Advice after Achilles surgery

Bump.. Gotta be someone out there.

How long ago did you have your surgery and how much of the diseased achilles did the surgeon remove?

It sounds like a Haglands deformity with calcific tendeonosis. In which case the doc has to remove the diseased portion of the achilles. Typically, to aument the achilles the surgeon will transfer the FHL tendon and attach it next to the insertion site for the achilles. He has to do this becaause the achilles tendon is not stout enough anymore to carry the load.

If he was aware that you were a runner he may not have done this because to lose your FHL (controls your big toe)the push off phase of the gait cycle could be adversly affected.

I'm guessing at a lot of stuff here sicnce I don't know the particularsb but these are possibilities.

Had mine in May. Got out of the boot last week and begin PT Wed, so am behind you and can offer no advice.

I am stunned about the toe lift which I find inplausible intellectually, but I stand there and nothing. So if you don't mind, when did you begin running and has it helped with rehab at all or are you substituting the prior pain for new pain? Lots of questions ie what percentage of your previous mileage are you able to handle, what are you doing with the PT, am I delutional thinking they will help with a course to get me on the road. BTW, although you didn't say it, the procedure I had sounds very similar and is called a debride.

Thanks.

I've had this surgery and it took a while for the pain and scar tissue to subside. It was a good 6-8 months of frustration and pain - AND no, could not do calf raises for a long time. If I did, it was terrible, terrible pain. It took a year before the pain was tolerable enough that I enjoyed running again - heel lifts help a lot BTW. I was a 3:52 1500 guy before the surgery. After the surgery, was very slow the next couple of years because I couldn't train the way I used to. 3 years later I was able to get back to the 4:13 - 4:15 range (in the mile) but I wasn't happy running slower than I used to. Every time I got in decent shape, my heel would be too inflammed from track workouts to run to my potential - Always had a hobble and was always cross-training. After a ton of frustration from the poor recovery between workouts in my heel and always being injured due to compensation, I switched to triathlons - plan on going pro with it 2013 or 2014. The mix of swimming and cycling have me in the best shape of my life and I can enjoy competing at a high level again - if not higher.

Suggestions -

- heel lifts - I wore them for a good 2 years after surgery

- ice after all activity

- pool is the best thing in the world - always seemed to help rejuvinate my achilles area, whether I was swimming or aqua running

- avoid the track if you can

- stretching and massage - I massage my own achilles - I'll pinch an area and flex my foot back.

- expect to be in pain for a while. 5 years later I still have achilles issues. Not as bad as it used to be but I accept where I am right now.

PS: I had a staph infection and was hospitalized for the next 4 days after surgery. I really feel that slowed down the healing process big time. BUT I NEVER QUIT.

I've had both Achilles tendons repaired, 7 years apart.

My left tendon burst during a late April hoops game and I started running again in the following January.

My right tendon underwent debridement during a double surgery during mid-July (combined with peroneal groove deepening) and I was cleared to run again in mid-January.

My surgeon is very conservative and well-respected in the trade. He wanted all trace of inflammation to be gone and made me wait until that was the case in both instances.

I have a crazy theory that perhaps I contributed to the downfall of my tendons by wearing overly tight ankle high socks for years and years and maybe I "girdled" the tendons over time, as both of my tendon issues were aligned with that spot where the elastic creates the most pressure.

AC MAN wrote:

I recently underwent Achilles surgery back in March. They shaved off a build up of bone and fibers that messed with my Achilles and made it immensively painful to deal with as time went on.

After surgery, I'm able run, and I'm taking it slow. But I still can't do a calf raise off the leg that had surgery. I'm getting close, but I think it may have something to do with how much the doctor released the Achilles area. The area is now way more flexible than the other foot, perhaps, it just takes time to stabilize? Or add muscle? Anyone been in a situation like this?

All advice appreciate. I'm also a previous sub 14 5k guy, so I'd love to really start training once this thing is fully strengthened. It just seems to have stalemated.

I had surgery for completely ruptured achilles back in 2007. It was fortified with a graft from my plantaris. I was in a hard cast first, then a moon boot. Know that the tendon takes long to heal because it does not have it's own blood supply. I was told mine would take a year to heal fully but I was good way before that.

The best thing you can do is to attend physical therapy religiously where it can be massaged, stretched and exercised. Vigorous massaging is important because it breaks up scar tissue and adhesion. Stretching and exercises will strenghten the tendon to where you need it to be. Also, get a flexible ice pack and ice the area after exercising to reduce inflammation.

