Achilles Rupture Recovery

Perhaps this injury “jumped out of nowhere” to cripple you, being triggered by something as banal as a hole in the ground, a stumble over a kerbstone or a slip on the stairs; perhaps you are transitioning from “Athlete/Active Person” to “Project Manager of a Recovery”, where the sport of your choice was at the centre of your injury (like me). However you happened to land on this ‘path’: the first few days can make it feel like taking care of your injury (and everything relating to it) is a full-time job; your life probably revolves around the injury and the effects on your everyday and future life.

Whether you’re a sporty person or not, it’s probably hard to accept that walking, running, cycling, driving, sports, all that normal everyday stuff will, at least for a period, be more or less taboo, regardless of how integral a part of your life these activities are (temporarily ‘were’). The inevitable questions regarding when you can start what again will abound; a plain concrete answer to any question will probably not be possible at this stage, rather it will be based upon “Well, it depends …” initially and then how your recovery progresses.

A very rough approximation I use, however: 3 months cast and/or boot; 3 months re-learning how to walk; 3 months re-learning how to run; finally, 3 months learning how to jump/skip/sprint/etc. … all those explosive activities. Some manage it quicker; some take much longer. Don’t try to rush it, stay with your protocol, consult your physiotherapist (PT) before attempting tougher steps … and remember, I’m not a doctor – I’m just journaling my own recovery and giving you some things to think about / some helpful information.

Re-focussing on the short term: there are a few things that one really needs to do as soon as possible to avoid having even more problems to deal with than the already unpleasant situation and challenge that a ruptured Achilles represents. So assuming you’re already in a cast or boot with the foot in an equinus (pointy foot) position, these things are actually more urgent than that big question of: “Do I need surgery?”. I’ll get to that later. on the next page. But don’t skip this one … please 🥹.

(If you’re not already in a cast or fitted with a boot yet: PLEASE click here!)

I slept surprisingly well – the throbbing I experienced directly after the injury and at the hospital, which then died down once I had elevated my foot back home, stayed away; no painkillers necessary … not even close to needing them 👏 💪 !

Monday started with a trip to the GP: a prescription for the blood thinner injections was top of the list … holy shit, THAT was a BIIIG package! Plus I got myself registered sick / off work for the first week, and picked up referrals for an MRI and an orthopedic doc appointment.

Next, I went down a floor in the same building to the orthopedic practice and saw a tall, dark, handsome, mid-30s doctor. Man, was he sure of himself: didn’t bother to do an ultrasound, said an MRI was a waste of time; someone ‘young and sporty’ like me (I’m 55 and no sports model 😅!) should just get myself operated as quickly as possible, REALLY the only way forward; “non-operative treatment” – what kind of negligent person was suggesting THAT was an option?!?.

Ok, maybe I’m exaggerating the tone a little, but he didn’t take more than a few minutes to look me over / ask me questions and was not willing to talk about anything other than an operation. That was a problem for me, an engineer with a scientific mindset: even though the limited googling the night before didn’t make me an expert on the subject (of course!), it did nevertheless suggest, together with the doctor’s letter from the ER, that there should at least be some kind of a discussion based on MRI pics; someone trying to ‘bulldoze’ me like this without any kind of conversation (and no good reasoning!) was a red flag.

Now, I know that many people view – subconsciously in general – doctors of all types, as much as lawyers and people of various other professions to be ‘perfect’: “But (s)he’s a doctor! Of course (s)he knows what (s)he’s talking about/doing!”. As obvious as it may seem to some, however, I learned many years ago that doctors are also just people … there are good ones, brilliant ones, mediocre ones … and those that simply have bad days or who haven’t stayed up to date on current techniques / methods … etc. etc.

Thus, already knowing that the healing was going to be very dependent upon how good the treatment was (at any rate being maaaany months until I would be through it) I spent the afternoon googling; “The Good-Looking Doctor” had at least given me one good tip: a clinic in Munich with a specialist foot department (Harlachinger Schön Klinik). It turned out that one of the ‘conservative’ (non-operative) generalists there had a slot the next morning, so I booked that.

I was less successful getting an MRI appointment: as a person with a ‘basic’ level health insurance I was looking at minimum 4 weeks before I could get one (if I had been privately insured, I could have had my choice of appointments at multiple places in the next 24 hours!). My GP was really unhappy at that when I revisited the surgery that same afternoon … she asked her assistant to telephone around and that got me onto an ‘acute list’ for cancellation replacement at a local MRI practice. Fingers crossed 🤞 🙏 !

Start the DVT Protocol (Deep Vein Thrombosis): This is the most important medical task (after getting a cast or boot on your foot); it should have been highlighted both in the ER as well as at that first doctor’s visit, but in case it wasn’t: immobilisation + trauma = risk of blood clots (i.e. thromboses). So pick up your prescription (e.g., Clexane/Enoxaparin) and don’t skip that first injection (some doctors may prescribe ‘baby aspirin’ as an alternative to such single-use hypodermic syringes).

Secure your sick leave: the stress of “what about work?” can impact your physical recovery negatively. Visit your GP immediately. Even if you think you can work from home, get at least the first week signed off – you will be very grateful of this time to navigate the medical appointments that are to come as well as taking care of getting a few logistical and supply tasks / items taken care of.

This is, of course, assuming that you are not self-employed or similarly dependent upon uninterrupted work and the generated income. One such example is this Redditor using an iWalk to keep the money coming in … when I first saw this post, I thought this was an extremely “radical logistical solution” 😜 … but he’s in a very different situation from me and I think I now fully appreciate the motivation to go down this path.

Anyway, going back to the assumption that you can get time off: typical times off work will vary hugely, depending upon what kind of job you have. Whilst those with an office job, particularly with the possibility to work from home, may only be off work for 2-4 weeks (I was only off for 1 week), those doing manual labour may need more like 3+ months … this will depend very much on healing progress as well.

Whilst at your GP’s for the sick leave, also get the following, where applicable:

• A referral for an MRI (“MRT” in German) if possible; an ultrasound can be an alternative
• A referral for a Foot/Ankle Specialist if possible / orthopedic + accident if not
• A prescription for a second boot liner (if you were given a boot at the ER)

< I’m going to come back and do a better job on the collation of prioritised lists later, but for the moment, have a look at this ‘gear’ page I wrote early on > … it’s not great, not complete, and there are some more lists on Reddit, but perhaps better than nothing.

.

First up: don’t overdo it on the first day! Once you’ve ticked off those tasks and purchases, pretty much the most important thing you can do is put your feet up and relax, get some sleep if you can. You’re going to get plenty of time to watch series, read books, catch up with all those kind of things in the coming weeks.

Buuut … if you simply can’t sleep and/or are really keen to put some more screen time into this subject: as with most things these days, you can find any number of articles, videos, forums, etc. dedicated to Achilles ruptures. To avoid hitting you with a massive list, these principally feel-good links will probably be enough for the first day … but there will be more on the next days’ pages, so by all means, if you get that far, carry on reading!