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In whistler with ruptured Achilles' tendon

 Poster: A snowHead
Poster: A snowHead
Hi, Two days ago I fell skiing, and after being stretched off the mountain and taken to the whistler clinc, I was diagnosed with a ruptured Achilles' tendon. The orthopaedic consultant thought the gap between the ends was about 2 cams, it was hard to see from the scan because of the swelling and bleeding around one end. She told me that there are two possible approaches to recovery either with surgery or by holding the ankle in a pointed toe position in a boot and let the ends heal together. Both would take about the same length of time to recover, and she says lately the non surgical route is being favoured. I have it now in the boot and if I were to have surgery, it would be when I get back to London. We arrive back on Sunday. Has anyone had the same thing and gone for the non surgical method? Or has any view on which is better? Or could recommend a good nhs surgeon? I'm trying to plan ahead and stay positive, it's looking like a long time on crutches...thanks for any help. Rachel
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
No advice, but commiseration... Sad
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Did my achilles three summers ago playing cricket (the sensation of a hand grenade going off in my right ankle remains vivid!). Six weeks in plaster with my foot angled in various progressive positions and another seven weeks in an orthopaedic boot did the trick. The consultant ummed and ahhed about surgery but decided to give it the first two weeks in plaster before making a final decision. Seemed to do the trick and after extensive physio, I was skiing the following season. Very Happy
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I've done both of mine over the years playing squash.....
The first time, around 25 years ago, I had the lower leg in 3 different plasters, changed once a month to more acute angles, worked fine....
The second time, 10 years ago, it was in a fibreglass support for a month, then in an adjustable angle boot for about 6-8 weeks, also worked fine, but at least could have a shower with this option!!
Both have recovered fully, it took about 6 months before I was fully confident to stand on tiptoes though.....
Both were on the NHS, no issues at all
Specialists prefer the non-surgical option as there is no risk of infection, a real problem in the foot area!
Feel for ya Rach, but's what's done is done and you'll soon be back Very Happy
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
You have my sympathy. It is no fun thats for sure' There are extensive threads on here with contributions from myself and many others so suggest a search. I did mine skiing in Feb 2009 and was merrily skiing again at Christmas but you have to work hard at the rehab. The advice I had from the London Foot and Ankle Centre was that I had a 2 cm gap and that created issues with non op recovery. The concern was that if it healed by itself, and at 2cm it was if, it might mean weak/no push off in that foot. I opted for the surgery and very happy that I did. Whatever you do make sure you get more than one opinion.
Good luck.
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+1 to 2nd opinion if the gap is 2cm, didn't spot that at first!
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Then you can post your own questions or snow reports...
Thanks so much for the replies, it really helps to hear other people have been there and made it. Especially that you are skiing again, which has been about the most frightening thought for me, that I would not be able to. I will certainly take the advice and get more than one opinion on what to do.
On a more positive note, whistler was great until the injury, even though the snow is very poor by their standards, and all the people who helped, snow patrol skiing me down on a stretcher, all the staff at the clinic, were really amazing, and everyone here is so helpful - our teenage son can hardly believe it, being used to the charm of South London!
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
@rachelb, sorry, no experience, but here's to a full and speedy recovery. Good luck.
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I had the non-operation treatment many years ago which was a success. Apparently prisoners in the South in the US regularly slashed their Achilles in order to avoid working in the fields. An outbreak of mass hysteria led to the whole prison slashing both, and a team of army surgeons were shipped in to treat them. Someone realised it was great opportunity to experiment, and they operated on one leg of each patient and let the other grow back. The success rate was greater with the non-invasive treatment. Obviously there are cases where an operation is preferred, but my surgeon said that with a rupture rather than a clean cut it was like trying to sew mop heads together. One problem with surgery is that if infection gets into the tendon sheath it is very difficult to treat. Anyway, commiserations and I hope it goes well.
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Thanks again for the kind thoughts, really appreciated. How shocking to think people would do this to themselves, and to both legs! It must be hell in those American prisons ( I doubt the affect on next years skiing was much of a consideration for them ). I am hoping that the non operative route will work for me, at least then I can count these days off my recovery time. The tear was actually very clean, the consultant remarked on it and that usually the tendon is far more shredded. Hopefully that will help with either method. Ill go straight to a&e when I get back and take it from there.
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My consultant said the ends of the tendon looked like horses tails! Apparently this actually helps with the non-surgical method.......
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And love to help out and answer questions and of course, read each other's snow reports.
rachelb wrote:
Hi, Two days ago I fell skiing, and after being stretched off the mountain and taken to the whistler clinc, I was diagnosed with a ruptured Achilles' tendon. The orthopaedic consultant thought the gap between the ends was about 2 cams, it was hard to see from the scan because of the swelling and bleeding around one end. She told me that there are two possible approaches to recovery either with surgery or by holding the ankle in a pointed toe position in a boot and let the ends heal together. Both would take about the same length of time to recover, and she says lately the non surgical route is being favoured. I have it now in the boot and if I were to have surgery, it would be when I get back to London. We arrive back on Sunday. Has anyone had the same thing and gone for the non surgical method? Or has any view on which is better? Or could recommend a good nhs surgeon? I'm trying to plan ahead and stay positive, it's looking like a long time on crutches...thanks for any help. Rachel


Sorry to hear about your achilles tendon.