Basically, to explain in more depth, and I'm trying to keep my identity on the dl here. But I'm kind of a freak with recovering. I recover really quick, have went up to 160 miles a week, held 140 consistently. Basically, got hurt from a non-related running job. I was smart, took time off, fully recovered. And as I came back into it. My Achilles would swell. Finally at its worst, It LITERALLY looked like there was a golf ball from flaring up so much. Extremely painful. I couldn't even wear dress shoes it hurt so bad.

I finally got an MRI on it, as I did everything for Achilles tendinitis... Even grastoned it like crazy with a butter knife. MRI showed during the time I took off for the previous injury, my body kept recovery more-so, that a surplus of bone was grinding against the Achilles. And I did EVERYTHING to loosen tendons to compensate for that. Finally bit the bullet and got surgery. The doc isn't a sports doctor, but he knew I was a runner. He take out the bone, and then some. He said there was so much muscle fibers trying to heal the area as well, that it looked like a bunch of stray grass when he operated, and had to clean them out as well.

It's really weird bc the non-surgerical one you can see the Achilles and it's extremely defined, but the surgerical one, it's very round and you can not make out the Achilles.

I run all my runs on a turf field and with heel lifts. I am noticing improvement... It's just ridiculously slow. I get paranoid and ask people, "How's my form, am I favoring a leg?!" And routinely, "No dude, you look solid."

I can go 6.30 mile pace comfortably, but the faster I go, the more I notice it. And when I try to do a heel lift on it, as a poster said, "Nothing". It was even hard to imagine doing it. I also think running helps... I can't really say.

I do work it, and did hardcore physical therapy for 6 weeks, improvement, but minimal... But improvement none the less. To note, the surgery foot has more flexibility now, and feels so loose when I run (and weaker of course, but almost to flexible)... Maybe that's preventing me from a calf raise, and pushing runs to actually get a workout out of them?

I really do appreciate all comments, and all advice and help. Keep it coming, personal experiences are great to with this stuff.

I do have a quarter size lump of scar tissue to, grinding it out slowly with time, which I feel was due to wearing a cast for a couple weeks and Gavin my foot point downward.

Sorry for the grammar, dang phone.

But basically my body allowed to much none growth to happen at the top of my heel, that it started to affect my Achilles greatly.

Has anyone been annoyed at how hard it is to get both calves to be the same size? Ha, the other one is still smaller, noticeable if one pays attention.

To answer a previous poster's (Boston33) running question:

I started running 6 weeks after surgery. 1/2 mile a day for a week. Had to focus on just using it as part of physical therapy an NOT for fitness. Ridiculously weak start out, like one leg was running for the first time... On the moon. Then a mile a week later, then 1.5 the following week, and now 50-55 minute around turf fields. I felt like if I just busted out in a sprint... It'd hurt like a mofo, or extend(give) too much and flare up really bad. As it did that when I was at 1.5 miles a day when I had to also run 1.5 miles for a FireFighter Test.

Every run, I've run on turf fields, or a 1/2 mile loop I have in the pasture. Over dirt and grass. It feels more natural on those surfaces. Hard surface, I notice it more.

Having an Achilles surgery in a week and a half, sounds like a lot of rehab. -sigh-

Bump for a chance to get info from anyone else that has undergone Achilles surgery.

have had achilles tendon/heel problems for about 3 years. never bad enough to stop training, but holding me back from the volume/intensity i have wanted. had the first operated on in april, the second in july. they still look weird/swollen and i have not even tried to run yet as the second one was just done. i CAN however, do calf raises (my full body weight) with the one that was operated on in april. no idea what to expect other than probably never being able to run on roads again.

I didn't have a ruptured tendon, but I did have surgery for tendinosis. From what I understand, ruptured tendons heal the quickest. It takes longer to heal from ordinary tendinosis debridement surgery and even longer to heal from the insertional type where they operate on both bone and tendon.

No matter what you do, it's tough. There's just so little blood supply there. Nine months after surgery I still couldn't run (although my non-surgical leg, which had also had tendinosis, had healed completely from rest). Towards 12 months I could do some tentative running, but certainly not long, fast, or frequent.

