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Mar 4th, 2019
I am a 45 year old male who recently ruptured my achilles near where the tendon meets the calf.
I am three weeks post tear and on a non-operative protocol. So I am in my walking boot with 4 wedges all day except for showering and have started partial weight bearing over the last few days on the advice of the surgeon.
However, over the last two days I have started to feel tightness and pain near the bottom of my heel of my ruptured Achilles foot. And last night, the pain/tightness actually woke me up so I’m concerned about what this might mean, how I can alleviate it in the short term and ultimately whether this means I have re-ruptured my Achilles in some way.
There is no increase in pain anywhere else along my leg and when I last saw the surgeon he thought it was healing fine.
Any advice would be welcome.
The Guru Responded:
You are where you are, and if you’ve got any concerns then I think you should have an ultrasound scan to check the integrity of your tendon.
Pain doesn’t always equal dysfunction and as you have lots of repairing tissue which can equally put stress on damaged tissue, this can be painful.
Your OS has put you on quite a rapid protocol – you want as much tissue to heal as possible and so listening to your body and doing a little less might be a good idea.
Keep wedged, booted and NWB for the next 48 hours and see how the pain settles – you may have just over cooked your loading.
I will follow your guidance and keep it non weight bearing for the next two days. Hopefully the pain in my heel will dissipate over the next few days.
Let me know if not…
I have asked you a couple of questions about my achilles rupture healing and you’ve been great. In fact, I have actually booked in to see Sixphysio off the back of your responses.
One final question – I am just over three week post-rupture in my right leg and still have some pain in my right calf near where the rupture was (it was high up on my leg). I did some early weight bearing with another physio and it didn’t cause any major pain or discomfort at the time but after coming home I noticed the area was tender to touch and swollen. I iced it a couple of times and have elevated it over the last 12 hours. I just wanted to know whether this is normal or not.
And whether to continue partial weightbearing or to hold off until the pain disappears.
It all depends on how much load and for what amount of time – when you first start PWB you’re drawing a line in the sand and you are carefully measuring your response to that load and that time.
If 24 hours later it’s too sore then you’ve done too much – load and time. Allow it to settle over the next 48-72 hours then restart at 50% of what you did first time – then reappraise.
So let the pain settle – don’t poke and it, and then go again -50%.
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