Recent studies have started to demonstrated that skilled non operative treatment can be as good as surgery.

Generally the feeling is that if you are going to operate to get on with it straight away. So you may be better off with non op treatment.

You need a foot and ankle specialist to advise you. Our clinic isn't an NHS one but your GP would know the foot and ankle specialists at you local hospital.

jonathan Bell
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
@rachelb, I popped mine on a squash court a few years back, late summer, had the op 36 hours or so later and was fine to ski the following March. First day or two on the slopes was v cautious but then quickly forgot all about it; hopefully same for you too.

You have all the advice re surgery or not options already, but regardless of option getting good physio advice (and following it!) from the outset was crucial for me. All the best.
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 You know it makes sense.
You know it makes sense.
So sorry, whichever route you take the key to full recovery is physio physio physio and doing exactly what you are told. Get healed soon!
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
I had the non-surgical treatment in a boot two years ago and that Achilles now feels stronger than the unruptured one. It's easier to keep active and mobile with the boot. You must do the physio regularly and to the letter. As said above physio physio physio.
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 Poster: A snowHead
Poster: A snowHead
Thanks for the excellent advice. I will take it and am determined to do all the physio. I'm usually very active so this will be my exercise. The good thing about skiing is that there is always a goal to head for, whether it's getting the legs strong for the next trip or making sure your achilles has healed by next season. It's a great motivator. Flying out in a few hours and looking forward to my business class upgrade, every cloud....
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
In France, 11 years ago, they just did the op. and I didn't know there was a non- operative option till I got home!

Having said that, my op and recovery went smoothly with no problems. Gap was defined enough for doctor to show nurses, and me, how to diagnose - a finger in the back of the ankle goes straight through! They released another small tendon below my knee and pulled it down to do some sort of boy scouts' crucifix whipping together of the Achilles.

BTW where is Achilles when you need him?
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
@rachelb, hope journey home went well and that you are soon on the way to recovery whichever route Very Happy
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Hi Rachelb, did mine in late Jan, playing squash. Got mine in a boot at present, and am currently in a ski resort with the family. Not skiing, obviously. Still got the boot on. Off in 3 more weeks hopefully. Be sure to remove the heels when suppose to. It was supposed to be off just before we came out, but needs an extra 4 weeks as not totally repaired yet. Quite pleased in that did not fancy walking on snow and ice without the boot. Still very sore. Half considered not coming, but been OK actually. Wouldn't have come if just done it though.
I was told by the consultant that now "we only operate on athletes...and you are not an athlete". Cheers for that.
Have been told physio is key to recovery, and can ski again hopefully. Squash and other similar sports are out though.
Interesting thread this because I am worried about not skiing, this is the first time in about 20 years I haven't skied. The thought of putting a boot on is bad enough at present.
One thing I have done is bought a support sock for my achillies from Amazon. Supposed to be good for protecting it. Costs about £40 and not tried it yet of course, but gets good reviews so will try it when I start trying sport again. Might even consider using it skiing if seems to do what it claims. We'll see.

I told my holiday insurance company about doing it of course and they have put a £300 access on my achillies now. Does anyone know will this apply in the future or just now because still injured? Never been in this situation before tbh!
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Ice packs, ice packs, ice packs and elevation. Mine swelled up in the afternoons/evenings once the boot was off. Bought a velcro strap ice pack thingy which was a great help. Plus the physio. It's now better than the other one Very Happy
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I've read this blog in the past and thought it might be helpful...tonnes of different stories and treatments (all through out blog): http://achillesblog.com/tkdco/2014/03/28/purchased-bfst-blood-flow-stimulation-therapy-ankle-wrap/
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 Then you can post your own questions or snow reports...
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Blood flow stimulation therapy sounds like complete and utter balderdash I sniff spam.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Hi, I've just seen this revived, so I thought I'd update on my progress. @igLou, the journey home went very well, upgraded to about the best seat on the plane, flat bed, 6 course meal etc, I had never flown anything but economy and now think I am spoiled forever more...how can one ever go back?
I had the surgery on the NHS the doctors generally agreed that the gap was too wide to leave to heal, as even with the foot pointing the ends didn't meet. They also tried to put my surgery slot off for a week but by then I had already waited two weeks so I had to insist forcefully (things got a bit messy) and they reinstated me.
I'm pleased to say its all gone really well, I'm paying for private physio, the NHS lasted ten minutes only, but as the surgery was free I don't mind that. It has all healed well, should be able to run in a few weeks and have followed all protocols and exercises fanatically. I am considering my skiing options next year, Lapland's looking good. Haven't booked just yet but I'm fully confident I'll be going.
@simonpa, hopes yours is nearly there too and thanks for the recommendation
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 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
@simonpa, _ I suspect that the support sock is for people who suffer from Achilles tendinitis?
When I researched snapped Achilles on the internet, I found that they think that some peoples' tendons degenerate and that they will then snap sooner or later - skiing, dancing, squash, running upstairs. I do not think a sock is likely to prevent this ! Mine was operated on and never felt sore before it snapped, nor after recovery.
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