Over the past several months I've gradually felt more confident in my tendon, so I decided to try my first road race since the tendinosis originally hit. As it got closer, I did my some speed work, which made my calves sore, but my tendon was hanging in there. The race itself was disappointingly slow, and I felt fine for several hours afterward. Then it felt like I'd pulled my calf muscle on the surgical side--very painfully. So apparently the surgery had weakened that calf, and it simply couldn't handle the speed work yet. If it's not one thing, it's another. I'm 48 and some days it feels like I'm aging mighty fast.

I feel for ya, brother.

I'm a huge road racer, ever since I was 13. I probably averaged 40 road races a year, up till when I ran in college. I just love doing them.

I just ran an hour today, it felt fine, still weak, but running on turf makes it not noticeable. I know part of it is in my head, but when I'm on the road (haven't ran more than a 1/4-1/2 mile on the road at a time, minus the 1.5 mile test for firefighter)... It felt... "Awkward".

The healing rate is coming along, just slow. I suppose since they took out a chunk of bone 'and' a bunch of muscle fibers, that it has made the strengthening process slow.

I'm just looking for confirmation that it is possible that 'all will be well' and I'll run on the roads again in 6-12 months, without noticing it, or someone's 'been there'. As I said, I'd like to be competitive again, and was wondering if it was sincerely possible...

6-12 months sounds pretty unrealistic for full recovery, given that you only had the surgery in March. When did Webb have his tendinosis surgery? I feel like that was at least two years ago now, because I was trying to get info about it during the worst of my own difficulties. Anyway, Webb was able to start running much more quickly than me, but a couple of years later, he still can't produce the old times. That tall Australian (drawing a blank on his name) took two years off to rest his tendon, which worked, but he's never regained his top form, either. The list could go on. To this day, I obsessively read about track athletes with Achilles problems. Most make it back, but a lot of times the injury recurs, and I can't recall anyone returning to peak form, owing perhaps to a loss of springiness in the tendon. I imagine it could be done, but only with a great deal of patience.

You sound a bit like me (i.e., impatient). Intellectually, I fight that impatience every day. I know that it was impatience (refusal to take more than a day off when the problem started worsening) that caused my original problem. And, if I don't overcome it this time, impatience will cause the problem to return. So I'm sitting here today, calf still sore from the road race, a bit of swelling having worked its way down from the calf to the tendon, and I'm forcing myself not to run today...or tomorrow...or any day until I'm certain the coast is clear again. Better to lose a few days now than a few years.

Also, I was told by doctors that my surgical calf would still be smaller after a year, and 1 1/2 years out, it is indeed still smaller.

Fair enough, I appreciate the answer. It's been tough. Today, I could tell the Achilles need a day off, *sigh*.

I suppose at this point, wondering if anyone's returned to full form after an Achilles operation.

Work on eccentrics with body weight then add more weight with hand weights or a machine at the gym. Work reps with bent and straight knees.

AC_MAN wrote:

Fair enough, I appreciate the answer. It's been tough. Today, I could tell the Achilles need a day off, *sigh*.

I suppose at this point, wondering if anyone's returned to full form after an Achilles operation.

Not sure if I stressed this enough but do PHYSICAL THERAPY as much as you can. Max it out on your health coverage. It is the fastest way to get back to normal.

Not sureif mine ordeal will help but here goes...Oct 2010 I was volunteering on my citys ambulance, stepped off..if had not air dumped and I had a partial thickness tear...for 2yrs I did eveything I could to avoid the surgery.July 9th I took one step in my back yard and the whole tendon slid and torn,,off to surgery by July11th...a tendon flap repair. 7wks of healing No weight bearing..UGH; then all Hell broke loose..a tiny little ozze came out my heal...called Ortho Dr..by 3rd day very painful.lots of ozze..Dr by 4th day.. straight to hospital from his office.Surgery the next day.. 3 kinds of infection had grown.. the whole tendon and more scraped out..they said it smelled like E-coli...later learned it was staph not mersa..and 2 other mean kinds...2 days later back to surgery for more scraping...they said they where trying to save me and my leg. This is like a horror storey for me...finally out of hospital Aug 30th...With Ivs every 6hrs at home and a wound vac on my leg.. nurse comes 3 times a wk...Its now Sept 14th and the new Dr says he would not think about any more surgery.. esp maybe a plastic man...I will get a brace that I can live with.. I have used up all my FMLA at work am days away from loosing my job and well depression has taken me over...oh yes I am only 58yrs and was very active all the time