase the specialist if I haven't heard from them in 10 days. This doctor had coincidentally suffered a similar sounding tear to me, so I'm happy with the second opinion... just as long as I'm back on the bike for the Spring. The awful irony is that my employer (West Sussex County Council) has finally signed up to the cycle-to-work scheme, and I'm desperate to go out and upgrade my road bike. Ho hum.

ratsbeyfus

I've just had a read of the chapter teticio linked to. By the looks and sounds of things the damage I've got is at the 'site of insertional tendinopathy' i.e. where the tendon joins the heel. When I injured it there was an audible 'snap' and the feeling as if a fraid rope had snapped a little (as well as a nasty sharp pain in my heel a bit like the sharp sensation you get when you stub a toe). Since then the heel has been uncomfortable but not necessarily painful. It tingles a lot if it is accidentally flexed in any way (e.g. by walking up the stairs).

Is this similar to what happened to you lost_in_thought /teticio? From your experience does this sound like a tear or a partial rupture? I'm still not clear about the difference between the two. I won't do any exercises suggested in the article, especially as the heel drop one is supposed to be painful, and therefore difficult to judge whether the pain is of the healing variety or the damaging variety. Also it really doesn't sound too good for achilles pain in the area I've got it, and, finally, I really wouldn't do anything without checking with my doctor first.

Any info. given by you two or other achilles sufferers is greatly appreciated. I guess I'm an impatient patient.

lost_in_thought

Hey again.

There is no difference between a tear and a rupture. A partial rupture is the same as a partial tear - both mean that you haven't torn it all the way through, but you have torn it.

The feeling of a 'snap' is one of the indicators that you have torn it, partly at least.

I also had tingling - according to my specialist this is how you can tell that you're making it worse.

Just for clarity, a tear = a rupture. A partial tear = a partial rupture. Torn = ruptured.

ratsbeyfus

That's crystal clear... thanks. Since yours has mended has it had any impact on your cycling?

lost_in_thought

ratsbeyfus wrote:

That's crystal clear... thanks. Since yours has mended has it had any impact on your cycling?

Cool!

Well, my right calf is still about 1/2" smaller (that's the one I tore) just over a year later, and it took a fair old while to build up strength again, say 3 months for it to be back to something like normality from when I started cycling again, so let's say 6 months from injury to normality.

However, partly because I left it too long before seeking medical advice (I thought it might have been a very, very bad sprain for about 18 hours before the pain got too much) mine was a severe tear.

teticio

aaargh. look, all i am saying is that in the chapter from the book (if you read it carefully) it is importnat to distinguish between what they term "rupture" (which should be tested for) and "tendinopathy" (which may include tears or partial tears). anyway, enough already about semantics. we agree on the basic principle.

if you heard an audible snap then it sounds more like a rupture (i.e, the heel-drops won't work for you). but again, its important to get the physio to give you a precise diagnosis.

good luck

ratsbeyfus

Thanks to both of you...

I've heard from consultant but have no appointment date yet. Achilles has been feeling better since I've started planting my foot flat on stairs rather than going up stairs on my toes. I live in a 4 storey house so just this simple change in behaviour (that and not riding) will hopefully stop it getting worse before my appointment. I'd love to go private but cant afford it.

Itching to get back on bike...

evilollie

havnt torn my achilles, however have ruptured my ACL & MCL both grade 3 tears, doesnt cause me ant problems and i cycle without a cruciate in my right knee